Training Resources
Training Resources
CA17– This Duty Status Report is used by a medical doctor to restrict a patient’s work duties or take them off work. The office’s standard off work slip does not work in OWCP. The CA17 must originate with the supervisor who fills out side A and sends it with the patient for the doctor to fill out side B before the MD signs the form.
If patients need to have work restrictions or need to be taken off work or need changes to their restrictions in any way, they must bring a new CA17 filled out by their supervisor for the MD to also fill out and sign.
Give patients 2 copies of this form (1 for their records and 1 to hand-deliver to their supervisor). Fax a copy to the agency as well. Keep a copy in the patient’s medical record.
This form must be signed by the MD or DO. A Chiropractor and Physical Therapist cannot sign this form. A PA or Nurse Practitioner can sign the form with the counter signature of the MD or DO.
The medical doctor can bill CPT code 99080 a maximum of one time each week for special forms like the CA17. This is a form of medical necessity and for assistance for patients. It should not be filled out and billed simply to increase charges to DOL.
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.