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  • Ca 16 Authorization For Examination Andor Treatment Form

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Authorization for Examination And/or Treatment U S. Department of Labor Employment Standards Administration Office of Workers Compensation Programs The following request for information is required under 5 USC 8101 et. Authorization may be terminated earlier upon written notice from OWCP. For extension of the authorization to treat beyond the 60 day period apply to the office shown in Part A Item 12. USE OF CONSULTANTS AND HOSPITALS 0 You may uti.

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Form CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation.

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.

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.

“For information about the workers' compensation claims process and your rights and obligations, go to .dwc.ca.gov or contact an Information and Assistance (I&A) officer of the state Division of Workers' Compensation. For recorded information and a list of offices, call toll-free 1-800-736-7401.”

Form CA-16 - Authorization for Examination and/or Treatment. This form guarantees payment to the care provider if the employee requires medical treatment because of a work-related traumatic injury. Your supervisor should complete page 1 of Form CA-16 and provide it to you for your attending physicians information.

CA-16s can be approved and provided only by a postal supervisor. A properly issued CA-16 must have the name, title and signature of the authorizing official. CA-16s are not available online—for a very good reason. Only the au- thorizing agency has the authority to provide the CA-16.

What is a recurrence of injury? A recurrence occurs when a worker had already sustained a work-related injury in the past.

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).

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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