Get Office Of Workers' Compensation Programs (owcp) - U.s. Department ...

This guide provides clear and supportive instructions for individuals completing the Office Of Workers' Compensation Programs (OWCP) claim form. By following these steps, users can effectively navigate through the form online and ensure all necessary information is accurately submitted.

Follow the steps to complete your claim form online.

1. Press the ‘Get Form’ button to access the claim form and open it in your selected application.
2. Begin by entering your OWCP number in the first field. If you do not have one, you may leave this blank. Then, provide the Carrier's number in the corresponding field.
3. Fill in your full name, including your first, middle initial, and last name in the designated fields.
4. Enter your address, including street number, city, state, and ZIP code, into the appropriate sections.
5. Specify your marital status by selecting married or single from the options provided.
6. Indicate your date of injury by selecting the appropriate date from the calendar tool.
7. Provide your date of birth in the specified format (mm/dd/yyyy).
8. Record your social security number in the required field.
9. Fill out the details regarding your work schedule, including the hour you began work, the hour of the accident, and whether you stopped work immediately after the incident.
10. Include details about your occupation, and answer questions regarding whether the injury caused loss of time beyond a day or shift.
11. Answer all subsequent questions regarding your earnings at the time of injury, the supervisor’s name, the location of the accident, and detailed descriptions of how the accident occurred.
12. Describe the nature of your injury, confirm if medical attention was received, and provide additional relevant details.
13. After completing all fields, review your responses for accuracy and consistency.
14. Save your changes. You can also download, print, or share the filled claim form as needed.

Complete your claim form online today to ensure proper processing of your compensation benefits.