Claim Form

Legal Form Number402(a)(2)
SectionOffice 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 ADR Claim Form 402(a)(2) 07/2023
Office of Congressional Workplace Rights
Administrative Dispute Resolution Claim Form
You ma y us e th is form to file a cl aim with t he Office of Con gre ssi ona l W ork pla ce Rights
(OC WR) . Cla ims m ust alle ge vi ola tio n(s) of th e Con gre ssi ona l Ac countabilit y Act
(CA A). 2 U.S .C. § 1302(c ); 2 U.S .C. §§ 1311 -1317.
The OCWR's rol e in the cla ims pro ces s is to b e a neut ral fac t- fin der . The OCWR does
not ac t a s a n a dvo cate f or any p art y duri ng the proc ess .
You hav e th e ri ght to consul t wi th a n OCWR Con fid ent ial Adv is or to dis cus s yo ur
concer ns p rio r to su bmi tti ng a c laim. The Co nfi den tia l Advisor is a n ex per ien ced
emp loyme nt law att orn ey w ith bro ad kno wle dge of t he l aws app li ed by t he C AA. The
Confidential Advisor may discuss your workplace concerns with you and inform you of your
rights under the CAA, and the OCWR’s administrative dispute resolution (ADR) procedures
to resolve claims. If you are not represented by an attorney, the Confidential Advisor also may
help you draft a 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 .
Filing and Submission
A claim alleging a violation of the CAA must be filed no later than 180 days after the date
of the incident. At the time of the alleged violation(s), you must have been an 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 its online platform. The OCWR will provide
you a link to your secure claim folder via e -mail.

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