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 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 ConfidentialAdvisor@ocwr.gov .

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.