Justification for 1240-0037 Medical Travel Refund Request

Justification

For

Nonsubstantive/No Material Change Request

1240-0037 ‘Medical Travel Refund Request’ (OWCP-957)

The Department of Labor’s Office of Workers’ Compensation Programs (OWCP) is the agency responsible for administration of the Federal Employees’ Compensation Act (FECA), 5 U.S.C. 8101, the Black Lung Benefits Act (BLBA), 30 U.S.C. 901 and the Energy Employees’ Occupational Illness Compensation Program Act of 2000 (EEOICPA), 42 U.S.C. 7384. These statutes require OWCP to pay for appropriate medical and vocational rehabilitation services provided to beneficiaries.

Form OWCP-957 is used by OWCP and contractor bill processing staff to process reimbursement requests for all covered medical travel expenses, including mileage.

A 60-day Federal Register Noticing inviting public comments was posted in the Federal Register on 06/01/2023 to revise a single OWCP-957 form into a 2-part form which served to reduce burden. The system that processes the forms to read the new fields that were added to the form, will be implemented on February 17, 2024 and the agency is requesting to begin using the 2-part form OWCP-957A and OWCP-957B on February 17, 2024. Also, a de minimis edit was added to the instructions of the forms 957A and 957B:

• Clarification added to instruction #3: “Not Applicable to FECA Program.”