Worker's Compensation

PROCEDURES
What A Federal Employee Should Do When Injured at Work (CA-10)
When Injured At Work Information Guide for Federal Employees (CA-11)
Injury Compensation for Federal Employees (CA-810)

FORMS
CA-1 (Federal Employee's Notice of Traumatic Injury and Claim for Continuance of Pay / Comp)
CA-2 (Notice of Occupational Disease and Claim for Compensation)
CA-2a (Notice of Recurrence)
CA-5a (Claim for Compensation by Widow, Widower, and/or Children)
CA-5b (Claim for Compensation by Parents, Brothers, Sisters, Grandparents, or Grandchildren)
CA-6 (Official Superior's Report of Employee's Death)
CA-7 (Claim for Compensation)
CA-7a (Time Analysis Form)
CA-7b (Leave Buy Back (LBB) Worksheet / Certification and Election)
CA-12 (Claim for Continuance of Compensation under the Federal Employees' Comp Act)
CA-17 (Duty Status Report)
CA-20 (Attending Physician's Report)
CA-35 (Evidence Required in Support of a Claim for Occupational Disease)
CA-915 (Claim for Medical Reimbursement)
OWCP-5a (Work Capacity Evaluation Psychiatric / Psychological Conditions)
OWCP-5b (Work Capacity Evaluation Cardiovascular / Pulmonary Conditions)
OWCP-5c (Work Capacity Evaluation Musculoskeletal Conditions)

ADDRESSES & PHONE NUMBERS
U.S. Department of Labor
District 16 (Dallas) Division of Federal Employee's Compensation (DFEC)
Phone: (972) 850-2300 M-F 8a-4:30 pm
Fax: (972) 850-2301

Send medical reports, bills and case correspondence to the central mail processing facility at the following address:

U.S. Department of Labor
DFEC Central Mailroom - District 16
P.O. Box 8300
London, KY 40742-8300

All correspondence and receipts sent in connection with claims should be on letter-size paper and should show claimant's name and case file number on each page.

Send Claim Forms (CA-1, CA-2, CA-5, CA-7, and CA-16's) and any attachments directly to the following District Office:

U.S. Department of Labor
Employment Standards Administration
Office of Worker's Compensation Programs
525 S. Griffin St., Rm 100
Dallas, TX 75202