An on the job injury (OJI) is something no employee wants to experience. However, on the job injuries do occur, when they do bargaining union employees (BUE) find themselves in a situation to where the injury must be reported to their supervisor and documents must be submitted. When these injuries happen, the process can be very confusing and difficult to maneuver. Documents must be filled out and submitted within time requirements. Contact the below OWCP experts for a consultation and assistance with your On the Job Injury (OJI) and OWCP forms.

The Doctors Guild
AFL-CIO affiliated - helping Injured workers since 2000
Patient Advocate Doctors Offices
214-225-5000

Our network of Doctors have a proven track record of serving Union Members for over 15 years are patient advocates. We are AFL-CIO affiliated and believe in good Health and Solidarity!!! OWCP paperwork can be very confusing and consuming. We will handle all of that for you.

Workers' Compensation (OWCP)
TSA Employees: You Have a Right to Workers Comp for Job-Related Injuries and Illnesses: 4-page booklet that describes your rights and responsibilities under the Federal Employees' Compensation Act (FECA)

Claimant Query System (CQS)
OWCP Makes CQS Information Available via ACSDOL
Web Bill Processing Portal (June 2009)

OWCP Forms
What a Federal Employee Should Do When Injured At Work down load Form CA-10

Form CA -1: A Traumatic Injury is defined as a wound or other condition of the body caused by external force, including stress or strain within a single day or work shift. The injury must be identifiable by time and place of occurrence and member of the body affected. It must be caused by a specific event or incident or series of events or incidents within a single day or work shift.

Traumatic injuries also include damage to or destruction of prosthetic devices or appliances, including eyeglasses, contact lenses, and hearing aids, if they were damaged incidental to a personal injury requiring medical services. (Personal property claims can be made only under the Military Personnel and Civilian Employees’ Claim Act, 31 U.S.C. § 3721.)

For Traumatic Injuries, the employee (or someone acting on his/her behalf) must report the injury by completing a Form CA-1, “Federal Employee’s Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation,” to his/her manager/supervisor. There is a portion of the Form CA-1 that will need to be completed by the manager/supervisor. The manager/supervisor should submit the completed Form CA-1 through appropriate agency channels to insure claim is received by the OWCP District Office as soon as possible, but no later than 10 working days after receipt of Form CA-1 from the employee. The employee must report the injury by completing the Form CA-1 within 30 days of the injury in order to be eligible for Continuation of Pay (COP) entitlements and within three (3) years to meet the FECA time limits of a claim. If the claim is not filed within the 30-day period, and COP is not authorized, employee may file a Form CA-7, “Claim for Compensation”, for loss of wage earnings. However, medical documentation is required within 10 days of the injury or the entitlement to COP will be suspended.

COP is continuation of an employee's regular salary for up to 45 calendar days of wage loss due to disability and/or medical treatment following a traumatic injury. The intent of this provision is to eliminate interruption of the employee's income while OWCP is processing the claim.

When warranted, the manager/supervisor will provide the injured employee a Form CA-16, “Authorization for Examination and/or Treatment.” Form CA-16 may be obtained through your manager /supervisor. The CA-16 is used to provide authorization for treatment. The manager/supervisor should complete the front of the Form CA-16 within 4 hours of the request whenever possible. If there is concern that the facts of the injury are in dispute, the supervisor can check the appropriate box on the Form CA-16 (6.B.2) but still provide the employee with the form. In the event there is no time to complete the Form CA-16, the manager/supervisor may authorize medical treatment by telephone and then forward Form CA-16 to the medical facility within 48 hours. Retroactive issuance of Form CA-16 is not allowed under any other circumstances. However, Form CA-16 may not be used to authorize treatment for Occupational Disease or Illness, without prior approval from OWCP.

The employee has the right to choose his/her initial treating physician. A physician is defined as a surgeon, podiatrist, dentist, clinical psychologist, optometrist, osteopathic, practitioner, and chiropractor within the scope as defined by state law. However, the services of chiropractors may be reimbursed only for treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by X-ray to exist. A chiropractor may also provide services in the nature of physical therapy under the direction of a physician. The term “physician” doesn’t include physician assistants or nurse practitioners.

A. Notice of Injury - Form CA-1
When an employee sustains a traumatic injury in the performance of duty, he or she should file a report on Form CA-1. It may be filed on the paper form or electronically, depending on the employing agency participation. The report should be submitted to the supervisor as soon as possible, but not later than 30 days from the date of injury. If the employee is incapacitated, this action may be taken by someone acting on his or her behalf, including a family member, union official, or representative. (The supervisor may provide such notice as well.) The paper form must contain the original signature of the person giving notice. Employing agencies that submit claims electronically must print a copy of the form and retain the claimant’s or representative’s signature. The supervisor should:

(1) Review page one of the form for completeness and accuracy, and assist the employee in correcting any deficiencies found;

(2) Complete and sign page two of the Form CA-1, including a telephone number in case OWCP staff has questions about the injury.
Also, the appropriate codes should be entered on the form. Include codes for occupation, type and source of injury, agency identification and location of duty station. (Appendix B of this publication describes the type and source of injury codes and their use.)

(3) Sign and return to the employee the receipt attached to the paper Form CA-1 and give a copy of the entire form to the employee. Or, if submitted electronically, print and sign the copy of the electronic form and give it to the employee.

(4) Authorize medical care, if needed, in accordance with paragraph C below;

(5) Inform the employee of the right to elect continuation of pay (COP), (discussed in detail in Chapter 5), or annual or sick leave if time loss will occur;

(6) Advise the employee whether COP will be controverted, and if so, whether pay will be terminated. The basis for the action must be explained to the employee. (Controversion is discussed in Chapter 5-3;
the reason for controverting a claim must always be shown on Form CA-1.)

(7) Advise the employee of his or her responsibility to submit prima facie medical evidence of disability within ten calendar days or risk termination of COP.

Form CA -2: An Occupational Disease or Illness is defined as a condition produced in the work environment over a period longer than one (1) workday or shift. It may result from systemic infection, repeated stress or strain, exposure to toxins, poisons or fumes, or other continuing conditions of the work environment. For an Occupational Disease or Illness, the employee (or someone acting on his/her behalf) must report the disease of illness by completing a Form CA-2, “Notice of Occupational Disease and Claim for Compensation.” to his/her manager/supervisor.

Form CA -2a: A Recurrence of disability is defined as a spontaneous return or increase of disability due to a previous injury or occupational disease without intervening cause, or a return or increase due to a consequential injury. (A consequential injury is a new injury, which occurs, as a result of a work related injury). A recurrence of a disability differs from a new injury in that with a recurrence, no event other than the previous accounts for the disability.

When an employee, after returning to work, is again disabled due to a prior injury or occupational disease, the employee completes and submits Form CA-2a, “Notice of Employee’s Recurrence of Disability and Claim for Pay/Compensation,” to their manager/supervisor. If the recurrent disability is related to the original injury, the employee is entitled to medical treatment and compensation.

The employee has the burden of establishing that the current condition is related to previous accepted injury or occupational disease condition, with or without work stoppage. If the employee was entitled to use COP and the 45-days of COP have not been exhausted, he/she may elect to use the remaining days, if the 45-days have not elapsed, since first return to duty; otherwise, the employee may elect to use sick, annual leave or leave without pay.

Form CA -7: Claim for Compensation

Form CA -7a: Time Analysis Form

Form CA -7b: Leave Buy Back (LBB) Worksheet/Certification and Election

Form CA -16: Authorization for Examination And/Or Treatment

Form CA -17: Duty Status Report

Form CA -20: Attending Physician's Report
Compensation for wage loss cannot be paid unless medical evidence has been submitted supporting disability for work
during the period claimed. For claims based on traumatic injury and reported on Form CA-1, the employee should detach
Form CA-20, complete items 1-3 on the front, and print the OWCP district office address on the reverse. The form should
be promptly referred to the attending physician for early completion. If the claim is for occupational disease, filed on Form
CA-2, a medical report as described in the instructions accompanying that form is required in most cases. The employee
should bring these requirements to the physician's attention. It may be necessary for the physician to provide a narrative
medical report in place of or in addition to Form CA-20 to adequately explain and support the relationship of the disability
to the employment.

For payment of a schedule award, the claimant must have a permanent loss or loss of function of one of the members of
the body or organs enumerated in the regulations (20 C.F.R. 10.304). The attending physician must affirm that maximum
medical improvement of the condition has been reached and should describe the functional loss and the resulting
impairment in accordance with the American Medical Association Guides to the Evaluation of Permanent Impairment.

Form CA -35: Evidence Required in Support of a Claim for Occupational Disease

Federal employees have the right to a workplace free from recognized hazards [29 CFR 1960.8(a)]. When employees get hurt or become ill as a result of their job exposures, they are entitled to workers' compensation benefits, including medical care, wage loss replacement, and vocational rehabilitation, among others.

Federal employees also have responsibilities—reporting injuries and illnesses, filing claims for compensation in a timely manner, and returning to work when medically cleared.

Many of these rights and responsibilities are not communicated to TSA employees, and if they are, the information is often wrong or misguided. Sometimes employees are denied the right to file, transmittal of their claims is delayed, claims are controverted, and employees are forced to return to work too soon for fear of losing their jobs.

To help you protect your rights—and your health and safety—AFGE is providing the following information:

• CA -1: Federal Employee's Notice of 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-16: Authorization for Examination And/Or Treatment
• CA-17: Duty Status Report
• CA-20: Attending Physician's Report
• CA-35: Evidence Required in Support of a Claim for Occupational Disease

• What a Federal Employee Should Do When Injured at Work: Provides basic guidance on filing a claim.
• Injury Compensation for Federal Employees Publication CA-810: This handbook is for agency personnel and covers the compensation process and requirements.  It is helpful for union representatives helping members with claims.
• ECOMP: Injured employees with existing claims can submit documents electronically through ECOMP. Some agencies are also using ECOMP for employees to initiate claims.
• Claimant Query System (CQS): CQS provides information on case status, accepted medical conditions, and compensation payments. Due to security concerns, registration on OWCP Connect is required to access CQS.

• For all AFGE member: ou Have a Right to Workers' Comp for Job-Related Injuries and Illnesses: This 4-page booklet describes your rights and responsibilities under the Federal Employees' Compensation Act (FECA)
• TSA Employees: You Have a Right to Workers Comp for Job-Related Injuries and Illnesses: This version of the 4-pager is specifically for TSA employees

In July 2010, AFGE Health and Safety Specialist Milly Rodríguez testified on behalf of AFGE before the House Subcommittee on Federal Workforce, Postal Service and the District of Columbia. While she testified on health and safety issues in the entire federal government, Rodríguez specifically discussed workplace exposure to ionizing radiation at TSA—which has been an issue since the agency's inception. TSA has held the position that there is no harmful exposure from radiation emissions from the X-ray machines used to view the contents of checked baggage as well as carry-on baggage. AFGE offered to conduct an independent study of radiation emissions, but TSA declined the offer. AFGE also offered to fund the purchase of dosimeters (which measure exposure to radiation) but TSA said TSOs are not allowed to wear dosimeters not issued by TSA, even though they refuse to provide them. TSA's position is that the agency has done the necessary testing and is not required by any applicable standards to issue dosimeters to its employees.

We know TSOs continue to be concerned about radiation. The lack of information, the agency's refusal to provide dosimeters, and the unsafe work practices TSOs implemented by TSA, contribute to TSOs' fears about radiation and its health effects. This year, AFGE locals in Boston and San Juan raised concerns about cancer deaths and diagnosis of thyroid conditions that appeared to be higher than expected. Their actions lead to studies by the National Institute for Occupational Safety and Health (NIOSH), and while the studies did not find excess cancers that could be attributed to radiation exposure, TSOs are still concerned about the effects of long-term exposures.