Forms

  • CA-1 – Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation
  • CA-2 – Notice of Occupational Disease and Claim for Compensation
  • CA-2a – Notice of Recurrence
  • CA-7 – Claim for Compensation
  • CA-7a – Time Analysis Form, used for claiming compensation, including repurchase of paid leave
  • CA-7b – Leave Buy Back (LBB) Worksheet/Certification and Election
  • CA-17 – Duty Status Report
  • CA-20 – Attending Physician’s Report
  • OWCP-5c – Work Capacity Evaluation for Musculoskeletal Conditions
  • OWCP-915 – Claim For Medical Reimbursement (Replaces Form CA-915)
  • OWCP-957 – Medical Travel Refund Request
  • SF1199A – Direct Deposit Sign-Up Form