What is the purpose of the OWCP‑16 form?

It authorizes the release of medical records, schedules examinations, and approves payment for treatment related to a workers’ compensation claim.

Can I complete OWCP‑16 on a mobile device?

Yes. The Formize PDF Filler is responsive and works on smartphones, tablets, and desktop browsers.

Do I need a PDF editor to fill out OWCP‑16?

No. The online fillable version lets you type directly into the fields without any extra software.

How long does it take for OWCP to process the form?

Processing time varies, but submitting a complete, correctly signed OWCP‑16 can reduce approval time to a few business days.

What if I make a mistake after submitting?

Download the completed PDF, correct the error in the Formize editor, and resend the revised document to the OWCP office.

Is the OWCP‑16 form free to download?

Yes. The official PDF is provided by the U.S. Department of Labor at no cost.

Do I need to attach supporting medical documents?

Attach any relevant medical reports or test results when you submit the completed OWCP‑16 to the OWCP regional office.

Can an attorney fill out the OWCP‑16 on my behalf?

Yes, but the claimant must still provide a signature (digital or handwritten) authorizing the request.

OWCP‑16 Authorization for Examination & Treatment – Fillable PDF

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OWCP‑16 Authorization for Examination & Treatment – Fillable PDF

The OWCP‑16 (Authorization for Examination and/or Treatment) is the official Department of Labor form used to request payment for medical care after a workplace injury covered by the Office of Workers' Compensation Programs (OWCP). Employers, claimants, and physicians must complete this form to ensure that medical expenses are reimbursed promptly.

What Is the OWCP‑16 Form?

OWCP‑16 authorizes the release of medical records, schedules examinations, and approves treatment costs. It is required for:

Traumatic injuries that need immediate medical attention
Ongoing treatment for occupational diseases
Verification of medical necessity for procedures

Key Sections You Must Complete

Each part of the form collects essential information:

Claimant Information – Name, SSN, injury date, and claim number.
Physician/Provider Details – License number, address, and contact.
Authorization Statement – Specific exams or treatments being requested.
Signature Block – Claimant, physician, and employer signatures.

How to Fill Out the OWCP‑16 Online with Formize

Instead of downloading, printing, and scanning, you can complete the form directly in your browser:

Click the **"Fill out this form"** button below.
The Formize PDF Filler app loads automatically.
Enter the required data into each field. The interface highlights mandatory fields.
Review your entries and press **Submit** to generate a completed PDF.
Save or email the finished document to your OWCP representative.

Common Mistakes to Avoid

Missing Claim Number – OWCP cannot process the request without it.
Illegible Signatures – Use the digital signature tool; handwritten signatures are not accepted in the online version.
Incorrect Dates – Verify the injury date and the date of the requested examination.
Omitting Provider Details – Include full address and license number.

Where to Submit the Completed Form

After you download the completed PDF, send it to the OWCP regional office handling your claim. You can also upload it through the OWCP online portal if you have an account.

Need the original fillable file? Download the OWCP‑16 PDF directly.

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FAQ

What is the purpose of the OWCP‑16 form?
It authorizes the release of medical records, schedules examinations, and approves payment for treatment related to a workers’ compensation claim.
Can I complete OWCP‑16 on a mobile device?
Yes. The Formize PDF Filler is responsive and works on smartphones, tablets, and desktop browsers.
Do I need a PDF editor to fill out OWCP‑16?
No. The online fillable version lets you type directly into the fields without any extra software.
How long does it take for OWCP to process the form?
Processing time varies, but submitting a complete, correctly signed OWCP‑16 can reduce approval time to a few business days.
What if I make a mistake after submitting?
Download the completed PDF, correct the error in the Formize editor, and resend the revised document to the OWCP office.
Is the OWCP‑16 form free to download?
Yes. The official PDF is provided by the U.S. Department of Labor at no cost.
Do I need to attach supporting medical documents?
Attach any relevant medical reports or test results when you submit the completed OWCP‑16 to the OWCP regional office.
Can an attorney fill out the OWCP‑16 on my behalf?
Yes, but the claimant must still provide a signature (digital or handwritten) authorizing the request.

HOW TO

How to fill out OWCP-16 for free, online in 6 easy steps:

1
Open the Fillable Form
Click the “Fill out this form” button on the page. The Formize PDF Filler loads instantly in your browser.
2
Enter Claim Information
Type the claimant’s name, SSN, injury date, and OWCP claim number into the highlighted fields.
3
Provide Provider Details
Add the physician’s name, license number, and contact information exactly as it appears on the provider’s license.
4
Specify the Requested Examination or Treatment
Select the appropriate codes and describe the medical service you are authorizing.
5
Sign and Submit
Use the digital signature tool for claimant, physician, and employer signatures, then click Submit to generate the completed PDF.
6
Save or Email the PDF
Download the finished form or email it directly to the OWCP regional office handling your claim.

ABOUT

Department of Labor (DOL) Forms

OWCP-16 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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