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2. Duty Status Report U.S. Department of Labor

   www.dol.gov/sites/dolgov/files/owcp/regs/compliance/ca-17.pdf

   INSTRUCTIONS FOR COMPLETING DUTY STATUS REPORT (CA-17) SUPERVISOR: Complete Side A and refer the form to the physician to complete Side B. Fill in the address of the Employing Agency and send a copy of this report to the OWCP address noted below. Enter the OWCP file number in the top right corner. PHYSICIAN:

3. Forms | U.S. Department of Labor

   www.dol.gov/agencies/owcp/FECA/regs/compliance/forms

   Submit forms online through the Employees' Compensation Operations and Management Portal (ECOMP). On the ECOMP site you can register for an account, initiate a claim, upload documents, submit forms, and access your case. OWCP's Federal Employees Program has made a variety of forms available online. These forms are only available in PDF format.

4. Forms | U.S. Department of Labor

   www.dol.gov/general/forms

   Duty Status Report (Form Number - CA-17; Agency - Office of Workers' Compensation Programs - Division of Federal Employees', Longshore and Harbor Workers' Compensation)

5. Duty Status Report U.S. Department of Labor - National...

   gacc.nifc.gov/rmcc/dispatch_centers/r2gjc/human_resources/owcp_forms/ca-17.pdf

   INSTRUCTIONS FOR COMPLETING DUTY STATUS REPORT (CA-17) Complete Side A and refer the form to the physician to complete Side B. Fill in the address of the Employing Agency and the appropriate OWCP District Office in the spaces below. Enter the OWCP file number in the top right corner.

6. Doc Explains Fed Work Comp (CA-17) - Ellis Clinic

   ellisclinic.com/DocEllisExplains/doc-explains-fed-work-comp-(ca-17).html

   It is recommended that you take a Form CA-17 - Duty Status Report with you to give to your physician. This form provides your supervisor and OWCP with interim medical reports containing information as to your ability to return to any type of work.

7. OWCP - U.S. Department of Labor

   www.ecomp.dol.gov

   Depending upon your agency, start by filing OSHA's Form 301, then file a claim using either form CA-1 (for traumatic injury) or form CA-2 (for occupational disease). After you have received an official FECA case number, you may also file form CA-7 (Claim for Compensation).

8. Workers' Compensation Program Forms - U.S. Department of the...

   www.doi.gov/workerscompensation/forms

   Workers' Compensation Program Forms. CA-1 - Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation. CA-2 - Federal Employee's Notice of Occupational Disease and Claim for Compensation. CA-2a - Notice of Recurrence. CA-17 - Duty Status Report.

9. Duty Status Report U.S. Department of Labor - AFGE

   www.afge.org/globalassets/documents/health--safety/ca-17.pdf

   INSTRUCTIONS FOR COMPLETING DUTY STATUS REPORT (CA-17) Complete Side A and refer the form to the physician to complete Side B. Fill in the address of the Employing Agency and the appropriate OWCP District Office in the spaces below. Enter the OWCP file number in the top right corner. SUPERVISOR:

10. ca-17 - Federal Injury Centers

    federalinjurycenters.com/wp-content/uploads/ca17.pdf

    Title: ca-17.pdf Author: DOLMAIN Created Date: 6/26/2019 9:31:59 AM

11. Form CA-17 - U.S. Department of Labor

    www.dol.gov/sites/dolgov/files/owcp/dfec/icstraining/returntowork/form_ca_17.html

    Form CA-17 - Duty Status Report: This form is provided for purpose of obtaining a medical duty status report for IW. It may be issued initially with Form CA-16.