The CA-1 is for traumatic injuries (specific event on a specific date). Use CA-2 for occupational diseases

You are entitled to up to 45 days of Continuation of Pay (COP) while your claim is reviewed

Choose your own treating physician — you are not limited to federal doctors

Workers' Compensationmoderate

Federal Employee Notice of Traumatic Injury

CA-1 · U.S. Department of Labor (OWCP)

Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. For workplace injuries occurring during a single work shift.

Form Details

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Where to Submit This Form

🌐

ECOMP (recommended)

https://www.ecomp.dol.gov/

File your Notice of Traumatic Injury electronically through ECOMP.

📬

Mail to OWCP

U.S. Department of Labor OWCP/DFEC PO Box 8300 London, KY 40742-8300

Filing Deadline

Within 3 years of the injury. However, you should file within 30 days of the injury for optimal processing.

Required Attachments

📎 Completed CA-1 (Federal Employee's Notice of Traumatic Injury)
📎 Medical evidence of the injury
📎 Witness statements (if available)
📎 Your employing agency must complete their section

Processing Time

OWCP aims for initial processing within 30 days. The Continuation of Pay (COP) period provides up to 45 days of salary while the claim is pending.

What Happens Next

OWCP will adjudicate the claim. Your employing agency must provide 45 calendar days of Continuation of Pay (COP) if you are disabled. OWCP will send a decision letter.

Tips for This Form

✓ The CA-1 is for traumatic injuries (specific event on a specific date). Use CA-2 for occupational diseases
✓ You are entitled to up to 45 days of Continuation of Pay (COP) while your claim is reviewed
✓ Choose your own treating physician — you are not limited to federal doctors
✓ File through ECOMP for fastest processing: https://www.ecomp.dol.gov/

More Workers' Compensation Forms

First Report of Injury (Generic FROI)

FROI · State Workers' Compensation Agencies

Report of workplace injury or occupational disease filed with the state agency and insurer. Required within 3-10 days of injury depending on state. Establishes the claim in the system.

California Workers' Comp Claim Form

DWC-1 · California Division of Workers' Compensation

Employee claim form for workers' compensation benefits in California. Employer must provide within one working day of learning of a workplace injury or illness.

New York Employee Claim

C-3 · New York Workers' Compensation Board

Employee's claim for compensation filed with the NY Workers' Compensation Board. Must be filed within 2 years of the accident or within 2 years of when the claimant knew or should have known the condition was work-related.

Texas Employee's Claim for Compensation

DWC-041 · Texas Department of Insurance, Division of Workers' Compensation

Employee's claim for compensation for a work-related injury or illness in Texas. Must be filed within one year of injury or within one year of when the employee knew or should have known the condition was work-related.

Florida First Report of Injury or Illness

DFS-F2 · Florida Division of Workers' Compensation

Florida's first report of injury or illness form. Employer must file within 7 days of knowledge of an injury or within 24 hours if the injury results in death.

North Carolina Notice of Accident to Employer

Form 18 · North Carolina Industrial Commission

Notice of Accident to Employer and Claim of Employee. Must be filed when injured on the job in North Carolina. Written notice to employer required within 30 days; claim filed within 2 years.

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the U.S. Department of Labor (OWCP) or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.