DOL-ESA Forms ca-2a 2025

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The document is a Claim for Reimbursement form from the U.S. Department of Labor's Office of Workers' Compensation Programs, intended for employers to report and claim reimbursement for expenses related to assisted reemployment of injured workers. It outlines the necessary information required from both the employer and claimant, including personal details, employment dates, pay rates, and reimbursement amounts. The form emphasizes the importance of completion for processing claims under the Federal Employees' Compensation Act (FECA) and includes privacy and public burden statements.

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When should I file a CA 2?

Follow instruction to complete the employee section of the Form CA-1 or CA-2 and provide it to your supervisor as soon as possible, but not later than 30 days after your injury. Complete these forms as precisely as possible in order to avoid delays caused by asking you for additional information.

What is a form CA 2a?

The CA-2a is used when an employee has an existing claim, but the claim has been administratively closed because the employee either has not treated with a doctor for 18 months or has previously returned back to full duty work and now has disability. The CA-2a is also referred to as a recurrence claim.

Do you get 100% pay on workers comp?

In that case, you may qualify for time-loss compensation due to the fact that youre temporarily unable to return to work. Typically, the workers comp system in most states offers 66% of your wages. Depending on the state, you may receive your salary benefits weekly, bi-weekly, or once a month.

What not to say to a workers comp doctor?

What You Shouldnt Tell Your Workers Comp Doctor Never lie about prior injuries, pre-existing conditions, or medical history. Never lie about the extent of your workplace injury or how it happened. Do not exaggerate your symptoms, including pain or functionality.

What is a DOL form?

Workers Compensation Claim Form (DWC-7) Form DWC-7 is a notice to provide injured workers with rights, benefits and contact information. DOWNLOAD DWC-7 FORM.

What is a CA 2 claim?

This form is used if the employee has sustained an occupational disease as a result of job duties. Occupational Disease - A condition produced in the work environment over a period longer than one work day or shift.

DOL-ESA Forms ca-2a 2025

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