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Federal Employees’ Compensation Act (FECA and CA)
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Form No. and Title
Price
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CA-1 Notice of Traumatic Injury
$7.50
CA-2 Notice of Occupational Disease and Claim for Compensation
$7.50
CA-2a Notice of Recurrence of Disability 
$7.50
CA-5 Claim for Compensation by Widow, Widower, and/or Children
$7.50
CA-6, Official Supervisor's Report of Employee's Death
$7.50
CA-7 Claim for Compensation on Account of Traumatic Injury or Occupational Disease
$7.50
CA-16 Authorization for Examination and/or Treatment
$7.50
CA-17, Duty Status Report
$7.50
CA-20 Attending Physician’s Report
$7.50
CA-915 Claimant Medical Reimbursement Form
$7.50
CA-35a Occupational Disease in General
$7.50
CA-35b Hearing Loss
$7.50
CA-35c Asbestos-Related Illness
$7.50
CA-35d Coronary/Vascular Condition
$7.50
CA-35e Skin Disease
$7.50
CA-35f Pulmonary Illness (NOT Asbestosis)
$7.50
CA-35g Psychiatric Illness
$7.50
CA-35h Carpal Tunnel Syndrome
$7.50
HCFA-1500, Health Insurance Claim Form
$7.50
CD 435 Procurement Request
$7.50
SF85
$7.50
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