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Attig Law Firm (MSPB Attorney, Dallax TX)
Adam J. Conti, Esq. (Federal Sector Employment Attorney, Atlanta,
Georgia)
Ronald
B. Schwartz (Federal & State Employment Law, Chicago, Illinois)
To Find Your
Congressperson
Some
of the following forms are PDF files. Adobe Acrobat Reader is required
to open them. To save them to your computer, click and "Save As..."
Family
and Medical Leave Act (FMLA)
The Family Medical Leave Act protects employees who are faced with
the necessity of taking time off work due to personal or family illness.
- Form
WH-380 (PDF)
An optional form that may be used to obtain a medical certification
from a health care provider.
- Form
WH-381 (PDF) An optional form that an employer may use to respond
to an employee's request for leave.
Federal
Labor Relations Authority
"The Federal Labor Relations Authority (FLRA) is an independent agency
responsible for administering the labor-management relations program for
Federal employees world-wide, approximately 1.3 million of whom are exclusively
represented in more than 2,200 bargaining units. Its mission is to promote
stable and constructive labor-management relations that contribute to an
efficient and effective government." Source: GPO
Access
NLRB
[Postal employees only]
"The National Labor Relations Board is an independent federal
agency created by Congress in 1935 to administer the National Labor Relations
Act, the primary law governing relations between unions and employers
in the private sector. The statute guarantees the right of employees to
organize and to bargain collectively with their employers or to refrain
from all such activity. Generally applying to all employers involved in
interstate commerce--other than airlines, railroads, agriculture, and
government--the Act implements the national labor policy of assuring free
choice and encouraging collective bargaining as a means of maintaining
industrial peace. Through the years, Congress has amended the Act and
the Board and courts have developed a body of law drawn from the statute."
Source:
US Business Advisor
OWCP
"The Office of Workers' Compensation Programs (OWCP) administers
the Federal Employees' Compensation Act (FECA), 5 U.S.C. 8101, et seq.,
the Black Lung Benefits Act (BLBA), 30 U.S.C. 901 et seq., and the Energy
Employees Occupational Illness Compensation Program Act of 2000 (EEOICPA),
42 U.S.C. 7384 et seq. These Acts require OWCP to pay for covered medical
treatment that is provided to beneficiaries, and also to reimburse beneficiaries
for any out-of- pocket covered medical expenses they have paid."
Source: OPM
The
following forms are PDF files. Adobe Acrobat Reader is required to open them.
- CA-1
Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation
- CA-2
Notice of Occupational Disease and Claim for Compensation
- CA-2a
Notice of Recurrence
-
CA-3
Report of Termination of Disability and/or Payment
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CA-5
Claim for Compensation by Widow, Widower, and/or Children
-
CA-5b
Claim for Compensation by Parents, Brothers, Sisiters, GrandParents,
or GrandChildren
-
CA-6
Official Supervisor's Report of Employee's Death
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CA-7
Claim for Compensation
-
CA-7a
Time Analysis Form, used for claiming compensation, including repurchase
of paid leave
-
CA-7b
Leave Buy Back (LBB) Worksheet/Certification and Election
-
CA-10
What A Federal Employee Should Do When Injured At Work
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CA-12
Claim For Continuance of Compensation Under the Federal Employees'
Compensation Act
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CA-17
Duty Status Report
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CA-20
Attending Physician's Report
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CA-35
Evidence Required in Support of a Claim for Occupational Disease
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CA-721
Notice of Law Enforcement Officer's Injury Or Occupational Disease
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CA-722
Notice of Law Enforcement Officer's Death
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CA-915
Claimant Medical Reimbursement Form
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CA-1108
Statement of Recovery Letter with Long Form
-
CA-1122
Statement of Recovery Letter with Short Form
-
CA-2231
Claim for Reimbursement Assisted Reemployment
- OWCP-1
Agreement and Undertaking
-
OWCP-5a
Work Capacity Evaluation Psychiatric/Psychological Conditions
-
OWCP-5b
Work Capacity Evaluation Cardiovascular/Pulmonary Conditions
-
OWCP-5c
Work Capacity Evaluation for Musculoskeletal Conditions
- OWCP-16 Rehabilitation Plan And Award
-
OWCP-17
Rehabilitation Maintenance Certificate
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OWCP-44
Rehabilitation Action Report
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OWCP-957
Medical Travel Refund Request
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HCFA-1500
Health Insurance Claim Form
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OWCP-1500
Health Insurance Claim Form
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UB-92
Uniform Health Insurance Claim Form
MSPB
"The U.S. Merit Systems Protection Board (MSPB) protects the integrity
of the Federal merit systems and the rights of Federal employees working
in the systems." Source:
GPO Access
- MSPB
Petition for Appeal Form PDF,
HTML or WORD)
- Form recommended to use in filing an initial appeal. To submit your
appeal, follow the instructions contained on the form.
- Petition
for Review Form - Optional form may be used to file a petition for review
with the full Board in Washington, D.C. (See 5 C.F.R. 1201.114 through
5 C.F.R. 1201.120 (PDF
70KB or HTML
22KB)
- Designation
of Representative Form (HTML
6kb, PDF
23kb) - optional form may be used to designate any organization or individual
to represent a party appearing before the Board at either the field/regional
level or headquarters level.
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he following list is offered as a courtesy to allow people to locate attorneys closer to home and/or for access to some commonly used forms. It does not constitute a recommendation or endorsement of the lawyers or sites listed. Any use of this must be at your own risk.