Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
FECA Medical Report Forms, Claim for Compensation Modified 282353 25605 110118 Form and Instruction CA-7 Claim for Compensation
Form and Instruction CA-17 Duty Status Report
Form and Instruction CA-1331,with CA-1087 enclosed Authorization to Doctor for Audiologic and Otologic Evaluation and enclosure PWCP Hearing Loss Medical Requirements
Instruction
Instruction
Form and Instruction CA-1332 Outline for Otologic Testing
Form and Instruction OWCP-5a Work Capacity Evaluation, Psychiatric/Psychological Conditions
Form and Instruction owcp-5b Work Capacity Evaluation, Cardiovascular/Pulmonary Conditions
Form and Instruction owcp-5c Work Capacity Evaluation Form, Musculoskeletal Conditions
Form and Instruction ca-20 Attending Physicians Report
Form and Instruction ca-16 Authorization for Examination and/or Treatment
Total burden requested under this ICR: 282353 25605 110118  
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