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If the employee elects to repurchase the leave submit all claim documents CA-7 CA-7a CA-7b plus any medical documentation to OWCP for processing. Page 4. U*S* Department of Labor Leave Buy Back LBB Worksheet/ Certification and Election Employment Standards Administration Office of Workers Compensation Programs Employee Statement - Please carefully read instructions on pages 3 and 4 before filling out this form* B. OWCP File Number A. Name of Employee Last First Middle C. Social Security Number ...

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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.

How do you calculate a scheduled award?

Schedule awards are paid for a certain number of weeks, calculated by multiplying the percentage of impairment of a body part (determined by the rating physician) times the number of weeks set out in the schedule in the FECA for that body part.

What is a schedule award in workers compensation awards?

The schedule award refers to a set schedule of monetary damages for impairment of an extremity or a body part recognized by Federal Workers' Compensation Act. Payments are based on impairment to certain body parts. Claimants are entitled to an award based on a set number of weeks to their impairment or loss.

What is a CA 7B form?

Instructions Form CA-7B Leave Buy Back Worksheet. This form is intended to accompany Form CA-7, Claim for Compensation, when the employee is claiming leave buy back.

What is a CA 7B?

Instructions Form CA-7B Leave Buy Back Worksheet. This form is intended to accompany Form CA-7, Claim for Compensation, when the employee is claiming leave buy back.

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Who fills 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 is a CA-7 schedule award?

When an injured worker has permanent loss of use of certain body parts or organs, s/he may request a schedule award by submitting a CA-7 Claim for Schedule Award and an impairment rating completed by her/his treating physician.

What is a CA-7 schedule award?

What is a ca7 form 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.

When should I file a ca7?

You must also send all medical documentation to Occupational Medical Services (OMS). 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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