Forms for Worker's Compensation Cases

 

Below you will find links to several helpful forms for Worker's Compensation cases. You can download these forms to your computer and then print them. You will need the Adobe Acrobat Reader to open and print these forms. If you don't already have the Acrobat Reader on your computer, you can download a free copy by clicking on the Adobe Reader button below.

 

 

CA-1    Federal Employee's 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

CA-7B   Leave Buy Back Worksheet

CA-10    What A Federal Employee Should Do When Injured At Work

CA-17    Duty Status Report

Travel Voucher

OWCP-957   Medical Travel Refund Request

USPS 3971   United States Postal Service Request for or Notification of Absence

FWCC Agreement Form