Procedure for Filing Claims for Workers’ Compensation Benefits. As soon as possible after experiencing a job-related injury or illness, the employee should contact his/her supervisor. The Department shall, at that time, assure the employee is provided the proper forms and assist the employee in filling them out. The CA-16, CA-17, CA-7, and CA-20 must be in hard copy; for other forms, the employee will be permitted to choose whether to use electronic or paper forms. The forms include: CA-1 is the appropriate form for reporting a traumatic injury. A traumatic injury is a wound or other condition of the body caused by external force, including stress or strain. The injury must be identifiable by time and place of occurrence and member of the body affected; it must be caused by a specific event or incident or series of events or incidents within a single day or work shift. A traumatic injury also includes damage to or destruction of prosthetic devices or appliances. CA-2 is the appropriate form for reporting an occupational disease or illness. An occupational disease is defined as a condition produced in the work environment over a period longer than one workday or shift. It may result from systemic infection, repeated stress or strain, exposure to toxins, poisons, or fumes, or other continuing conditions of the work. CA-2A is the appropriate form for recording a recurrence of disability. A recurrence of disability is defined as a spontaneous return or increase of disability due to a previous injury or occupational disease without intervening cause or a return or increase of disability due to a consequential injury. CA-16 authorizes an injured employee to obtain immediate examination and/or treatment from a physician for an on-the-job injury. An employee has the initial right to select a physician of his/her choice to provide necessary treatment. The physician must be listed by name on the CA-16. The term ‘physician’ includes doctors of medicine (MD), surgeons, osteopathic practitioners, podiatrists, dentists, clinical psychologists, optometrists, and chiropractors within the scope of their practice as defined by state law. Whenever possible, the employee will be provided CA-16 (Authorization for Examination and/or Treatment) within four hours after requesting the CA-16. When it is not possible, the Department will authorize medical treatment by telephone and send the completed form to the medical facility within 48 hours. The Department will provide the employee with information about accessing DOL’s online medical provid...
Procedure for Filing Claims for Workers’ Compensation Benefits. The Department shall post the Human Resources Management Service (HRMS) Workers Compensation Specialist office location, phone number, and email address in appropriate locations at the facility. The following publications are provided as information to assist employees in the filing of an OWCP claim: Publication CA-810: Injury Compensation For Federal Employees Publication CA-550: "Questions and Answers about Federal Employees Compensation Act (FECA)" The employee who sustains a job related injury or illness has the responsibility to inform their appropriate supervisor as soon as possible. If the employee is incapacitated, this action may be taken by someone acting on behalf of the employee. The Department shall, at that time, assure the employee is provided the proper forms and assist the employee in filling them out. The CA-16, CA-17, CA-7, and CA-20 must be in hard copy; for other forms, the employee will be permitted to choose whether to use electronic or paper forms. At the time the employee files a claim, the employee will be asked to designate whether he or she wishes a representative of the Union to be notified that the employee has filed a claim, and/or to receive a copy of the claim. The law provides that a claim for compensation must be filed within three years of the injury or death. Even if a claim is not filed within three years, however, compensation may still be allowed if written notice of injury was given within 30 days or the immediate supervisor had actual knowledge of the injury or death within 30 days after occurrence. This knowledge may consist of written records or verbal notification. An entry into an employee's medical record may also satisfy this requirement, if the data is sufficient to place the agency on notice of a possible work-related injury or illness. Employees and supervisors are responsible for filling out the appropriate forms and adhering to OWCP time frames. Employees will not be required by the Department officials to release medical records or personally identifiable information except in accordance with DOL requirements. The release of such information will assist the Department in its ability to find temporary placement consistent with the employee’s limitations.
Procedure for Filing Claims for Workers’ Compensation Benefits. The employee must obtain Form CA-1, Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation, from the Employer or via the OWCP web site. As the CA-1 is time sensitive, the appropriate sections of the form should be filled out by the employee and given to the supervisor as soon as possible, but not later than thirty (30) calendar days from the date of the occurrence. If the employee is incapacitated, this action may be taken by someone acting on his or her behalf.
