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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. Instructions for Employee: Blocks 1, 2, and 3: Self-explanatory.
What is the CA-16 period?
\u25cb Form CA-16 is valid for up to sixty days from date of issuance, and may be terminated earlier upon written notice from OWCP to the provider. It should not be used to authorize a change of physicians after the initial choice is exercised by the employee.
What is the difference between a ca-1 and a Ca 2?
Form CA-1 is used for a traumatic injury (a medical condition resulting from an incident or activity occurring during one work shift). Form CA-2 is for an occupational disease (a medical condition resulting from an incident or activity occurring over more than one work shift).
What counties are in district 4 in California?
Counties of the 4th District Alpine County. Amador County. Calaveras County. El Dorado County. Mariposa County. Tuolumne County. and includes portions of: Fresno County. Madera County.
What is the difference between a ca-1 and a Ca 2?
Form CA-1 is used for a traumatic injury (a medical condition resulting from an incident or activity occurring during one work shift). Form CA-2 is for an occupational disease (a medical condition resulting from an incident or activity occurring over more than one work shift).
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What is a CA-7 form used for?
Form CA-7, Claim for Compensation: This form is used by a federal employee to claim compensation for employment-related disability. The form must be filed with one's employing agency.
Who fills out a CA-7 form?
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. This form may be filled online, or downloaded and filled offline.
What counties are in district 1 in California?
It consists of: Butte County, Lassen County, Modoc County, Plumas County, Shasta County, Sierra County, Siskiyou County, Tehama County, most of Nevada County, part of Glenn County and part of Placer County.
What is a CA 16 used for?
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.
When can I file CA-7 form?
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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