The CA-7A Time Analysis Form is a critical document within the Federal Employees' Compensation Act (FECA) claims system, administered by the U.S. Department of Labor's Office of Workers' Compensation Programs. It works as a companion to Form CA-7 (Claim for Compensation) and Form CA-7b (Leave Buy Back Worksheet), providing a detailed breakdown of leave periods claimed by an injured or ill federal employee.
Who Should Use the CA-7A Form
Federal civilian employees who suffered a work-related injury or occupational illness and took leave as a result are the primary users of this form. You need the CA-7A when claiming compensation for two or more consecutive periods of leave, or when requesting leave buy back (also called leave repurchase). The form must be completed by the employee and certified by the employing agency before submission to OWCP.
Key Sections of the CA-7A Form
The Time Analysis Form has five main areas you must complete accurately. The first section captures your basic information, including your claim number, date of injury, and the pay periods covered. The second section is the time analysis grid itself, where you record each calendar day and classify the type of leave used: sick leave, annual leave, leave without pay (LWOP), continuation of pay (COP), or other leave. The third section documents the total hours and dollar amounts for each category. The fourth section requires your signature as the claimant, certifying the accuracy of the information. The fifth section is completed by your agency, with an authorized official certifying the leave records and providing agency contact details.
Documentation Required
Supporting medical evidence is required for most CA-7A submissions. This typically includes medical reports from your treating physician that specify the diagnosis, prognosis, and the period of disability directly related to your work injury. OWCP reviews these records alongside the time analysis to determine compensation eligibility and amounts.
Tips for Accurate Completion
Ensure every pay period column is filled in, even if you worked the full period without taking leave. Errors or blank fields are among the most common reasons OWCP returns forms for correction, delaying compensation. Use the exact leave category codes specified in the form instructions, and coordinate with your agency's human resources office to verify leave records before signing.
| Question | Answer |
|---|---|
| Form Name | CA-7A Time Analysis Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | CA-7A form, Time Analysis Form, ca7a form department of labor, OWCP form CA-7A, ca 7a form owcp |
