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ResetPrintWork Capacity Evaluation Psychiatric/Psychological Conditions Injured Worker 's Name ( First, middle, last )MEOWU.S. Department of LaborOffice of Workers ' Compensation ProgramsOMB No: 12400046.

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How to fill out the OWCP-5a online

The OWCP-5a form is essential for assessing the work capacity of individuals with psychiatric or psychological conditions. This guide provides step-by-step instructions for completing the form online.

Follow the steps to complete the OWCP-5a form smoothly.

  1. Click the ‘Get Form’ button to access the OWCP-5a document and open it in your online editor.
  2. Begin by entering the injured worker's name in the designated field, ensuring accurate spelling of their first, middle, and last names.
  3. Input the OWCP number in the appropriate section. This number is essential for tracking the claim.
  4. Carefully address each question regarding the employee's work capacity. For question 1, indicate whether the employee is competent to work 8 hours a day and provide medical reasons if the answer is 'no'.
  5. If the employee cannot work 8 hours daily, specify the number of hours they can work and answer whether this number might increase. If applicable, indicate when they might return to full-time work.
  6. Respond to question 3 about the employee's competency to perform their usual job duties. If they are not competent, explain which aspects of the position pose problems.
  7. In question 4, describe suitable duties or work environments for the employee, noting any medical restrictions and potential accommodations.
  8. For question 5, list any other medical factors that should be considered in finding a position for the individual.
  9. Enter the physician's name clearly, ensuring it is typed or printed legibly.
  10. Include the physician's telephone number with the area code, followed by the signature of the physician.
  11. Finally, date the completed form. After filling out all sections, save the changes, and consider downloading or printing a copy for your records.

Complete the OWCP-5a form online today to ensure efficient processing of your claim.

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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.

Form CA-17 is designed to be filled out by the injured worker's supervisor and his/her treating physician to complete. It is split into two sections: A and B. Side A is to be completed by the employee's supervisor.

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.

The CA-17 was designed to provide the doctor with an accurate description of the physical work requirements of the injured letter carrier. The CA-17 is a legal document that determines both an injured worker's medical restrictions and entitlement to wage-loss compensation benefits.

General: This form is used when claiming FECA compensation, including repurchase of paid leave. It must be used when claiming compensation for more than one consecutive period of leave.

Form CA-17 is designed to be filled out by the injured worker's supervisor and his/her treating physician to complete. It is split into two sections: A and B. Side A is to be completed by the employee's supervisor.

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.

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© Copyright 1997-2026
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
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
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
altaFlow
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 1997-2026
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232