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About Form CA-17. Form CA-17 Suggestions. More Resources. It is recommended that you take a Form CA-17 - Duty Status Report with you to give to your physician. This form provides your supervisor and OWCP with interim medical reports containing information as to your ability to return to any type of work.
Instructions for Completing Form CA-7A Time Analysis. 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.
The CA-1 form is used if the employee has sustained a Traumatic Injury on the job. Traumatic Injury - A wound or other condition of the body caused by external force, including stress or strain.
FORM CA-20, PHYSICIANS REPORT. Compensation for wage loss cannot be paid unless medical evidence has been submitted supponing disabilily for work during the period claimed.
In California, a workplace injury must be reported within 30 days of the incident and a workers compensation claim must be filed within one year. Simply stated, when it comes to filing forms for work-related injuries, the sooner the better.
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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. CA-2 - Notice of Occupational Disease and Claim for Compensation.
Form CA-7 is used to claim compensation for wage loss while in a leave without pay (LWOP) status due to disability or absence to obtain medical treatment (after continuation of pay (COP) period for traumatic injury cases).
Under the FECA, medical evidence must be submitted by a qualified physician. Nurse practitioners and physician assistants are not considered qualified physicians under the FECA unless the medical report is countersigned by a physician.

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