1 

U.S. Department of Labor 

Office of Workers’ Compensation Programs 

Division of Energy Employees Occupational Illness Compensation 

Frequently Asked Questions Regarding the Division of Energy Employees Occupational 

Illness Compensation’s (DEEOIC) Medical Benefit Authorization Process

This brochure provides information to claimants for whom the DEEOIC has awarded medical benefits under 

the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). An employee who 

meets the legal conditions of coverage is entitled to medical care consisting of services, appliances, supplies, 

and home/vehicle modifications or travel expenses necessary to cure, give relief, or reduce the degree or the 

period of a covered condition. When your claim is accepted, a DEEOIC Medical Benefits Examiner (MBE) 

assigned to your case will work closely with you to ensure proper adjudication of medical benefits under 

EEOICPA. 

WHEN DOES DEEOIC BEGIN COVERING MEDICAL CONDITIONS? 

The EEOICPA provides medical benefits for medical condition(s) accepted in a claim from the day a person 

files a claim for those conditions. 

In addition to an accepted condition, the EEOICPA will cover any consequential illness incurred as a result of 

an accepted condition. A consequential illness is a new and separate medical problem that a doctor identifies 

as having developed due to the original accepted illness. To file a consequential illness, please contact your 

local Resource Center (Contact information below). 

INTRODUCTION 

DEEOIC MEDICAL BENEFITS 

COVERED MEDICAL CONDITIONS 
2 

WHAT TYPE OF MEDICAL BENEFITS ARE COVERED? 

Medical benefits for covered illnesses include reasonable and customary medical care, physician prescribed 

medications, and travel directly associated with the treatment of a covered illness. The following is a list 

of some of the services that are covered: 

 Doctor’s office visits, medical

treatments, and consultations.

 Diagnostic laboratory and

radiological testing.

 Home and Residential Health Care.

 Inpatient and outpatient

hospital charges, including

emergency room visits.

 Drugs prescribed by a

physician, both brand-named

and generic.

 Travel to the doctor, hospital,

clinic, or other medical facility.

 Durable medical equipment.  Ambulance services.

WHO IS THE PRIMARY PAYER FOR MY ACCEPTED MEDICAL CONDITION? 

DEEOIC is the primary payer for all care linked to an accepted illness. Being a primary payer means 

DEEOIC is responsible for covering the cost of treatment of your accepted illness. However, you must 

submit costs linked to care unrelated to an accepted illness (i.e., any non-covered condition) to other forms 

of medical coverage you may possess, i.e., to your private insurance or to other government health 

programs such as Medicare or Medicaid. 

DEEOIC pays costs associated with the treatment of an accepted medical condition from the EEOICPA 

compensation fund and these costs are subject to a fee schedule. A fee schedule is an agreement under 

which a provider agrees to accept a payment for a medical service at a set rate. For your coverage, 

DEEOIC does not require you to pay a co-payment or deductible. 

HOW WILL DEEOIC PAY MY MEDICAL BILLS?

Providers, claimants, and DEEOIC staff are to send medical bills, bill attachments, treatment notes, and 

requests for claimant reimbursement to the Medical Bill Processing Agent for scanning and keying into 

their system. Providers are to submit bills for covered medical services electronically or mail them to 

the DEEOIC Medical Bill Processing Agent at: 

 Energy Employees Occupational Illness Compensation Program

P.O. Box 8304

London, KY 40742-8304

MEDICAL BENEFITS 

MEDICAL BILL PAYMENTS 
3 

Any medical provider enrolled with DEEOIC will receive payment for services directly. If your physician 

or medical provider has not enrolled with DEEOIC, they may contact the DEEOIC Medical Bill Processing 

Agent or a Resource Center for enrollment information. 

You may also pay for medical services out-of-pocket and then request reimbursement of your expenses. 

HOW DO I LOCATE ENROLLED PROVIDERS?

A provider search feature is available on the Medical Bill Processing Agent’s website at: 

http://owcpmed.dol.gov. 

WILL I RECEIVE A MEDICAL BENEFITS CARD? 

Yes. Once DEEOIC awards you medical benefits, you will receive a DEEOIC Medical Benefits 

Identification Card (MBIC). The MBIC is imprinted with your Name, Case ID Number, Benefits 

Identification Number (BIN), DEEOIC Group ID Number, and the Department of Labor logo. The back of 

the card includes the address to submit bills, and the toll-free customer service numbers that you or your 

provider can call to address any billing questions. The back of the card also identifies the Medical Bill 

Processing Website: http://owcpmed.dol.gov. 

Present the card to your doctor at the time of treatment for your accepted condition(s). If your card is lost 

or destroyed, call DEEOIC’s Medical Bill Processing Agent toll-free at (866) 272-2682 to ask for a 

replacement card. 

HOW DO I CONTACT A RESOURCE CENTER? 

DEEOIC has 11 Resource Centers nationwide to assist employees and their families. If you need help with 

medical benefits or the medical billing process, contact the Resource Center nearest you. Resource Center 

staff can provide assistance in person or over the telephone. 

California Resource Center 

7027 Dublin Blvd., Suite 150 

Dublin, California 94568 

Telephone: (925) 606-6302 

Fax: (925) 606-6303 

Toll Free: (866) 606-6302 

California, Hawaii

New York Resource Center 

6000 North Bailey Avenue 

Suite 2A, Box #2 

Amherst, New York 14226 

Telephone: (716) 832-6200 

Fax: (716) 832-6638 

Toll Free: (800) 941-3943 

Connecticut, Delaware, Maine, Maryland, 

Massachusetts, New Hampshire, New Jersey, New 

York, Pennsylvania, Rhode Island, Vermont 

MEDICAL BENEFITS IDENTIFICATION CARD 

DEEOIC RESOURCE CENTERS 
4 

Denver Resource Center 

8758 Wolff Court, Suite 101 

Westminster, Colorado 80031 

Telephone: (720) 540-4977 

Fax: (720) 540-4976 

Toll Free: (866) 540-4977 

Colorado, Iowa, Kansas, Nebraska, Oklahoma, 

Wyoming

Espanola Resource Center 

412 Paseo De Onate, Suite "D" 

Espanola, NM 87532 

Telephone: (505) 747-6766 

Fax: (505) 747-6765 

Toll Free: (866) 272-3622 

New Mexico, Texas 

Hanford Resource Center 

303 Bradley Blvd., Suite 206 

Richland, WA 99352 

Telephone: (509) 946-3333 

Fax: (509) 946-2009 

Toll Free: (888) 654-0014 

Alaska, Oregon, Washington 

Idaho Resource Center 

Exchange Plaza 

1820 East 17th Street, Suite 250 

Idaho Falls, ID 83404 

Telephone: (208) 523-0158 

Fax: (208) 557-0551 

Toll Free: (800) 861-8608 

Idaho, Montana, North Dakota, South Dakota, Utah 

Oak Ridge Resource Center 

Jackson Plaza Office Complex 

800 Oak Ridge Turnpike, Suite C-103 

Oak Ridge, TN 37830 

Telephone: (865) 481-0411 

Fax: (865) 481-8832 

Toll Free: (866) 481-0411 

Alabama, Arkansas, Louisiana, Mississippi, 

Tennessee, Virginia 

Paducah Resource Center

Barkley Center 

125 Memorial Center

Paducah, KY 42001 

Telephone: (270) 534-0599 

Fax: (270) 534-8723 

Toll Free: (866) 534-0599 

Illinois, Indiana, Kentucky, Missouri 

Portsmouth Resource Center 

3612 Rhodes Ave

New Boston, OH 45662-4935 

Telephone: (740) 353-6993 

Fax: (740) 353-4707 

Toll Free: (866) 363-6993 

Ohio, Michigan, Minnesota, Puerto Rico, West 

Virginia, Wisconsin 

Savannah River Resource Center 

1708-B Bunting Drive 

North Augusta, SC 29841 

Telephone: (803) 279-2728 

Fax: (803) 279-0146 

Toll Free: (866) 666-4606 

Florida, Georgia, North Carolina, South 

Carolina 

Las Vegas Resource Center 

Flamingo Grand Plaza 

1050 East Flamingo Road, Suite W-156 

Las Vegas, NV 89119 

Telephone: (702) 697-0841 

Fax: (702) 697-0843 

Toll Free: (866) 697-0841 

Nevada, Arizona 
5 

WHEN SHOULD I REQUEST PRE-APPROVAL OF A MEDICAL EXPENSE? 

The following expenses require review and approval by your Medical Benefits Examiner (MBE) before 

you or your provider submit a reimbursement request or a bill. 

 Overnight travel for medical treatment of the accepted condition(s) (each occurrence)

 Travel for medical treatment of the accepted condition(s) if the mileage exceeds 200

miles round trip (each occurrence)

 Companion travel to a medical appointment

 Home health care services (in-home nursing)

 Rehabilitative Therapy

o Physical Therapy

o Occupational Therapy

o Speech Therapy

 Nursing home or assisted living facility

 Hospice care

 Psychiatric treatment

 Chiropractic treatment

 Acupuncture treatment

 Special equipment as prescribed by your treating physician

 Durable medical equipment

 Any health or gym facility membership

 Home exercise equipment

 Home renovations

 Automobile modifications

 Organ or stem cell transplants

 Medical documentation retrieval

Your assigned MBE reviews requests for these services to establish medical necessity in treating or 

relieving the effects of your accepted work related illness. In most cases, the MBE will work directly 

with you and your doctor to obtain the information necessary to authorize a request for these services. 

PRE-APPROVAL MAY BE REQUIRED FOR SOME MEDICAL EXPENSES 
6 

WHAT IS THE PROCESS IF I AM REQUESTING HOME HEALTH CARE, NURSING 

HOME, OR ASSISTED LIVING FOR THE FIRST TIME? 

If you are requesting Home Health Care, Nursing Home, or Assisted Living benefits directly related to 

your DEEOIC accepted condition(s) and ordered by your treating physician, you must submit Form EE17A to your Medical Benefits Examiner, and your treating physician must submit Form EE-17B along 

with documentation in support of your request for these benefits. For assistance, please contact your 

local Resource Center. The forms are available online at: 

https://www.dol.gov/owcp/energy/regs/compliance/EEOICPForms/ee-17a.pdf

https://www.dol.gov/owcp/energy/regs/compliance/EEOICPForms/ee-17b.pdf

HOW DOES DEEOIC REIMBURSE FOR OUT-OF-POCKET MEDICAL EXPENSES FOR 

COVERED MEDICAL CARE? 

To obtain reimbursement for out-of-pocket medical expenses for covered medical care, complete 

Form OWCP-915, Claim for Medical Reimbursement. The form is available online at: 

https://www.dol.gov/owcp/dfec/regs/compliance/OWCP-915.pdf In addition, you must submit the following 

items, which are to be attached securely to the form: 

 A copy of your provider’s itemized billing statement to include a description of services and

clear receipt of payment.

 Evidence of your method of payment. Acceptable evidence of payment includes a cash

receipt, copy of your cancelled check (both front and back), or a copy of your credit card

receipt.

You may include up to eight (8) visits or services on a single form for reimbursement, as long as you 

receive services by the same medical provider. You must be sure to complete each entry on the form 

completely. If you have receipts, you may mark the entry, “See Attached” and then submit the receipts 

with the form. 

When seeking reimbursement involving multiple providers, you must complete a separate form for each 

medical provider. 

Mail the completed Claim for Medical Reimbursement form, with attachments, to the Medical Bill 

Processing Agent at: 

 Energy Employees Occupational Illness Compensation Program

P.O. Box 8304

London, KY 40742-8304

INITIAL REQUESTS FOR HOME HEALTH CARE, NURSING HOME, OR ASSISTED LIVING 

REQUIRE SUBMISSION OF FORMS EE-17A and EE-17B 

REIMBURSEMENT OF MEDICAL EXPENSES 
7 

SHOULD I KEEP COPIES OF THE BILLS I SUBMIT? 

Yes. Always keep copies of your bills and receipts submitted so that you have a record of your 

reimbursement request(s). 

ARE THERE TIME LIMITS FOR THE SUBMISSION OF MEDICAL BILLS OR REQUESTS 

FOR REIMBURSEMENT? 

Yes. You must submit bills no more than one year beyond the end of the calendar year in which the 

expense was incurred, or the service or supply was provided; or, more than one year beyond the end of 

the calendar year in which DEEOIC first accepted the claim, whichever is later. DEEOIC pays providers 

and reimburses employees promptly for all bills that are properly submitted on an approved form and 

which are submitted in a timely manner. 

You should submit requests for reimbursement by the end of the calendar year after the year when the 

expenses were incurred. For example, if you incurred expenses in 2019, submit your request no later than 

December 31, 2020. 

WHAT MEDICATIONS ARE COVERED? 

DEEOIC will pay for medications that your doctor prescribes to treat an accepted condition. To verify 

that a medication is payable for treating your accepted condition, you or your pharmacist may call the 

Pharmacy Bill Processing Agent toll-free at (866) 664-5581. You will need the 11-digit National Drug 

Code (NDC) for each medication; you can obtain the NDC from your pharmacist. 

HOW DOES THE PHARMACY BILL DEEOIC FOR MY COVERED PRESCRIPTIONS? 

If you have any questions regarding how the pharmacy will bill for your prescriptions, you may call the 

pharmacy helpdesk toll-free at (866) 664-5581. 

WHAT IF MY PHARMACY IS NOT ENROLLED WITH DEEOIC? 

If DEEOIC does not have your pharmacy enrolled, you may pay for your prescription(s) out-of-pocket 

and then submit a request for reimbursement using Form OWCP-915, Claim for Medical Reimbursement. 

TIME LIMITS 

PRESCRIPTION BENEFITS 
8 

HOW DO I GET REIMBURSED FOR OUT-OF-POCKET EXPENSES FOR COVERED 

PRESCRIPTIONS? 

To obtain reimbursement for covered prescriptions, complete Form OWCP-915, Claim for Medical 

Reimbursement. Up to eight prescriptions can be listed on one form if purchased from the same 

pharmacy. If you use more than one pharmacy, submit a separate form for each pharmacy. Each entry 

on the form must be filled in completely. If you need help obtaining or completing this form, you may 

contact one of the Resource Centers. 

In addition to submitting Form OWCP-915, you must submit original pharmacy receipts which are to 

be attached securely to the form. Acceptable receipts include any of the following: 

 Pharmacy bag or sticker containing the payment information for each prescription

 Itemized bill or computer printout of your bill, which includes a clear description of services and/or

each drug prescribed

 Itemized listing of your prescriptions and costs on pharmacy’s letterhead

NOTE: A self-written itemized list or cash register receipt is not considered proof of payment. 

To allow reimbursement, DEEOIC must have the following information 

 Your full name and address

 Date prescription was filled

 Prescription number

 Name of prescribing doctor

 Name and address of pharmacy

 Name of each prescription drug

 11-digit National Drug Code (NDC) number for each prescribed medicine

 Dosage prescribed such as mg per pill or ml or cc per measurement

 Total number of pills or liquid amount per bottle prescribed (quantity)

 Charge actually paid for each drug, after any discount is applied (e.g., senior citizen discount,

coupon, or pharmacy transfer incentive)

 Statement marked “patient paid” or “paid by patient” showing who paid the charge. “Paid” or

“Paid in Full” are not acceptable.

Reimbursement for of out-of-pocket expenses may be subject to an established list of maximum dollar 

allowances for medical services. 

REIMBURSEMENT OF PRESCRIPTION EXPENSES 
9 

HOW DO I OBTAIN REIMBURSEMENT FOR THE COST OF TRAVEL FOR MEDICAL 

TREATMENT? 

If you must travel to obtain medical treatment, DEEOIC will reimburse you for mileage. The 

reimbursement rate for mileage is based on the rate established by the General Services Administration 

(GSA) and can be found on their website at www.gsa.gov. If you travel by privately owned vehicle 

(POV) in a single day and do not exceed 200 miles roundtrip, authorization for travel prior to travel is 

not required. 

Overnight travel, any travel other than by POV, and POV travel that exceeds 200 miles round-trip requires 

authorization from your Medical Benefits Examiner prior to travel. Additionally, if a travel companion is 

required, you must obtain authorization from your Medical Benefits Examiner prior to travel. Upon 

authorization, which may cover multiple trips, DEEOIC will send you an approval letter and further 

information. 

DEEOIC can reimburse overnight travel, lodging, plus meals and incidental expenses (M&IE) according 

to the federal government per diem rate, which is based on the travel location. The per diem rates can be 

found on the GSA website at www.gsa.gov. Reimbursement for lodging will not exceed the daily federal 

government per diem rate. 

The reimbursement for M&IE is based on a daily, flat-rate allowance for each day of authorized travel. 

The first and last days of travel are reimbursed at 75% of the M&IE allowance. If DEEOIC approves your 

companion travel request, we will also pay an additional daily allowance for your travel companion. 

Local transportation costs, such as taxis, airport shuttles, or bus fares are reimbursable separately from the 

M&IE allowance. Services such as airport or hotel courtesy shuttles should be used when available. 

To obtain reimbursement for covered travel expenses, complete Form OWCP-957, Medical Travel Refund 

Request. The form is available online at: https://www.dol.gov/owcp/dfec/regs/compliance/OWCP957.pdf. You can list up to three single days of travel on each form. You must submit lodging receipts and

receipts for reimbursement of any allowable expense of $75 or more with your travel reimbursement

request. Receipts are always required, regardless of amount, for lodging, airfare, rental cars, and gasoline

purchases for rental cars. Mail the completed Medical Travel Refund Request, with the required receipts

securely attached to the form, to the Medical Bill Processing Agent at:

Energy Employees Occupational Illness Compensation Program

P.O. Box 8304

London, KY 40742-8304

REIMBURSEMENT OF TRAVEL EXPENSES FOR MEDICAL TREATMENT 
10 

HOW LONG DOES IT TAKE TO PROCESS A REIMBURSEMENT REQUEST? 

DEEOIC will process a properly completed reimbursement request within thirty (30) days after it is 

received. 

WILL I BE NOTIFIED IF MY REIMBURSEMENT REQUEST IS NOT COMPLETED 

CORRECTLY? 

Yes. If a reimbursement request form needs your correction or DEEOIC requires additional information, 

the Medical Bill Processing Agent will contact you by telephone. If attempts to reach you by telephone 

are not successful, the form and receipts will be returned to you with a letter of explanation. It is 

important that you make the required corrections and return these materials as soon as possible. Mail the 

corrected reimbursement request forms, with receipts securely attached, to the Medical Bill Processing 

Agent at: 

 Energy Employees Occupational Illness Compensation Program

P.O. Box 8304

London, KY 40742-8304

If you need assistance with completing the reimbursement request, contact one of the DEEOIC Resource 

Centers. 

HOW WILL I KNOW IF MY REIMBURSEMENT REQUEST HAS BEEN PAID? 

You will receive a Remittance Voucher (RV) by mail that will notify you once DEEOIC has processed 

your reimbursement for payment. A Remittance Voucher will contain the following information: 

 Remittance Voucher number (RV No.)

 Reference number

 Date paid

 Description and amount of your reimbursement request

 Amount you will be paid

NOTE: You will not receive a Remittance Voucher if your medical provider directly billed the 

Department of Labor. 

If you have a question about a Remittance Voucher or a reimbursement amount, please contact a 

Resource Center or the DEEOIC Medical Bill Processing Agent. 

HOW IS MY REIMBURSEMENT PAYMENT MADE? 

Reimbursement for out-of-pocket expenses, such as qualified medical bills and medical travel expenses, is 

payable via paper check. A check will be issued by the U.S. Department of the Treasury and mailed 

separately from the Remittance Voucher. You should receive the check within fourteen (14) days after 

you receive the Remittance Voucher. In accordance with Department of the Treasury regulations, 

individuals requesting payment by check can only be approved under limited circumstances, and upon 

written request from the payee. 

PROCESSING A REQUEST FOR REIMBURSEMENT 
11 

Electronic Funds Transfer (EFT) is offered as the preferred payment method. EFT is available for deposit 

directly into your checking or savings account. EFT is a much faster and more secure way to receive 

reimbursement compared to paper checks. DEEOIC strongly encourages beneficiaries to select EFT as 

the preferred payment method. To obtain the Direct Deposit Sign-Up Form 1199A go online 

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

WHAT HAPPENS IF MY REIMBURSEMENT REQUEST IS DENIED? 

If DEEOIC has to deny a reimbursement, it will provide an explanation of benefits at the bottom of the 

Remittance Voucher sent to you and it will explain why DEEOIC had to reject any portion of the 

reimbursement request. 

ARE COVERED SURVIVORS ENTITLED TO MEDICAL BENEFITS? 

In an accepted claim filed by a survivor, where the claim was originally filed by the employee, medical 

benefits can be awarded for the accepted condition(s) for medical expenses incurred by the employee 

from the date the employee filed the claim to the date of death of the employee. 

In this scenario, a survivor may file a request for reimbursement of out-of-pocket expenses incurred by 

the employee for medical treatment and prescriptions for the accepted illness. Submit Form 

OWCP-915, Claim for Medical Reimbursement, along with the appropriate documentation. DEEOIC 

will then issue payment to the estate of the deceased employee. 

WILL THE OUTSTANDING MEDICAL EXPENSES BE PAID TO A MEDICAL PROVIDER? 

If a medical expense for treatment of an accepted illness(s) was incurred during the covered period, and 

it remains outstanding with a medical provider who is enrolled in the program, the medical provider 

may submit the bill for payment to the Medical Bill Processing Agent. To be considered for payment, 

bills and requests for reimbursement must be submitted by the end of the calendar year after the year 

when the claim was first accepted as compensable by the Department of Labor. 

MEDICAL BENEFITS FOR CLAIMS FILED BY SURVIVORS 
12 

HOW DO I CONTACT THE BILL PROCESSING AGENT? 

MEDICAL BILL PROCESSING AGENT 

Mailing address: 

Energy Employees Occupational Illness 

Compensation Program 

P.O. Box 8304

London, KY 40742-8304

Toll-free telephone number: (866) 272-2682 

Customer Service Agents are available MondayFriday, 8:00 a.m. to 8:00 p.m. (ET) 

Website: http://owcpmed.dol.gov

PHARMACY BILL PROCESSING AGENT 

Mailing address:

Department of Labor Pharmacy Bill Processing, 

DEEOIC 

P.O. Box 8310 

London, KY 40742-8310 

Toll-free telephone number: (866) 664-5581 

Customer Service Agents are available MondayFriday, 8:00 a.m. to 8:00 p.m. (ET) 

Website: http://owcprx.dol.gov

IF I CHANGE MY MAILING ADDRESS, WHO SHOULD I NOTIFY? 

Any changes in your mailing address must be reported in writing to the following address: 

 U.S. Department of Labor

DEEOIC Central Mailroom

P.O. Box 8306

London, KY 40742-8306

You may also upload change-of-address information directly to the Energy Document Portal at: 

https://eclaimant.dol-esa.gov. 

ATTACHMENTS 

 Sample EEOICP Medical Identification Card

 Sample Medical Reimbursement Form - OWCP-915 (Office Visit)

 Sample Medical Reimbursement Form - OWCP-915 (Prescriptions)

 Sample Pharmacy Receipt & Proof of Payment

 Sample Medical Travel Refund Request Form - OWCP-957

 Sample Remittance Voucher

 Sample How to Read Your Remittance Voucher

CONTACT INFORMATION 
Sample DEEOIC Medical Identification Card 

Front 

Back 
Sample Medical Reimbursement Form (OWCP-915) – Office Visit 
Sample Medical Reimbursement Form (OWCP-915) – Prescriptions 
Sample Pharmacy Receipt 

Sample Pharmacy Proof of Payment 

Thank you very much!

Patient Paid RPh

$7.99

RX 9166, Refill 1 time, 15 days

Lasix 20MG Tab SA

NDC: 00039‐0067‐10

QTY: 15

Tunnelsport Drug

345 Main Street, Tunnelsport PA 16600

(814) 999‐0123

Smith, Charles Date: 04/15/2015

319 Jefferson Drive Dr. J. C. Wazab

Tunnelsport, PA 16600

999‐99‐9999
Sample Travel Refund Request Form (OWCP-957) 
SAMPLE REMITTANCE VOUCHER