DOL Forms
To better assist you in filing your federal workers compensation claim, we have provided links below to several helpful forms. You can download these forms to your computer and then print them.
Form CA-1. Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation
Form CA-2. Notice of Occupational Disease and Claim for Compensation
Form CA-2a. Notice of Recurrence
Form CA-7. Claim for Compensation – Form CA-7 replaces ALL prior versions of CA-7 & CA-8 (see FECA Bulletin No. 99-18)
Form CA-7a. Time Analysis Form, used for claiming compensation, including repurchase of paid leave
Form CA-10. What A Federal Employee Should Do When Injured At Work
Form CA-12. Claim For Continuance of Compensation Under the Federal Employees’ Compensation Act
Form CA-16. Authorization for examination and/or treatment. This form is only available to authorized employee agency personnel, and may be obtained in electronic format via the agency query system (AQS) or ECOMP, or by contacting the employment agency workers compensation personnel.
Form CA-17. Duty Status Report
Form CA-20. Attending Physician’s Report