Form CA-7: Filing, Medical Evidence, and Leave Buyback

Form CA-7 is the claim federal employees file to receive wage-loss compensation or a schedule award after a work-related injury accepted by the Office of Workers’ Compensation Programs (OWCP). To fill it out, you complete Sections 1 through 7 with your case number, claim type, dates of disability, and any outside earnings, attach medical evidence covering every date claimed (plus Form CA-7a if the dates are intermittent), then pass the form to your supervisor, who completes Sections 8 through 15 and forwards everything to OWCP.¹ Most claimants file electronically through the ECOMP portal at ecomp.dol.gov.

One quick boundary before the walkthrough: Form CA-7 (federal, filed by the employee) is a different document from Form C-7, the New York State notice used by employers to dispute a claim. If you are a federal worker seeking benefits, CA-7 is what you want.

What To Have Ready Before You Start

You cannot complete CA-7 productively without a few items in front of you:

Your OWCP case number, assigned when your initial CA-1 (traumatic injury) or CA-2 (occupational disease) was accepted.
Your pay information as of the date of injury, including base pay and any night differential, Sunday premium, holiday premium, or subsistence allowance.
Medical documentation covering every date you plan to claim.
The specific dates of disability, and whether they were one continuous block or scattered across the calendar.
The name, date of birth, and relationship of each dependent, if this is your first CA-7 on the case.

The form is available for download from the OWCP website or can be completed directly in ECOMP.²

Sections 1 Through 7: The Employee Half

Section 1 — Claim type. Check the box that matches what you are claiming: leave without pay, leave buy-back, other wage loss, or schedule award. The rest of the form and the evidence you need to attach follow from this choice.

Section 2 — Dates claimed. Enter the exact dates. A single continuous period goes here as a start and end date. If your time off was intermittent, note that here and complete Form CA-7a as well (covered below).

Section 3 — Outside earnings. Report any and all earnings from employment outside your federal job during the claimed period, including salary, wages, commissions, or payment of any kind. Leaving this blank when you had outside income is one of the fastest routes to a denial or an overpayment finding later.¹

Sections 4 and 5 — Dependents and direct deposit. On your first CA-7, list each dependent’s name, date of birth, and relationship. FECA pays two-thirds of your regular pay if you have no dependents and three-quarters if you have at least one, so this section directly changes what you receive.³ Eligible dependents include a spouse living with you or dependent on you for support (including one living apart for reasonable cause); a child under 18, or over 18 and incapable of self-support, including stepchildren, adopted children, and posthumous children; a parent, stepparent, or adoptive parent; and an unmarried sibling under 18, or over 18 and incapable of self-support.⁴ You do not need to re-list dependents on subsequent CA-7s unless something changed.

Sections 6 and 7 — Signature and claim statement. Sign and date the form. Section 7 is the formal claim statement you are signing under.

Add Form CA-7a for Intermittent Dates

If the dates in Section 2 are not one continuous stretch, Form CA-7a is required. It is a day-by-day time analysis sheet that logs, for each date claimed, the hours of leave without pay, hours actually worked, and the type of leave used (sick, annual, or other).⁵ Missing CA-7a on an intermittent claim will stall the file.

Sections 8 Through 15: What Your Agency Adds

Once your part is done, the form goes to your supervisor or the agency’s workers’ compensation office. On the first CA-7 filed against a case, the agency completes all of Sections 8 through 15. On later CA-7s in the same case, only Sections 12 through 15 need updating.¹

Section 8: Base pay and any additional pay elements as of the date of injury.
Section 9: Work schedule.
Section 10: Enrollment in health benefits, life insurance, and retirement.
Section 11: Continuation of pay received, and dates of sick leave, annual leave, leave without pay, and work.
Section 13: Whether you have returned to work, and if so, whether the job matches your pre-injury duties and hours.
Section 15: The agency official’s signature, given under penalty of false certification.

The agency then forwards the form together with the medical evidence to OWCP.

Timing Around Continuation of Pay

For traumatic injuries, you may be entitled to continuation of pay for up to 45 calendar days while OWCP reviews your claim, provided you started losing time within 45 days of the incident.⁶ COP keeps your paycheck flowing during adjudication, but it runs out. When your disability is expected to continue past those 45 days, your employer should give you Form CA-7 by the 30th day of COP, and the completed form should be with OWCP by the 40th day.⁷ Waiting until COP has already expired to file the CA-7 typically means a gap with no income.

Non-postal federal employees are also subject to a three-day waiting period. You are not paid compensation for the first three days of disability unless total disability exceeds 14 days, the disability leads to permanent impairment, or the time off was solely for medical treatment. Weekends and holidays count. If disability later crosses the 14-day threshold, those three days are paid retroactively. Postal Service employees have a different rule under the Postal Accountability and Enhancement Act: the three-day waiting period sits at the beginning of the disability period regardless of injury type, and COP starts on the fourth day.⁷

Medical Evidence That Actually Supports the Claim

OWCP needs medical documentation that covers the exact dates you are claiming and shows that you are disabled as a result of the accepted work injury, and that you either cannot perform any work or have restrictions your agency cannot accommodate.² A note that says only “patient is off work” is a common reason claims stall. Ask your doctor to include the diagnosis, physical limitations, objective findings, and a clear rationale connecting the disability to the accepted injury.

Schedule award claims require more. The treating physician or a second-opinion examiner must provide an impairment evaluation based on the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, including clinical history, physical findings, clinical studies, and a calculated impairment percentage. OWCP’s District Medical Advisor then verifies the rating and sets the date of maximum medical improvement.⁷

Buying Back Sick or Annual Leave

If you used sick leave or annual leave during your recovery, you can buy that leave back through the CA-7 process. Your agency converts the period from leave with pay to leave without pay, OWCP pays compensation for those dates, and you repay the agency the difference so your leave balance is restored.

The steps:

File CA-7 and CA-7a for the dates you want to buy back. CA-7a is mandatory whenever you are claiming more than one continuous period.⁸
Submit medical evidence supporting disability for every date claimed.
Your agency estimates the FECA entitlement and the amount you owe to restore the leave.
Complete Section III of Form CA-7b to elect the buy-back and arrange payment to your agency for the difference.

A minimum of 10 hours of leave must be claimed unless you do not plan to file any further claims. You cannot buy back leave used during a period you were eligible for COP. If your disability does not exceed 14 days beyond the COP period, three days of leave without pay are charged before compensation begins.⁸ Completing the buy-back in the same calendar year the leave was used keeps the tax picture clean; if it crosses into the following year, you cannot amend the prior return and can only claim the repaid amount as an itemized employee expense.

How To Submit Form CA-7

The fastest submission route is ECOMP at ecomp.dol.gov. Register for an account, then either complete the form online or upload a completed PDF along with your medical documentation. The form routes automatically to your agency, which fills in its sections and forwards everything to OWCP. To add records to an open case later, use “Access Case and Upload Document” and enter your case information.⁹

On paper, submit the completed form to your agency’s personnel or workers’ compensation office and get a date-stamped copy for your records. Your supervisor is responsible for promptly forwarding it to OWCP.¹

After You File

OWCP aims to review wage-loss claims within five days of receipt and take action to develop or pay within 14 days.¹⁰ Action does not always mean a check. It may mean a development letter asking for more medical evidence or clarification. Watch the ECOMP dashboard and answer any requests quickly; slow responses are the biggest single cause of long processing times.

Also worth knowing on the tax side: compensation payments for personal injury or sickness under FECA are not taxable, and OWCP does not issue 1099s for disability compensation. Continuation of pay, however, is wages, and sick leave used while a claim is being processed is taxable income.¹¹

Common Reasons CA-7 Claims Stall

Insufficient medical evidence: the report does not connect the disability to the accepted injury, lacks objective findings, or does not cover every date claimed.
Missing CA-7a on intermittent claims.
Unreported outside earnings in Section 3.
Filing after COP expires, creating an income gap.
Agency delays in completing Sections 8–15 or forwarding the form.

If OWCP denies your claim, the denial letter will lay out your appeal rights: a hearing before an OWCP hearing representative, reconsideration based on new evidence or a legal argument that OWCP erred, or an appeal to the Employees’ Compensation Appeals Board. Each has its own deadline, so read the letter closely before choosing a path.

1
U.S. Department of Labor. CA-7 – Claim for Compensation
2
eCFR. 20 CFR Part 10 – Claims for Compensation Under the Federal Employees’ Compensation Act, as Amended
3
U.S. Department of Labor. Benefits Available
4
U.S. Department of Labor. Federal Employees’ Compensation Act
5
U.S. Department of Labor. Time Analysis Form – CA-7a
6
U.S. Department of Labor. Continuation of Pay COP
7
U.S. Department of Labor. FECA Part 2 – Procedure Manual
8
U.S. Department of Labor. Leave Buy Back Worksheet/Certification and Election
9
U.S. Department of Labor. Federal Employees’ Compensation Act — Frequently Asked Questions
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U.S. Department of Labor. Wage Loss
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U.S. Department of Labor. Claimant TAX Information