OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

War Hazards Compensation Act Claims, Benefits, and Notices

OMB 1240-0006 · DOL/OWCP.

OMB 1240-0006

Information collected using OWCP Form CA-278, Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act, allows OWCP to consider requests filed by insurance carriers and self-insured that have paid benefits to workers injured due to a war-risk hazard to be reimbursed for such benefits out of the Employees' Compensation Fund. The WH-1 Form, Notice of Injury or Disease and Claim for Benefits under the War Hazards Compensation Act, allows beneficiaries to file a claim under the WHCA and will simplify the process of filing an initial claim for benefits and gather the necessary information to expedite claim decisions and reimbursements.

The latest form for War Hazards Compensation Act Claims, Benefits, and Notices expires 2029-08-31 and is listed under ICR 202511-1240-002.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form WH-1 Notice of Injury or Disease and Claim for Benefits under the War Hazards Compensation ActForm and Instruction
Form CA-278 Claims for Reimbursement of Benefit Payments and Claims Expense Under the War HazardsForm and Instruction
Supporting Statement 1240-0006 (CA-278 and new WH-1) OCIO4.docxSupporting Statement A
60 day FRN correction posted 9.29.25.pdfSupplementary Document
60 day FRN posted 9.10.25.pdfSupplementary Document
WCPO-2025-0039-DRAFT-0003_Jessica Singleton.htmlPublic Comments
WCPO-2025-0039-DRAFT-0002_Samantha Sanford.htmlPublic Comments
OPM Salary Tables 2025.pdfSupplementary Document
81 Fed. Reg. 47418 (July 21, 2016) (1).pdfSupplementary Document
5 usc 8147 2025.docxSupplementary Document
20 cfr 61.104.docxSupplementary Document
20 cfr 61.101.docxSupplementary Document
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act Form and Instruction
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act Form and Instruction
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202511-1240-002 Revision of a currently approved collection 2026-03-17
202303-1240-003 Extension without change of a currently approved collection 2023-05-01 Approved with change
202302-1240-004 No material or nonsubstantive change to a currently approved collection 2023-02-22 Approved with change
202301-1240-008 No material or nonsubstantive change to a currently approved collection 2023-02-01 Approved without change
202208-1240-002 No material or nonsubstantive change to a currently approved collection 2022-08-10 Approved without change
201911-1240-005 Extension without change of a currently approved collection 2020-03-27 Approved without change
201609-1240-003 Revision of a currently approved collection 2016-12-30 Approved without change
201306-1240-002 Revision of a currently approved collection 2013-10-29 Approved without change
201005-1240-003 Revision of a currently approved collection 2010-08-06 Approved without change
201003-1240-006 Extension without change of a currently approved collection 2010-03-12 Approved without change