Search results
immediately authorize examination and appropriate medical care by use of Form CA-16 to either a United States medical officer/hospital or any duly qualified physician/hospital of the employee’s choice.
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.
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.
11 lip 2023 · Form CA-16 is valid for up to sixty days from date of injury, and may be terminated earlier upon written notice from OWCP to the provider. It should not be used to authorize a change of physicians after the initial choice is exercised by the employee.
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.
Complete a written report (Form CA-1 or CA-2) and give it to the supervisor; If a traumatic injury is involved, and further medical treatment is needed, obtain authorization (Form CA-16) from the supervisor for treatment by a physician of the employee's choice.
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.
