This is a legal form that was released by the U.S. Department of Labor - Office of Workers' Compensation Programs on March 1, 2017 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form CA-721A?
A: Form CA-721A is a Notice of Law Enforcement Officer's Injury or Occupational Disease.
Q: Who uses Form CA-721A?
A: Law enforcement officers use Form CA-721A.
Q: What is the purpose of Form CA-721A?
A: Form CA-721A is used to report an injury or occupational disease suffered by a law enforcement officer.
Q: How do I fill out Form CA-721A?
A: You need to provide personal information, details of the injury or occupational disease, and signed statements on Form CA-721A.
Q: Is Form CA-721A mandatory?
A: Yes, as a law enforcement officer, it is mandatory to submit Form CA-721A to report any injury or occupational disease.
Q: What should I do after filling out Form CA-721A?
A: After filling out Form CA-721A, you should submit it to your employing agency and keep a copy for your records.
Download a fillable version of Form CA-721A by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor - Office of Workers' Compensation Programs.