WebHealth Insurance Claim Form (OWCP-1500) Block 25 • Enter the 9-digit Federal Tax-ID number • Select either SSN/EIN to indicate if your Tax-ID is an (SSN or EIN). Uniform … WebRequirements for Reimbursement of the OWCP 957 Form Original receipts are required for lodging, airfare, rental car, and any other expense that exceeds $75. Claimant’s last name and OWCP Claim Number should be listed on submitted attachments. Keep a copy for your records. Black Lung Claimants: • Travel expenses for the miner are reimbursable
NOTICE TO PATIENT ABOUT THE COLLECTION AND USE OF …
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Claimant Reimbursement Forms - DOL
http://aplusrehabmedical.com/forms/OWCP-44.pdf WebHealth Insurance Claim Form (OWCP-1500) Block 25 • Enter the 9-digit Federal Tax-ID number • Select either SSN/EIN to indicate if your Tax-ID is an (SSN or EIN). Uniform Health Insurance Claim Form (OWCP-04) Block 5 • Enter the 9-digit Federal Tax-ID number. Note: The Tax-ID on the bill must match the Tax-ID on the OWCP Provider File. If the WebForm OWCP-44 is used to collect information necessary to decide if maintenance allowances should continue to be paid. Form OWCP-44 is submitted to OWCP by … st thomas usvi all inclusive resorts