
CA-1 within thirty days of the injury, you may be entitled to receive continuation of pay (COP) from your employing agency. COP is paid for up to 45 calendar days of disability, and is not charged against sick or annual leave. If you elect sick or annual leave you may not claim compensation to repurchase leave used
Forms | U.S. Department of Labor
All of the Federal Employees Program's online forms (with the exception of Forms CA-16 and CA-27) are available to print and to manually fill and submit. Simply click on the appropriate form and print it using the [Print] button provided near the top of the form.
CA-1: Traumatic Injury Claim Form | Office of Human Resources
The CA-1 form is used if the employee has sustained a Traumatic Injury on the job. Traumatic Injury - A wound or other condition of the body caused by external force, including stress or strain.
acting on his/her behalf, must file Form CA-1 within 30 days following the injury; however, to avoid possible interruption of pay, the form should be filed within 2 working days.
Form CA-1 - U.S. Department of Labor
The CA-1 must be submitted to the EA within 30 days of the date of injury in order for the injured employee to be eligible for Continuation of Pay (COP). COP will be discussed in more detail further in the presentation.
An Employee's Guide on Reporting A Work-Related Injury Or …
Nov 19, 2020 · Traumatic Injury (Form CA-1): If the condition happened in the course of one work shift, the condition is an injury. Examples: cut finger; tripped and fell; hit by forklift, etc. Sometimes the reported condition may not seem like an injury, such as mental stress or back strain.
- [PDF]
Filing a CA 1 - DOL
Click “File a CA‐1 or CA‐2” to proceed. If you filed an OSHA 301 form, information about the incident will be displayed. To file a CA‐1 to claim a traumatic injury, review the information and click “Select & Continue” under the CA‐1 heading.
Page 1
Filing Form CA-1, Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. Use this form if you have sustained a traumatic injury on the job. A traumatic injury is a condition of the body caused by a specific event or incident, or series of events or incidents, within a single workday or shift.
CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation To obtain this form go to http://www.dol.gov/owcp/regs/compliance/ca-1.pdf
Immediately report work-related injury to your supervisor and seek medical care, if required. File CA-1 Workers’ Compensation claim in ECOMP at https://www.ecomp.dol.gov/. Obtain all medical documentation and witness statements necessary to support your claim.