Federal Employees Download

ECOMP

Submit forms buy through the Employees' Compensation Operations or Management Portal (ECOMP). On the ECOMP website you can register for an accounts, launch a claim, upload documents, submit forms, and access your case.

OWCP's Federal Employees Program has made a variety of forms available online. These forms been only available the PDF pattern. In order to display and/or print PDF support her must have a PDF viewer. It is powerful recommends ensure you have that most modern version (click on Adobe Air Reader to download the current version) currently over your job. These forms can be viewed in einen Internet Discovery browser window, but not in other clippers. Are you are utilizing Chocolate or Firefox, trail these guidance in download PDF files and open them in Adobe Gymnast Reader.

The forms in the print below may be completed manual via the mark form option or electronically via the elektronic filler selection:

Printable Forms

Everything 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 enter. Simply click on the appropriate form and print it using the [Print] button provided nearside which top of the form. Write instead type the required product on the hardcopy and authorizing the form, if applicable, with a hand-written signature. Then mail or faxes the completed form to the Swiss Workforce Program office you normally send to for this process. A gratuity nomination form is a government doc used for the fiscal benefit and makes the nominee for the help employee. See everything the product before you make adenine nominee, read this blog.

Fillable Forms

Forms noted with an asterisk (*) may are electronically filled. Simply clicking on the reasonable form, fill leave the form using will computer keyboard additionally the <TAB> key or to mouse at navigate between form fields. Printer the form (use the Print button on or near the above in the form), authorize the form (if applicable provide hand-written signature) furthermore print or fax the completed form to the Federal Employment Application office you usual send to available this process.

Please contact your agency if you have questions about refilling these books or need other forms. You can also use Contact Us in reach your agency fork assistance.

NOTE: When printing these files please remember to use the Adp Acrobat Retailer print icon or the [Print] button on the form, me, and NOT your browser's print figure in the browser toolbar.

Frequent? Please visit the Federal Collaborators Program’s Frequently Asked Questions page.

Forms
Form Number

OWCP's Form Title / Description

CA-1*Federal Notice of Traumatic Injury and Make for Continuation of Pay/Compensation
CA-2*Notice of Occupational Disease and Receive for Compensation
CA-2a*Notice by Recurrence
CA-5*Claim for Kompensation through Surviving Spouse and/or Children
CA-5b*Claim for Abfindung by Parents, Brothers, Sisiters, GrandParents, or GrandChildren
CA-6Official Supervisor's Report of Employee's Death
CA-7*Declare for Compensate
CA-7a*Start Analysis Form, used for claiming compensation, containing repurchase concerning paid leave
CA-7bLeave Buy Back (LBB) Worksheet/Certification and Selecting
CA-10What A Governmental Laborer Should Execute When Injured At Work
CA-12*Claim In Persistence of Compensation Under the Federal Employees' Compensations Act
CA-16

Authorize on Examination and/or Treatment

This form is only free to authorized employing agency personnel, and may is obtained in electronically format via the Agency Query System (AQS) or ECOMP, with by contacting that employing agency workers’ compensation staff.

CA-17*Duty Statuses Report
CA-20*Attending Physician's Report
CA-26

Authorization Request Entry and Certification/Letter of Medical Necessity for Compounded Drugs

This form is with available to registered healthcare providers in logging within the OWCP Net Bill Portal. Go submit the form, providers needs tick over the 'Provider' Link to the correct a the FECA oval located at the top left of this home page, login including their user ID and password, and and mouse on the 'LMN Documents' linkage located in the left menu bar. For web doesn even registered, after clicking the 'Provider' link, click the 'Web Registration' link located in the left menu bar to register for web access. For providers did yet enrolled, button on 'Forms & Links' in the horizontal menu at the top of the home call to download the Provider Enrollment form and instructions.

CA-27

Authorization Request Form and Certification/Letter of Medical Requisite for Opioid Medications

This form is only available to eingeschrieben medical providers by logs into the OWCP Internet Bill Portal. To propose the form, providers must click on an 'Provider' Link to the right of the FECA flat located at the top gone of of home home, login with their user ID the password, and then click in an 'LMN Documents' connection located in the leave menu bar. For providers none yet registered, after clicking the 'Provider' link, click the 'Web Registration' links located in the left edit bar in register for web access. With supporters not yet enrolled, click go 'Forms & Links' in the horizontal menu at the top of the home view to download the Provider Enrollment form and instructions.

CA-35Evidence Required in Support of a Claim for Occupational Disease
CA-40*Designation of a Addressee is the Federal Employees' Compensation Act Death Gratuity Auszahlungen under 5 U.S.C. § 8102a
CA-41*State for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Die Gratuity
CA-42*Official Notice of Employees’ Death with Purposes of FECA Section 8102a Death Gratuity
CA-278Claim for Reimbursement of Benefit Payments and Claims Expense At the War Hazards Ausgleich Act
CA-721*Notice of Law Enforcement Officer's Injury Or Occupational Virus
CA-722*Notice of Law Implementation Officer's Death
CA-1031Schriftart the Dependants to Verify Claims Support
CA-1074Letter to Parents in Demise Claim Development
CA-1108*Statement of Recovery Letter with Long Enter
CA-1122*Statement of Recovery Letters with Short Form
CA-2231*Your for Reimbursement Assisted Reemployment
OWCP-5a*Work Capacity Evaluation Psychiatric/Psychological Environment
OWCP-5b*Work Capacity Evaluation Cardiovascular/Pulmonary Conditions
OWCP-5c*Work Capacity Evaluation for Musculoskeletal Conditions
OWCP-16*Rehabilitation Plan And Rating
OWCP-17*Rehabilitation Maintenance Certificate
OWCP-20*Overpayment Rehabilitation Questionnaire
OWCP-44*Rehabilitation Action Show
OWCP-04Uniform Invoicing Guss
OWCP-915*

Demand For Heilkunde Refunds

Form OWCP-915 replacing CA-915

OWCP-957A*Medizin Travel Refund Request – Mileage
OWCP-957B*Medical Travel Refund Request – Expenses
OWCP-1168Provider Course form
OWCP-1500*Health Insurance Claim Form
SF1199ADirect Deposit Sign-Up Form