immediately authorize examination and appropriate medical care by use of Form CA-16 to either a United States medical officer/hospital or any duly qualified physician/hospital of the …
Forms | U.S. Department of Labor
CA-16: Authorization for Examination and/or Treatment. This form is only available to authorized employing agency personnel, and may be obtained in electronic format via the Agency Query …
CA-16. • When there is no time to complete Form CA-16, supervisor may authorize medical treatment by telephone and send completed form to medical facility within 48 hours. …
ca 16 Authorization for Examination and or Treatment. The following request for information is required under (5 USC 8101 et. seq.). Benefits and/or medical services expenses may not be …
immediately authorize examination and appropriate medical care by use of Form CA-16 issued to either a United States medical office or hospital or any duly qualified physician/ hospital of the …
Before you seek medical treatment for a traumatic injury, ask your supervisor to authorize medical treatment using Form CA-16. This form may be obtained by contacting your employing …
Please read Part A of Form CA-16. You are authorized to examine and provide treatment for the injury or disease described in Item 5, for a period of not mo re than 60 days from the date of …
When a traumatic injury requires emergency care, and a CA-16 cannot be provided at the time of the care, it will be issued to the source of emergency care within 48 hours. When to Prepare …
Form CA-16 This form was electronically produced by National Production Services Staff Rev. Oct. 1988
Form CA-16 shall be issued for an Occupational Disease claim. Please refer to the Decision Tree. If in doubt call HRM-WC for guidance. (Attachment 5)