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Click ‘Get Form’ to open the OWCP 1240 0037 in the editor.
Begin by entering the claimant's full name in the designated field, ensuring you include the last name, first name, and middle initial.
Next, input the case or claim number accurately to link your request with your records.
If applicable, provide the payee's name if it differs from the claimant's. This is crucial for reimbursement processing.
Fill in the address of the claimant or payee, including street/RFD, city, state, and zip code for accurate correspondence.
For each medical facility visited on a travel date, complete a separate block. Enter the date of travel and mark whether it was a round trip or one-way.
List all expenses incurred during travel such as taxi fares or lodging costs in their respective fields and ensure to total them correctly.
Finally, sign and date the form to certify that all information provided is true and correct before submitting it along with any required receipts.
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California Labor Code section 2802 requires employers to reimburse their employees for mileage they incur in the course of their employment. Section 2804 says that employees cannot waive (i.e., forfeit) their right to receive reimbursement for miles driven for work.
What is the number for OWCP mileage reimbursement?
If you have any questions regarding the completion of the form, please call Toll Free: 1-866-272-2682.
What is the compensation rate for OWCP?
OWCP pays compensation at 66 2/3% of your pay rate (if you have no eligible dependents) or at 75% (if you have at least one eligible dependent), while official leave is paid at 100% of your pay rate.
How to fill out workers comp mileage reimbursement form?
0:45 2:26 Box by 0.575. Dont forget to add any parking payments or tolls. Once you have reached a total ofMoreBox by 0.575. Dont forget to add any parking payments or tolls. Once you have reached a total of over $25. You can then submit your form copy your completed form. And send it to your adjuster.
How much is mileage reimbursement for OWCP?
Effective July 28, 2008, the General Services Administration increased the mileage reimbursement rates for Federal employees traveling on official duty from 50.5 to 58.5 cents per mile.
By calling 1-866-OWCP-IVR (1-866-692-7487), injured workers and their representatives may access information regarding case status, compensation payments, reimbursement of treatment and travel expenses, and authorization of medical treatment such as physical therapy and diagnostic testing.
How does OWCP calculate a schedule award?
Schedule awards are paid for a certain number of weeks, calculated by multiplying the percentage of impairment of a body part (determined by the rating physician) times the number of weeks set out in the schedule in the FECA for that body part.
How long can I be on OWCP?
After the initial 45 days, payments decrease to two-thirds of the regular wage amount (three-quarters if the employee has dependents). Compensation continues at this rate for an indefinite length of time based on the extent of the injury and what continued supporting documents the worker can provide.
Related links
OWCP-957A - Medical Travel Refund Request Mileage
This is a mileage only reimbursement form. If you need other travel expenses reimbursed, complete Form OWCP-957. Part B Medical Travel Refund Request - Expenses
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