DOL Form CA-2a

View OWCP-DFEC's Form CA-2a Online htm

Agency:

OWCP-DFEC

Title:

DFEC CA-2a, Notice of Recurrence

Form Description:

DFEC CA-2a, Notice of Recurrence: This form is used by a federal employee to provide notice of a recurrence of a traumatic injury or occupational disease, and to claim continuation of pay or compensation. The form must be filed with one's employing agency.

OMB Control Number:

1215-0167