Training Resources
Training Resources
When patient’s have accepted claims and they are outside of their 45-day COP period, they are eligible to be paid for time away from work to go to medical visits, physical therapy, imaging appointments, surgeries, and other healthcare appointments related to the accepted work injury. Patients can also be off work if taken off work by the physician.
In these cases, patients are paid by filling out and submitting form CA7, Claim for Compensation. These forms must be submitted every 2 weeks to the claims examiner.
Patients fill out page 1 of the CA7 and the supervisor fills out page 2. Often, patients also need to fill out a form CA7a, Time Analysis Form, to account for their time at work and time off work. Supervisors have 5 days from the date the form is complete and received in their office to turn the form into the Claims Examiner. Patients should be encouraged to keep copies of everything they submit to the supervisor as they may have to submit it again themselves.
Submitting perfectly completed CA7 forms is rarely enough for patients to get paid. They also have to submit supporting documentation with their CA7’s. The following documentation must be submitted with all CA7 forms.
1. Form CA202. Form CA17 (if one has been used to take patients off work)3. A brief narrative explaining why the patient has needed to be off work4. A copy of any appointments the patient attended when away from work (signed by the licensed healthcare provider who the patient was with)
1. Not eligible for CA7 pay if currently on COP. Start filling your CA7’s at least 2 weeks before COP runs out.
2. The employee fills out page 1 of the CA7 and the supervisor fills out page 2.
3. The supervisor has 5 work days after the date of signature to submit CA7’s to OWCP.
4. CA7’s should be filed at 2-week intervals unless otherwise notified by OWCP.
5. CA7’s should be filed electronically (ecomp) by the employer to speed up processing of claims.
6. Documentation required to support payment with a CA7 includes:
a. “A certificate of the physician stating the nature of the injury and the nature and probable extent of the disability.”b. “Medical Evidence which establishes both that disability continues and that the disability is due to the work-related injury.”c. “Provide medical documentation supporting any periods of disability claimed.”d. CA20a – appears to be an outdate-“retired” form that is no longer listed on the OWCP forms page, but continues to be referenced in the CFR.e. CA20 should be “submitted to OWCP along with CA7 for wage loss or leave buy back.f. A narrative that describes continuing medical treatment for the accepted condition, a prognosis, a description of work limitations, if any, and the physician’s opinion as to the continuing relationship between the employee’s condition and factors of his or her federal employment.g. A print-out of all appointments from doctors, physical therapy, imaging, etc. This should be on the office’s letterhead and signed by the physician / therapist.
7. Compensation for total disability is payable at the rate of 66 2/3% with zero dependents or 75% with one or more dependents.
8. For time off that is intermittent, also fill out form CA7a. You’ll need documentation for each period away from work proving that the time away was due to the accepted work injury.
9. Chiropractors, Nurse Practitioners and Physicians Assistants can not sign off on medical reports required for CA7 Claims for Compensation. With NP and PA Signatures, an MD countersignature is required.