What is Form CA-7?
Form CA-7 is a claim form specifically designed for federal employees seeking compensation for work-related injuries or illnesses. This form allows employees to request payment for lost wages and medical expenses tied to job-related injuries. It is crucial to file the CA-7 within one year of the injury or the claim acceptance date. Timely submission initiates the process for receiving essential benefits, including wage compensation and medical treatment, ensuring that employees receive the necessary support during their recovery period.
What is Form CA-7 used for?
Form CA-7 is important for workers who have suffered injuries or illnesses on the job. Here's what it can be used for:
- Wage Loss Compensation: Claim for lost wages due to disability or medical treatment.
- Leave Buy Back: Request reimbursement for leave used due to injury or illness.
- Schedule Award: Seek compensation for permanent impairment to a body part or function.
- Intermittent Wage Loss: Claim for wage loss during doctor’s appointments and medical treatments.
How to fill out Form CA-7?
- 1
Fill in your name, mailing address, date of injury, and social security number in the employee portion.
- 2
Specify the type of compensation claimed: leave without pay, leave buy back, or other wage loss.
- 3
Report any earnings from outside employment during the claimed period.
- 4
List dependents and their relationship to you.
- 5
Indicate if this is your first claim and provide additional claim information as needed.
- 6
Complete sections on pay rate, work schedule, and pay status if applicable.
- 7
Ensure all sections are completed before downloading the form.
Who is required to fill out Form CA-7?
The groups responsible for completing Form CA-7 are the employee and their supervisor. The employee fills out sections 1 through 7, while the supervisor completes sections 8 through 15 before sending it to the Office of Workers' Compensation Programs (OWCP).
After completion, the form is reviewed by the supervisor and then sent to OWCP. Employees can also track their claim status using this form.
When is Form CA-7 not required?
Form CA-7 is not required if the employee does not qualify for continuation of pay (COP) for 45 days. It is also unnecessary for those not receiving COP and who haven’t reached maximum improvement. Employees who are not disabled and can work without pay or leave do not need this form. Independent contractors and non-Federal employees are generally excluded from this requirement.
When is Form CA-7 due?
The deadline for Form CA-7 is within five workdays of the injured worker's signature date. For initial claims, you must complete it no more than 14 calendar days after pay stops due to injury or disease. For continuing claims, submit it every two weeks while disabled, unless the OWCP gives different instructions.
How to get a blank Form CA-7?
To get a blank Form CA-7, go to our website. The form, issued by the U.S. Department of Labor’s Office of Workers' Compensation Programs, is already pre-loaded in our editor. You can fill it out and download it, but remember, we do not support filing forms.
How to sign Form CA-7?
To sign Form CA-7, you should provide a handwritten signature, as official sources indicate that only this type of signature validates the form. PDF Guru allows you to fill out the form, and you can create a simple electronic signature for forms that accept them. However, remember to check for the latest updates regarding signature requirements. Once completed, download your form, but keep in mind that submission is not supported through our platform.
Where to file Form CA-7?
To submit Form CA-7 for work-related injury or disease compensation, log in to the Employees' Compensation Operations & Management Portal (ECOMP). If you don't have an account, create one to start your claim.
Ensure you have your supervisor's email handy and upload all medical documents required. Send these to Occupational Medical Services (OMS) for processing.
