Information Collection

Claim for Compensation on Account of Traumatic Injury or Occupational Disease (CA-7) and Claim for Continuing Compensation on Account of Disability (CA-8)

IC 122154 under ICR 199509-1215-002 · OMB 1215-0103.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1215-0103 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Claim for Compensation on Account of Traumatic Injury or Occupational Disease (CA-7) and Claim for Continuing Compensation on Account of Disability (CA-8)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	CA-20	No	No
Form	CA-20A	No	No
Form	CA-7	No	No
Form	CA-8	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 487,350	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	487,350	487,350	0
Annual IC Time Burden (Hours)	175,398	200	175,198
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.