BOP Program Statement 1601.07 § 6

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

the 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.

The supervisor, OSD or CWCU should advise the staff member of their right to their initial

choice of physician. The employer must allow the IW to select a qualified physician, after

advising them of those physicians excluded under 20 CFR10.815. A “provider search” is

available via DOL’s website; a list of physicians will not be provided by the employer.

If the IW is incapacitated, the supervisor, OSD, or any management official will notify CWCU,

who may give notice of injury on behalf of the staff member.

Upon receipt, documentation received from the DOL must be forwarded to the CWCU promptly,

but no later than two working days.

The local OSD will be available for information and instructions on filing a Federal Workers’

Compensation claim.