[Code of Federal Regulations]

[Title 20, Volume 1]

[Revised as of April 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 20CFR61.101]



[Page 141]

 

                      TITLE 20--EMPLOYEES' BENEFITS

 

                      CHAPTER I--OFFICE OF WORKERS'

                         COMPENSATION PROGRAMS,

                           DEPARTMENT OF LABOR

 

PART 61_CLAIMS FOR COMPENSATION UNDER THE WAR HAZARDS COMPENSATION ACT, 

AS AMENDED--Table of Contents

 

                   Subpart B_Reimbursement of Carriers

 

Sec.  61.101  Filing a request for reimbursement.



    (a) A carrier or employer may file a request for reimbursement. The 

request shall be submitted to the U.S. Department of Labor, Office of 

Workers' Compensation Programs, Branch of Special Claims, P.O. Box 

37117, Washington, DC 20013-7117;

    (b) Each request for reimbursement shall include documentation 

itemizing the payments for which reimbursement is claimed. The 

documentation shall be sufficient to establish the purpose of the 

payment, the name of the payee, the date(s) for which payment was made, 

and the amount of the payment. Copies of any medical reports and bills 

related to medical examination or treatment for which reimbursement is 

claimed shall also be submitted. If the carrier cannot provide copies of 

the payment drafts or receipts, the Office may accept a certified 

listing of payments which includes payee name, description of services 

rendered, date of services rendered, amount paid, date paid check or 

draft number, and signature of certifier.

    (c) When filing an initial request for reimbursement under the Act, 

the carrier shall submit copies of all available documents related to 

the workers' compensation case, including--

    (1) Notice and claim forms;

    (2) Statements of the employee or employer;

    (3) Medical reports;

    (4) Compensation orders; and

    (5) Proof of liability (e.g., insurance policy or other 

documentation).