Claim Form

• Legal Form Number: 402(a)(2)
• Section: Office of Congressional Workplace Rights (United States)

Office of Congressional Workplace Rights

John Adams Building, 110 Second Street, SE, Room LA-200 | Washington, DC 20540 -1999

(202) 724-9250 (O) | (202) 426-1913 (F)

ocwr.gov

OCWR ADR Claim Form 402(a)(2)07/2023

Office of Congressional Workplace Rights

Administrative Dispute Resolution Claim Form

Instructions

You may use this form to file a cl aim with the Office of Congressional Workplace Rights

(OCWR). Claims mustallege violation(s) of the Congressiona l Ac countability Act

(CAA). 2 U.S.C. § 1302(c ); 2 U.S.C. §§ 1311-1317.

TheOCWR'srole in theclaimsprocess is to be a neutralfact-finder. The OCWR does

not act as an advo cate for any part y during the process.

YouhavetherighttoconsultwithanOCWRConfidentialAdvisortodiscussyour

concernspriortosubmittingaclaim.TheConfidentialAdvisorisanexperienced

employmentlawattorneywithbroadknowledgeofthelawsappliedbytheCAA.The

Confidential Advisor may discuss your workplace concerns with you and inform you of your

rights under the CAA,and the OCWR’sadministrativedispute resolution (ADR) procedures

to resolve claims. If you are not represented by an attorney, the Confidential Advisoralso may

help you drafta claim. The Confidential Advisor may not represent any party in any proceeding.

The services of the Confidential Advisor are provided on a privileged and confidential basis.

If you would like to request the assistance of the Confidential Advisor, please contact the

OCWR at (202) 724-9250 or send an e-mail to ConfidentialAdvisor@ocwr.gov.

Filing and Submission

A claim alleging a violation of the CAAmust be filed no later than 180 days after the date

of the incident.At the time of the alleged violation(s), youmust have beenan employee,

a former employee, applicant, intern, detailee, or fellow of a legislative branch employing office

covered by the CAA.

After you have submitted your claim form, an electronic copy will be available to you in your

secure claim folder created by the OCWR on itsonline platform. The OCWR will provide

you a link to your secure claim folder via e -mail.