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Relevant Forms

  • 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-35, Occupational Disease Checklists (includes eight checklists for various diseases/illnesses – most appropriate checklist should accompany Form CA-2)
  • CA-2a, Notice of Employee's Recurrence of Disability and Claim for Continuation of Pay/Compensations
  • CA-7, Claim for Compensation
  • CA-16, Authorization for Examination and/or Treatment (used when going to ER/or PCP).
  • CA-17, Duty Status Report
ORS breadcrumbDOHS > Occupational Medical Service > Workers' Compensation Program

Workers' Compensation Program

OMS assists employees in documenting injuries/illnesses and helping employees/supervisors file claims with the Department of Labor (DOL).  DOL makes the decision to accept or deny benefits, including medical payments and compensation for loss of earning capacity.

The Federal Employees' Compensation Act (FECA) provides compensation benefits to civilian employees for disabilities due to personal injury or disease sustained in the performance of duty. 

Definitions Related to Workers' Compensation

Traumatic Injury:  A wound or other condition of the body caused by external force, including stress or strain.  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.

Occupational Disease/Illness:  A condition produced in the work environment over a period longer than one 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.

Continuation of Pay (COP):  Continuation of an employee’s regular pay  for a period not to exceed 45 calendar days with no charge to sick or annual leave.  COP is only given in traumatic injury cases.           

Supervisors Responsibilities When Notified of a Work-related Injury

  1. Refer employee to OMS for documentation of injury and treatment .
  2. RETURN Form CA-1, to OMS within 48 hours of notification of occupational injury  or COP.
  3. Obtain CA-16, from OMS and give to employee within four hours request for medical treatment due to the injury, and prior to seeking medical attention. (Form is not given if more than a week has passed since the injury nor if treatment was already received ).  Use this form when employee goes to emergency room, or is requesting to see a personal healthcare provider. 
  4. Supervisors are expected to make a good faith effort to provide appropriate light/limited duty and/or alternative work assignments to the injured employee.  Supervisors should try and match the employee’s physical limitations to the needs of the agency.  Often providing a copy of their job description to the employee to take to OMS or their healthcare provider will provide more detailed instructions for employee's capabilities for light duty.

Employee Responsibilities

  1. Complete and submit to the supervisor CA-1, along with OMS NIH 2558 Form as soon as possible.
  2. Employee must give written notice of injury to supervisor (by completing Form CA-1) within 30 days from the date of injury in order to be eligible for COP.