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INSTRUCTIONS FOR COMPLETING DUTY STATUS REPORT (CA-17) SUPERVISOR: Complete Side A and refer the form to the physician to complete Side B. Fill in the address of the Employing Agency and send a copy of this report to the OWCP address noted below. Enter the OWCP file number in the top right corner. PHYSICIAN:
1 Αυγ 2014 · Download a fillable version of Form CA-17 by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor - Office of Workers' Compensation Programs.
3 Ιουλ 2017 · While many doctors have their own forms for describing work restrictions, compensably injured workers should provide their doctors with a properly filled out OWCP Form CA-17, Duty Status Report.” Download [148.26 KB] Source: NALC.
Form CA-17 - Duty Status Report: This form is provided for purpose of obtaining a medical duty status report for IW. It may be issued initially with Form CA-16.
31 Οκτ 2008 · View, download and print fillable Ca-17 - Duty Status Report in PDF format online. Browse 1 Ca-17 Form Templates collected for any of your needs.
INSTRUCTIONS FOR COMPLETING DUTY STATUS REPORT (CA-17) SUPERVISOR: Complete Side A and refer the form to the physician to complete Side B. Fill in the address of the Employing Agency and the appropriate OWCP District Office in the spaces below. Enter the OWCP file number in the top right corner. PHYSICIAN:
Printable Forms. All of the Federal Employees Program's online forms (with the exception of Forms CA-16, CA-26 and CA-27) are available to print and to manually fill and submit. Simply click on the appropriate form and print it using the [Print] button provided near the top of the form.
