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View ESA-OWCP-DFEC's Form 1215-0167 Online 
| Agency: |
ESA-OWCP-DFEC |
| Title: |
DFEC CA-2a, Notice of Recurrence |
| Form Description: |
DFEC CA-2a, Notice of Recurrence: This form is used by a federal employee to provide notice of a recurrence of a traumatic injury or occupational disease, and to claim continuation of pay or compensation. The form must be filed with one's employing agency. |
| OMB Control Number: |
1215-0167 |
| OMB Expiration Date: |
Tuesday, May 31, 2011
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