CA Forms - Department of Labor, Office of Workers' Compensation

CA forms can be found on the following Web site.

• U.S. Department of Labor Forms

Some forms frequently used by NRCS are:

• CA-1 Traumatic Injury and Claim for Continuation of Pay/Compensation
• CA-2 Notice of Occupational Disease and Claim for Compensation
• CA-2a Notice of Recurrence
• CA-7 Claim for Compensation
• CA-7a Time Analysis Form
• CA-7b Leave Buy Back (LBB) Worksheet/Certification and Election
• CA-17 Duty Status Report
• CA-20 Attending Physician's Report

Last Modified: 09/18/2008