What Federal Employees Should Do When Injured At Work
This file provides guidance for federal employees on the steps to take when they are injured at work. It includes instructions on reporting injuries to supervisors, obtaining medical treatment, and filing various forms. It also outlines the benefits available under the Federal Employees' Compensation Act.
Edit, Download, and Sign the What Federal Employees Should Do When Injured At Work
Form
eSign
Add Annotation
Share Form
How do I fill this out?
To fill out this form, first gather all relevant information about the injury and your employment details. Follow the steps outlined in the guide to properly report the injury to your supervisor and obtain the necessary medical authorization. Ensure all forms are completed accurately and submitted within the designated time frames.
How to fill out the What Federal Employees Should Do When Injured At Work?
1
Report the injury to your supervisor as soon as possible.
2
Obtain medical treatment authorization using form CA-16.
3
Complete the employee's portion of Form CA-1 or CA-2 for occupational diseases.
4
Submit the completed form to your supervisor.
5
If claiming continuation of pay or compensation, submit the necessary medical evidence and additional forms within the specified time frames.
Who needs the What Federal Employees Should Do When Injured At Work?
1
Federal employees who have sustained a job-related injury.
2
Supervisors of injured federal employees who need to process injury reports.
3
Medical professionals treating federal employees with job-related injuries.
4
Human resources personnel handling federal employee injury claims.
5
Legal advisors assisting federal employees with injury compensation claims.
How PrintFriendly Works
At PrintFriendly.com, you can edit, sign, share, and download the What Federal Employees Should Do When Injured At Work along with hundreds of thousands of other documents. Our platform helps you seamlessly edit PDFs and other documents online. You can edit our large library of pre-existing files and upload your own documents. Managing PDFs has never been easier.
Edit your What Federal Employees Should Do When Injured At Work online.
You can edit this PDF on PrintFriendly using our PDF editor. Simply upload the document, and you will be able to make all necessary changes directly in the file. Save the edited document and download it for your records.
Add your legally-binding signature.
You can sign the PDF on PrintFriendly by uploading the document and using our PDF editor to add your digital signature. Place your signature in the appropriate fields and save the document. Download the signed PDF for your records.
Share your form instantly.
You can share the PDF on PrintFriendly by uploading the document and using our sharing options. Send the document via email or generate a shareable link. Easily distribute the PDF to necessary parties while keeping a copy for your records.
How do I edit the What Federal Employees Should Do When Injured At Work online?
You can edit this PDF on PrintFriendly using our PDF editor. Simply upload the document, and you will be able to make all necessary changes directly in the file. Save the edited document and download it for your records.
1
Upload the PDF document to PrintFriendly.
2
Open the document in the PDF editor.
3
Make the necessary changes to the form fields.
4
Save the edited document.
5
Download the edited PDF for your records.
What are the instructions for submitting this form?
Submit completed forms to your supervisor as soon as possible. For continuation of pay claims, submit Form CA-1 no later than 30 days following the injury. Obtain medical authorization using Form CA-16 before seeking treatment, unless emergency treatment is required. Submit medical evidence within 10 work days if claiming COP for a disabling injury. For further information or to submit additional forms, contact the Office of Workers' Compensation Programs (OWCP) at the U.S. Department of Labor. Mail physical forms to the specified OWCP office address provided by your employing agency.
What are the important dates for this form in 2024 and 2025?
Ensure to submit claims for continuation of pay within 30 days following the injury. Submit medical evidence within 10 work days if claiming continuation of pay for a disabling traumatic injury.
What is the purpose of this form?
The purpose of this form is to provide federal employees with a clear and structured process for reporting work-related injuries and obtaining necessary medical treatment. By following the outlined steps, employees can ensure they receive the appropriate compensation and benefits under the Federal Employees' Compensation Act (FECA). This form helps maintain accurate records of injuries and facilitates communication between employees, supervisors, medical professionals, and human resources personnel. Timely and accurate submission of this form is crucial to ensure that all injury claims are processed efficiently and that employees receive the benefits they are entitled to. The form also provides essential information for medical authorization and compensation claims, streamlining the entire process for all parties involved.
Tell me about this form and its components and fields line-by-line.
- 1. Employee Information: Includes fields for the employee's name, contact details, and employment information.
- 2. Supervisor Information: Includes fields for the supervisor's name, contact details, and department information.
- 3. Injury Details: Includes fields for the date, time, and description of the injury, as well as any witnesses.
- 4. Medical Authorization: Includes a section for authorizing medical treatment using form CA-16.
- 5. Claim for Compensation: Includes sections for claiming continuation of pay (COP) and compensation beyond the COP period using forms CA-1, CA-2, and CA-7.
What happens if I fail to submit this form?
Failure to submit this form in a timely manner can result in delays or denial of compensation and benefits.
- Loss of Compensation: Delay or denial of wage loss compensation due to late submission.
- Medical Treatment Delays: Potential delays in receiving authorized medical treatment.
- Incomplete Injury Records: Lack of proper documentation for the injury, leading to difficulties in processing claims.
How do I know when to use this form?
- 1. Traumatic Injury: Use Form CA-1 for reporting traumatic injuries.
- 2. Occupational Disease: Use Form CA-2 for reporting occupational diseases.
- 3. Continuation of Pay: Use Form CA-1 to claim continuation of pay within 30 days of the injury.
- 4. Medical Treatment Authorization: Use Form CA-16 to authorize medical treatment.
- 5. Compensation Claim: Use Form CA-7 to claim compensation for wage loss beyond the COP period.
Frequently Asked Questions
How do I report an injury at work?
Report the injury to your supervisor as soon as possible and follow the steps outlined in this file.
What forms do I need to complete for a traumatic injury?
Complete Form CA-1 for traumatic injuries and submit it to your supervisor.
Can I choose my own physician for treatment?
Yes, you may choose your own physician or use a local Federal medical officer/hospital for treatment.
How do I claim continuation of pay (COP)?
Submit a claim for COP using Form CA-1 within 30 days following the injury.
What if I need emergency medical treatment?
Emergency medical treatment can be obtained without prior authorization.
How do I file a claim for compensation beyond the COP period?
Complete Form CA-7 and submit it to your employing agency for compensation beyond the COP period.
What should I do if I have an occupational disease?
Complete Form CA-2 for occupational diseases and submit it to your supervisor.
When should I submit medical evidence for a disabling injury?
Submit medical evidence within 10 work days if claiming continuation of pay for a disabling traumatic injury.
Where can I find more information about FECA benefits?
Read pamphlet CA-11 'When Injured at Work' or the Federal Personnel Manual, Chapter 810, available from your employing agency.
How do I get a receipt of my injury notice?
A 'Receipt' of Notice of Injury is attached to each Form CA-1 and CA-2. Your supervisor should complete and return it to you for your records.
Related Documents - Injury Guidelines
PANDORA Village Pointe Return Form Instructions
This file provides the return form for PANDORA Village Pointe. It includes sections to fill out the original purchaser information, return reason, and item details. Ensure all fields are completed accurately before sending.
Time Conversion Chart for Payroll
This file provides a time conversion chart for payroll, converting minutes into decimal hours. It aids in accurate and consistent time reporting. Ideal for employees paid on an hourly basis.
Procedures for Providing Reasonable Accommodation
This file outlines procedures for providing reasonable accommodation to individuals with disabilities. It includes various forms of reasonable accommodation such as job restructuring, modifying worksites, accessible facilities, adjusting work schedules, and flexible leave policies. The file is meant for Federal agencies to ensure compliance with the Rehabilitation Act of 1973.
Amazon Sales Tax Map and Collection Details
This document provides a map of U.S. states where Amazon collects sales taxes and details the reasons for tax collection. It includes information on states with physical Amazon facilities, affiliate nexus laws, and states that will begin collecting taxes in the future. This is useful for understanding Amazon's tax obligations across states.
2019 ANCHOR Application for Homeowners - New Jersey
The 2019 ANCHOR Application for Homeowners provides eligibility details and instructions for applying for the New Jersey ANCHOR benefit. Learn how to file, eligibility requirements, and submission guidelines. This document ensures proper benefit distribution for eligible homeowners.
QuickBooks Online Payroll Taxes and Liabilities Guide
This file provides comprehensive instructions on how to set up, pay, and file payroll taxes and liabilities using QuickBooks Online. Employers can track and report income taxes, CPP, and EI contributions. The guide also covers entering tax history and accessing various payroll forms and reports.
Understanding Your Paycheck and Direct Deposit Stub
This file helps employees understand their paycheck and direct deposit stub. It includes various sections explaining earnings types, tax withholding status, and deductions. Perfect for those who need clarity on their payroll system.
ICANN Income Tax Form 2019 for Tax Compliance
This file contains the information required under sub-section (5) of section 90 or 90A of the Income-tax Act, 1961 for ICANN. It includes details about tax identification, residential status, and a verification declaration for the year 2019. The information is provided by Xavier Calvez, the Senior Vice President and Chief Financial Officer at ICANN.
Tanzania Premises Value Declaration Form
This document is used for declaring the value of premises in Tanzania as required by the Urban Authorities (Rating) Act, 1983. It must be filled out by the property owner or their representative, providing information on property location, specifications, current cost, and ownership details. Failure to provide accurate information could result in fines or imprisonment as per the Local Government Finances Act, 1982.
Form 10F: Information under Section 90/90A of Income-tax Act
Form 10F is used to provide information under sub-section (5) of section 90 or 90A of the Income-tax Act, 1961. It is relevant for the prior year 2019-2020 for SWIFT SCRL in Belgium. This form includes details about the assessee's status, account numbers, residency period, and address.
Employer Certificate for PAN Application - Income-tax Rules
This certificate is used by the employer to certify the employment status of an individual for PAN application under Income-tax Rules, 1962. It includes organization details, employee verification, and needs to be attested.
Customer Satisfaction Refund Form For Dog Toys
This file is a refund form for customer satisfaction guaranteed dog toys from Ethical Products Inc. If your dog has chewed through one of their durable toys, you can request a one-time refund using this form. Follow the instructions to obtain a refund via a prepaid MasterCard debit card.
