Ca1 2025

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The document is a form (CA-1) from the U.S. Department of Labor's Office of Workers' Compensation Programs, designed for federal employees to report traumatic injuries and claim continuation of pay or compensation. It outlines the necessary information that employees must provide regarding their injury, including personal details, description of the incident, and witness statements. The form also includes sections for supervisors to complete and provides instructions on filing claims under the Federal Employees' Compensation Act (FECA), detailing benefits available for job-related injuries.

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Click ‘Get Form’ to open the CA-1 form in the editor.
Begin by filling out your personal information in boxes 1-15. This includes your name, date of birth, email address, and social security number. Ensure all details are accurate.
In section 9, describe where the injury occurred. Be specific about the location to provide clarity.
For section 13, detail the cause of your injury. Include what happened and any relevant circumstances surrounding the incident.
Complete section 15 by certifying that the injury was sustained while performing your duties. Check any applicable benefits you are claiming.
If applicable, have a witness complete section 16 with their statement regarding the incident.
Finally, review all entries for accuracy before saving or printing your completed form.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (180 Votes)
1999	4.1 Satisfied (54 Votes)

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What is a C-1 form?

Forms. Form Number. OWCPs Form Title / Description. CA-1* Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation.

What is timely filing for a Nalc?

The Federal Employees Compensation Act (FECA) requires that an original claim for compensation for disability or death must be filed by written notice of injury or occupational disease and file claim for compensation within three years after injury or death.

How far back can you file a workers comp claim?

State Deadlines for Filing a Workers Compensation Claim AlabamaWithin 2 years from the date of injury or the date of the last compensation payment California Within 1 year from the date of injury Colorado Within 2 years from the date of injury or within 3 years with a compelling reason48 more rows

What does CA-1 stand for?

Continuation of Pay. Excused Absence. Medical Treatment. Return to Work (Employee)

How long do I have to submit a CA-1?

To be eligible for COP, you must submit a CA-1 within 30 days of the injury. If disabled and claiming COP, you must submit medical evidence supporting your disability to your employing agency within 10 workdays.

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What is the difference between CA-1 and CA 2?

Form CA-1 is used for a traumatic injury (a medical condition resulting from an incident or activity occurring during one work shift). Form CA-2 is for an occupational disease (a medical condition resulting from an incident or activity occurring over more than one work shift).

How long does an employee have to file a CA-1?

For traumatic injuries, file Form CA-1 within 30 days following the injury, and for occupational disease claims, file Form CA-2. Once you complete your portion of the claim form, it will be forwarded to your supervisor who will complete the supervisors portion before forwarding the form for review.

What is CA1 and CA2?

Within the hippocampus, recent studies show that area CA2 is important for social memory, and is an anomaly compared to its better understood neighboring region, CA1. Unlike CA1, CA2 displays a lack of typical synaptic plasticity, enhanced calcium buffering and extrusion, and resilience to cell death following injury.