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Re Rendered) 8. Payee's Certification: I hereby certify that the information given by me on and in connection with this form is true and correct to the best of my knowledge and belief. I am aware that any person who knowingly makes any false statement or misrepresentation to obtain reimbursement from OWCP is subject to civil penalties and/or criminal prosecution. Claimant's/Payee's Signature: Date: Form OWCP-957 Rev. Aug 2003 Instructions (Form OWCP-957) 1. Enter claimant's full name: last n.

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Once the OWCP receives the completed OWCP-957 form and all necessary documentation, they will review the request and determine if the mileage is reimbursable under FECA. If approved, the OWCP will reimburse the employee at the current federal mileage rate, which is currently 58 cents per mile.

U.S. Department of Labor DFEC Central Mailroom PO Box 8300 London, KY 40742-8300 Page 4 4 Be sure to include your claim number on EVERY page you send. If OWCP does not pay my provider's bill in full, am I required to pay my provider the difference between what was billed and what OWCP paid?

Complete the OWCP-957 "Medical Travel Refund Request" form to request reimbursement for your transportation/mileage expenses. This form is available on the OWCP Web Bill Processing Portal. Write your OWCP claim number on the top right side of the form. You may record 3 trips on each form.

Complete the OWCP-957 “Medical Travel Refund Request” form to request reimbursement for your transportation/mileage expenses. This form is available online at http://owcp.dol.acs-inc.com – click on the “Forms and Links” link. Write your OWCP claim number on the top right side of the form.

Employing agency (EA) should submit completed Form CA-7 to the Office of Workers' Compensation Programs (OWCP) within five work days of receipt from IW. OWCP tries to review wage loss claims within five days of receipt, and take action to develop or pay within 14 days of receipt from EA.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232