CA-7B form plantilla
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Fillable CA-7B Claim for Compensation Benefits PDF
- Idioma Inglés
- País EE.UU
- Departamento Federal Employees' Compensation
- Actividad Benefits
The CA-7B is the federal employee’s claim form used to request continuing compensation after a work‑related injury or illness. It is part of the Federal Employees' Compensation Act (FECA) and must be completed accurately to receive benefits.
What Is the CA-7B Form?
The CA-7B captures personal information, injury details, medical treatment, and the type of compensation you are seeking. It is required when you have already filed a CA-7 and need to claim additional or ongoing benefits.
How to Complete the CA-7B Online
Instead of printing, filling, and scanning, you can fill the form directly in your browser using Formize’s PDF Filler. Follow the simple steps below.
Common Mistakes to Avoid
- Leaving sections blank: Every required field (sections 1‑7) must be completed.
- Incorrect dates: Use the exact dates of injury and treatment.
- Wrong signature format: Sign electronically using the Formize tool.
- Submitting outdated forms: Always use the latest PDF version linked on this page.
Download the Official CA-7B PDF
Click the button below to open the fillable PDF in the Formize app. No software download is required.
Where to Find Help
If you have questions about eligibility, medical documentation, or submission deadlines, contact your agency’s Workers’ Compensation office or the Department of Labor’s Office of Federal Employees’ Compensation.
What is the difference between CA-7 and CA-7B?
CA-7 is the initial claim for compensation. CA-7B is used to request continuing or additional benefits after the first claim has been filed.
Can I file the CA-7B electronically?
Yes. Using Formize’s online PDF filler, you can complete and save the form without printing.
Do I need a medical examiner’s report?
A current medical report supporting your claim is required. Attach it as a separate PDF when you submit the CA-7B.
How long do I have to submit a CA-7B after my injury?
The claim should be filed within 180 days of the injury, but extensions may be granted under certain circumstances.
What should I do if I make a mistake on the form?
Correct the error in the Formize editor before saving. If you have already submitted, contact your agency’s Workers’ Compensation office for a correction.
Is there a fee to use the Formize PDF Filler?
No. Formize provides free online filling for government PDF forms like the CA-7B.
Can I save my progress and finish later?
Yes. Use the "Save" button in the Formize app to download a draft version, then reopen it later to continue.
Cómo completar CA-7B form gratis, en línea en 4 sencillos pasos:
- 1Open the Fillable FormClick the "Fill out this form" button above. The Formize PDF Filler app will load the CA-7B directly in your browser.
- 2Enter Your InformationComplete each required field (sections 1‑7). Use the navigation toolbar to move between pages and add your electronic signature.
- 3Review & SaveDouble‑check all entries for accuracy, then click "Save" to download a copy for your records.
- 4Submit the FormPrint the saved PDF or email it directly to your agency’s Workers’ Compensation office as instructed.
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