in the 21st Century

DOL Form CA-1

View OWCP-DFEC's Form CA-1 Online htm

Agency:

OWCP-DFEC

Title:

DFEC CA-1, Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation

Form Description:

DFEC CA-1, Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation: This form is used by a federal employee to provide notice of traumatic injury and to claim continuation of pay (compensation). The form must be filed with one's employing agency.

OMB Control Number: