Forms

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41 - 60 of 167 results
Form name Agencies Form files Details
OWCP CA-20: Attending Physician’s Report OWCP
OWCP CA-2231: Claim for Reimbursement Assisted Reemployment OWCP
OWCP CA-278: Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act OWCP
OWCP CA-2a: Notice of Recurrence OWCP
OWCP CA-35: Evidence Required in Support of a Claim for Occupational Disease OWCP
OWCP CA-40: Designation of a Recipient of the Federal Employees' Compensation Act Death Gratuity Payment under 5 U.S.C. § 8102a OWCP
OWCP CA-41: Claim for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Death Gratuity OWCP
OWCP CA-42: Official Notice of Employees’ Death for Purposes of FECA Section 8102a Death Gratuity OWCP
OWCP CA-5: Claim for Compensation by Surviving Spouse and/or Children OWCP
OWCP CA-5b: Claim for Compensation by Parents, Office of Workers' Compensation Programs Brothers, Sisters, Grandparents, or Grandchildren OWCP
OWCP CA-6: Official Superior’s Report of Employee’s Death OWCP
OWCP CA-7: Claim for Compensation OWCP
OWCP CA-721: Notice of Law Enforcement Officer's Injury Or Occupational Disease OWCP
OWCP CA-722: Notice of Law Enforcement Officer's Death OWCP
OWCP CA-7a: Time Analysis Form OWCP
OWCP CA-7b: Leave Buy Back (LBB) Worksheet/ Certification and Election OWCP
OWCP CM-1159: Report of Arterial Blood Gas Study OWCP
OWCP CM-2907: Report of Ventilatory Study OWCP
OWCP CM-2970: Ventilatory study form documenting spirometry results, flow‑volume loops, miner cooperation, and bronchodilator response to assess Black Lung benefit eligibility. OWCP
OWCP CM-2970a: Operator Response To Notice of Claim OWCP