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| DOL Home > Find It! By Form > DOL Form |
DOL Form CA-2a
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 |