Form CA-2 Disability Benefits for Employees under the Federal Employees' Compensation Act (FECA)

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.

The CA-2 Notice of Occupational Disease form should be used if you have sustained an occupational disease injury on the job. An Occupational Disease is a condition produced in the work environment over a period longer than one work day or shift.

Form CA-2 The front portion of Form CA-2 should be completed by the IW. However, if the IW is incapacitated, this form may be completed by authorized EA official (Agency Reviewer (AR) in ECOMP).

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‐2 to claim an occupational disease, review the information and click “Select & Continue” under the CA‐2 heading.

Instructions for Completing Form CA-2 Complete all items on your section of the form. If additional space is required to explain or clarify any point, attach a supplemental statement to the form. In addition to the information requested on the form, both the employee and the supervisor are required to submit additional evidence as described below.

To file a CA-2 to claim an occupational disease, click “Select & Continue.” Your name will be pre-populated from your ECOMP account. Enter your social security number (SSN) and confirm it. The SSN you enter must match the SSN of record for your ECOMP account.

CA-2 - Federal Employee's Notice of Occupational Disease and Claim for Compensation. CA-2a - Notice of Recurrence. CA-17 - Duty Status Report: U.S. Department of Labor (DOL) Forms Library

Filing a CA-2, Notice of Occupational Disease (NIH-specific guide) You must report any workplace-related illness as soon as possible to Occupational Medical Service (OMS). OMS will provide you will further instructions on how to complete the form needed in the ECOMP system.