Ca 3 Form – Fill Out and Use This PDF

Ca 3 Form PDF Details

The Ca 3 Form (CA-3, Report of Termination of Total Disability) is an OWCP document filed by federal employees when returning to work after a total disability claim. Submitting this form notifies the Department of Labor to adjust or stop ongoing compensation payments under the Federal Employees' Compensation Act (FECA).

Who Must File This OWCP Form?

Federal employees who have been receiving total disability benefits under FECA must submit this form when any of these events occur:

• Return to full-duty work after a work-related injury or illness
• Return to modified or light-duty work assigned by the employing agency
• Recovery from total disability as documented by a treating physician

What Information Is Required?

The form requires the following details to process your claim update:

• Employee name, Social Security number, and date of birth
• OWCP claim file number (assigned at initial claim filing)
• Date of return to work or end of total disability
• Agency name and supervisor contact information
• Signatures of the employee and employing agency representative

Related OWCP Forms for Federal Employees

This OWCP document is part of a series of federal workers' compensation forms. You may also need the OWCP-915 medical bill form, the OWCP-1168 form, or the workers' compensation injury report for related documentation.