import { chromium } from 'playwright';
const browser = await chromium.launch();
const page = await browser.newPage();
// Navigate to OWCP system
await page.goto('https://www.dol.gov/agencies/owcp/FECA/regs/compliance/forms');
// Start new OWCP-915 form
await page.click('[data-testid="new-claim"]');
await page.selectOption('[name="form_type"]', 'owcp_915');
await page.selectOption('[name="claim_type"]', 'medical_benefits');
// Employee information
await page.fill('[name="employee_last_name"]', 'Anderson');
await page.fill('[name="employee_first_name"]', 'Robert');
await page.fill('[name="employee_middle_name"]', 'James');
await page.fill('[name="ssn"]', '123-45-6789');
await page.fill('[name="date_of_birth"]', '04/18/1980');
// Contact information
await page.fill('[name="address"]', '345 Federal Plaza, Apt 7B');
await page.fill('[name="city"]', 'Washington');
await page.selectOption('[name="state"]', 'DC');
await page.fill('[name="zip"]', '20001');
await page.fill('[name="phone_home"]', '202-555-0167');
await page.fill('[name="phone_cell"]', '202-555-0168');
await page.fill('[name="email"]', 'randerson@email.com');
// Employment information
await page.fill('[name="agency_name"]', 'Department of Commerce');
await page.fill('[name="agency_code"]', 'DOC-1300');
await page.fill('[name="employing_office"]', 'Bureau of Economic Analysis');
await page.fill('[name="job_title"]', 'Economic Analyst');
await page.fill('[name="occupation_code"]', 'GS-0110-12');
await page.fill('[name="pay_grade"]', 'GS-12');
await page.fill('[name="step"]', '5');
// Duty station
await page.fill('[name="duty_station_address"]', '4600 Silver Hill Road');
await page.fill('[name="duty_station_city"]', 'Suitland');
await page.selectOption('[name="duty_station_state"]', 'MD');
await page.fill('[name="duty_station_zip"]', '20746');
// Supervisor information
await page.fill('[name="supervisor_name"]', 'Margaret Division Chief');
await page.fill('[name="supervisor_title"]', 'Division Chief');
await page.fill('[name="supervisor_phone"]', '301-555-0145');
await page.fill('[name="supervisor_email"]', 'mdivisionchief@commerce.gov');
// Injury or illness information
await page.fill('[name="injury_date"]', '02/15/2025');
await page.fill('[name="injury_time"]', '10:30 AM');
await page.selectOption('[name="injury_type"]', 'traumatic_injury');
await page.fill('[name="date_disability_began"]', '02/15/2025');
// Location of injury
await page.selectOption('[name="injury_location"]', 'duty_station');
await page.fill('[name="injury_specific_location"]', 'Third floor office, Room 315');
// Nature of injury
await page.selectOption('[name="injury_category"]', 'strain_sprain');
await page.selectOption('[name="body_part"]', 'lower_back');
await page.fill('[name="injury_description"]', 'Lower back strain while lifting heavy box of documents from floor to desk. Immediate sharp pain in lumbar region.');
// How injury occurred
await page.fill('[name="injury_circumstances"]', 'Employee was retrieving archived files from storage boxes. Lifted approximately 40-pound box using improper technique. Felt immediate pain and muscle spasm in lower back. Unable to continue work duties.');
// Witnesses
await page.click('[data-testid="add-witness"]');
await page.fill('[name="witness_name_1"]', 'David Colleague');
await page.fill('[name="witness_phone_1"]', '301-555-0178');
await page.fill('[name="witness_email_1"]', 'dcolleague@commerce.gov');
// Medical treatment information
await page.selectOption('[name="medical_treatment_received"]', 'yes');
await page.fill('[name="first_treatment_date"]', '02/15/2025');
await page.selectOption('[name="treatment_type"]', 'emergency_room');
// Medical facility information
await page.fill('[name="facility_name"]', 'Prince George\'s Hospital Center');
await page.fill('[name="facility_address"]', '3001 Hospital Drive');
await page.fill('[name="facility_city"]', 'Cheverly');
await page.selectOption('[name="facility_state"]', 'MD');
await page.fill('[name="facility_zip"]', '20785');
await page.fill('[name="facility_phone"]', '301-555-0200');
// Attending physician
await page.fill('[name="physician_name"]', 'Dr. Sarah Emergency Physician');
await page.fill('[name="physician_specialty"]', 'Emergency Medicine');
await page.fill('[name="physician_phone"]', '301-555-0201');
// Diagnosis and treatment
await page.fill('[name="diagnosis"]', 'Acute lumbar strain, L4-L5 region');
await page.fill('[name="treatment_provided"]', 'Physical examination, X-rays, pain medication, muscle relaxants, ice therapy, ergonomic counseling');
// Work status
await page.selectOption('[name="return_to_work_status"]', 'limited_duty');
await page.fill('[name="work_restrictions']', 'No lifting over 10 pounds, no bending or twisting, frequent position changes, ergonomic chair required');
await page.fill('[name="estimated_return_date"]', '03/15/2025');
// Time loss information
await page.selectOption('[name="time_lost"]', 'yes');
await page.fill('[name="first_day_missed"]', '02/16/2025');
await page.fill('[name="total_days_lost"]', '5');
await page.fill('[name="work_hours_per_day"]', '8');
// Continuation of pay (COP) election
await page.check('[name="elect_cop"]');
await page.fill('[name="cop_start_date"]', '02/16/2025');
await page.fill('[name="cop_days_requested"]', '45');
// Leave usage
await page.check('[name="used_leave"]');
await page.selectOption('[name="leave_type"]', 'sick_leave');
await page.fill('[name="leave_hours"]', '40');
await page.fill('[name="leave_dates"]', '02/16/2025 - 02/20/2025');
// Claim for compensation
await page.selectOption('[name="claim_type_detail"]', 'medical_expenses');
await page.check('[name="claim_wage_loss"]');
await page.check('[name="claim_schedule_award"]');
// Medical expenses claimed
await page.fill('[name="emergency_room_cost"]', '850');
await page.fill('[name="physician_fees"]', '350');
await page.fill('[name="xray_cost"]', '275');
await page.fill('[name="medication_cost"]', '125');
await page.fill('[name="total_medical_expenses"]', '1600');
// Previous injuries or conditions
await page.selectOption('[name="prior_back_injury"]', 'no');
await page.selectOption('[name="preexisting_condition"]', 'no');
// Third party liability
await page.selectOption('[name="third_party_liability"]', 'no');
// Safety equipment
await page.selectOption('[name="safety_equipment_available"]', 'not_applicable');
// Accident investigation
await page.check('[name="supervisor_notified"]');
await page.fill('[name="notification_date"]', '02/15/2025');
await page.fill('[name="notification_time"]', '10:45 AM');
await page.check('[name="incident_report_filed"]');
await page.fill('[name="incident_report_number"]', 'IR-2025-0234');
// Supporting documentation
await page.click('[data-testid="upload-medical-report"]');
await page.setInputFiles('[name="medical_documentation"]', './documents/er_report.pdf');
await page.click('[data-testid="upload-xray"]');
await page.setInputFiles('[name="diagnostic_imaging"]', './documents/lumbar_xray_report.pdf');
await page.click('[data-testid="upload-receipts"]');
await page.setInputFiles('[name="expense_receipts"]', './documents/medical_receipts.pdf');
await page.click('[data-testid="upload-incident-report"]');
await page.setInputFiles('[name="incident_documentation"]', './documents/supervisor_incident_report.pdf');
// Employee statement
await page.fill('[name="employee_statement"]', 'I was performing routine work duties retrieving archived files when injury occurred. I have consistently followed all safety protocols. The injury was purely accidental and occurred in the normal course of my federal employment.');
// Employee certification
await page.check('[name="certify_accuracy"]');
await page.check('[name="certify_work_related"]');
await page.check('[name="understand_penalties"]');
await page.check('[name="authorize_medical_disclosure"]');
// Employee signature
await page.fill('[name="employee_signature"]', 'Robert James Anderson');
await page.fill('[name="employee_signature_date"]', '02/20/2025');
// Supervisor section
await page.selectOption('[name="supervisor_agrees"]', 'agree');
await page.fill('[name="supervisor_comments"]', 'Employee injury confirmed. Witnessed by coworker. Employee followed reporting procedures. Limited duty assignment available upon medical clearance.');
// Supervisor verification
await page.check('[name="injury_occurred_on_duty"]');
await page.check('[name="employee_good_standing"]');
await page.fill('[name="supervisor_signature"]', 'Margaret Division Chief');
await page.fill('[name="supervisor_signature_date"]', '02/21/2025');
// Agency action
await page.selectOption('[name="cop_approved"]', 'yes');
await page.fill('[name="cop_approval_date"]', '02/21/2025');
await page.fill('[name="agency_case_number"]', 'DOC-WC-2025-0456');
// Personnel office contact
await page.fill('[name="hr_contact_name"]', 'Patricia Personnel Specialist');
await page.fill('[name="hr_contact_phone"]', '301-555-0150');
await page.fill('[name="hr_contact_email"]', 'hr.benefits@commerce.gov');
await page.click('[data-testid="submit-claim"]');
// Download confirmation
await page.click('[data-testid="download-confirmation"]');
await browser.close();
