OWCP Form CA-17
OWCP Form CA-17 is the Duty Status Report used by the Office of Workers’ Compensation Programs (OWCP) to track the work status of a federal employee who has been injured on the job. The form is completed by the employee and their DOL doctor physician, and it provides information about the employee’s ability to work, their current restrictions, and their expected return to work date.
The CA-17 form is an important part of the OWCP claims process. It helps the OWCP determine whether the employee is entitled to benefits, and it can also be used to dispute a decision about the employee’s work status.
To complete the CA-17 form, the employee will need to provide the following information:
- Their name, address, and OWCP file number
- The date of their injury
- The nature of their injury
- Their current work status (e.g., unable to work, light duty, full duty)
- Any restrictions on their work activities
- Their expected return to work date
The physician will also need to complete the CA-17 form. They will need to provide their name, address, and DEA number. They will also need to provide a medical opinion about the employee’s ability to work, their current restrictions, and their expected return to work date.
The CA-17 form can be obtained from the OWCP website or from the employee’s employing agency. It can also be completed electronically through the OWCP’s ECOMP system.
Once the CA-17 form is completed, it should be submitted to the OWCP district office that is handling the employee’s claim.
Here are some additional things to keep in mind about the CA-17 form:
- The form must be completed and submitted within 15 days of the employee’s return to work.
- If the employee’s work status changes, they must complete a new CA-17 form.
- The CA-17 form is confidential and should not be shared with anyone other than the OWCP and the employee’s physician.