Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act

OMB 1240-0006

OMB 1240-0006

Information collected using Form CA-278 will allow 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 program requests clearance by the expiration date of March 31, 2020.

The latest form for Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act expires 2023-07-31 and can be found here.


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