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DOL Form CA-1
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: |