Form CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay / Compensation

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of Form CA-1 for the current year.

Form CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay / Compensation

What Is Form CA-1?

This is a legal form that was released by the U.S. Department of Labor on January 1, 2013 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form CA-1?
A: Form CA-1 is a document used by federal employees to report a traumatic injury that occurred while on the job and to file for continuation of pay or compensation.

Q: Who uses Form CA-1?
A: Form CA-1 is used by federal employees who have suffered a traumatic injury while working for the federal government.

Q: What is the purpose of Form CA-1?
A: The purpose of Form CA-1 is to report a traumatic injury and initiate a claim for continuation of pay or compensation for federal employees.

Q: When should Form CA-1 be filled out?
A: Form CA-1 should be filled out as soon as possible after a traumatic injury occurs while on the job.

Q: How should I fill out Form CA-1?
A: You should provide accurate and detailed information about the traumatic injury, including when and how it occurred, as well as your personal and contact information.

Q: What should I do after filling out Form CA-1?
A: After filling out Form CA-1, you should submit it to your federal agency's human resources department for processing.

Q: What happens after submitting Form CA-1?
A: After submitting Form CA-1, your federal agency will review the information and determine your eligibility for continuation of pay or compensation based on the reported traumatic injury.

Q: Can I appeal a decision made on my Form CA-1 claim?
A: Yes, if you disagree with the decision made on your Form CA-1 claim, you have the right to appeal the decision.

Q: Is there a deadline to file Form CA-1?
A: Yes, Form CA-1 must be filed within 30 days of the traumatic injury or within 30 days of becoming aware of a latent condition caused by the injury.

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Form Details:

  • Released on January 1, 2013;
  • The latest available edition released by the U.S. Department of Labor;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CA-1 by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor.

Download Form CA-1 Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay / Compensation

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