What A Federal Employee Should Do When Injured At WorkĬlaim For Continuance of Compensation Under the Federal Employees' Compensation ActĪuthorization for Examination and/or Treatment Leave Buy Back (LBB) Worksheet/Certification and Election Time Analysis Form, used for claiming compensation, including repurchase of paid leave Official Supervisor's Report of Employee's Death Notice of Occupational Disease and Claim for CompensationĬlaim for Compensation by Surviving Spouse and/or ChildrenĬlaim for Compensation by Parents, Brothers, Sisiters, GrandParents, or GrandChildren Formsįederal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation Questions? Please visit the Federal Employees Program’s Frequently Asked Questions page. NOTE: When printing these files please remember to use the Adobe Acrobat Reader print icon or the button on the form, itself, and NOT your browser's print icon on the browser toolbar. You can also use Contact Us to reach your agency for assistance. Please contact your agency if you have questions about filling these forms or need other forms. Print the form (use the Print button on or near the top of the form), authorize the form (if applicable provide hand-written signature) and mail or fax the completed form to the Federal Employees Program office you normally send to for this process. Simply click on the appropriate form, fill out the form using your computer keyboard and the key or your mouse to navigate between form fields. Fillable Formsįorms noted with an asterisk (*) may be electronically filled. Then mail or fax the completed form to the Federal Employees Program office you normally send to for this process. Write or type the required information on the hardcopy and authorize the form, if applicable, with a hand-written signature. Simply click on the appropriate form and print it using the button provided near the top of the form. The forms in the list below may be completed manually via the print form option or electronically via the electronic fill option: Printable FormsĪll of the Federal Employees Program's online forms (with the exception of Forms CA-16, CA-26 and CA-27) are available to print and to manually fill and submit. If you are using Chrome or Firefox, follow these instructions to download PDF files and open them in Adobe Acrobat Reader. These forms can be viewed in an Internet Explorer browser window, but not in other browsers. It is highly recommended that you have the most current version (click on Adobe Acrobat Reader to download the current version) available on your workstation. In order to view and/or print PDF documents you must have a PDF viewer. These forms are only available in PDF format. OWCP's Federal Employees Program has made a variety of forms available online. On the ECOMP site you can register for an account, initiate a claim, upload documents, submit forms, and access your case. Submit forms online through the Employees' Compensation Operations and Management Portal (ECOMP).
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