Guide · Updated
What Is a CA-20 Form?
Form CA-20 is the Attending Physician's Report in a federal workers' comp (FECA) claim. Your treating doctor fills it out to tell OWCP your diagnosis, exam findings, treatment, whether the condition is work-related, and how it affects your ability to work. It can be used for the first medical report and for later updates.
When you are hurt on a federal job, your own statement starts the claim, but the medical record is what OWCP leans on to decide it. The CA-20 is one of the main ways your doctor puts that record in writing. Knowing what goes on it helps you understand why your doctor asks so many questions at each visit.
What the CA-20 is
The CA-20, Attending Physician’s Report, is a Department of Labor form for claims under the Federal Employees’ Compensation Act (FECA). The treating doctor fills it out and it goes into your OWCP case file.
OWCP rules say the CA-20 “may be used for the initial report and for subsequent reports” (20 CFR 10.331(a)). The form is optional. A doctor can also write a narrative report on letterhead, as long as it is signed.
What the report covers
Every case reported to OWCP needs a medical report from the attending physician. Under 20 CFR 10.330, that report should include:
- Dates of exam and treatment
- The history you gave the doctor
- Physical findings and test results
- The diagnosis
- The course of treatment, and the treatment given or recommended
- Any other conditions found that are not from the work injury
- The doctor’s opinion, with medical reasons, on whether your condition was caused by your work
- How much the injury limits your ability to work
- Your outlook for recovery
The causation opinion is often the piece that decides a claim. A report that just says “work injury” without explaining how your job duties caused or worsened the condition is weaker than one that walks through the medical reasons.
CA-20, CA-20a, CA-16 and CA-17: what’s the difference?
Several OWCP forms carry medical information, which can be confusing:
- CA-16 is the agency’s authorization for exam and treatment. It can also serve as the first medical report (20 CFR 10.331(a)).
- CA-20 is the attending physician’s report, for the first report and for updates.
- CA-20a is used when continued compensation is claimed. It goes with a continuing CA-7 to show your disability is ongoing and tied to the injury (20 CFR 10.102(b)(3)).
- CA-17 is the duty status report your agency uses to get your current work restrictions (20 CFR 10.331(b)).
If you are not sure whether your claim started on the right form, our post on the difference between a CA-1 and a CA-2 can help. You can also see the full list on our OWCP forms page.
How the CA-20 gets to OWCP
Medical reports go straight to OWCP “as soon as possible after medical examination or treatment,” sent either by you or by the doctor (20 CFR 10.331(b)). Your agency can ask OWCP for a copy, but it is not the go-between.
Once you have a case number, documents can be uploaded through the Document Upload feature in ECOMP. DOL says uploads “should usually be available to OWCP within 4 hours” (ECOMP help). Our guide on how to log in to ECOMP explains the portal.
Why the CA-20 matters to you
Under OWCP rules, it is up to you, the claimant, to submit or arrange for a medical report from your attending physician. If you are claiming wage loss, you also need medical evidence showing the condition is disabling (20 CFR 10.115(f)).
In other words, a CA-7 for lost wages depends on solid medical reports. Read what a CA-7 form is to see how the two forms work together.
Tips for your doctor visits
- Tell the whole story. Describe exactly how the injury happened and what your job requires: lifting, standing, driving, carrying mail, or long shifts at a port of entry.
- Bring your paperwork. Your claim number, any CA-16 from your agency, and copies of forms you filed.
- Report changes. If pain gets worse or new symptoms show up, say so, so the report stays accurate.
- Ask for copies. Keep your own copy of every report sent to OWCP.
How Alivio can help
At Alivio, Dr. Peter Ruiz, MD, our medical director, oversees care and reviews and signs the FECA medical reports for our federal patients. We are enrolled with OWCP, bill the Department of Labor directly, and offer free OWCP forms help at our McAllen and Harlingen clinics. Call (956) 679-3451 for a free consultation, or learn more about our OWCP doctors.
Quick answers
Do I fill out any part of the CA-20 myself?
The CA-20 is a doctor's form, so your treating physician completes it. Your part is to give the doctor an accurate history of how you were hurt, a clear description of your job duties, and your OWCP claim number so the report lands in the right file.
Is there a Spanish version of the CA-20?
Yes. The Department of Labor posts a Spanish-language CA-20 on its forms page, which can help patients in the Rio Grande Valley follow along with what the doctor is reporting. OWCP also posts Spanish versions of the CA-17 duty status report.
Does my doctor have to use the CA-20 form?
No. OWCP rules say medical report forms are not required. A doctor can write a narrative report on letterhead instead, as long as it covers what OWCP needs and is signed. Many doctors use both, depending on the stage of the claim.
Sources
Medically reviewed by Peter Ruiz, MD, Medical Director. MD · Family Medicine · Texas Medical Board license N2270
Last reviewed · How we review content