OWCP will handle your claim more efficiently if you and your doctor use the proper OWCP form. OWCP Attorney Gregory Hall has been handling OWCP cases since 1996 and has the requisite expertise to properly advise you on your federal workers’ compensation claim. All of the OWCP forms listed below can be downloaded directly from the Department of Labor’s, OWCP website:
http://www.dol.gov/owcp/dfec/regs/compliance/forms.htm
| Form Number |
OWCP’s Form Title / Description |
| 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-5* | Claim for Compensation by Widow, Widower, and/or Children |
| CA-5b* | Claim for Compensation by Parents, Brothers, Sisters, Grand Parents, or Grand Children |
| CA-6 | Official Supervisor’s Report of Employee’s Death |
| CA-7* | Claim for Compensation Form CA-7 replaces ALL prior versions of CA-7 & CA-8 (see FECA Bulletin No. 99-18) |
| 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-10 | What A Federal Employee Should Do When Injured At Work |
| CA-12* | Claim For Continuance of Compensation Under the Federal Employees’ Compensation Act |
| CA-17* | Duty Status Report |
| CA-20* | Attending Physician’s Report |
| CA-35 | Evidence Required in Support of a Claim for Occupational Disease |
| CA-40* | Designation of a Recipient of the Federal Employees’ Compensation Act Death Gratuity Payment under 5 U.S.C. § 8102a |
| CA-41* | Claim for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Death Gratuity |
| CA-42* | Official Notice of Employees’ Death for Purposes of FECA Section 8102a Death Gratuity |
| CA-278 | Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act |
| CA-721* | Notice of Law Enforcement Officer’s Injury Or Occupational Disease |
| CA-722* | Notice of Law Enforcement Officer’s Death |
| CA-1031 | Letter to Dependants to Verify Claimant Support |
| CA-1074 | Letter to Parents in Death Claim Development |
| CA-1108* | Statement of Recovery Letter with Long Form |
| CA-1122* | Statement of Recovery Letter with Short Form |
| CA-2231* | Claim for Reimbursement Assisted Reemployment |
| OWCP-5a* | Work Capacity Evaluation Psychiatric/Psychological Conditions |
| OWCP-5b* | Work Capacity Evaluation Cardiovascular/Pulmonary Conditions |
| OWCP-5c* | Work Capacity Evaluation for Musculoskeletal Conditions |
| OWCP-16* | Rehabilitation Plan And Award |
| OWCP-17* | Rehabilitation Maintenance Certificate |
| OWCP-20* | Overpayment Recovery Questionnaire |
| OWCP-44* | Rehabilitation Action Report |
| OWCP-04 | Uniform Billing Form |
| OWCP-915* | Claim For Medical ReimbursementForm OWCP-915 replaces CA-915 |
| OWCP-957* | Medical Travel Refund Request |
| OWCP-1168 | Provider Enrollment form |
| OWCP-1500* | Health Insurance Claim Form |
| HCFA-1500* | Health Insurance Claim Form |
