CA-20 - Attending Physician s Report 2026

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The document is an Attending Physician's Report (Form CA-20) required by the U.S. Department of Labor for the Office of Workers' Compensation Programs. It outlines the necessary information that physicians must provide regarding a patient's work-related injury, including patient details, injury description, medical findings, diagnoses, disability status, and physician certification. The form aims to facilitate the processing of workers' compensation claims under the Federal Employees' Compensation Act (FECA).

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Click ‘Get Form’ to open the CA-20 in our platform's editor.
Begin by entering the patient's full name in Box 1. This is essential for identifying the individual associated with the report.
In Box 2, input the OWCP File Number if available; otherwise, leave it blank.
For Box 3, record the date of initial treatment for the work-related injury.
In Box 4, enter the date of this examination to provide context for your findings.
Detail how the injury occurred in Box 5. Be specific to ensure clarity regarding causation.
In Box 6, document objective findings from your physical examination and any diagnostic tests performed.
Provide medical diagnoses in Box 7, ensuring that you do not list 'pain' as a standalone diagnosis.
Complete Box 9 by explaining whether employment activities contributed to the diagnosed conditions.
Indicate current disability status in Box 10 and provide relevant dates as necessary.
If applicable, describe physical limitations and potential work capabilities in Box 11.
Add any additional remarks in Box 12 before signing and dating the form in Box 13.

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Versions	Form popularity	Fillable & printable
2023	4.6 Satisfied (31 Votes)
2014	4.8 Satisfied (224 Votes)
1999	4.3 Satisfied (45 Votes)

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What is a CA20 form?

OWCP Form CA-20 is the Attending Physicians Report. It is a medical report that is required by the U.S. Department of Labors Office of Workers Compensation Programs (OWCP) before payment of compensation for loss of wages or permanent disability can be made to the employee.

What is an attending physicians report?

An Attending Physician Statement (APS) plays a critical role when youre filing a disability insurance claim for benefits. The APS provides detailed information to insurance companies about your medical condition and how it impacts your ability to work.

Who completes an attending physicians statement?

Have the appropriate doctor complete the APS. You may have multiple doctors treating you for different medical issues, not all relating to your disability. It is important that the doctor treating your disabling condition is the one completing the APS.

What information is needed for CA20?

Include results of any diagnostic testing performed. Also, please reference any pre-existing injury or condition to the body part(s) affected by the work injury.

What is an attending physician report?

An attending physician statement (APS) is a report by a physician, hospital, or medical facility that has treated, or is currently treating, a person seeking insurance. In traditional underwriting, an APS is one of the most frequently ordered additional sources of medical background information.

ca20 pdf

Attending Physician Statement pdf Attending Physician STATEMENT example Attending Physician Statement form Attending Physician STATEMENT for disability ca-17 CA 20a Attending Physician Statement Short Term Disability ca-2 form

Who needs to complete a CA20?

Purpose: The CA-20 form is completed by your treating physician to provide medical evidence that supports your workers compensation claim. When to File: After filing your CA-1 or CA-2 form, your physician will fill out the CA-20 to document your injury or illness, the treatment plan, and your prognosis.

What does attending physician mean in medical terms?

(uh-TEN-ding fih-ZIH-shun) A medical doctor who is responsible for the overall care of a patient in a hospital or clinic setting. An attending physician may also supervise and teach medical students, interns, and residents involved in the patients care.

What is included in an attending physician statement?

An APS will typically include: Diagnosis and medical history. Symptoms and severity. Functional limitations (what you can and cant do) Treatment plan and prognosis.