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  • Ca-7b, Leave Buy Back Worksheet. This Form Accompanys The Ca-7 Form When The Claimant Is Claiming

Get Ca-7b, Leave Buy Back Worksheet. This Form Accompanys The Ca-7 Form When The Claimant Is Claiming

U.S. Department of Labor Leave Buy Back (LBB) Worksheet/ Certification and Election Office of Workers' Compensation Programs Employee Statement - Please carefully read instructions on pages 3 and.

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How to fill out the CA-7b, Leave Buy Back Worksheet: A guide for online filing

This guide is designed to help users accurately complete the CA-7b, Leave Buy Back Worksheet, which is essential when claiming compensation for leave used due to a work-related injury or condition. By following the outlined steps, users can ensure a smooth and effective filing process.

Follow the steps to complete the CA-7b form efficiently.

  1. Press the ‘Get Form’ button to access the CA-7b form and open it in the designated editor.
  2. Begin filling out the personal information: enter your name, social security number, and OWCP file number. Ensure accuracy to avoid processing delays.
  3. Indicate the period for which you are claiming leave buy back by entering the start and end dates in the designated fields.
  4. In section I, provide the agency's estimate of FECA entitlement. Fill in the weekly base pay, compensation rate (circle either 2/3 or 3/4), and total hours claimed as specified.
  5. Complete the calculations in section G to determine the estimated FECA entitlement. Use the given formula based on your details for precise figures.
  6. Move to section II for agency certification. Ensure the agency official accurately verifies and signs this section, indicating the total amount due for leave repurchase.
  7. Finalize your claim by completing section III. Decide whether to elect to repurchase the leave or not, and provide your signature and date.
  8. Once all sections are completed and verified, save your changes, and prepare to download, print, or share your form as necessary for submission.

Complete your CA-7b form online today to streamline your leave buy back process.

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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.

As soon as possible, but no more than five working days after receipt from the employee, the employer shall forward the completed CA-7 and any accompanying medical report to OWCP. Postal Service regulations are similarly unambiguous. The Employee Labor Manual (ELM) Section 545.82(d):

When an injured worker has permanent loss of use of certain body parts or organs, s/he may request a schedule award by submitting a CA-7 Claim for Schedule Award and an impairment rating completed by her/his treating physician.

The CA-7 must be filed within one year of the dates claimed, or the date your claim is accepted, whichever is later.

Form CA-7 is used by federal workers seeking to claim compensation for traumatic injuries suffered while on the job, as well as those who may have sustained an occupational disease during the performance of work-related duties. This form may be filled online, or downloaded and filled offline.

This form is intended to accompany Form CA-7, Claim for Compensation, when the employee is claiming leave buy back. Things to Know About Leave Buy Back: When an employee uses their sick or annual leave to cover an injury-related absence from work, they may elect to receive compensation instead.

Federal Workers' Compensation Injured postal workers are required to fill in form CA-17, which is a form which outlines information from a doctor forbidding an injured federal employee from carrying out certain activities due to their inherently physically taxing nature.

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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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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 WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
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