“It’s very important that patients get a complete copy of all pages of the CA1 after it is filled out completely by the supervisor. “
CA1 – Patients fill this out when they need to report an injury to their supervisor that happened in a single work shift. Patients fill this out at and with the agency / supervisor. We want to see a copy of this during intake so we can understand what happened to the patient and what the supervisor says about the incident. Key pieces of information are also found here: DOB, DOI, Last Name (all needed for EComp and for looking up patient cases on ACS). Information from the CA1 is used to write medical narratives to get injury claims accepted.
Common injuries that happen in a single work shift include ankle sprains, torn ligaments, herniated disks, dog bites, auto accidents on-the-job, as well as a huge number of other injuries that can happen in a single shift.
The CA1 consists of 4 pages. Page 1 is for the patient to fill out. Page 2 is for the supervisor. Page 3 is the Notice of Receipt that patients need in order to prove they reported their injuries on time. Page 4 is an instruction sheet.
It’s very important that patients get a complete copy of all pages of the CA1 after it is filled out completely by the supervisor. Supervisors are asked several questions on page 2 that negative answers to could cause claims to be denied. Doctors should be aware of these negative answers and respond to them in the initial narrative.
This form is filled out by the injured employee and the supervisor (sometimes HR). The CA1 has no place for the doctor to fill out or sign. For doctors, this form is for informational purposes only.
“Common injuries that happen in a single work shift include ankle sprains, torn ligaments, herniated disks, dog bites, auto accidents on-the-job, as well as a huge number of other injuries that can happen in a single shift.”
Federal employees need help from expert, trained, and compliant doctors and staff who understand their unique needs, concerns, and struggles after they’re hurt at work. Work injuries may be inevitable, but losing is not. We have the power to help them. Federal employees make this country go. When they break, we have to fix them.