BOP Program Statement 1601.07 § 3

When a staff member is injured at work or experiences an occupational exposure due to work-related reasons, they are required to report it to their supervisor immediately or as soon as they

become aware of the injury/illness.

Any staff member who will be or is absent due to work-related illness or injury will notify the

supervisor prior to the start of the staff member’s shift, or as soon as possible, of their inability to

report to duty and the expected length of absence.

Staff have the right to their initial choice of healthcare provider. The employer (supervisor,

Occupational Safety Department (OSD), or CWCU) must allow the IW to select a qualified

healthcare provider, after advising them of those healthcare providers excluded under 20 CFR

10.815. A “provider search” is available via DOL’s website.

OSD must issue Form CA-16, Authorization for Examination and/or Treatment, within four

hours of the claimed injury; however, after hours and on weekends, designated staff will issue a

Form CA-16. Where there is no time to complete a Form CA-16, the employer should authorize

medical treatment by telephone and send the completed form to the medical facility within 48

hours.

The employer is not required to issue a Form CA-16 more than one week after the occurrence of

the claimed injury. The employer may not authorize examination or medical or other treatment in

any case that OWCP has disallowed. The name and address of the medical provider must be

written on the Form CA-16 prior to issuance. Refer to Attachment A, Commonly Used DOL

Forms.

Form CA-16 or Form CA-20 “Attending Physician’s Report” may be used for the initial report.

This report may also be provided in narrative form on the physician’s letterhead stationery. The

report will bear the physician’s signature or signature stamp. Advanced Practice Providers (nurse

practitioners and physician assistants) must be countersigned by a qualified physician. OW CP

may require an original signature on the report.

The report must be submitted directly to OWCP, using DOL’s electronic transmission system, as

soon as possible after medical examination or treatment is received.

To claim benefits under the FECA, staff who sustain a work-related traumatic injury must give

notice of the injury by submitting a Form CA-1, Federal Employee’s Notice of Traumatic Injury

and Claim for Continuation of Pay/Compensation, using DOL’s electronic transmission system.

The person submitting a notice must include the Social Security Number (SSN) of the injured

staff member. To elect Continuation of Pay (COP), the IW needs to check box 15a on the Form

CA-1, Federal Employee’s Notice of Traumatic Injury and Claim for Continuation of

Pay/Compensation.

First time users of DOL’s electronic transmission system are highly encouraged to access the

FECA Claimant User Guides (U.S. Department of Labor). These tutorials are accessible in video

format in the “HELP” section of DOL’s electronic transmission system.

If incapacitated, the supervisor, OSD, or any management official will notify CWCU, who may

give notice of injury on behalf of the staff member.

The IW verifies the official employer’s email address of the supervisor before submitting forms

through DOL’s electronic transmission system. They then complete and submit the appropriate

forms through DOL’s electronic transmission system.

After the COP period is exhausted, the staff member, or someone acting on their behalf, must file

Form CA-7, Claim for Compensation before compensation can be paid to the IW by DOL. The

staff filing a Form CA-7 is responsible for submitting or arranging for the submittal of medical

evidence to OWCP which establishes both that disability continues, and that the disability is due

to the work-related injury.

Staff who have an occupational disease/illness they believe to be work-related must give notice

on Form CA-2, Notice of Occupational Disease and Claim for Compensation using DOL’s

electronic transmission system. Staff claiming injury under a Form CA-2 are not eligible for

COP.

For periods of disability not covered by COP, the IW may elect to use accrued personal leave or

OWCP leave without pay (LWOP). If OWCP/LWOP is elected, for time and attendance (T&A)

purposes, the IW must submit a written request to their CEO, or designee. OWCP/LWOP in this

context is expected to be approved when connected to the OWCP accepted condition pursuant to

applicable laws/regulations.

If OWCP/LWOP is elected, the IW must complete and submit Form CA-7, using DOL’s

electronic transmission system. The system will forward the completed portion of the claim form

to the supervisor and AR. DOL’s electronic transmission system will not allow IWs to file a Form

CA-7 for future dates. To ensure timely processing of this form, duplicate dates should not be

filed.

1601.07 5/7/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 4

To facilitate payment for the initial Form CA-7, a SF-1199A, Direct Deposit Sign-Up Form must

be uploaded to DOL’s electronic transmission system. This form may be obtained online from the

“Forms” section of the DOL Federal Employees’ Compensation Program.

Upon receipt of initial medical documentation, the IW will upload the documentation in DOL’s

electronic transmission system and forward a copy to the CWCU. If this initial medical

documentation is not received within 10 calendar days, COP will be terminated, in which the

staff member will then be keyed sick, annual, Absent Without Leave (AWOL), and/or LWOP.

Where the medical evidence is later provided, however, COP will be reinstated retroactive to the

date of termination.

The appropriate documentation being submitted in support of the absence should include the

following information:

 Medical diagnosis

 Prognosis for recovery

 Projected treatment

 Restrictions, if appropriate

The IW provides a completed Form CA-17, Duty Status Report; OWCP-5a, Work Capacity

Evaluation Psychiatric/Psychological Conditions; OWCP-5b, Work Capacity Evaluation

Cardiovascular/Pulmonary Conditions; OWCP-5c, Work Capacity Evaluation Musculoskeletal

Conditions, or the equivalent, to CWCU along with keeping their supervisor informed of

appointments, work status and/or restriction(s).

If an LLD assignment has been made, the IW notifies the supervisor and CWCU when the LLD

assignment is no longer necessary, or when medically cleared to return to duty if no LLD

assignment, and provides a written release from the physician.

If an IW can resume regular federal employment, they must do so. No further compensation for

wage loss is payable once the IW has recovered from the work-related injury to the extent they

can perform the duties of the position held at the time of injury or earn equivalent wages.

The IW will be afforded the opportunity to attend the Workers’ Compensation Committee

(WCC) meeting telephonically or virtually. If the IW did not attend their WCC meeting, and

they object to the LLD assignment, the supervisor and CWCU will confer as soon as practicable

with the IW, to include their representative when applicable, to discuss the IW’s objections.

If the IW’s objections are not resolved, they will provide their objections in writing. CWCU will

forward these objections to the WCC for reconsideration.

1601.07 5/7/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 5

In the event the IW’s objection(s) to the LLD are not resolved by the WCC, the LLD proposal

and objection(s) are forwarded to DOL/OWCP/FECA for a suitability determination.

The facility is responsible for identifying areas for potential LLDs. Ordinarily the IW will

maintain their regular shift and days off.

An IW who refuses or neglects to work after suitable work has been offered, has the burden to

show this refusal or failure to work was reasonable or justified. Unacceptable refusal may result

in OWCP terminating the staff member’s entitlement to further compensation.

Unacceptable reasons for refusing an LLD offer as determined by OWCP:

 Personal dislike of assignment offered or work hours scheduled

 Lack of potential for promotion