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Yee, if applicable: (Middle) (Last) 2. Date of OWCP Decision(s) Being Appealed: NOTICE: YOUR APPEAL WILL BE SUBJECT TO DISMISSAL UNLESS YOU PROVIDE THE OWCP DECISION DATE YOU ARE APPEALING. An Application for Review must be filed within 180 days following the date of the OWCP Decisi on(s) being appealed. If your appeal is not timely filed, you must attach a statement with supporting documentation establishing compelling circumstances which prevented timely filing. 3. Appellant s Street Add.

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CA-1 - Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. Use for traumatic injury - employee was hurt because of a single event or within one workday.

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.

The Federal Employees' Compensation Act (FECA) Claims Administration adjudicates new claims for benefits and manages ongoing cases; pays medical expenses and compensation benefits to injured workers and survivors; and helps injured employees return to work when they are medically able to do so.

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.

In case you're receiving continuation of pay, you must ask that form CA-7 be availed to you within 30 days of the COP period, and then sent over to OWCP by the 40th day of COP. Your employer will then have 5 days to submit the form to OWCP after checking it for accuracy and completion.

The CA-1 form is used if the employee has sustained a Traumatic Injury on the job. Traumatic Injury - A wound or other condition of the body caused by external force, including stress or strain.

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.

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
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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