Form Ca-3 - Report Of Termination Of Disabilty And/or Payment Page 2
Download a blank fillable Form Ca-3 - Report Of Termination Of Disabilty And/or Payment in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Ca-3 - Report Of Termination Of Disabilty And/or Payment with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2INSTRUCTIONS FOR COMPLETING FORM CA-3
WHEN EMPLOYEE RETURNS TO WORK
PART - A
.
When disability ceases and/or employee returns to work, the official
REQUIRED
superior shall immediately report that fact to the OWCP on Form CA-3
WRITTEN
unless this information has been previously submitted on Form CA-1
REPORT
or CA-2 or otherwise. This form should be submitted for each injury
resulting in time lost from work whether or not claim for compensation is
made.
.
If the employee is receiving disability compensation periodically
TELEPHONE/
each four weeks, the official superior should immediately telephone
TELEGRAPH
or telegraph the OWCP advising the date employee returned to work.
REPORT
This will avoid an overpayment of compensation. Follow-up should
then be made with Form CA-3.
.
Employee’s base pay in items 12a or 21a should not include value
PAY RATE
of subsistence, quarters or other pay. These should be shown
INFORMATION
separately in their own columns.
PART - B
.
In most traumatic injury cases, the employee will have qualified for
CONTINUATION
and received continuation of pay under 5 USC 8118 (FECA). When
OF PAY
this occurs, items 9, 13, and 15 in Part A will usually be left blank.
When there is a continuation of pay, Part B must always be completed,
unless the information has been submitted on Form CA-7, Claim for
Compensation on Account of Traumatic Injury.
For sale by the Superintendent of Documents, U.S. Government Printing Office, Washinton, D.C. 20402
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form 92a936 - Election To Qualify Terminable Interest Property And / Or Power Of Appointment Property
Financial
Form 92a936 - Election To Qualify Terminable Interest Property And/or Power Of Appointment Property
Financial
Form 92a936 - Election To Qualify Terminable Interest Property And/or Power Of Appointment Property - 2012
Financial
Form 92a936 - Election To Qualify Terminable Interest Property And/or Power Of Appointment Property
Legal
Related Categories
Parent category: Legal