NOTICE TO REVIEWER
Date: April 26, 2012
Request Type: Non-substantive Change
Employing Agency: Office of Workers’ Compensation Programs/Division of Federal Employees’ Compensation
Form Number/Name: CA-7, Claim for Compensation
OMB/Expiration Date: 1240-0046, October 31, 2014.
Justification:
DFEC is seeking approval for the electronic version of the CA-7 (see attached sample screen shots) for use in the Employee Compensation Operations and Management Portal, known as ECOMP.
In the current Supporting Statement associated with this OMB, it was indicated in item 3 that DFEC would implement in FY2012 an alternative in which our customers would be able to submit some forms electronically.
In using this alternative filing system, this interface will allow the claimant to input data to complete their portion of the form that matches the CA-7 form. Once data is input, the form can be downloaded and printed, and will appear as the exact same CA-7 form that is currently approved by OMB.
The CA-7 that is currently approved has not and is not changing in any way. There is no change in the information collected or the form used. This interface is just an OPTION for the claimant to use to complete the form.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | NOTICE TO REVIEWER |
| Author | US Department of Labor |
| File Modified | 0000-00-00 |
| File Created | 2021-01-30 |