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, Sisiters, GrandParents, or GrandChildren
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 Section 1105 of Public Law 110-181 (Section 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 Reimbursement
Form OWCP-915 replaces CA-915
OWCP-957*
Medical Travel Refund Request
OWCP-1168
Provider Enrollment form
OWCP-1500*
Health Insurance Claim Form
HCFA-1500*
