Get Form Cb Ca1

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.

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.

(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.

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

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.

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.