A federal agency issues this authorization when one of its employees has a traumatic injury, naming the physician or medical facility that may examine and treat the worker for up to 60 days. The attending physician completes the initial report on the reverse side and returns it to the Office of Workers' Compensation Programs (OWCP), which pays for the authorized care under the FECA program.
Authorized employing-agency personnel issue the form and complete the authorization for the specific injury. The attending physician named in the authorization completes the attending physician's report on the reverse side.
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Authorization for Examination and/or Treatment
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It cannot be downloaded. DOL's FECA forms page says CA-16 is only available to authorized employing-agency personnel, who obtain it electronically through the Agency Query System (AQS) or ECOMP. A clinic treating a federal employee without one can ask the employing agency's workers' compensation personnel, the other route the page lists.
The employing agency's written authorization covers examination and treatment for a traumatic injury for up to 60 days. It names the specific physician or medical facility authorized to provide care, and the attending physician's initial report goes on the reverse side of the same form.
No. The FECA forms page says all of the Federal Employees Program's online forms can be printed except CA-16 and CA-27. Forms such as CA-17 and CA-20 are posted for printing and can be filled electronically.