OWCP Forms and Filing Timeline
08/27/2015 - Written by NBPC
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 |
