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A claim form to report a work injury or illness to your employer.
If your business is incorporated or if you have employees, you must provide workers compensation insurance.
WRITTEN. REPORT. . When disability ceases and/or employee returns to work, the official. superior shall immediately report that fact to the OWCP on Form CA-3 unless this information has been previously submitted on Form CA-1 or CA-2 or otherwise.
If you are an employee covered by Workplace Safety and Insurance, you will be eligible to collect benefits if you have a work-related injury or disease which causes you to lose wages or to require medical treatment.
CA-7 - Claim for Compensation on Account of Traumatic Injury or Occupational Disease. Used for the following purposes: To claim lost wages when continuation of pay expires on a traumatic injury, and to claim wage loss on occupational disease claims.
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Employing agency (EA) should submit completed Form CA-7 to the Office of Workers Compensation Programs (OWCP) within five work days of receipt from IW. OWCP tries to review wage loss claims within five days of receipt, and take action to develop or pay within 14 days of receipt from EA.
CA-1 - Federal Employees Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. Use for traumatic injury - employee was hurt because of a single event or within one workday.
Notice of Occupational Disease and Claim for Compensation. CA-2a* Notice of Recurrence. CA-5* Claim for Compensation by Surviving Spouse and/or Children.
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.
This form is intended to accompany Form CA-7, Claim for Compensation, when the employee is claiming leave buy back. Things to Know About Leave Buy Back: When an employee uses their sick or annual leave to cover an injury-related absence from work, they may elect to receive compensation instead.

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