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CA-1 Form is a document that federal employees fill out when they are injured on the job. It contains information about the employee, the injury, the claim, and the supervisor's report.
Find online and printable forms for filing claims, authorizing treatment, and reporting injuries or deaths under the FECA. Form CA-1 is the notice of traumatic injury and claim for continuation of pay or compensation.
The CA-1 form is used to report and review traumatic injuries on the job at NIH. Learn how to complete the form, submit it to the Workers' Compensation Program, and discuss continuation of pay and return to work options.
Download and print the CA-1 form to report a traumatic injury and claim continuation of pay or compensation as a federal employee. The form has instructions, boxes, and shaded areas for employee, witness, and supervisor information.
Once you register for an ECOMP account, you will be able to file either Form CA-1 ‘Notice of Traumatic Injury’ (single event trauma) or Form CA-2 ‘Notice of Occupational Disease’ (repeated exposure).
acting on his/her behalf, must file Form CA-1 within 30 days following the injury and provide medical evidence in support of disability within 10 days of submission of the CA-1.
CA-1 Form is a document that employees and supervisors fill out when an injury occurs at work. It includes information such as employee data, injury description, witness statement, pay and leave options, and filing instructions.
