Understanding Some of the Required Federal Forms
Understanding the difference between CA-1 & CA-2
Ca-1 is considered a traumatic injury, which simply states that the accident occurred with a specific incident while you were working and can tell (WHERE, WHEN AND HOW) it occurred. When filing a traumatic injury you should receive a CA-1 form along with a CA-16
Make sure to get copies of all your paperwork and you must receive a copy of the completed CA-1 from your supervisor. Most of all notify your union steward so if problems arise they can intervene on your behalf.
View OWCP-DFEC's Form CA-1 Online
Example: On Tuesday March 10th at 2:00pm, I was delivering mail on the 200 block of 10th st. I stepped in a hole, tripped and fell to the ground. I had severe pain in my right knee.
Example: On Monday April 20th at 1:00pm, I was pushing a cart of mail at the P&D Dallas unit, tripped on a box, fell on the concrete floor, hurting my leg, knee and hand.
COP (Continuation of pay) Continuation of regular pay for up to 45 calendar days of wage loss due to disability and/or medical treatment after a traumatic injury. When filling out the CA-1 you are entitled to COP for up to 45 days. It can only be used for a traumatic injury. On the CA-1 form there is an area to elect COP (Continuation of Pay). Intent is to avoid interruption of pay while the claim is adjudicated. Subject to usual deductions from pay, such as income tax, retirement, allotments, etc. Decision to use leave over COP is not irrevocable. Employee’s who use leave can later elect COP within one year of the leave usage or date the case is accepted by OWCP, whichever is later.
Ca-2 is considered an occupational injury or disease, This is an injury that has occurred or happened over more than (1) day of work, which means over the course of days, weeks or months and once you feel that the job has caused or aggravated your condition. The CA-2 type of injury is your responsibility to (1) get the form and (2) go to the doctor on your own. After you have been examined by the doctor, a diagnosis has been determined, along with your statement as to what you believed to have happened, turn it in to your supervisor with supporting medical documentation. Once it is approved then you can receive compensation and get treated for your injury.
View OWCP-DFEC's Form CA-2 Online
Example: While working on my route for the last couple months I have noticed when I begin walking up steps to deliver mail my knee began to hurt, this has been happening for 2-3 months now. That makes this a CA-2 injury due to the fact that it has happened over time.
Ca-7 (How to get paid) Once an injured employee is hurt, a (CA-7) compensation form is used. If it’s a CA-1/CA-16 for a traumatic injury, the first 45 days is COP. After that period the regulation states that on the 40th day, If the injury is going beyond 45 days, you will then need to fill out a CA-7. If you have a CA-2 OWCP injury, compensation is paid after the case is approved. Also, the CA-7 is used for a scheduled award, which will be discussed later under the scheduled awards section. If the employee does not qualify for continuation of pay (45 days), this form should be completed and filed with the OWCP as soon as pay stops. The CA-7 should also be submitted when the employee reaches maximum improvement and claims a schedule award. If the employee is receiving continuation of pay and will continue to be disabled after 45 days, the CA-7 should be filed with OWCP, (5) working days prior to the end of the 45-day period.
View OWCP-DFEC's Form CA-7 Online
Ca-17 (Difference between your full job tasks and what you can currently do) Your supervisor will complete Side A and refer the form to the physician to complete Side B. Your doctor will complete Side B, sign and return to the employee as soon as possible to prevent interruption of the employee's income.
View OWCP-DFEC's Form CA-17 Online
OWCP-5 Is sometimes used instead of the CA-17. If you work for an agency that your supervisor does not supply you with a job limitations form, your doctor’s office can print an OWCP-5 form and fill it out so that you can return it to your supervisor.
View OWCP's Form OWCP-5c Online
CA-20 (Attending Physicians report) A medical report is required by the office or Workers’ Compensation programs before payment of compensation for loss of wages or permanent disability can be made available to the employee. This information is required to obtain or retain a benefit. Your doctor will fill this out during your visit.
View OWCP-DFEC's Form CA-20 Online
Mileage form 957 OWCP pays the claimant for travel to and from the medical provider, therapy treatments and the pharmacy for medicine used for the injuries. You must submit your request for travel pay on form OWCP Form 957 – Medical Travel Refund Request within one year of the travel. Be sure to fill out every line fully to keep from being rejected. Direct deposit 1199a form (which is included in your packet) should also be filled out so compensation will be deposited directly into your bank account. It is highly recommended to keep track of your mileage weekly and turn in at least monthly.
View OWCP's Form OWCP-957 Online
Scheduled Awards Once the injured employee has returned back to work and you as well as your doctor feels that you have reached MMI (Maximum Medical Improvement) you are entitled to a scheduled award. It is a percentage of your ability loss due to your work related injury.
Example: When you were hired you were considered at 100%. After your MMI is determined you might now only be at 80%. Your scheduled award will be based on your 20% loss.
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