View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

FECA Medical Report Forms, Claim for Compensation
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction ca-17 http://www.dol.gov/esa/regs/compliance/owcp/ca-17.pdf Yes No Fillable Printable
Form and Instruction CA-7 http://www.dol.gov/esa/regs/compliance/owcp/ca-7.pdf Yes No Fillable Printable
Form and Instruction CA-17 http://www.dol.gov/esa/regs/compliance/owcp/ca-17.pdf Yes No Fillable Printable
Form and Instruction CA-1331 No   Paper Only
Instruction No   Paper Only
Instruction No   Paper Only
Instruction No   Paper Only
Form and Instruction CA-1332 No   Paper Only
Instruction No   Paper Only
Instruction No   Paper Only
Form and Instruction OWCP-5A http://www.dol.gov/esa/regs/compliance/owcp/ca-5a.pdf Yes Yes Fillable Fileable Signable
Form and Instruction owcp-5b http://www.dol.gov/esa/compliance/owcp/ca-5b.pdf Yes Yes Fillable Fileable Signable
Form and Instruction owcp-5c http://www.dol.gov/esa/regs/compliance/owcp/ca-5c.pdf Yes Yes Fillable Fileable Signable
Form and Instruction ca-20 http://www.dol.gov/esa/regs/compliance/owcp/ca-20.pdf Yes Yes Fillable Fileable Signable
Form and Instruction ca-16 No   Paper Only

Workforce Management Labor Rights Management

DOL/GOVT-1 

294,540 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 294,540 0 0 -7,945 0 302,485
Annual IC Time Burden (Hours) 30,493 0 0 -255 0 30,748
Annual IC Cost Burden (Dollars) 132,543 0 0 11,543 0 121,000

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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