Step-By-Step: How to File an EEOICPA Claim

When you break down the filing process step-by-step, you can minimize any anxiety or feelings of overwhelm associated with the process. As you make your way through these steps, keep in mind you can always connect with AtomicWorkers® to get assistance or support.

Step One: Determine Eligibility

Most former workers are eligible to file; however, your chances for success and approval are primarily driven by answers to the questions listed below. Start with these basic questions to determine your eligibility, and assess whether you should spend the time and energy filing a claim:

  • Did the worker have a defined, diagnosed medical condition? Does your health condition fit the EEOICPA program guidelines?
  • Can you provide a basic or general employment history? Do you have paperwork to back up worker history?
  • How many years did worker work? At which work site?
  • What is/was worker’s job function?

If you can clearly answer these questions, you likely have a legitimate claim to file.

Step Two: Fill Out Paperwork and Submit to the EEOICPA Program

Fundamentally, your claim should be as complete as possible from the start. The right forms, the right supporting evidence. This is not as easy as some people make it sound (“fill out one or two forms and you’ll get your white card”)

Getting your claim organized can be a tedious process, but it is crucial to faster processing and approval. Skipping a form or omitting key required evidence slows the process and may lead to denials.

Step Three: What to Do If Your Claim Is Denied

Finding out the DOL denied your claim can be devastating, but it’s not always the end of the road. Estimates show that the Department denies about 60% of all EEOICPA claims at some point. If you have a denied claim, you can always resubmit with new evidence. It might also be a good idea to connect with the AtomicWorkers team to explore your options. We can take a closer look at your paperwork and provide you with honest, straightforward advice regarding what you can do with your claim.

In many cases, denials are the result of missing or unclear evidence. Perhaps you failed to send in a particular piece of information. Maybe you missed a step in the process. Alternatively, the claimed medical condition may not align with the job function or the medical evidence submitted. When you receive a denial, it is important to review your claim to determine exactly what you need to file again.

Step Four: What to Do After Approval

If your claim was accepted, you are now eligible for 100% medical benefits coverage for ongoing care and treatment of your approved condition. You should determine if your doctor is enrolled in EEOICPA as a medical provider. If your doctor is enrolled, they direct bill the DOL for all related medical expenses. If your doctor is not enrolled, they may be interested to add this program as a benefit for you and other patients. And there are other options for reimbursement.

Medical services EEOICPA may cover include:

  • Home health care
  • Prescription medication
  • Medical co-pays
  • Medical travel
  • Oxygen supplies and other medical devices
  • Health-related housing modifications

Our free guide “EEOICPA Claims in Half the Time” describes each of these steps in more detail, and offers some “Pro Tips” to make sure you get through each stage the right way.

Click Here to Download Our 5-Minute Guide to EEOICPA Claims

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