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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.
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.
Learn how to use Form CA-16 to authorize medical treatment for a traumatic injury of a federal employee. Find out the instructions, information, chain of referral, and questions for Form CA-16.
11 lip 2023 · OWCP requires that when services are performed in an emergency situation, and in an Acute Care Facility for emergency surgery or care, a copy of the OWCP Uniformed Billing Form (UB-04-1450), should be supplied together with the submitted Form CA-16.
Medical Association standards billing form (AMA OP 407/408/409; OWCP-1500a) should be supplied together with Form CA-16. Form CA-16 is valid for up to sixty days from date of issuance, and may be
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 guarantees payment to the original treating physician for 60 days from date of issuance (unless OWCP terminates this authority at an earlier date). The basic rules for authorizing emergency medical care are: The employer shall issue Form CA-16 within 4 hours of the claimed injury.
