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  • Form Cb Ca1

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WARNING THIS DOCUMENT MUST BE PRINTED ON 81/2" X 14" (LEGALSIZED) PAPER. IF IT IS NOT, YOUR FORM WILL BE REJECTED BY THIS AGENCY REGARDLESS OF ANY MONETARY COST TO YOU. LETTERSIZED IS UNACCEPTABLE.

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Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. The Form CA-1 was developed to ensure regulatory compliance and to be more customer friendly. The form must be completed by the injured employee, a witness, and the injured employee's supervisor.

Form CA-1 must be complete in a detailed manner; that is, you are expected to describe how you sustained your injuries, what you were doing and so on, or how you fell sick. You are also required to input the date, or, if you gradually became sick, indicate the time period.

For traumatic injuries, file Form CA-1 within 30 days following the injury, and for occupational disease claims, file Form CA-2.

(To be eligible for continuation of pay, the employee, or someone acting on his/her behalf, must file Form CA-1 within 30 days following the injury and provide medical evidence in support of disability within 10 days of submission of the CA-1.

The CA-1 form, with original signatures, will be filed in the district injury compensation (HRM) office. If your injury did not result in lost time from work or any medical expense, or first aid treatment only, your claim will not be submitted to OWCP for creation of a case.

Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. The Form CA-1 was developed to ensure regulatory compliance and to be more customer friendly. The form must be completed by the injured employee, a witness, and the injured employee's supervisor.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232