OWCP Form 915 is the U.S. Department of Labor form for claimants seeking reimbursement of out-of-pocket medical treatment, prescription, medical-supply, or appliance costs related to an accepted condition. Use a separate form for each provider, attach the required itemized provider or pharmacy bill and proof of payment, and use Form OWCP-957—not OWCP-915—for medical-travel reimbursement.
What is OWCP Form 915?
The current Department of Labor form is titled “Claim for Medical Reimbursement.” It is Form OWCP-915, revised December 2025, with an expiration date of July 31, 2027. The Department of Labor’s forms page identifies OWCP-915 as the replacement for the former CA-915.
The form is for a claimant who personally paid an eligible medical expense and is asking OWCP to reimburse that payment. It is not a provider bill, a request for travel reimbursement, or a guarantee that OWCP will approve the expense.
When should a claimant use OWCP-915?
The current form says it may be used for out-of-pocket costs for medical treatment, prescription medication, medical supplies, or appliances that pertain to treatment of an accepted condition. Current 20 CFR 10.802 similarly addresses bills the employee paid for medical, surgical, or dental services, supplies, or appliances due to an injury sustained in the performance of duty.
The expense must satisfy the applicable OWCP program requirements. A completed form does not establish that a condition is accepted, that a service was authorized, or that the full amount paid will be reimbursed.
OWCP-915 is not for travel reimbursement
Current 20 CFR 10.802(h) directs employees seeking reimbursement for transportation costs, wage loss, or incidental expenses related to medical treatment to Form OWCP-957. NuThera’s OWCP travel-reimbursement guide explains the separate OWCP-957 process.
What information does the form request?
OWCP-915 asks for the claimant’s name, mailing address, telephone number, OWCP file number, provider name, a description of the expense, date of service, amount paid, and the total reimbursement requested. The claimant signs and dates the certification.
The form also directs claimants to submit a separate reimbursement claim for each provider. Keeping each provider’s expenses, billing form, and proof of payment together makes the request easier to review.
Documents for physician or facility expenses
For non-prescription medical expenses, the current OWCP-915 instructions call for the completed reimbursement form plus the appropriate itemized provider bill. Physicians and other health care professionals use Form OWCP-1500 or CMS-1500; hospitals and facilities use Form OWCP-04 or UB-04.
Current 20 CFR 10.802 requires the provider-prepared bill to identify the diagnosed condition and applicable diagnosis code, the service performed, the applicable service code, and a brief narrative description—or a detailed description when no code applies. The regulation says OWCP may deny a request that lacks the required code or description, with correction and resubmission required.
Documents for prescription reimbursement
For prescription expenses, the current form instructs the claimant to attach a paper pharmacy billing form. That pharmacy record should include the pharmacy’s name, address, telephone number, and provider number; the prescription number; the claimant’s name; the purchase date; the 11-digit National Drug Code; whether the prescription was new or a refill; the quantity; and the amount paid.
The prescription request also needs proof that the claimant paid the expense. A cash-register receipt by itself may not contain all of the pharmacy billing data required by the form.
What counts as proof of payment?
Current 20 CFR 10.802 requires evidence that the provider received payment and a statement of the amount paid. Examples in the regulation include a signed provider statement, a receipt stamp, both sides of a canceled check, a credit-card receipt, or a form showing a zero balance.
- Match the proof of payment to the provider, date of service, and amount requested.
- Keep the itemized provider or pharmacy bill with the related proof of payment.
- Retain a copy of the completed OWCP-915 and every attachment.
- Do not combine expenses from different providers on one reimbursement form.
How long does a claimant have to submit the bill?
Current 20 CFR 10.803 uses a calendar-year rule. OWCP will not pay a bill submitted 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 OWCP first accepted the claim as compensable, whichever is later.
That formula can produce different dates depending on the service year and acceptance year. Claimants should organize and submit complete requests promptly rather than relying on the outside limit.
Why reimbursement may be less than the amount paid
Under 20 CFR 10.802(d) and (e), reimbursement generally may not exceed OWCP’s maximum allowable charge. If the claimant paid more than that amount, OWCP may reimburse only part of the expense and advise the claimant about seeking a refund or credit from the provider.
This is one reason to avoid describing an OWCP-915 submission as a guaranteed repayment. Acceptance of the underlying condition, the relationship of the expense to that condition, documentation, timeliness, and applicable payment limits all matter.
Before submitting OWCP-915: a practical checklist
- Confirm that the expense concerns treatment, medication, supplies, or an appliance related to an accepted condition.
- Use the current OWCP-915 form and complete the claimant, provider, service, payment, and certification fields.
- Prepare a separate OWCP-915 for each provider.
- Attach the appropriate itemized provider or pharmacy billing form.
- Attach proof that the provider or pharmacy received payment and the amount paid.
- Check that names, dates, codes, amounts, and the OWCP file number are consistent across the form and attachments.
- Keep a complete copy and submit the package to the destination specified for the applicable OWCP program.
How NuThera supports medical documentation
NuThera provides clinical evaluation and documentation for the care it delivers. The clinical record may include the reported work-injury history, examination findings, diagnosis, treatment, work status, and medically reasoned opinions when supported by the evaluation. NuThera does not decide claim acceptance, reimbursement eligibility, or the amount OWCP will pay.
Patients can also use the NuThera OWCP resource center and OWCP forms directory, or review the Las Vegas and North Las Vegas clinic pages for local information.
Sources
- U.S. Department of Labor, Form OWCP-915, Claim for Medical Reimbursement, revised December 2025, expires July 31, 2027; accessed October 1, 2026.
- U.S. Department of Labor, DFEC forms page, OWCP-915 listing and CA-915 replacement notation; accessed October 1, 2026.
- Electronic Code of Federal Regulations, 20 CFR 10.801–10.803, Title 20 up to date September 28, 2026 and last amended September 16, 2026; accessed October 1, 2026.
- U.S. Department of Labor, OWCP forms update notice for OWCP-915; accessed October 1, 2026.
This article is educational and does not provide individualized medical, legal, benefits, or reimbursement advice.
Keep exploring.
- NuThera OWCP resource center
OWCP care and documentation resources for federal employees.
- OWCP forms directory
Official forms and NuThera’s form-by-form educational guides.
- OWCP-957 travel reimbursement guide
Learn about the separate form used for medical-travel reimbursement.
- NuThera — Las Vegas
Clinic information for NuThera’s Las Vegas location.
- NuThera — North Las Vegas
Clinic information for NuThera’s North Las Vegas location.
Common questions.
What is OWCP Form 915 used for?
OWCP-915 is used by a claimant seeking reimbursement for eligible out-of-pocket medical treatment, prescription, medical-supply, or appliance costs related to an accepted condition. The request needs the required billing documentation and proof of payment.
Does OWCP-915 replace Form CA-915?
Yes. The Department of Labor’s current forms page identifies OWCP-915 as the replacement for CA-915.
Can I use OWCP-915 for mileage or medical travel?
No. Current 20 CFR 10.802(h) directs transportation, wage-loss, and incidental-expense reimbursement related to medical treatment to Form OWCP-957.
Do I need proof that I paid the expense?
Yes. Current 20 CFR 10.802 requires evidence that the provider received payment and a statement of the amount paid. Examples include a signed provider statement, receipt stamp, canceled check, credit-card receipt, or zero-balance form.
What provider bill should accompany OWCP-915?
Professional services generally require an itemized OWCP-1500 or CMS-1500 prepared by the provider. Hospital or facility services generally require OWCP-04 or UB-04. Prescription reimbursement requires the pharmacy billing information specified by the current form.
Can expenses from several providers go on one OWCP-915?
No. The current form instructs claimants to submit a separate reimbursement claim for each provider.
How long do I have to submit a medical bill?
Current 20 CFR 10.803 bars payment when a bill is submitted more than one year beyond the end of the calendar year of the expense or service, or more than one year beyond the end of the calendar year in which OWCP first accepted the claim, whichever is later.
Does submitting OWCP-915 guarantee full reimbursement?
No. Reimbursement depends on the applicable OWCP requirements, including the accepted condition, documentation, timeliness, and payment limits. The fee schedule may limit reimbursement to less than the amount paid.