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How to fill out the Form 2573 online
Filling out Form 2573 online can streamline the process of requesting a claim status from the Office of Workers Compensation Programs. This guide provides a clear and supportive step-by-step approach to assist users in successfully completing the form.
Follow the steps to efficiently fill out Form 2573 online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- In Section A, the requester should enter their File Number and complete the relevant fields. Ensure all information is accurate, and check the necessary request boxes in Section B (1-5).
- Provide the names and addresses for both the requester and the claimant. Include the date of injury in the designated field.
- In Section B, the OWCP Office will assist by completing the checked items (1-5) regarding the claimant's status. Ensure that all responses are detailed and accurate.
- If applicable, complete the information for the type and amount of payment under Item 3, including any necessary dates for acceptance or rejection. Provide details regarding the last medical examination.
- Ensure that the form is signed and dated by an OWCP officer. Review all information for clarity before finalizing your submission.
- Once completed, save your changes. Options may include downloading, printing, or sharing the form to submit as required.
Complete your documents online today to ensure a smooth processing experience!
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Fill Form 2573
INSTRUCTIONS: Use this form to explain to the contractor (named in Item 7) the mailing and distribution work that you are requesting. Federal Housing Administration (FHA) Forms, National Pest Management Association (NPMA) Forms, Single Family Acquired Asset Management System (SAMS) Forms. (a) Item 2b of PS Form 2573 may be checked only if the DMA agrees that the claimant is permanently and totally disabled. PLEASE FAX COMPLETED FORM TO 1-. I attest that the medication requested is medically necessary for this patient.
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