| Form Number |
OWCP Form Title or Description |
| CA-1 |
Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation |
| CA-2 |
Notice of Occupational Disease and Claim for Compensation |
| CA-2a |
Notice of Recurrence |
| CA-5 |
Claim for Compensation by Widow, Widower, and/or Children |
| CA-5b |
Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren |
| CA-6 |
Official Supervisor’s Report of Employee’s Death |
| CA-7 |
Claim for Compensation – Form CA-7 replaces ALL prior versions of CA-7 & CA-8 (see FECA Bulletin No. 99-18) |
| CA-7a |
Time Analysis Form, used for claiming compensation, including repurchase of paid leave |
| CA-7b |
Leave Buy Back (LBB) Worksheet/Certification and Election |
| CA-10 |
What A Federal Employee Should Do When Injured At Work |
| CA-12 |
Claim For Continuance of Compensation Under the Federal Employees’ Compensation Act |
| CA-17 |
Duty Status Report |
| CA-20 |
Attending Physician’s Report |
| CA-35 |
Evidence Required in Support of a Claim for Occupational Disease |
| CA-40 |
Designation of Recipient of FECA Death Gratuity Payment, under Section 1105 of Public Law 110-181 (Section 8102a) |
| CA-41 |
Claim for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Death Gratuity |
| CA-42 |
Official Notice of Employees’ Death for Purposes of FECA Section 8102a Death Gratuity |
| CA-278 |
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act |
| CA-721 |
Notice of Law Enforcement Officer’s Injury Or Occupational Disease |
| CA-722 |
Notice of Law Enforcement Officer’s Death |
| CA-1031 |
Letter to Dependents to Verify Claimant Support |
| CA-1074 |
Letter to Parents in Death Claim Development |
| CA-1108 |
Statement of Recovery Letter with Long Form |
| CA-1122 |
Statement of Recovery Letter with Short Form |
| CA-2231 |
Claim for Reimbursement Assisted Reemployment |
| OWCP-5a |
Work Capacity Evaluation Psychiatric/Psychological Conditions |
| OWCP-5b |
Work Capacity Evaluation Cardiovascular/Pulmonary Conditions |
| OWCP-5c |
Work Capacity Evaluation for Muscular Skeletal Conditions |
| OWCP-16 |
Rehabilitation Plan And Award |
| OWCP-17 |
Rehabilitation Maintenance Certificate |
| OWCP-20 |
Overpayment Recovery Questionnaire |
| OWCP-44 |
Rehabilitation Action Report |
| OWCP-04 |
Uniform Billing Form |
| OWCP-915 |
Claim For Medical Reimbursement Form OWCP-915 replaces CA-915 |
| OWCP-957 |
Medical Travel Refund Request |
| OWCP-1168 |
Provider Enrollment form |
| OWCP-1500 |
Health Insurance Claim Form |
| HCFA-1500 |
Health Insurance Claim Form |