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275 E. Street Road #27, Feasterville, PA, U.S.A.
|OWCP (Office of Workers' Compensation Program) Appeals
|Disclaimer: Forms herein were obtained from various government websites, including OWPC's and are provided herein by courtesy of EEO 21, LLC for
public use. EEO 21, LLC is not responsible for failure to maintain updates or alteration in the form made either by OWCP or by users. Use these
forms at your own peril.
If you disagree with the attached decision, you have the right to request an appeal. If you wish to request an appeal, you should
review these appeal rights carefully and decide which appeal to request.
There are 3 different types of appeal:
Place an "X" on the attached form (RTF or PDF) indicating which appeal you are requesting. Complete the information requested
at the bottom of the form. Place the form on top of any material you are submitting. Then mail the form with attachments to the
address listed for the type of appeal that you select. Always write the type of appeal you are requesting on the outside of the
envelope ("HEARING REQUEST", "RECONSIDERATION REQUEST", or "ECAB REVIEW").
Your appeal rights are as follows:
1. HEARING: If your injury occurred on or after July 4, 1966, and you have not requested reconsideration, as described below, you
may request a Hearing. To protect your right to a hearing, any request for a hearing must be made before any request for
reconsideration by the District Office (5 U.S.C. 8124(b)(1)). Any hearing request must also be made in writing, within 30 calendar
days after the date of this decision, as determined by the postmark of your letter. (20 C.F.R. 10.616).
There are two forms of hearing. You may request either one or the other, but not both.
near your home or by teleconference/videoconference. You may present oral testimony and written evidence in support of
your claim. Any person authorized by you in writing may represent you at an oral hearing. At the discretion of the hearing
representative, an oral hearing may be conducted by teleconference or videoconference.
b. The other form of a Hearing is a Review of the Written Record. This is also conducted by a hearing representative. You
may submit additional written evidence, which must be sent with your request for review. You will not be asked to attend or
give oral testimony.
2. RECONSIDERATION: If you have additional evidence or legal argument that you believe will establish your claim, you may
request, in writing , that OWCP reconsider this decision. The request must be made within one calendar year of the date of the
decision, clearly state the grounds upon which reconsideration is being requested, and be accompanied by relevant evidence not
previously submitted. This evidence might include medical reports, sworn statements, or a legal argument not previously made,
which apply directly to the issue addressed by this decision. In order to ensure that you receive an independent evaluation of the
new evidence, persons other than those who made this determination will reconsider your case. (20 C.F.R. 10.605-610).
3. REVIEW BY THE EMPLOYEES' COMPENSATION APPEALS BOARD (ECAB): If you believe that all available evidence that would
establish your claim has already been submitted, you have the right to request review by the ECAB (20 C.F.R. 10.625). The ECAB
will review only the evidence received prior to the date of this decision (20 C.F.R. Part 501). Effective November 19, 2008, ECAB
has changed its Rules of Procedure on the time limit to appeal and has eliminated its practice of allowing one year to file an
appeal. Request for review by the ECAB must be made within 180 days from the date of this decision. More information on the
new Rules is available at www.dol.gov/ecab.
If you request reconsideration or a hearing (either oral or review of the written record), OWCP will issue a decision that includes
your right to further administrative review of that decision.
Appeal Request Form in RTF or PDF
Other relevant information
EEO 21, LLC can help you with OWCP appeal. Contact Mr. Lee at 215-939-5831 or email him at email@example.com.