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Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act

This form is a Claim for Reimbursement of Benefit Payments and Claims Expenses under the War Hazards Compensation Act. It is provided by the U.S. Department of Labor, Office of Workers’ Compensation Programs. The claim is made by an insurance carrier or self-insured for reimbursement of benefits paid in discharge of their liability and for claims expenses under applicable workers' compensation law or contracts. The form requires identifying information of the employee, beneficiary, and address, as well as details of the benefits paid and claimed expenses. The insurance carrier or self-insurer agrees to abide by OWCP rules, permit examination of records, reimburse OWCP if employee recovers damages in a third-party suit, and disclaims any right to claim for war-risk hazard reimbursement. Instructions specify where to mail the form with attached supporting documents, complete every item on the form, list all expenses, indicate the basis for paying the claim, and attach relevant papers as exhibits.

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ABOUT

Department of Labor (DOL) Forms

Form CA-278 is one of the official forms that are used by the United States Department of Labor and its various agencies to collect information, administer programs, and enforce labor-related laws and regulations. The Department of Labor is a federal executive department responsible for promoting and protecting the welfare of workers, ensuring fair employment practices, and overseeing various aspects of labor and employment in the United States.

Here are some examples of Department of Labor forms:

Employment Eligibility Verification (Form I-9): While administered by the U.S. Citizenship and Immigration Services (USCIS), Form I-9 is often associated with the Department of Labor. It is used by employers to verify the identity and employment eligibility of individuals hired for employment in the United States.

Family and Medical Leave Act (FMLA) Forms: The DOL's Wage and Hour Division administers the FMLA, and various forms are used to implement and comply with the provisions of this federal law, including the Certification of Health Care Provider form and the FMLA Notice of Eligibility and Rights & Responsibilities form.

Occupational Safety and Health Administration (OSHA) Forms: OSHA, a division of the DOL, requires certain employers to maintain records of workplace injuries and illnesses using forms such as OSHA Form 300, OSHA Form 300A, and OSHA Form 301.

Unemployment Insurance Forms: The DOL's Employment and Training Administration oversees the Unemployment Insurance (UI) program, and various forms are used by state workforce agencies to administer and process UI benefits claims.

Wage and Hour Compliance Forms: The DOL's Wage and Hour Division enforces various labor laws, including the Fair Labor Standards Act (FLSA) and the Family and Medical Leave Act (FMLA). Employers may be required to use specific forms to maintain compliance with these laws, such as records of hours worked, wage rates, and other related information.

These examples represent some common categories of Department of Labor forms, but there are many other forms used by the DOL and its various agencies to carry out their responsibilities related to labor and employment. The specific forms required may vary depending on the program, regulation, or enforcement action involved. It's advisable to visit the official website of the U.S. Department of Labor (www.dol.gov) or consult with the relevant DOL agencies or legal professionals to obtain accurate and up-to-date information regarding the specific DOL forms relevant to your labor-related needs or compliance requirements.

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