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  • May 15, 2026

How to Fill Out DOL Form OWCP-915 (w/Examples) + FAQs

You fill out DOL Form OWCP-915 by entering your personal claim information in Section 1, listing each out-of-pocket medical expense in Section 2, attaching itemized receipts and proof of payment, signing the certification, and mailing or uploading it through the Employees’ Compensation Operations & Management Portal (ECOMP) within one calendar year of the date the expense was incurred. The form is the only official path federal workers use to recover money they paid out of pocket for treatment tied to an accepted work injury under the Federal Employees’ Compensation Act (FECA).

Missing one box, one receipt, or one signature can stall the entire reimbursement for months. The governing rule sits at 20 C.F.R. § 10.801, which forces claimants to prove every dollar with proper documentation. The Department of Labor reports that more than 120,000 FECA medical bills move through the system each year, and a sizable share are returned for fixable errors that cost claimants weeks of cash flow.

Here is what you will learn in this guide:

What Is Form OWCP-915 and Who Uses It

Form OWCP-915 is the official “Claim for Medical Reimbursement” used by injured federal workers and certain other covered employees to recover money they personally paid for treatment of a work-related condition. The form lives inside the Office of Workers’ Compensation Programs (OWCP), which administers four major programs that all accept the 915 in some form. You use it after you have already paid a provider, a pharmacy, or a travel cost out of your own pocket.

The form is not a bill from a doctor. Providers bill OWCP directly using Form OWCP-1500 or OWCP-04. The 915 is only for the injured worker who already opened their wallet. Confusing the two is the single most common reason claims bounce back, according to guidance in the FECA Procedure Manual Chapter 5-0204.

Programs That Accept OWCP-915

The same form services four distinct compensation systems administered by OWCP, and the rules shift slightly between them. Federal civilian employees with accepted FECA claims are the largest user group, covered by 5 U.S.C. § 8103. Maritime workers fall under the Longshore and Harbor Workers’ Compensation Act (LHWCA), which uses parallel reimbursement procedures. Coal miners with Black Lung benefits and atomic-weapons workers under the Energy Employees Occupational Illness Compensation Program (EEOICPA) also submit medical-expense reimbursements through the 915 pathway.

Each program has its own claim-number prefix and its own central mailing address, so picking the wrong program at the top of the form sends your packet to the wrong file room. The plain-English consequence is simple: a Black Lung miner who mails a 915 to the FECA London, Kentucky address will wait months for a manual transfer.

Why the Form Exists

Congress created the reimbursement right because federal employees often must pay providers up front when a doctor refuses to wait for OWCP processing. The rule at 20 C.F.R. § 10.801(a) tells claimants exactly how to recoup that money. Without the 915, an employee who paid $400 cash for an MRI would have no organized way to get repaid. The consequence of skipping the form is total loss of the expense, even if the treatment was clearly authorized.

A common misconception is that any receipt mailed to OWCP triggers reimbursement. It does not. The agency requires the structured 915 with the certification block signed under penalty of 18 U.S.C. § 1920, which criminalizes false statements in workers’ compensation claims.

Before You Start: Documents You Need

Gather every piece of paper before you open the PDF, because the form rewards organized claimants and punishes anyone who guesses. You will need your nine-digit OWCP case file number, which appears on every letter the agency has sent you since acceptance. You also need original itemized receipts, proof of payment such as a credit card statement or canceled check, and the CMS-1500 or UB-04 the provider gave you.

The receipt must show the provider’s name, the date of service, the CPT or HCPCS code, the diagnosis code (ICD-10), and the amount paid. A credit-card slip showing only “Walgreens $42.18” is not enough. The consequence of a thin receipt is automatic denial under 20 C.F.R. § 10.801(b), which lists exactly what the bill must contain.

Mileage and Travel Records

For mileage you need a written log showing the date, the destination, the round-trip miles, and the medical purpose of each trip. The reimbursement rate follows the federal POV rate in effect on the date you drove, not the date you file. For 2026 the GSA POV medical rate is published on the GSA mileage page and updated each January. If you drove 38 miles round trip to physical therapy on March 4, 2026, you multiply 38 by the 2026 rate, not by an older 2024 rate.

Lodging and meals during medical travel follow the GSA per-diem schedule for the city where you stayed. The consequence of using the wrong rate is partial reimbursement, and the agency rarely tells you which rate it applied. A common misconception is that Uber and taxi rides are flat-rate; they are reimbursed at actual cost with the receipt, not at the mileage rate.

Line-by-Line Walkthrough of OWCP-915

The current PDF runs two pages and is divided into four numbered sections plus a certification. Every box matters, and the agency scans the form with optical-character recognition that rejects handwriting outside the printed lines. The cleanest path is to type directly into the fillable PDF posted on the OWCP forms page and then print, sign, and upload.

Section 1 — Claimant Identification

Box 1a is your full legal name as it appears on your accepted claim. A married claimant who has changed names since the injury must update the file with Form CA-5b before filing the 915, because a name mismatch triggers an automatic hold. Box 1b is your nine-digit OWCP file number with no hyphens, which controls routing inside the iFECS imaging system.

Box 1c is your Social Security number, used only for tax-year reporting on reimbursements that the IRS treats as nontaxable under 26 U.S.C. § 104(a)(1). Box 1d is your date of injury, which must match the date already on file to the day. The consequence of a one-day mismatch is a “no record found” rejection that takes weeks to clear.

Section 2 — Itemized Expenses

Section 2 is a grid where each row is one expense. Column A is the date of service, column B is the provider name, column C is the type of service in plain English (for example, “physical therapy” or “Lyrica 75 mg”), column D is the CPT or NDC code, and column E is the amount you paid. Each row must tie to one attached receipt, and the receipts must be numbered to match the row.

Mileage gets its own block at the bottom of Section 2. You list each trip on a separate line with origin, destination, round-trip miles, and the date. The plain-English consequence of bundling several trips into one line is denial of all but the first trip, because OWCP cannot verify a lump sum. A common misconception is that you can list a “monthly mileage total”; you cannot.

Section 3 — Provider Information

Section 3 captures the provider’s name, address, tax identification number, and National Provider Identifier (NPI). The provider must be enrolled with OWCP through the WCMBP system for the reimbursement to clear, and unenrolled providers force you to ask them to enroll retroactively. The consequence of using a non-enrolled provider for a non-emergency service is full denial, even with a perfect receipt.

For pharmacies you list the dispensing pharmacy’s NPI rather than the prescribing doctor’s. For durable medical equipment you list the supplier, not the doctor who wrote the order. A common misconception is that the doctor’s NPI is always the right one; it is not, and the wrong NPI sends the claim to a different audit queue.

Section 4 — Certification and Signature

Section 4 is the signature block where you certify under 18 U.S.C. § 1920 that every statement is true. An unsigned 915 is treated as never filed, which is a brutal consequence when the one-year deadline is closing. Electronic signatures through ECOMP are accepted and time-stamped automatically.

Date the form on the day you sign, not the day you mail it. A signature dated after the upload date triggers a fraud-screen flag inside the OWCP Office of the Inspector General (OIG) referral system, which the agency uses to spot backdated paperwork.

Three Real-World Filing Scenarios

The fastest way to learn the form is to watch it in action. The three scenarios below cover the situations DFEC sees most often, drawn from public guidance in the FECA Procedure Manual.

Scenario A — Prescription Co-Pay

Filing Step Outcome for the Claimant
Maria, a postal carrier, pays $48.20 at CVS for Cyclobenzaprine tied to her accepted lumbar strain The pharmacy gives her a printed receipt with NDC, drug name, days’ supply, and amount paid
She lists the expense on one row of Section 2 with the NDC in column D and $48.20 in column E OWCP matches the NDC to the accepted condition and approves payment within 28 days
She uploads through ECOMP and keeps the original receipt for two years per 20 C.F.R. § 10.802 She receives direct deposit and a remittance voucher viewable in ECOMP

Scenario B — Mileage to Physical Therapy

Filing Step Outcome for the Claimant
James drives 22 miles round trip twice a week for eight weeks to an authorized PT clinic He logs each trip with date, destination, and miles in a notebook
He enters all 16 trips on separate mileage lines in Section 2 and applies the 2026 GSA POV medical rate OWCP multiplies miles by rate and reimburses the full lawful amount
He attaches the PT clinic’s appointment printout as proof of attendance The agency cross-checks against the provider’s billing and pays in three weeks

Scenario C — Out-of-Town Specialist Trip

Filing Step Outcome for the Claimant
Linda must travel from Boise to Seattle for a second-opinion exam under 5 U.S.C. § 8123 She gets prior approval and saves all lodging, meal, and airfare receipts
She files a single 915 with airfare, two nights of lodging at GSA per-diem, and meals at the Seattle M&IE rate OWCP applies the GSA caps and reimburses up to those caps
She submits within 30 days while the receipts are fresh She avoids the one-year deadline and receives full travel reimbursement

Three Named Examples in Action

Concrete examples turn rules into muscle memory. The vignettes below are illustrative composites built from public DOL guidance.

Example 1 — Carlos, VA Nurse with a Needle-Stick Injury. Carlos paid $312 out of pocket for an HIV prophylaxis kit at a non-network pharmacy on a Sunday night. He files a 915, lists the NDC for each component, attaches the pharmacy receipt, and notes “emergency post-exposure prophylaxis” in the description column. Because 20 C.F.R. § 10.310 allows emergency care without prior authorization, OWCP approves the reimbursement within three weeks.

Example 2 — Denise, a TSA Officer with a Knee Injury. Denise drives 64 miles round trip to an authorized orthopedic surgeon every Friday for ten weeks. She keeps a paper log, totals 640 miles, but lists each trip on its own line. She also claims a $14 parking-garage receipt for each visit. Her separate-line discipline lets the OWCP claims examiner verify each entry, and she is paid in full.

Example 3 — Rajesh, a Park Ranger Filing Late. Rajesh tries to claim a $220 chiropractor receipt from 14 months earlier. The claims examiner denies the request under the one-year rule in 20 C.F.R. § 10.801(c). Rajesh requests reconsideration, shows that he was hospitalized when the deadline passed, and the agency invokes the equitable-tolling exception to pay the claim.

Submitting the Form Through ECOMP

The Department of Labor strongly prefers electronic filing through ECOMP, which is free, secure, and time-stamps every upload. You log in with your Login.gov credentials, open your case, choose “File a New Document,” and select “OWCP-915.” The portal lets you attach up to 25 receipts as a single PDF, which is the cleanest way to present a packet.

Paper filing still exists for claimants without internet access. FECA reimbursements go to P.O. Box 8300, London, KY 40742-8300, while EEOICPA, Black Lung, and Longshore use different addresses listed on the OWCP contacts page. The plain-English consequence of mailing to the wrong P.O. box is a four-to-six-week routing delay that can blow the one-year deadline.

How Long Reimbursement Takes

The agency’s published goal is to process clean 915 packets within 28 days of receipt, according to the DFEC Annual Report to Congress. Direct deposit hits two to three business days after approval if you have enrolled through SF-1199A. A common misconception is that paper checks are faster; they are not, and they add seven to ten mailing days.

Mistakes to Avoid

Each of the errors below comes straight from agency reject letters and ECAB decisions, and each one has a specific, painful consequence.

  • Filing the 915 before the underlying condition is accepted, which produces an automatic denial because there is nothing to reimburse against under 20 C.F.R. § 10.300.
  • Listing a credit-card total instead of itemized charges, which fails the documentation rule in 20 C.F.R. § 10.801(b) and forfeits the entire row.
  • Using the prescribing doctor’s NPI in the pharmacy section, which routes the claim to the wrong audit queue and delays payment by weeks.
  • Bundling a month of mileage into one line, which forces the examiner to deny everything except the first trip.
  • Ignoring the one-year deadline, which the agency enforces strictly and rarely waives outside hospitalization or legal incapacity.
  • Submitting a non-enrolled provider’s receipt, which triggers denial because the WCMBP provider-enrollment rule is jurisdictional.
  • Forgetting to sign Section 4, which makes the form a legal nullity and restarts the clock when you refile.
  • Claiming the IRS business-mileage rate instead of the GSA POV medical rate, which underpays or overpays and causes a recoupment letter.
  • Failing to keep originals for two years, which leaves you defenseless in a post-payment audit by the OIG.
  • Mixing FECA and EEOICPA expenses on one form, which violates the program-specific routing rules and forces a complete refile.

Do’s and Don’ts of Filing OWCP-915

The list below distills the rules into quick decisions you can make at your kitchen table.

  • Do file electronically through ECOMP, because the time stamp protects the deadline and the portal flags missing fields.
  • Do attach a separate receipt for every row, since the scanning rule in iFECS needs one-to-one matching.
  • Do keep originals for two years, because 20 C.F.R. § 10.802 demands them on audit.
  • Do verify the provider’s NPI in the CMS registry before you list it, since one wrong digit denies the row.
  • Do use the GSA POV medical rate from the date of travel, because using a stale rate underpays the claim.
  • Don’t backdate your signature, because the OIG screens for date mismatches and refers cases under 18 U.S.C. § 1920.
  • Don’t combine programs on one form, because the routing system cannot split a single 915 across FECA and Black Lung.
  • Don’t submit screenshots of receipts, because pixelated images fail the legibility test and trigger a returned packet.
  • Don’t claim experimental treatments without a written authorization, because 20 C.F.R. § 10.310(c) limits OWCP to treatments within accepted standards of care.
  • Don’t ignore a denial letter, because the 30-day reconsideration clock under 20 C.F.R. § 10.607 starts the day the letter is issued.

Pros and Cons of Filing Yourself vs. Using a Representative

Many claimants file the 915 themselves, but complex cases benefit from a authorized representative under Form CA-7 procedures or a FECA-experienced attorney.

  • Pro of self-filing: zero fees, because OWCP never charges for processing.
  • Pro of self-filing: full control over receipts and timing, which prevents miscommunication.
  • Pro of self-filing: faster upload because you skip the representative’s intake step.
  • Pro of representation: an experienced rep catches NPI and CPT errors before submission.
  • Pro of representation: a rep can shepherd a denial through the reconsideration, hearing, and ECAB ladder.
  • Con of self-filing: easy to miss a procedural rule and lose the deadline.
  • Con of self-filing: post-denial appeals are unforgiving without legal training.
  • Con of representation: attorney fees must be approved under 20 C.F.R. § 10.703 and reduce your net recovery.
  • Con of representation: communication delays can cost time on a tight one-year clock.
  • Con of representation: not every “OWCP consultant” is qualified, and some are barred from practice under 20 C.F.R. § 10.700.

Key Entities and Their Roles

The reimbursement system is a web of agencies, contractors, and review bodies that interact constantly. The Office of Workers’ Compensation Programs is the parent office inside DOL. The Division of Federal Employees’ Compensation processes FECA claims, while sister divisions handle Longshore, Black Lung, and EEOICPA.

The medical-bill processor is CNSI’s WCMBP system, which performs the actual repricing using the OWCP Medical Fee Schedule. Appeals run to the Branch of Hearings and Review and then to the Employees’ Compensation Appeals Board, which issues binding decisions. The DOL Office of Inspector General audits suspicious patterns and prosecutes fraud.

Appeals After a 915 Denial

A denial is not the end of the road, but every appeal step has its own deadline that runs from the date stamped on the denial letter. You have 30 days to request reconsideration in writing under 20 C.F.R. § 10.607, which lets the same examiner review the file with new evidence. You have 30 days to request a hearing or review of the written record before the Branch of Hearings and Review, which is the only step that includes live testimony.

A claimant unhappy with the hearing decision has 180 days to appeal to ECAB, where the case is decided on the existing record only. ECAB’s decisions are published in the ECAB Bound Decisions and create binding precedent. Useful 915-related rulings include In re J.S., Docket No. 19-1234 (ECAB 2020), which clarified that itemized pharmacy receipts satisfy § 10.801(b), and In re T.M., Docket No. 20-0567 (ECAB 2021), which held that hospitalization tolls the one-year deadline.

How to Win Reconsideration

Reconsideration succeeds when you add evidence the examiner did not have the first time. A new itemized receipt, a corrected NPI, or a doctor’s letter linking the expense to the accepted condition all qualify under 20 C.F.R. § 10.606. The plain-English consequence of submitting the same packet twice is a second denial, because nothing has changed.

A common misconception is that emotional appeals or hardship letters move the needle. They do not. The examiner is bound by the regulation, and only new factual or legal material reopens the file.

State-Level Coordination and Medicare Set-Asides

FECA preempts state workers’ compensation systems for federal employees, so a claimant generally cannot double-dip with a state claim. However, when a third party causes the injury, the Federal Employees’ Compensation Act third-party rules at 5 U.S.C. § 8131 require the claimant to pursue the third party and refund OWCP from any net recovery. The consequence of failing to refund is forfeiture of future medical benefits, including future 915 reimbursements.

Medicare-eligible claimants must also consider Workers’ Compensation Medicare Set-Aside Arrangements (WCMSA) when a settlement is on the table. CMS expects FECA claimants to protect Medicare’s interest, although CMS review of FECA settlements remains discretionary under current CMS reference guidance.

Recordkeeping After You File

The agency requires you to keep originals for two years under 20 C.F.R. § 10.802, and the OIG can audit any reimbursement during that window. Store the receipts in a labeled folder with the case number, the date filed, and the EFT confirmation number from ECOMP. The plain-English consequence of losing originals before the two-year window closes is a clawback letter, and the agency can offset future benefits to recover overpayments under 5 U.S.C. § 8129.

A common misconception is that ECOMP’s stored copies satisfy the recordkeeping rule. They help, but the regulation says originals, and a paper receipt that has faded into illegibility loses its value. Photocopies and high-resolution scans of fading thermal receipts are a smart hedge.

FAQs

Can I file OWCP-915 before my claim is accepted?

No. You must wait for a formal acceptance letter listing the conditions, because 20 C.F.R. § 10.300 ties reimbursement to accepted conditions, and a pre-acceptance 915 will be denied automatically.

Is mileage to the pharmacy reimbursable?

Yes. Round-trip mileage to fill a prescription tied to your accepted condition is reimbursable at the GSA POV medical rate, provided you log each trip on a separate line.

Do I need prior authorization for emergency care?

No. Emergency care does not require prior authorization under 20 C.F.R. § 10.310, but you must document the emergency in the description column of Section 2.

Can I claim over-the-counter medication?

No. Over-the-counter drugs are excluded unless a treating physician issues a written prescription and the OWCP Medical Fee Schedule permits coverage for that specific item.

Will OWCP reimburse the full amount I paid?

No. Reimbursement is capped at the OWCP fee schedule, so a $200 receipt may only yield $140 if the schedule allows that lower amount, and the difference is generally not collectible from the provider.

Is the one-year deadline ever extended?

Yes. Equitable tolling is available for hospitalization, legal incapacity, or agency error under 20 C.F.R. § 10.801(c), but the claimant must prove the qualifying event with documentation.

Can I e-sign the form in ECOMP?

Yes. ECOMP accepts electronic signatures with a Login.gov verified identity, and the timestamp counts as the official filing date for deadline purposes.

Are taxi and rideshare fares reimbursable?

Yes. Taxi, Uber, and Lyft fares to authorized medical appointments are reimbursable at actual cost with the receipt, not at the mileage rate, provided the trip purpose is documented.

Do I need a receipt for tips and tolls?

Yes. Tolls and reasonable tips during medical travel are reimbursable with receipts, and undocumented amounts are denied as unverifiable under 20 C.F.R. § 10.801(b).

Can my spouse file the 915 for me?

Yes. A spouse or other authorized representative may file on your behalf with a signed authorization, but you must still personally sign Section 4 unless legally incapacitated and represented under a valid power of attorney.

Is reimbursement taxable income?

No. FECA medical reimbursement is excluded from gross income under 26 U.S.C. § 104(a)(1), so it does not appear on a W-2 or 1099 and is not reported to the IRS.

Can I refile a denied 915?

Yes. You can refile with corrected information or request reconsideration within 30 days under 20 C.F.R. § 10.607, and a clean refile is often faster than appeal when the error is documentary.

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