OWCP Provider Access Survey

Improving Customer Experience (OMB Circular A-11, Section 280 Implementation) for the Department of Labor (DOL)

Simple CX Provider Access Survey_Final 11.19.24

OWCP Claimant Access to Care Survey

OMB: 1225-0093

Document [docx]
Download: docx | pdf

Department of Labor | Office of Workers’ Compensation Programs (OWCP)

Workers’ Compensation Medical Bill Process (WCMBP)

OMB Control Number: 1225-0093 OMB Expiration Date: 1/31/2027



Claimant Survey – Identifying Provider Access Challenges



Introduction: Thank you for sharing your thoughts with us. The survey should take approximately 5 minutes to complete. Your participation is voluntary, and responses are anonymous. Please do not include any personal information on this survey, including your name, date of birth, email address, SSN, etc.


The Office of Management and Budget has approved this survey under control number 1225-0093 for use through 01/31/2027. A Federal agency cannot conduct a survey without such approval. According to the Paperwork Reduction Act of 1995, no person is required to respond to a collection of information unless such collection displays a valid OMB control number. All responses to this survey are voluntary. If you have any feedback about this survey, please send it to [email protected], referencing survey number 1011 in the subject line.



Q1 Based on my experience seeking care for a workers’ compensation claim, I trust that the Office of Workers’ Compensation Program/Federal Employees’ Compensation Act Program (OWCP/FECA) is providing sufficient access to medical care for claimants’ work-related injuries/illnesses.

  • Yes

  • No

If Yes: Q2A What about your experience seeking care made the biggest difference to you? Select all that apply.


Driver

Statement

Effectiveness

I was able to find a medical provider by using the OWCP Medical Bill Processing website provider search tool or toll-free phone line

Ease

It was easy to find a medical provider who would submit medical bills to OWCP

Efficiency

I was able to receive medical care for my work-related injury/illness within a reasonable amount of time

Employee Interaction

The OWCP staff was committed to helping me find a treating physician for my workplace injury or illness

Transparency

I understood what I needed to do to find a treating physician for my workplace injury or illness

Other

Something else: (write in)

If No: Q2B What could have been better? Select all that apply.


Driver

Statement

Effectiveness

I was not able to find a medical provider by using the OWCP Medical Bill Processing website provider search tool or toll-free phone line

Ease

It was difficult to find a medical provider who would submit medical bills to OWCP

Efficiency

I was not able to receive medical care for my work-related injury/illness within a reasonable amount of time

Employee Interaction

The OWCP staff was not committed to helping me find a treating physician for my workplace injury or illness

Transparency

I didn’t understand what I needed to do to find a treating physician for my workplace injury or illness

Other

Something else: (write in)

3. Is there anything else you'd like us to know about your experience using the Office of Workers’ Compensation Program benefits to receive treatment for your injury/illness? Please do not include any personal information on this survey, including your name, date of birth, email address, SSN, etc.

  • Free Text


4. Is there a particular provider or medical group you would have liked to receive care from that does not currently accept or work with OWCP? Please provide the provider’s name, practice/hospital address (city/state) and phone number. Please do not include any personal information on this survey, including your name, date of birth, email address, SSN, etc.

  • Free Text

Demographic Questionnaire

  1. What is your age?

    • 18-24

    • 25-34

    • 35-44

    • 45-54

    • 55-64

    • 65-74

    • 75+


  1. What is your zip code?

    • Free text with validation


  1. What is your race and/or ethnicity? Select any that apply, you may select more than one response.

    • American Indian or Alaskan Native 

    • Asian 

    • Black or African American 

    • Hispanic or Latino 

    • Middle Eastern or North African 

    • Native Hawaiian or Pacific Islander 

    • White

    • I prefer not to answer



  1. What sex were you assigned at birth, on your original birth certificate?

  • Female

  • Male

  • I prefer not to answer



  1. How do you currently describe yourself (mark all that apply)?

  • Woman

  • Man

  • Transgender

  • I use a different term {free text}

  • I prefer not to answer



  1. Which of the following best represents how you think of yourself?

    • Straight/heterosexual 

    • Gay 

    • Lesbian 

    • Bisexual 

    • Other/self-identify 

    • I prefer not to answer



  1. What is your preferred spoken language when communicating with healthcare providers? 

    • English

    • Spanish

    • Navajo

    • Chinese

    • French (Including Patois, Cajun, Creole, Haitian)

    • Tagalog

    • Vietnamese

    • Arabic

    • Korean

    • Russian

    • German

    • Hindi

    • Portuguese

    • Other Language Not Listed: _________________

    • I prefer not to answer


  1. In which language do you prefer to read health-related resources or information?

    • English

    • Spanish

    • Navajo

    • Chinese

    • French (Including Patois, Cajun, Creole, Haitian)

    • Tagalog

    • Vietnamese

    • Arabic

    • Korean

    • Russian

    • German

    • Hindi

    • Portuguese

    • Other Language Not Listed: _________________

    • I prefer not to answer



Thank You Page


Thank you for taking the time to complete our survey. Your response has been recorded.







File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorGallagher, Rachel S - OWCP
File Modified0000-00-00
File Created2025-03-05

© 2025 OMB.report | Privacy Policy