Get the free OWCP-957 Medical Travel Refund Request
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30 Nov 2013 ... OCP is subject to civil penalties and/or criminal prosecution. Claimant#39’s/ Payee#39’s Signature: Date: Form OWCP-957. Rev. Aug 2003 ...
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How to fill out owcp-957 medical travel refund
How to fill out owcp-957 medical travel refund:
01
Obtain the form: The owcp-957 medical travel refund form can be obtained from the website of the Office of Workers' Compensation Programs (OWCP) or through your employer's HR department.
02
Personal Information: Fill in your personal information accurately. This includes your full name, address, phone number, and social security number.
03
Claim Information: Provide the necessary details about your claim, such as the claim number, date of injury, and the name of the employer.
04
Travel Details: Fill out the travel information section with all the required details. This includes the purpose of travel, destination, mode of transportation (air, car, etc.), dates of travel, and the total mileage covered for each trip.
05
Supporting Documentation: Attach all the supporting documentation to validate your claim. This may include itemized receipts for transportation expenses, parking fees, tolls, and lodging expenses if applicable. Be sure to keep copies for your records.
06
Certification and Authorization: Sign and date the form, certifying that the information provided is true and accurate to the best of your knowledge. By signing, you authorize the release of this information to the OWCP for review and processing.
Who needs owcp-957 medical travel refund:
01
Federal employees: If you are a federal employee who has suffered a work-related injury or illness, and you have traveled for necessary medical treatment, you may be eligible for the owcp-957 medical travel refund.
02
Non-federal employees: In some cases, non-federal employees who are covered under the Federal Employees' Compensation Act (FECA) may also be eligible for the owcp-957 medical travel refund. This includes individuals working for certain non-appropriated fund activities or entities associated with federal agencies.
03
Dependent/survivor beneficiaries: If you are a dependent or survivor beneficiary of a deceased federal employee, and you have incurred travel expenses related to medical treatment, you may also be eligible for the owcp-957 medical travel refund.
Note: It is important to consult the OWCP or your employer's HR department to determine your eligibility and to receive proper guidance throughout the process.
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What is owcp-957 medical travel refund?
The OWCP-957 medical travel refund is a form used by injured federal workers to request reimbursement for travel expenses related to medical treatment.
Who is required to file owcp-957 medical travel refund?
Injured federal workers who incur travel expenses for medical treatment related to a workplace injury are required to file OWCP-957 medical travel refund.
How to fill out owcp-957 medical travel refund?
The OWCP-957 medical travel refund form can be filled out by providing details of the travel expenses incurred for medical treatment and submitting it to the appropriate authority.
What is the purpose of owcp-957 medical travel refund?
The purpose of OWCP-957 medical travel refund is to provide reimbursement for travel expenses incurred by injured federal workers for medical treatment related to a workplace injury.
What information must be reported on owcp-957 medical travel refund?
The OWCP-957 medical travel refund form requires information such as the date of travel, mode of transportation used, distance traveled, and expenses incurred for lodging and meals.
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