Traumatic Injury Claim

Office of Workers' Compensation Programs Form CA-1

Traumatic injury means a wound or other condition of the body caused by external force, including stress or strain, which is identifiable as to time and place of occurrence and member or function of the body affected. The injury must be caused by a specific event or incident or series of events or incidents within a single work day or shift.

The injury must be caused by a specific event or incident. This injury was caused by picking up a heavy object, or slipping and falling down. Picking up a heavy object which caused an injury to lower back and right knee, is a specific event.

    One should answer the following questions:

  • 1. What date and time did the specific event occur?
  • 2. What specific event occurred? Example: while walking out of the restroom, I slipped in a puddle of water.
  • 3. Where did the incident occur? Example: the restroom on the second floor of the building at 125 N. Smith St. Tampa, Florida 00001.
  • 4. What body functions were injured? Example: lower back and right knee.

The most misunderstood injury that falls under CA-1 is a series of events or incidents, within a single work day or work shift. This injury occurs when one picks up numerous objects in a single work day. For example: “I picked up 25 heavy objects during the work day, weighing from 5 to 55 lbs. each. I don’t know which object caused my shoulders, and both arms to hurt, but by the end of that work shift, the pain to those areas increased.”

  • 1. What happened? Example: picking up 25 heavy objects.
  • 2. When did it happen? During my normal work shift, between 8A.M. and 2PM on March 15, 2023.
  • 3. What did you injure? Both shoulders, and arms.

Again, this is a CA-1 Traumatic Injury. Important, check “COP” when filing a CA-1. This means the agency will have to pay your regular pay for the first 45 calendar days after the injury if loss of work occurs.

CHOICE OF PHYSICIAN

Under the Federal Employees’ Compensation Act (FECA), an employee is guaranteed the right to a free choice of physician. The immediate supervisor authorizing first aid for the injured employee is responsible for fully explaining the employee’s right to his/her choice of physician and/or health care facility.

The following provisions apply:

The Agency medical officer or contract physician’s evaluation is not required before an employee makes an initial choice of physician or receives continuation of pay. If an employee declines first aid treatment or medical evaluation by the Agency medical officer or contract physician, authorization for first aid medical examination and treatment by the physician of the employee’s choice must not be delayed or denied. An employees’ declination in such cases may not be used as a basis to discontinue pay or to controvert a claim.

CHOICE OF BENEFITS

The employee must elect either continuation of pay (COP) or sick / annual leave in traumatic injury cases. When filing traumatic injury cases on the CA-1, COP is payable for up to 45 calendar days with eligibility for compensation following the initial 45 days. The employee may also receive compensation or sick/annual leave in occupational disease cases filed on a CA-2.

“Ask yourself: Have you been injured in the performance of your duties? Is your pain or illness related to your work? Have you received all the benefits you are entitled to under the Federal Workers' Compensation program? Our experienced consultants can help. You are not alone.”