Medical Benefits:

Questions and Answers 

About the 

Energy Employees 

Occupational Illness 

Compensation Program

U.S. Department of Labor

Employment Standards Administration

Office of Workers’ Compensation Programs

Division of Energy Employees

Occupational Illness Compensation

Medical Benefits:

Questions and Answers 

About the 

Energy Employees 

Occupational Illness 

Compensation Program

01/08
Contents...

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

1. What costs are covered under the EEOICP? . . . . . . . . . . . . . . . . . . .2

2. Will I receive a Medical Benefits Identification Card? . . . . . . . . . .3

3. What drugs are covered? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

4. What costs are not covered under the EEOICP? . . . . . . . . . . . . . . .4

5. What is the best way to get my medical bills paid? . . . . . . . . . . . .5

6. How can a medical provider get enrollment and 

billing information from the EEOICP? . . . . . . . . . . . . . . . . . . . . . . . . .5

7. Where should medical providers send bills

related to the EEOICP? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

8. Does the medical provider need

billing forms?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

9. When do I use my U.S. Department of Labor

EEOICP Medical Benefits Identification Card? . . . . . . . . . . . . . . . . . .6

10. What if the medical provider wants to bill 

Medicare or other insurance carriers instead 

of EEOICP? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

11. What if I have to pay the Medical Provider?

How do I get reimbursed by the EEOICP? . . . . . . . . . . . . . . . . . . . . . .7

12. How do I get reimbursed for prescription drugs? . . . . . . . . . . . .10

13. Can I be reimbursed for the cost of travel 

to get medical treatment or prescriptions related

to my accepted condition? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

14. How much time will my reimbursement

requests take to be processed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

15. Will I be notified if the reimbursement requests 

I send in are going to be paid? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Samples...

Sample Page 

1. Claim for Medical Reimbursement Form, OWCP-915 . . . . . . . . .9

(Doctor Visit)

2. Claim for Medical Reimbursement Form, OWCP-915 . . . . . . . .13

(Prescription Drugs)

3. Pharmacy Bill Receipt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

4. Proof of Payment: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Computerized Printout Pharmacy Receipt

5. Medical Travel Refund Request, OWCP-957 . . . . . . . . . . . . . . . . .17

6. Remittance Voucher (Front of Form) . . . . . . . . . . . . . . . . . . . . . . .19

16. What will happen if I have not submitted 

my reimbursement request forms or receipts correctly? 

Will I still receive a Remittance Voucher? . . . . . . . . . . . . . . . . . . . . . .19

17. Will a check come with the Remittance Voucher? . . . . . . . . . . . .20

18. Whom should I notify if my mailing address changes? . . . . . . .21

19. Should I keep copies of the bills that I send to the EEOICP? . .21

20. Whom do I call if I have questions about my 

medical bills; if I need reimbursement forms for 

treatment, prescriptions or travel; or if my EEOICP

Medical Benefits Identification Card has been 

lost or destroyed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

21. What do I do if I have additional questions? . . . . . . . . . . . . . . . .22

EEOICP District Office Locations . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
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IN

Introduction

As a qualified claimant under the U.S. Department of Labor’s

Energy Employees Occupational Illness Compensation

Program (EEOICP), you are entitled to medical benefits to

cover the reasonable cost of treatment for your covered

condition(s). Medical providers (such as physicians,

pharmacies, and hospitals) may bill the Department of Labor

medical bill processing facility directly.

The questions in this booklet are those most often asked by

EEOICP beneficiaries about:

● Medical benefits – covered and non-covered 

services; and 

● Reimbursement for medical care and associated 

travel.

While this booklet gives you basic information about your

medical treatment benefits, it is not intended to cover every

possible exception or special case, and it does not have the

effect of law or regulations.

For further information about special circumstances or

individual cases, please call your claims examiner at the

EEOICP District Office. A list of District Offices is on the

last page of this booklet.

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1. Question: What costs are covered under the 

EEOICP?

Answer: The cost of medical treatment services and

associated travel directly related to the treatment of

your accepted condition(s) is covered as authorized

under the EEOICP. These costs are payable at

established rates for covered medical services. There is

no deductible.

The following is a list of some of the services that may

be covered when they are performed for the treatment

of your covered condition:

● Doctor’s office visits, medical treatments,

hospital visits, and consultations;

● Inpatient and outpatient hospital charges,

including emergency room visits for the 

accepted conditions, diagnostic laboratory 

testing, and chest x-rays;

● Drugs prescribed by a doctor, both brand 

name and generic;

● Ambulance services; and

● Travel to the doctor, hospital, clinic, other 

medical facility, or pharmacy.

The following items require special approval for travel,

treatment or purchase:

● Overnight travel, related meals and lodging,

and/or mileage that exceeds 200 miles 

round trip;

Q: 

1, 2
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● Treatment for consequential conditions;

● Special equipment as prescribed or 

recommended by the treating physician 

especially those items over $5,000.

These require special approval from your claims examiner

at the EEOICP District Office. A list of EEOICP

District Offices is on the last page of this booklet.

Note: All durable medical equipment will be reimbursed

at a predetermined rate according to the fee schedule

aministered by the Office of Workers’ Compensation

Programs.

2. Question: Will I receive a Medical Benefits 

Identification Card?

Answer: Once you have been accepted for medical

benefits under the EEOICP, you will receive a Medical

Benefits Identification Card. On the front of the card,

your name will be printed along with the accepted

diagnosis for your condition. Also, it will be clearly

printed that you have no co-pay or deductible expenses.

On the back of your Medical Benefits Identification

Card, the address for medical billing purposes is

printed, along with the toll-free customer service

number for medical billing questions. Also on the back

of your Medical Benefits Identification Card is a 10-

digit access number that will allow you to check on the

status of your medical bills on the internet (see page 20

and 21 of this booklet).

3. Question: What drugs are covered?

Answer: Most drugs prescribed by your doctor for the

Q: 

1, 2

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treatment of your covered condition(s) will be covered

(brand name or generic). However, there are some

exceptions. In order to be sure a drug is covered, you

or your pharmacist may call toll-free, Mon.-Fri, 8:00

a.m.-8:00 p.m. (EST) at 1-866-272-2682.

You may purchase your prescriptions and then file for

out-of-pocket reimbursement.

A new feature for pharmacy billing is the Point of Sale

(POS). With this feature, you can present your Medical

Benefits Identification Card to the pharmacist for your

covered prescription(s). The pharmacist may then

access the following website http://owcp.dol.acsinc.com to verify immediately if a particular

prescription(s) will 

be paid or denied. You are able to pick up your

prescription(s) without any out-of-pocket expense. By

using POS, the pharmacist is not required to submit any

billing paper work. The billing process is totally

electronic. For more information regarding this feature,

have your pharmacist call the toll-free number for

billing questions at 1-866-272-2682, Mon.-Fri., 8:00

a.m.-8:00 p.m. (EST).

4. Question: What costs are not covered under the 

EEOICP?

Answer: The following are among the costs not

covered under the EEOICP:

● Treatment of medical problems not related 

to your covered condition(s);

● Medical treatment for your spouse or other 

family members;

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3, 4, 

5, 6
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● Medicine that is not prescribed by a doctor;

and

● Personal services in the hospital, such as 

TV or telephone.

5. Question: What is the best way to get my medical 

bills paid?

Answer: Whenever possible, have your doctor, hospital,

pharmacy, and other medical providers bill the

Department of Labor directly. If providers are enrolled

in the EEOICP, the Department of Labor will pay

them directly.

Your provider may also obtain enrollment information

at the following website:

http://owcp.dol.acs-inc.com.

6. Question: How can a medical provider get 

enrollment and billing information from 

the EEOICP?

Answer: Medical providers can apply for enrollment at

anytime. Those having questions about enrollment or

billing may call the EEOICP toll-free, Mon.-Fri., 8:00

a.m.-8:00 p.m. (EST) at 

1-866-272-2682.

7. Question: Where should medical providers send 

bills related to the EEOICP?

Answer: All EEOICP medical treatment bills should be

sent to the following address:

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3, 4, 

5, 6
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Energy Employees Occupational Illness 

Compensation Program

P.O. Box 8304

London, KY 40742-8304

8. Question: Does the medical provider need

billing forms?

Answer: YES. The doctor, clinic, laboratory,

ambulance, and nursing service should bill using the

standard OWCP-1500 or HCFA-1500 form.

The pharmacy can bill using the Universal Pharmacy

Billing form.

The hospital can bill using the UB-92 form for all

inpatient charges, other outpatient charges, emergency

room, chemotherapy, and ambulatory surgical care.

These are standard forms used throughout the medical

community.

9. Question: When do I use my U.S. Department of 

Labor EEOICP Medical Benefits Identification Card?

Answer: You should present your Medical Benefits

Identification Card whenever you seek treatment for

your accepted condition(s). Showing a medical provider

your card will identify you as 

an EEOICP beneficiary and will help the medical

provider determine the proper way to bill for services.

You will need to have your Social Security Number

available when you present your card.

Q: 

7, 8, 9,

10, 11
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10. Question: What if the medical provider wants to 

bill Medicare or other insurance carriers instead 

of the EEOICP?

Answer: Other insurance carriers should not be billed

first for treatment of your accepted condition(s),

because EEOICP benefits represent primary coverage

for beneficiaries.

11. Question: What if I have to pay the medical 

provider? How do I get reimbursed by the 

EEOICP?

Answer: We strongly encourage you to present your

Medical Benefits Identification Card to the medical

provider whenever you seek treatment for your accepted

condition so that your medical provider may bill the

Department of Labor directly.

If the medical provider will not bill directly, you may

pay for the medical services out-of-pocket and then

request reimbursement yourself.

To obtain a list of medical providers enrolled in our

program, call the EEOICP toll-free, Mon.-Fri., 8:00

a.m.-8:00 p.m. (EST) at 1-866-272-2682.

To obtain reimbursement, complete the U.S.

Department of Labor Claim for Medical

Reimbursement Form, OWCP-915, as shown in Sample

1 on page 9. In addition to the OWCP-915, you must

submit the provider's billing statement, receipt of

payment by your provider and evidence of your method

of payment. Acceptable evidence of payment include:

a cash receipt, a copy of your canceled check (both

Q: 

7, 8, 9,

10, 11
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front and back) or a copy of your credit card receipt.

Up to eight visits or services can be listed on this form.

However, each line used must be filled in completely.

Statements such as “see attached” or “see attached

receipts” are not acceptable when used in any of the

boxes on the form.

All medical bills submitted to the EEOICP are subject

to a fee schedule.

Send the completed Claim for Medical Reimbursement

Form with your itemized paid statement or detailed

receipts, securely 

attached, to:

Energy Employees Occupational Illness 

Compensation Program

P.O. Box 8304

London, KY 40742-8304

Q: 11

S: 1
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Q: 11

S: 1

Sample 1 – Claim for Medical Reimbursement 

(Doctor Visit)
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Q: 12

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12. Question: How do I get reimbursed for 

prescription drugs?

Answer: We strongly encourage you to present your

EEOICP Medical Benefits Identification Card at the

pharmacy when you have a prescription filled for your

accepted condition. If the pharmacy is enrolled as a

medical provider, the EEOICP may be billed directly, or

use Point of Sale. If the pharmacy will not bill the

Department of Labor directly, you must pay for the

medicine out-of-pocket and then submit for

reimbursement yourself.

To obtain reimbursement, complete the Claim for

Medical Reimbursement Form, OWCP-915, as shown

in Sample 2 on page 13. Up to eight individual

prescription drugs may be listed on this form.

However, each line used must be filled in completely.

Therefore, statements such as “see attached” or “see

attached receipts” are not acceptable when used in any

of the boxes on the form.

Send the completed Claim for Medical Reimbursement

Form, along with the original pharmacy receipts

securely attached, to:

Energy Employees Occupational Illness Compensation

Program

P.O. Box 8304

London, KY 40742-8304

Acceptable receipts include: a pharmacy bag or sticker,

a computerized printout or an itemized listing on the

pharmacy’s letterhead. These receipts must include:

● Your full name, address, and Social Security 

number;
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● Name of the prescribing doctor;

● Name and address of the pharmacy;

● Prescription number;

● Amount prescribed – mg/ml or cc and total or 

cc per bottle for liquid medication, and/or mg 

per tablet and total number of tablets per 

prescription;

● Date purchased;

● Name of each drug;

● 11-digit National Drug Code (NDC) number for 

the prescribed medication;

● Charge actually paid for each drug less any 

discount (for example, senior citizen, coupon);

and

● A statement marked “patient paid” or “paid by 

patient” showing specifically who paid the 

charges. “Paid” or “paid in full” are not 

acceptable.

(See Sample 3 on page 14.)

NOTE: If you send an itemized computerized printout, it

must include all of the information already listed, as well as

the pharmacist’s original signature.

(See Sample 4 on page 15.)

Your own itemized listing or cash register receipt is not

considered proof of payment.

Q: 12
A copy of the front and back of your canceled check may

serve as proof of payment, only when accompanied by an

itemized statement or pharmacist’s ledger record.

If you need help getting or completing forms for the

reimbursement of drugs, please call toll-free, Mon.-Fri., 8:00

a.m.-8:00 p.m. (EST) at 1-866-272-2682.

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Q: 12

S: 2

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Q: 12

S: 2

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Sample 2 – Claim for Medical Reimbursement

(Prescription Drugs)
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S: 3, 4

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Sample 3 – Pharmacy Bill Receipt
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S: 3, 4

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Sample 4 – Proof of Payment
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Q: 13, 14

S: 5

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13. Question: Can I be reimbursed for the cost of 

travel to get medical treatment or prescriptions 

related to my accepted condition?

Answer: Mileage costs for most travel to obtain medical

treatment or prescriptions for your accepted condition

may be reimbursed. To receive reimbursement for

mileage, you must complete a Medical Travel Refund

Request,

OWCP-957, as shown in Sample 5 on page 17.

You may submit up to three trips on each form.

Mail the completed Medical Travel Refund Request to:

Energy Employees Occupational Illness Compensation

Program

P.O. Box 8304

London, KY 40742-8304

Note: Overnight travel, related meals and lodging,

and/or mileage that exceeds 200 miles round trip

requires special approval from 

your claims examiner in the EEOICP District Office

prior to travel. A list of toll-free numbers for the

District Offices is on the last page of this booklet.

Travel to a pharmacy to pick up prescribed drugs is

covered. You must have the pharmacy name, city, state,

and zip code indicated in block “E” for each visit and

your signature is required in 

block 8 of Form OWCP-957.
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Q: 13, 14

S: 5

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14. Question: How much time will my 

reimbursement requests take to be processed?

Answer: Reimbursement requests which are submitted

correctly will be processed by the EEOICP within 30

days.

Sample 5 – Medical Travel Refund Request
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Q: 15, 16

S: 6

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15. Question: Will I be notified if the reimbursement

requests I send in are going to be paid?

Answer: YES. You will be notified by mail if your

reimbursement requests will be paid or denied, through

a form called a Remittance Voucher (RV), as shown in

Sample 6 on page 19.

This statement will contain the following information:

● The date of service;

● The amount of your reimbursement request;

● The amount you will be paid;

● An RV number on the top left-hand side of the 

form (this number will also appear on your 

check, if you receive a payment, so you can 

match payments with your reimbursement 

requests); and

● Explanation of Benefits Codes (EOB Codes) 

will explain why you were not paid for any 

portion of the reimbursement request.

You will not receive a Remittance Voucher if your

medical provider bills the Department of Labor directly.
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Q: 15, 16

S: 6

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16. Question: What will happen if I have not 

submitted my reimbursement request forms or 

receipts correctly? Will I still receive a 

Remittance Voucher?

Answer: If you have any reimbursement request forms

Sample 6 – Remittance Voucher (Front of Form)
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Q: 16, 17,

18, 19, 

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and receipts that need correction or additional

information, a customer service representative will

attempt to reach you by phone to obtain the correct or

additional information. If the customer service

representative is unable to reach you by phone, your

reimbursement request forms and receipts that need

correction or additional information will be returned to

you along with a letter explaining what is wrong or

missing. It is very important that you correct and mail

back these forms and receipts as soon as possible. You

cannot be paid by the EEOICP until you submit all

forms and receipts properly. All corrected

reimbursement forms and receipts should be mailed to:

Energy Employees Occupational Illness Compensation

Program

P.O. Box 8304

London, KY 40742-8304

If you need help correcting reimbursement requests

which have been returned, you may call toll-free, Mon.-

Fri., 8:00 a.m.-8:00 p.m. (EST) at

1-866-272-2682.

17. Question: Will a check come with the Remittance 

Voucher?

Answer: NO. The check is always mailed separately.

Checks are issued by the U.S. Department of Treasury.

The Remittance Voucher is sent from the EEOICP

office in Dallas, Texas, where your reimbursement

requests are processed. The Remittance Voucher

should arrive shortly before your check. Please

remember to allow enough time (10 to 14 days) for

both the check and the Remittance Voucher to arrive

before making inquiries.
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Q: 16, 17,

18, 19, 

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If you have questions about your Remittance Voucher,

if you fail to receive either a check or a Remittance

Voucher, or if your payment is incorrect and requires

an adjustment, you may call toll-free, Mon.-Fri., 8:00

a.m.-8:00 p.m. (EST) at 1-866-272-2682.

18. Question: Whom should I notify if my mailing 

address changes?

Answer: Any changes in your mailing address should be

reported in writing to the EEOICP District Office with

which your claim is filed.

A list of the District Offices is on the last page 

of this booklet.

19. Question: Should I keep copies of the bills that I 

send to the EEOICP?

Answer: YES, if possible. Keeping a copy will give you

a record of the reimbursement requests and receipts

you have submitted.

20. Question: Whom do I call if I have questions 

about my medical bills; if I need reimbursement 

forms for treatment, prescriptions or travel; or if 

my EEOICP Medical Benefits Identification Card 

has been lost or destroyed?

Answer: You may call the EEOICP toll-free,

Mon.-Fri., 8:00 a.m.-8:00 p.m. (EST) at 1-866-272-2682.

In addition, you may check the status of any medical

bill(s) that you have submitted for payment by accessing

the ACS Web Bill Processing Portal on the internet.

The internet address is http://owcp.dol.acs-inc.com. In

order to log on to the system, you will be required to
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enter the following three (3) fields:

1. Case File Number—this is your social security 

number

2. Card ID Number—this is the 10-digit number 

printed on the back of your Medical Benefits 

Identification Card (MBIC)

3. Date of Birth

You may also download forms from this website.

21. Question: What do I do if I have additional 

questions?

Answer: You may call the EEOICP toll-free,

Mon.-Fri., 8:00 a.m.-8:00 p.m. (EST) at 

1-866-272-2682.

Q: 20,

21

District

Offices
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District

Offices

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EEOICP DISTRICT OFFICE LOCATIONS

District Office 1 – Jacksonville, Florida

(Alabama, Florida, Georgia, Kentucky, Mississippi, North

Carolina, South Carolina and Tennessee)

U.S. Department of Labor, DEEOIC

400 West Bay Street, Suite 722

Jacksonville, FL 32202

(877) 336-4272 (Toll Free)

District Office 2 – Cleveland, Ohio

(Connecticut, Delaware, District of Columbia, Illinois,

Indiana, Iowa, Maine, Maryland, Massachusetts, Michigan,

Minnesota, New Hampshire, New Jersey, New York, Ohio,

Pennsylvania, Puerto Rico, Rhode Island, Vermont, Virgin

Islands, Virginia, West Virginia and Wisconsin)

U.S. Department of Labor, DEEOIC

1001 Lakeside Avenue, Suite 350

Cleveland, OH 44114

(888) 859-7211 (Toll Free)
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District

Offices

District Office 3 – Denver, Colorado

(Arkansas, Colorado, Kansas, Louisiana, Missouri, Montana,

Nebraska, North Dakota, Oklahoma, South Dakota, Texas,

Utah, Wyoming and all claims from RECA Section 5

awardees)

U.S. Department of Labor, DEEOIC

1999 Broadway, Suite 1120

P.O. Box 46550

Denver, CO 80201-6550

(888) 805-3389 (Toll Free)

District Office 4 – Seattle, Washington

(Alaska, Arizona, California, Idaho, Hawaii, Marshall Islands,

Nevada, New Mexico, Oregon and Washington)

U.S. Department of Labor, DEEOIC

719 2nd Avenue, Suite 601

Seattle, WA 98104

(888) 805-3401 (Toll Free)