Ca 35 form 2026

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The document outlines the evidence required for filing claims related to various occupational diseases under the U.S. Department of Labor's Office of Workers' Compensation Programs. It includes detailed checklists for employees and employing agencies, specifying the necessary information and documentation needed to support claims for conditions such as occupational disease, hearing loss, asbestos-related illness, coronary/vascular conditions, skin diseases, pulmonary illnesses, psychiatric conditions, and carpal tunnel syndrome. The document emphasizes the importance of providing factual and medical evidence to establish a connection between employment conditions and health issues.

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Click ‘Get Form’ to open the CA-35 form in the editor.
Begin by providing your employment history, including job titles and dates. Be specific about your roles and responsibilities.
Detail the factors of employment you believe contributed to your condition. Include specifics such as duration and nature of exposure.
Describe any previous similar conditions, including treatment history and symptoms experienced over time.
Attach a medical report from your physician that includes examination dates, findings, and a diagnosis related to your condition.
Review the checklist provided within the form to ensure all required information is included before submission.

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Ca 35 form 2026

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