This is a legal form that was released by the U.S. Department of Labor - Office of Workers' Compensation Programs on June 1, 1996 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-7A?
A: Form CA-7A is a Time Analysis Form.
Q: Why is Form CA-7A used?
A: Form CA-7A is used to provide detailed information about the time spent on work-related activities.
Q: Who needs to fill out Form CA-7A?
A: Form CA-7A needs to be filled out by injured federal workers who are filing for compensation.
Q: What information is required on Form CA-7A?
A: Form CA-7A requires information about the employee, their work schedule, and a breakdown of their daily activities.
Q: What should I do with completed Form CA-7A?
A: You should submit the completed Form CA-7A to your employer or the appropriate workers' compensation office.
Q: Is there a deadline for submitting Form CA-7A?
A: Yes, there is a deadline for submitting Form CA-7A. It should be submitted within 30 days of the end of the period covered by the form.
Q: Can I make changes to a submitted Form CA-7A?
A: Yes, you can make changes to a submitted Form CA-7A by submitting a corrected form.
Q: What if I need help filling out Form CA-7A?
A: If you need help filling out Form CA-7A, you can contact your employer's human resources department or seek assistance from a workers' compensation attorney.
Q: Are there any other forms related to Form CA-7A?
A: Yes, there are other forms related to Form CA-7A, such as Form CA-7 for claiming compensation and Form CA-7b for claiming continuation of pay.
Q: Can I submit Form CA-7A electronically?
A: Yes, you can submit Form CA-7A electronically if your employer or the workers' compensation office accepts electronic submissions.
Q: What happens after I submit Form CA-7A?
A: After you submit Form CA-7A, it will be reviewed by your employer or the workers' compensation office, and a decision will be made regarding your compensation.
Q: Can I appeal a decision made based on Form CA-7A?
A: Yes, you can appeal a decision made based on Form CA-7A if you disagree with the outcome.
Q: Is there a fee for filing Form CA-7A?
A: No, there is no fee for filing Form CA-7A.
Q: Can I use Form CA-7A for non-work-related injuries?
A: No, Form CA-7A is specifically for work-related injuries.
Download a fillable version of Form CA-7A by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor - Office of Workers' Compensation Programs.
Form CA-7a is a one-page document, which mostly consists of free blocks that are supposed to be filled in by an applicant with different types of information. A CA-7a example may be found above, however, in order to fill it out without any mistakes, the application is provided with instructions on how to complete it.
The document can be divided into two parts:
First Part - Employee Statement. In the first part after filling out the personal information, such as full name, Social Security Number (SSN), and Office of Workers' Compensation Programs (OWCP) File Number, an applicant must indicate the beginning and ending dates covered by this document. These must be the same as on Form CA-7, Claim for Compensation, and Form CA-7b, Leave Buy Back Worksheet.
If a filer is claiming compensation for any dates detailed in the previous part of the document, they must state the total number of hours claimed for leave without pay (LWOP) and the total number of hours of leave. If it is not the final claim, then the number of hours should be at least ten.
The last block of the Employee Statement is presented with columns and each one of them is supposed to be filled out by an employee. In those columns an applicant must indicate:
Agency Statement/Certification. An agency is supposed to verify two things:
If there is a challenging entitlement for any date, an agency should try to resolve discrepancies prior to submitting a claim to OWCP. If the discrepancy cannot be resolved, an agency should indicate the specific basis for the challenge in the space provided in the form.