DOL New Patient Intake
Federal Injury Centers of Upper Darby
Patient Registration & Care

DOL-OWCP Injury Care

The DOL credentialed doctors and OWCP claims experts at Federal Injury Centers in Upper Darby, Pennsylvania, treat injured federal workers in compliance with the Federal Employees Compensation Act (FECA).

  • Complete patient intake & free consultations
  • Receive expert OWCP claims assistance
  • Receive SMS alerts and appointment reminders
  • Stay informed with clinic news and updates

DOL New Patient Intake

Please fill out this form completely prior to your visit.

Section 1 — Patient Information
Section 2 — Contact & Communication
Section 3 — Medical History

Please list the requested information below. Write "None" if not applicable.

Section 4 — Work Injury & Federal Employment
Section 5 — OWCP Claim Status

(*Authorization for Exam/Medical Treatment)

Section 6 — Prior Medical Treatment
Section 7 — Patient Questionnaire

For Traumatic Injuries (CA-1) - Answer Question # 1.
For Repetitive Conditions (CA-2) - Answer Questions # 1-3.

Certifications & Consents

Our Mission & Standards

DOL Doctors

The credentialed DOL doctors at FIC Upper Darby provide excellent medical care, injury rehabilitation, and expert claims assistance.

OWCP Claims

If you file your OWCP forms incorrectly you could lose your benefits. We provide complementary OWCP claims assistance.

Who We Serve

We proudly treat and assist injured employees from the USPS, TSA, VA, DOD, DHS, ICE, BOP, and all other federal agencies.

Win Medical and Rehab, P.C dba Federal Injury Centers of Upper Darby
115 E Township Line Rd, Ste B, Upper Darby Township, PA 19082
Phone: (610) 789-1800
Email: [email protected]
Privacy Policy | Terms of Service

Copyright © Win Medical and Rehab, P.C. All Rights Reserved.

Federal Injury Centers is in no way associated with or affiliated with the United States Department of Labor (DOL) or with OWCP.