Create your Workplace Compensation Form from scratch

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Here's how it works

01. Start with a blank Workplace Compensation Form
Open the blank document in the editor, set the document view, and add extra pages if applicable.
02. Add and configure fillable fields
Use the top toolbar to insert fields like text and signature boxes, radio buttons, checkboxes, and more. Assign users to fields.
03. Distribute your form
Share your Workplace Compensation Form in seconds via email or a link. You can also download it, export it, or print it out.

A detailed guide on how to build your Workplace Compensation Form online

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Step 1: Start with DocHub's free trial.

Visit the DocHub website and register for the free trial. This gives you access to every feature you’ll need to create your Workplace Compensation Form with no upfront cost.

Step 2: Navigate to your dashboard.

Log in to your DocHub account and go to the dashboard.

Step 3: Craft a new document.

Click New Document in your dashboard, and choose Create Blank Document to design your Workplace Compensation Form from scratch.

Step 4: Utilize editing tools.

Place various fields such as text boxes, radio buttons, icons, signatures, etc. Organize these fields to match the layout of your form and designate them to recipients if needed.

Step 5: Modify the form layout.

Rearrange your form effortlessly by adding, moving, removing, or combining pages with just a few clicks.

Step 6: Set up the Workplace Compensation Form template.

Transform your newly designed form into a template if you need to send many copies of the same document multiple times.

Step 7: Save, export, or share the form.

Send the form via email, share a public link, or even post it online if you want to collect responses from more recipients.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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As a general rule, TD pays two-thirds of the gross (pre-tax) wages you lose while you are recovering from a job injury. However, you cannot receive more than the maximum weekly amount set by law.
Injured postal workers are required to fill in form CA-17, which is a form which outlines information from a doctor forbidding an injured federal employee from carrying out certain activities due to their inherently physically taxing nature.
The CA-1 or CA-2 workers compensation forms are available after completing the OSHA-301. The CA-1 should be completed within 30 days of the date of injury to be eligible for continuation of pay (COP). Claims filed on form CA-2 are not eligible for COP.
The CA-17 was designed to provide the doctor with an accurate description of the physical work requirements of the injured letter carrier. The CA-17 is a legal document that determines both an injured workers medical restrictions and entitlement to wage-loss compensation benefits.
Official Supervisors Report of Employees Death. CA-7* Claim for Compensation. CA-7a* Time Analysis Form, used for claiming compensation, including repurchase of paid leave.
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Related Q&A to Workplace Compensation Form

QIW means an employee who, as the result of his/her injury, whether or not combined with the effects of any other medical condition, cannot return to his/her usual customary occupation or job at time of injury.
Form CA-16 - Authorization for Examination and/or Treatment. This form guarantees payment to the care provider if the employee requires medical treatment because of a work-related traumatic injury. Your supervisor should complete page 1 of Form CA-16 and provide it to you for your attending physicians information.
Form CA-7 should be submitted by an injured worker (IW) every two weeks while disabled and in a LWOP status, unless the IW has been placed on the periodic roll. For traumatic injury cases, Form CA-7 should be completed before the end of the COP period, if disability will continue.

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