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Please read Part A of Form CA-16. You are authorized to examine and provide treatment for the injury or disease described in Item 5, for a period of not more than 60 days from the date of issuance, subject to the conditions in Item 6.
11 lip 2023 · The supervisor shall immediately authorize examination and appropriate medical care by use of Form CA-16 issued to either a United States medical office or hospital or any duly qualified physician/ hospital of the employee's choice.
Initial Authorization of Medical Care. Medical Treatment - Form CA-16. If an employee requires medical treatment for a traumatic injury, supervisor should complete front of Form CA-16, within four hours of request whenever possible. If supervisor doubts whether employee’s condition is related to employment, he/she should so indicate on Form. CA-16.
Printable Forms. All of the Federal Employees Program's online forms (with the exception of Forms CA-16, CA-26 and CA-27) are available to print and to manually fill and submit. Simply click on the appropriate form and print it using the [Print] button provided near the top of the form.
Please read Part A of Form CA-16. You are authorized to examine and provide treatment for the injury or disease described in Item 5, for a period of not mo re than 60 days from the date of issuance, subject to the conditions in Item 6. A physician who is debarred from the FECA program as provided at 20 CFR
OWCP Form CA-16 Instructions. Authorization for Examination and/or Treatment. Summary. Purpose Authorization for an employee to obtain medical care or treatment from a doctor or medical facility of his or her choice following an injury or illness.
Form CA-16 is only available from your ICPA (Injury Compensation Program Administrator, HRO, or your Safety Officer). Before you obtain medical treatment, ask your supervisor to authorize medical treatment by use of form CA-16. You may initially select the physician to provide necessary treatment.
