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Dol form ca2a 2026
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- Click ‘Get Form’ to open the dol form ca2a in the editor.
- Begin with Part A, where you will enter your personal information. Fill in your name, date of birth, and Social Security Number accurately.
- Continue by providing details about your original injury, including the OWCP file number and the date of the recurrence. Ensure all dates are formatted correctly.
- In section 10, if your employing agency has changed since the original injury, provide the new agency's name and address.
- Complete sections regarding medical treatment and any limitations experienced after returning to work. Be thorough in describing your condition and how it relates to your original injury.
- If applicable, fill out Part C if you are no longer employed with the Federal Government. Provide details about previous employment and any training received since the original injury.
- Finally, review all entries for accuracy before signing and dating the form at the end of Part A or C as required.
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form ca 2a
Notice of Occupational Disease and Claim for Compensation. (3) CA-2a, Notice of Employees Recurrence of Disability and Claim for Pay/Compensation. (4) CA-3Read more
If you no longer work for the Federal Government, complete Parts A and C of this form and submit all materials directly to the Office of. Workers CompensationRead more