Office of Workers’ Compensation Programs

Division of Energy Employees Occupational Illness Compensation

U.S. DEPARTMENT OF LABOR

HOME AND RESIDENTIAL 

HEALTH CARE SERVICES 

UNDER THE ENERGY EMPLOYEES 

OCCUPATIONAL ILLNESS 

COMPENSATION PROGRAM ACT
U.S. DEPARTMENT OF LABOR | dol.gov/agencies/owcp/energy

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 1

Home and 

Residential 

Health Care 

Services 

Under the 

Energy 

Employees 

Occupational 

Illness 

Compensation 

Program Act

GENERAL INFORMATION

Under the Energy Employees Occupational Illness Compensation Program Act 

(EEOICPA), eligible claimants are entitled to medical benefits recommended by a qualified 

physician that the U.S. Department of Labor’s Division of Energy Employees Occupational 

Illness Compensation (DEEOIC) determines are likely to:

• Cure;

• Give relief to; or

• Reduce the degree or the period of the accepted illness.

DEEOIC is responsible for ensuring that claimants who have an accepted illness receive 

appropriate and necessary medical care. When your claim is accepted, a DEEOIC Medical 

Benefits Examiner assigned to your case will work closely with you to ensure proper 

provision of medical benefits under the law. Medical care can include Home and Residential 

Health Care (HRHC) services.

WHAT IS HOME AND RESIDENTIAL HEALTH CARE?

HRHC includes medically appropriate care, from qualified providers either in the home or in 

an authorized HRHC facility, to treat an accepted work-related illness. This includes:

• Home health care;

• Care in a skilled nursing facility;

• Care in an assisted living facility; and

• Hospice care.

WHEN CAN I APPLY FOR HOME AND RESIDENTIAL HEALTH CARE?

A covered employee can seek HRHC once DEEOIC has accepted a work-related illness and 

there is a medical need for such care.

DO I NEED PREAPPROVAL TO BILL FOR HOME AND RESIDENTIAL HEALTH CARE?

Yes. We must preapprove payment for HRHC services.

NOTE: If you receive care without preapproval for billing and later seek reimbursement, you may not receive full 

cost reimbursements if you paid more than the allowable fee scheduled rates.
U.S. DEPARTMENT OF LABOR | dol.gov/agencies/owcp/energy

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 2

To request 

authorization to 

bill for HRHC, 

you or a properly 

designated 

authorized 

representative 

must complete 

and submit 

Form EE-17A 

HOW DO I SUBMIT A REQUEST TO BILL FOR HOME AND RESIDENTIAL 

HEALTH CARE?

To request authorization to bill for HRHC, you or a properly designated authorized representative 

must complete and submit Form EE-17A, Claim for Home Health Care, Nursing Home, or 

Assisted Living Benefits. (Note: This form is not required for re-authorizations.) On the 

form, indicate which benefits you are seeking; provide the name, address, and telephone 

number of the physician responsible for medical management of your HRHC services; sign 

and date the bottom of the form; and submit it.

Web: DEEOIC’s Energy Document Portal at 

https://eclaimant.dol.gov/portal/?program_name=EN

Mail: U.S. Department of Labor OWCP/DEEOIC

PO Box 8306 

London, KY 40742-8306

The EE-17A form is available at https://www.dol.gov/owcp/energy/regs/compliance/

EEOICPForms/ee-17a.pdf.

NOTE: You do not have to submit Form EE-17A to initiate a request to bill for in-home hospice care. To 

initiate an authorization request to bill for in-home hospice care, your DEEOIC-enrolled provider of hospice 

services must submit a request (electronically or via mail) to medical bill contractor at U.S. Department of 

Labor OWCP/DEEOIC; PO Box 8304; London, KY 40742-8304. The authorization request must include a 

Hospice Certification specifying the individual’s prognosis for life expectancy as 6 months or less, and clinical 

information supporting the medical prognosis.

DO I NEED A PHYSICAL EXAMINATION FOR AUTHORIZATION TO BILL FOR 

HOME AND RESIDENTIAL HEALTH CARE?

Yes. A treating physician must conduct a face-to-face physical examination in support 

of any request to bill for HRHC within 60 days before submitting an HRHC authorization 

request.

WHAT INFORMATION MUST MY TREATING PHYSICIAN PROVIDE TO 

SUPPORT MY REQUEST TO BILL FOR HOME AND RESIDENTIAL HEALTH 

CARE?

Your treating physician must submit a completed Form EE-17B, Physician’s Certification 

of Medical Necessity, (Note: This form is not required for re-authorizations). The physician 

should sign and date the EE-17B form and submit it.

Web: DEEOIC’s Energy Document Portal: 

https://eclaimant.dol.gov/portal/?program_name=EN

Mail: U.S. Department of Labor OWCP/DEEOIC 

PO Box 8306 

London, KY 40742-8306.

The EE-17B form is available at https://www.dol.gov/owcp/energy/regs/compliance/

EEOICPForms/ee-17b.pdf.
U.S. DEPARTMENT OF LABOR | dol.gov/agencies/owcp/energy

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 3

Along with 

Form EE-17B, 

the physician 

must attach 

a Letter of 

Medical Necessity

Along with Form EE-17B, the physician must attach a Letter of Medical Necessity that 

contains both a plan of care and the rationale for why the prescribed home health care, 

nursing home, or assisted living services are medically necessary to treat the DEEOICaccepted condition(s). The letter must include:

• Type of Care Required. The letter must explain why the specific service is required in

the home versus outside the home or at a facility that provides a higher level of care,

such as a nursing home or assisted living facility. For example, for in-home services,

perhaps you cannot travel to a clinic or physician’s office, or you need medical

services on an hourly, daily, or unpredictable basis.

• Level of Care Required. The letter of medical necessity must specify the appropriate

level of care you require. Care services may include:

• Skilled Nursing Services (RN/LPN): To assess your medical condition,

administer prescription medications, dress wounds, administer intravenous

medications, provide other services appropriate to the level of medical credentials

attained by this skilled provider, etc.

• Assistive Health Care Personnel (home health aide/personal care attendant/

certified nursing assistant): To assist with activities of daily living, including

mobility within the household, dressing and undressing, toileting, bathing, and

meal preparation.

• Home Therapeutic Services: Such as physical therapy, occupational therapy,

speech therapy, respiratory therapy, or any other professional therapeutic service,

which requires home delivery when the claimant is medically unable to travel

outside the home.

• Targeted Case Management (TCM): The coordination of multidisciplinary HRHC

services to help you access necessary medical, social, educational, and other

services directly related to your accepted condition(s).

• Assisted Living Facilities: A system of housing and limited care, for people

who need some assistance with activities of daily living but don’t need care in a

residential nursing home.

• Nursing Home, Skilled Nursing Facility, and Rehabilitation Hospital: Facilities

where skilled nurses and therapy staff treat, manage, observe, and evaluate

medical care.

• Hospice: A public agency or private organization that cares for terminally ill

people whose medical prognosis indicates a life expectancy of 6 months or

less. Hospice care emphasizes palliative care (relief of pain and uncomfortable

symptoms) and end-of-life counseling, as opposed to curative care.

• Frequency of Service. The number of times each level of HRHC service will be

performed, (e.g., daily, weekly, monthly, intermittently as needed, etc.).
U.S. DEPARTMENT OF LABOR | dol.gov/agencies/owcp/energy

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 4

Once we approve 

payment for 

HRHC services, 

you may choose 

any licensed 

medical provider

• Duration of Care. The number of minutes or hours required to perform the HRHC service

at the frequency prescribed. For example, a home health aide is required 4 hours each

day, 5 days per week, to assist with daily living activities; or a nurse is required 2 hours a

day, 3 days per week, to clean, dress, and evaluate wounds.

• Period of Required Care. The length of time for which the HRHC care is required. For

example, your physician prescribes home health aide services for 6 months. For assisted

living or nursing home requests, the physician must describe the relative permanency of

the claimant’s medical need for such care.

• Conditions Requiring Care. The letter of medical necessity must list the accepted

medical condition(s) and the care prescribed for each condition; physician notes

describing your general health, prognosis, and changes since your last exam; and

measurements, observations, and test results, which support the need for HRHC specific

to your accepted condition(s). The physician should also describe any effect that

noncovered illnesses have on the claimant’s need for HRHC services and must try to

differentiate those from services required because of the accepted condition(s).

• Evidence of a recent Face-to-Face Examination. The letter of medical necessity should

include evidence of a face-to-face medical examination by your treating physician within

60 days of the letter’s date.

CAN I CHOOSE FROM ANY HOME AND RESIDENTIAL HEALTH CARE PROVIDER?

Yes. Once we approve payment for HRHC services, you may choose any licensed medical 

provider. You may change HRHC providers at any time. However, you must notify us in writing 

and include the new provider’s name and contact information, and the reason for the change.

CAN I REQUEST CHANGES TO AN APPROVED LEVEL OF HOME AND 

RESIDENTIAL HEALTH CARE?

Yes. You must submit a written request for any changes to an approved level of home health 

care that includes medical documentation from your treating physician that explains the basis 

for any change in your current care plan.

ONCE DEEOIC APPROVES PAYMENT FOR HOME AND RESIDENTIAL HEALTH 

CARE SERVICES, IS MY APPROVAL PERMANENT?

No. Approval for HRHC services is not permanent. We can authorize payment for home health 

care for up to 6 months, and residence in an assisted living facility, or nursing home care, for up 

to 12 months.

HOW DO I RENEW AUTHORIZATION TO BILL FOR HOME AND RESIDENTIAL 

HEALTH CARE SERVICES?

To request renewal of your authorization to bill for HRHC services, you must have another 

face-to-face evaluation with your treating physician within 60 days before your existing 

authorization ends, and your treating physician must submit updated medical information and 

the results of that evaluation to DEEOIC. Your Medical Benefits Examiner will notify you 60 

days before your existing HRHC authorization ends that you need to request a renewal and an 

updated letter of medical necessity.
U.S. DEPARTMENT OF LABOR | dol.gov/agencies/owcp/energy

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 5

There may be 

circumstances 

that require 

payment for 

HRHC on an 

emergency basis

CAN DEEOIC APPROVE AN EMERGENCY AUTHORIZATION OF HOME AND 

RESIDENTIAL HEALTH CARE SERVICES?

Yes. There may be circumstances that require payment for HRHC on an emergency basis 

—for example, if you need immediate home care after leaving the hospital, or if your 

condition suddenly requires an urgent change in the level or frequency of currently 

authorized services.

To approve an emergency billing authorization, DEEOIC’s Bill Processing Agent must 

receive (by fax or letter) an emergency care order from your treating physician or a 

hospital discharge order signed by a physician. The letter of medical necessity or hospital 

discharge order must describe the medical need for emergency HRHC. The agent will 

forward the request to your Medical Benefits Examiner, who will evaluate your request. The 

Medical Benefits Examiner can grant authorizations to bill for emergency HRHC in 30-day 

increments, for no more than 90 days.

HOW CAN I FIND OUT IF A HOME AND RESIDENTIAL HEALTH CARE 

PROVIDER HAS ENROLLED IN THE ENERGY EMPLOYEES OCCUPATIONAL 

ILLNESS COMPENSATION PROGRAM? 

Go to https://owcpmed.dol.gov/portal/provider/search. You should also check with your 

HRHC provider.

HOW CAN A HOME AND RESIDENTIAL HEALTH CARE PROVIDER OBTAIN 

ENROLLMENT AND BILLING INFORMATION?

If the HRHC provider you wish to use is not enrolled in the program, they can obtain 

enrollment and billing information by calling our Bill Processing Agent at 1-866-272-2682 

or contacting one of the Resource Centers listed at the end of this flyer. Enrollment forms 

are available at https://owcpmed.dol.gov.

DOES DEEOIC ENDORSE A PARTICULAR PROVIDER OR CERTIFY PROVIDERS 

OF HOME AND RESIDENTIAL HEALTH CARE SERVICES?

No. We do not endorse or sponsor any HRHC provider or any other entity providing 

medical services.

WHO PAYS FOR THE COST OF HOME AND RESIDENTIAL HEALTH CARE?

DEEOIC pays for care that is medically necessary to treat DEEOIC-accepted conditions. 

However, you must directly pay for any costs for care unaffiliated with your accepted 

illness, or bill to private insurance or other government health programs such as Medicare 

or Medicaid.

We pay costs associated with the treatment of accepted medical conditions from the 

EEOICPA compensation fund

NOTE: We cannot pay for care for any condition that may be a consequence of a DEEOIC-accepted condition 

until you file a specific claim for that “consequential illness” and it is accepted.
U.S. DEPARTMENT OF LABOR | dol.gov/agencies/owcp/energy

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 6

If seeking 

reimbursement 

from multiple 

providers, you 

must complete 

a separate form 

for each medical 

provider

HOW ARE HOME AND RESIDENTIAL HEALTH CARE BILLS PAID?

If your HRHC provider has enrolled in the program, we will pay them directly based upon 

our fee schedule. If your HRHC provider has not enrolled in the program, you can obtain 

reimbursement for your out-of-pocket expenses for covered medical care by completing 

Form OWCP-915, Claim for Medical Reimbursement. Along with Form OWCP-915, you 

must submit the following items (attach them securely to the form):

• Provider’s itemized billing statement,

• Evidence of receipt of payment to your provider (cash receipt, front-and-back copy

of your canceled check, or a copy of your credit card receipt), and

• Evidence of your method of payment.

If seeking reimbursement from multiple providers, you must complete a separate form for 

each medical provider.

Mail the completed Form OWCP-915, Claim for Medical Reimbursement, with attachments, to: 

U.S. Department of Labor OWCP/DEEOIC 

PO Box 8304

London, KY 40742-8304

The OWCP-915 form is available at https://www.dol.gov/owcp/dfec/regs/compliance/

OWCP-915.pdf.

You will be reimbursed by check unless you elect payment via electronic funds transfer 

deposited directly into your checking or savings account. This is a much faster and more 

secure way to receive reimbursement. To obtain the Direct Deposit Sign-Up Form 1199A, 

go to https://www.dol.gov/owcp/energy/regs/compliance/EEOICPForms/SF1199A.pdf. 

CAN DEEOIC REVIEW MY HOME AND RESIDENTIAL HEALTH CARE 

AUTHORIZATION AT ANY TIME?

Yes. We can review HRHC billing authorizations at any time.

WHOM DO I CONTACT FOR HELP WITH MY HOME AND RESIDENTIAL 

HEALTH CARE BENEFITS? 

Contact DEEOIC’s Branch of Medical Benefits, Medical Benefits Adjudication Unit, by 

telephone at 1-888-805-3389 or by mail at: 

U.S. Department of Labor OWCP/DEEOIC

PO Box 8306

London, KY 40742-8306
U.S. DEPARTMENT OF LABOR dol.gov/agencies/owcp/energy

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 7

Cleveland District Office

1240 East Ninth Street

Room 851

Cleveland, OH 44199

Telephone: 216-802-1300

Toll-Free: 1-888-859-7211

Fax: 216-802-1308

Denver District Office

PO Box 25601

One Denver Federal Center, Bldg. 53

Denver, CO 80225-0601 Telephone: 

720-264-3060

Toll-Free: 1-888-805-3389

Fax: 720-264-3099

Jacksonville District Office

400 W Bay St

Room 722

Jacksonville, FL 32202

Telephone: 904-357-4705

Toll-Free: 1-877-336-4272

Fax: 904-357-4704

Seattle District Office

300 5th Ave

Suite 1210

Seattle, WA 98104-2397

Telephone: 206-373-6750

Toll-Free: 1-888-805-3401

Fax: 206-224-1216

DEEOIC

District Offices
U.S. DEPARTMENT OF LABOR | dol.gov/agencies/owcp/energy

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION 8

DEEOIC has established 11 Resource Centers nationwide to assist employees and their 

families apply for benefits under the EEOICPA. If you need help with any part of your 

EEOICPA claim, including the medical billing process, you may contact one of the Resource 

Centers. They can help in-person or over the telephone, regardless of where you live. You 

should contact the Resource Center in the state of your last claimed employment. The list 

below shows the Resource Centers and the states they cover:

DEEOIC

Resource 

Centers and 

Regional 

Jurisdiction

California Resource Center

7027 Dublin Blvd

Suite 150

Dublin, CA 94568

Telephone: 925-606-6302

Toll-Free: 1-866-606-6302

Fax: 925-606-6303

California, Hawaii

Denver Resource Center

8758 Wolff Ct

Suite 101

Westminster, CO 80031

Telephone: 720-540-4977

Toll-Free: 1-866-540-4977

Fax: 720-540-4976

Colorado, Iowa, Kansas, Nebraska, 

Oklahoma, Wyoming

Española Resource Center

412 Paseo De Onate

Suite D

Española, NM 87532

Telephone: 505-747-6766

Toll-Free: 1-866-272-3622

Fax: 505-747-6765

New Mexico, Texas

Oak Ridge Resource Center

800 Oak Ridge Turnpike

Suite C-103

Oak Ridge, TN 37830

Telephone: 865-481-0411

Toll-Free: 1-866-481-0411

Fax: 865-481-8832

Alabama, Arkansas, Louisiana, 

Mississippi, Tennessee, Virginia

Hanford Resource Center

303 Bradley Blvd

Suite 206

Richland, WA 99352

Telephone: 509-946-3333

Toll-Free: 1-888-654-0014

Fax: 509-946-2009

Alaska, Oregon, Washington

Idaho Resource Center

1820 E 17th St

Suite 250

Idaho Falls, ID 83404

Telephone: 208-523-0158

Toll-Free: 1-800-861-8608

Fax: 208-557-0551

Idaho, Montana, North Dakota, 

SouthDakota, Utah

Las Vegas Resource Center

1050 E Flamingo Rd

Suite W-156

Las Vegas, NV 89119

Telephone: 702-697-0841

Toll-Free: 1-866-697-0841

Fax: 702-697-0843

Arizona, Nevada

New York Resource Center

6000 N Bailey Ave

Suite 2A, Box #2

Amherst, NY 14226

Telephone: 716-832-6200

Toll-Free: 1-800-941-3943

Fax: 716-832-6638

Connecticut, Delaware, Maine, 

Maryland, Massachusetts, 

NewHampshire, New Jersey, New York, 

Pennsylvania, Rhode Island, Vermont

Portsmouth Resource Center

3612 Rhodes Ave

New Boston, OH 45662-4935 

Telephone: 740-353-6993

Toll-Free: 1-866-363-6993

Fax: 740-353-4707

Ohio, Michigan, Minnesota, 

PuertoRico, West Virginia, Wisconsin

Savannah River Resource 

Center

1708-B Bunting Dr

North Augusta, SC 29841

Telephone: 803-279-2728

Toll-Free: 1-866-666-4606

Fax: 803-279-0146

Florida, Georgia, North Carolina, 

South Carolina

Paducah Resource Center 

125 Memorial Center

Paducah, KY 42001

Telephone: 270-534-0599

Toll-Free: 1-866-534-0599

Fax: 270-534-8723

Illinois, Indiana, Kentucky, Missouri