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Dispute Resolution Forms

The following forms are provided to assist a claimant in pursuing a claim of a violation of sections 201–206 and 208 of the Congressional Accountability Act (CAA), 2 U.S.C. §§ 1311-1317, under the Office of Congressional Workplace Rights (OCWR) Administrative Dispute Resolution (ADR) process. To learn more, visit the Dispute Resolution page.

Once these forms are completed, please print, sign, scan and e-mail the completed form to OCWRefile@ocwr.gov.

Claim Form*

Amended Claim Form

Request for Mediation Form

Notice of Designation of Representative

Filing and Submission:

Please e-mail completed forms to OCWRefile@ocwr.gov; or hand-deliver to Room LA-200, John Adams Building, 110 Second Street SE, Washington, DC 20540-1999; or fax to (202) 426-1913.

The best method for filing a claim with the OCWR is electronically through the OCWR’s Secure Online Claims Reporting and Tracking E-filing System (SOCRATES) web application. The claim form must be filed with the OCWR within 180 days of the date of the alleged violation of the CAA.

Filing the claim form initiates formal proceedings on a claim(s) alleging that the CAA has been violated. Immediately after a claim form is submitted, a copy will be provided to the employing office. Visit the How to File a Claim with the OCWR page to learn more.

A claim can be amended within 15 calendar days after filing of the initial claim either electronically through SOCRATES or a PDF version of the amended claim form.

Please note: The OCWR provides employees the services of a Confidential Advisor. The Confidential Advisor is an experienced employment law attorney with extensive knowledge of the employee protection laws applied by the CAA. The Confidential Advisor may discuss employees’ workplace concerns and inform them of their rights and options under the CAA. The Confidential Advisor also may help employees draft a claim, but may not represent them in any proceeding. The Confidential Advisor will provide these services, at no cost, on a privileged and confidential basis.


*A special claim form must be used by applicants for employment vacancies with employing offices in the legislative branch to file a claim alleging violations(s) of the Fair Chance to Compete for Jobs Act (FCA), which is codified at Section 207 of the Congressional Accountability Act (CAA), 2 U.S.C. § 1316b. The FCA prohibits employing offices from requesting that applicants for most jobs disclose information on their arrest and conviction history before a conditional job offer is made.

 

Occupational Safety and Health

Safety and Health Inspection Request

Legislative branch employees have rights under the CAA ensuring that their workplace is free from health and safety hazards. If there is a suspected health or safety hazard on the Capitol campus or in a district office, an employee may complete the form below and submit it to the OCWR.

Request for Safety and Health Inspection of Employing Office Form 1341

Please e-mail completed forms to OSH@ocwr.gov; or hand-deliver to Room LA-200, John Adams Building, 110 Second Street SE, Washington, DC 20540-1999; or fax to (202) 426-1913.

OSH Self-Certification for District and State Offices Form

The Congressional Accountability Act (CAA) applies provisions of the Occupational Safety and Health Act (OSHAct) to the legislative branch. The OSHAct requires that workplaces be free from recognized hazards that might cause death or serious injury. The Office of Congressional Workplace Rights (OCWR) presents Safety Recognition Awards to those Members of Congress who presented a hazard-free workplace on the date of the OCWR inspection and completed a brief self-certification form regarding basic safety measures for all of their additional district or state offices. The self-certification is voluntary and not required by the CAA. Each district and state office should complete the Safety Inspection Checklist, but only one certification form is required to be submitted for each Member of Congress. The deadline is November 30, 2022. For additional guidance, contact the Office of Congressional Workplace Rights at (202) 724-9250, the House Service Center at (202) 225-4141, or the Senate Service Center at (202) 224-3141.

 

ADA Inspection Request

Members of the public (including legislative branch employees and constituents) have rights under the CAA ensuring that the Capitol Hill complex and district and state offices are accessible to individuals with disabilities in the provision of public services and accommodations established by Titles II and III of the ADA. To request an ADA inspection or to file a charge alleging a violation of the ADA, please complete the form below.

Please e-mail completed forms to ADAaccess@ocwr.gov; or hand-deliver to Room LA-200, John Adams Building, 110 Second Street SE, Washington, DC 20540-1999; or fax to (202) 426-1913.

Request for ADA Inspection Form

 

Fair Chance to Compete (Ban the Box)

The Fair Chance to Compete for Jobs Act of 2019 (FCA), also known as the Federal “Ban the Box” law, prohibits Federal employers, including employing offices in the legislative branch, from requesting that applicants for most jobs disclose information on arrest and conviction history before a conditional job offer is extended to the applicant. This form may be used by applicants for employment vacancies with employing offices in the legislative branch to file a claim with the OCWR alleging violations(s) of the FCA, which is codified at Section 207 of the Congressional Accountability Act, 2 U.S.C. § 1316b.

Please e-mail completed forms to OCWRefile@ocwr.gov.

FCA Claim Form

 

Labor-Management Rights

 
Representation Proceedings

The term “representation proceedings” in labor-management relations usually refers to elections, clarifications of bargaining units, consolidations of bargaining units, and/or decertifications of bargaining units.

For more information about representation proceedings, please see our Labor-Management Relations FAQs.

Please download the appropriate forms for use with OCWR Representation Proceedings:

Petition Form, Form 1351d

Petition Form 1351d is used to request an election; determine eligibility for dues allotment in an appropriate unit without an exclusive representative; and clarify, amend, consolidate, or decertify a bargaining unit.

Notice of Designation of Representative Form, Form 75

Withdrawal Request Form, Form 43

 
Impasse

At the point in the negotiation of conditions of employment where the parties are unable to reach an agreement, despite efforts to do so by direct negotiations and the use of third-party mediation or other arrangement, a party or parties may request the Board consider the matter by filing a request that the Board consider a negotiation impasse or approve a joint request for binding arbitration procedure to resolve a negotiation impasse.

Impasse Services Request Form

 
Unfair Labor Practice Charge 

Section 220 of the Congressional Accountability Act (CAA) prohibits unfair labor practices (ULPs) as set forth in the Federal Service Labor-Management Relations Statute (FSLMRS) at 5 U.S.C. § 7116. If a legislative branch employee, union, or employing office believes that a ULP has occurred, the aggrieved party may file a ULP Charge with the OCWR General Counsel, using the appropriate form below. The OCWR General Counsel is responsible for investigating and prosecuting meritorious ULP Charges as provided in Part 2423 of the OCWR’s labor-management regulations.

Unfair Labor Practice Charge Against an Employing Office, Form 1351c-EO

Unfair Labor Practice Charge Against a Labor Organization, Form 1351c-LO

 

Ergonomics Outreach Program

Office Workspace Ergonomic Self-Evaluation Form

Request for Ergonomic Evaluation Form