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May 8, 2009   
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DOL Form OWCP-5a

View ESA-OWCP's Form OWCP-5a Online htm
Agency: ESA-OWCP
Title: OWCP-5a, Work Capacity Evaluation For Psychiatric/Psychological Conditions
Form Description: OWCP-5a, Work Capacity Evaluation For Psychiatric/Psychological Conditions: Attending physicians use this form to report on a federal employee's work capacity limitations due to psychiatric/psychological conditions he/she has reported.
OMB Control Number: 1215-0103

 

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