OWCP Forms and Filing Timeline
The National Border Patrol Council developed this table of the most commonly used OWCP forms and the respective timeline for filing each form. For a fillable version of the form, click on the form number. Additional Form are located on the DOL DFEC forms page.
Download a PDF version of this table
| FORM | TITLE | USE | EMPLOYEE TIMELINE | AGENCY TIMELINE |
| CA-1 | Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation | Traumatic injury, occurs within one work shift | Within 30 days of injury to get COP; within 3 years for eligibility | Submit to OWCP within 10 days of receipt from employee |
| CA-2 | Notice of Occupational Illness/Disease and Claim for Compensation | Long term or chronic illness or disease | 3 years from date first aware of nexus to employment | Submit to OWCP within 10 days of receipt from employee |
| CA-2a | Notice Employee’s Recurrence of Disability and Claim for Pay/ Compensation | After returning to work, the employee needs to stop work due to injury / illness | As soon as possible* | Submit to OWCP within 10 days of receipt from employee |
| CA-7 | Claim for Compensation | Request compensation for wage loss (not COP | In traumatic injury cases, submit 10 days before end of COP; otherwise, as soon as pay stops (tied to pay periods) | Submit to OWCP within 5 days of receipt from employee |
| CA-7a | Time Analysis | Claiming intermittent compensation, partial days, or repurchase of leave | Submit 10 days before end of COP; otherwise, as soon as pay stops (tied to pay periods) | Submit to OWCP within 5 days of receipt from employee |
| CA-7b | Leave Buy Back | Claiming repurchase of accrued leave used due to injury / illness* | Submit 10 days before end of COP; otherwise, as soon as pay stops (tied to pay periods) | Submit to OWCP within 5 days of receipt from employee |
| CA-16 | Authorization for Examination and/or Treatment | Guarantees payment of medical care after a traumatic injury | Obtain ASAP, within 4 hours; NLT 7 days from DOI; MD submits to OWCP | Issue within 4 hours of injury; 48 hours if verbal authorization given |
| CA-20 | Attending Physician’s Report | Provides medical support for claim | Submit to OWCP ASAP following examination(s) | N/A |
| CA-35 | Evidence Required in Support of a Claim for Occupational Disease | Provides medical support for specific conditions | Upon completion , should be submitted directly to OWCP | N/A |
| OWCP-915 | Claim for Medical Reimbursement | Claim reimbursement for out of pocket expenses (co-pay, medication, DMEs) | Date of service +12 months* | N/A |
| OWCP-957 | Medical Travel Refund Request | Claim for reimbursable travel r/t treatment | 12 months from date of service | N/A |
| OWCP-1500 | Health Insurance Claim Form | Standard billing form | Physician submits; DOS +12 months* | N/A |
