Owcp 915 2026

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4.9 out of 5

44 votes

The document is a claim form (OWCP-915) for medical reimbursement from the U.S. Department of Labor's Office of Workers' Compensation Programs. It outlines the necessary personal and provider information required to seek reimbursement for out-of-pocket medical expenses related to accepted conditions. The form includes instructions for submission, documentation requirements, and a privacy statement regarding the handling of personal information.

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Click ‘Get Form’ to open the OWCP-915 in the editor.
Begin by filling in your personal information. Enter your name, OWCP file number, address, and telephone number clearly in the designated fields.
Next, provide the provider information. Specify the name of the doctor’s office or medical facility where you incurred expenses. Include a description of the charge and the date of service.
Indicate the amount you paid for each service and ensure you check 'YES' or 'NO' regarding proof of payment for each item.
Finally, certify that all information is correct by signing and dating the form at the bottom before submitting it through our platform.

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owcp form 915

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