Workers’ Compensation Medical Bill Process (WCMBP) OMB Control Number: 1225-0093 OMB Expiration Date: 1/31/2027
|
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
What is your age?
18-24
25-34
35-44
45-54
55-64
65-74
75+
What is your zip code?
Free text with validation
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
What sex were you assigned at birth, on your original birth certificate?
Female
Male
I prefer not to answer
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
Which of the following best represents how you think of yourself?
Straight/heterosexual
Gay
Lesbian
Bisexual
Other/self-identify
I prefer not to answer
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
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 Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Gallagher, Rachel S - OWCP |
File Modified | 0000-00-00 |
File Created | 2025-03-05 |