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The Division of Workers Compensation (DWC) monitors the administration of workers compensation claims, and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers compensation benefits.
Form CA-7 is used by federal workers seeking to claim compensation for traumatic injuries suffered while on the job, as well as those who may have sustained an occupational disease during the performance of work-related duties.
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.
(a) Form CA-16 may be used for the initial medical report; Form CA-20 may be used for the initial report and for subsequent reports; and Form CA-20a may be used where continued compensation is claimed. Use of medical report forms is not required, however.
The CA-7 must be filed within one year of the dates claimed, or the date your claim is accepted, whichever is later.
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A CA-2a form is a claim for recurrence. If for instance an employee has an injured back and they go out of work for awhile and theyre returned back to work, and then they have a worsening of that back injury condition, they would claim a recurrence. To do that they would file a form CA-2a.
DWC-7 Notice to Employees-Injuries Caused by Work (English and Spanish). This form provides your employees with information regarding workers compensation benefits and the Medical Provider Network (MPN) in California.
Overview: The Request for Authorization for Medical Treatment (DWC Form RFA) is required for the employees treating physician to initiate the utilization review process required by Labor Code section 4610.
Leave Buy Back. Compensation for Leave without Pay. The CA-7 must be filed electronically through the Employees Compensation Operations Management Portal (ECOMP). If you do not already have an account, one must be created at .
General: This form is used when claiming FECA compensation, including repurchase of paid leave. It must be used when claiming compensation for more than one consecutive period of leave.

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