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This form is used by current, or occasionally former, Federal employees to claim wage loss or medical treatment resulting from a recurrence of a work-related injury while Federally employed. The information is necessary to ensure the accurate payment of benefits. |
Form #:
CA 2a
A
Agency:
Department of Labor
Bureau:
Employment Standards Administration
Common Name:
Notice of Recurrence
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TYPE |
PAGES |
SIZE (KB) |
CAPABILITY |
WHAT'S NEEDED |
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Form Only
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4
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[3] Fillable + Printable
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Adobe Reader
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