ALL Technicians & Technician Supervisors
In order to meet Federal Employment Compensation Guidelines, it is mandatory that Supervisors and Employees use the following electronic process for submission of OWCP forms any time there is an injury at work.
Department of Labor requires that forms CA-1’s and CA-2’s be at OWCP within 10 calendar days from the date of notice of injury.
The following Guidelines MUST be utilized to submit Workers Compensation Electronic Forms CA-1’s and CA-2’s to HRO-ERS:
Note: If an employee needs immediate medical care, at the supervisor’s discretion, issue a CA-16 prior to completing CA-1. Supervisor completes page 1 of Ca-16. Doctor completes page 2 of CA-16. Ensure employee gets page 2 of the CA-16 back from the doctor. See CA-16 Cover Letter (Attached Below) for more information on the CA-16. A CA-16 is not needed for military medical clinics for first aid treatment. We encourage the use of military medical clinics, but it is not mandatory. If you need a copy of the CA-16 please call DSN 608-562-0870.
The Supervisor & Employee should go to the below web site to complete electronic CA-1’s and CA-2’s.
Go to the CPMS Website: http://www.cpms.osd.mil/ICUC/ICUC_index.aspx, then click on "Filing Claims Electronically with EDI" (on the left). It will take a few minutes for the form to populate.
In order for link to work, you must have JAVA Plus Systems loaded to your computer (contact your Helpdesk for this program). In order for the Electronic CA-1/CA-2 to come up, you may have to temporarily allow pop-ups.
Enter SSN and DOB. Click Enter Claim. Name will auto-populate. Complete all tabs on the form. You must have JAVA Plus and a recent ADOBE version for this to work. Call your IT/computer help desk if you need help getting these loaded.
White fields are mandatory, yellow fields are optional. No dashes in phone numbers.
Periodically click in the zip code fields to prevent the claim from timing out.
It is recommended to input claims before Noon (Eastern) for faster processing times, as the West Coast is also using EDI in the evening.
Once the form is completed, click "print" and "submit to ICPA". Once the form is submitted it will be electronically sent to HRO-ERS to be reviewed and forwarded to OWCP. Please call HRO DSN 608-562-0870 to verify that the claim was received. HRO-ERS will e-mail a copy of the CA-1 to the supervisor and HRO Reps if applicable.
Supervisor and Employee should sign printed forms (CA-1, CA-16) and mail signed originals to:
New Jersey National Guard
HRO - Employee Relations, Benefits, & Services
3650 Saylors Pond Road
JBMDL, NJ 08640
Workers Compensation Program Manager
Phone: (609) 562-0866
Fax: (609) 562-0845
Once a CA-1 is entered, if the employee needs medical care, supervisor at his/her discretion should issue a CA-16 to accompany technician to the doctor. (A CA-20 should be sent with employee to the doctor if the claim is questionable by supervisor or medical attention is needed later than 4 days after injury)
7. A CA-17 is recommended to send with the employee to determine work restrictions. The supervisor completes the left-hand side of CA-17. The doctor completes the right side. Please see attached Policy Memo stating that supervisors are required to provide light duty. Please call 608-562-0870 if you have questions regarding Light Duty or Continuation of Pay (COP).
The attending nurse/physician should complete their portion of the CA-16, CA-17, or CA-20 and return all forms to the employee and supervisor so the forms can be mailed to NJ National Guard, HRO-ERBS, ATTN: Worker's Compensation, 3650 Saylors Pond Road, JBMDL, NJ 08640 as soon as possible. Bills and claim may be denied if CA-16 is not received in HRO-EBRS in a timely manner. Make sure to tell the medical providers that the claim is a Federal Workers Compensation claim. The bills should be mailed to ACS, on Forms HCFA 1500’s or UB 92’s to US DEPT OF LABOR, PO BOX 8300, LONDON, KY 40742-8300. Providers can call ACS at 1-866-335-8319 for billing questions.
Please report injury to your local Safety Offices for reporting and prevention.
For more Workers’ Compensation concerns contact the Human Resources Office.