OWCP Form CA-20 is the Attending Physician’s Report that may be used for an initial or later medical report in a federal workers’ compensation case. It gives the treating physician a structured way to document examination and treatment dates, history, findings, diagnosis, treatment, a medically reasoned opinion about work-related causation, work disability, and prognosis. A CA-20 can support the medical record, but OWCP may still request a detailed narrative report.
What is OWCP Form CA-20 used for?
Form CA-20 is an attending physician’s medical report used under the Federal Employees’ Compensation Act. Current 20 CFR 10.331 says CA-20 may be used for an initial medical report or a later report. It does not file the employee’s claim, authorize treatment, or serve as the employing agency’s interim duty-status report.
The form organizes medical evidence for OWCP. The underlying evidence standard comes from 20 CFR 10.330, so completing the form is not a substitute for providing the medical reasoning and supporting findings the claim requires.
What should a CA-20 medical report contain?
Under 20 CFR 10.330, an attending physician’s report should include the following information when applicable:
- Dates of examination and treatment.
- The employee’s history of injury or disease.
- Physical findings.
- Results of diagnostic tests.
- The diagnosis.
- The course of treatment and treatment given or recommended.
- A description of other conditions found that are not related to the claimed injury.
- The physician’s opinion, with medical reasons, on whether the diagnosed condition was caused or aggravated by the claimed work factors.
- The extent of any injury-related disability affecting the employee’s ability to work.
- The prognosis and other material findings.
A checked box or diagnosis alone may not explain why the work event or duties caused or aggravated the condition. OWCP can require a detailed narrative report when the medical issue needs fuller explanation.
Who completes and submits Form CA-20?
The attending physician completes and signs the medical report. Under 20 CFR 10.331, the employee or the physician may submit it directly to OWCP, and it should be submitted as soon as possible after the examination or treatment. The employee should follow the instructions for the individual claim and keep a copy.
The employee can help by bringing the OWCP claim number, an accurate injury history, a clear description of job duties, relevant records and test results, a medication list, and any written request from OWCP or the employing agency. The physician supplies the medical findings, diagnosis, reasoning, work-capacity opinion, and prognosis.
CA-20 compared with CA-16, CA-17, and a narrative report
| Document | Main purpose | Key distinction |
|---|---|---|
| CA-16 | Authorization for Examination and/or Treatment | An employing agency may issue it to authorize examination or treatment in qualifying traumatic-injury situations. |
| CA-17 | Duty Status Report | The employing agency uses it for interim work-status information; the agency completes the job-demand side and the physician completes the medical side. |
| CA-20 | Attending Physician’s Report | The physician uses it for an initial or later medical report addressing the evidence required by OWCP. |
| Narrative medical report | Detailed explanation on physician letterhead | Current regulations allow a narrative instead of a required form, and OWCP may request one when more medical reasoning or detail is needed. |
What makes a causation opinion useful?
A useful causation opinion identifies the diagnosed condition, describes the accepted or claimed work event or exposure, connects relevant examination or test findings to the diagnosis, and explains the medical reasoning for whether the work factors caused or aggravated that condition. It should be based on the physician’s independent medical judgment rather than a requested claim outcome.
The history should be accurate and complete, including relevant prior injuries or conditions. If the physician believes a condition is unrelated to the claimed work injury, the report should distinguish it rather than blending unrelated findings into the work-injury analysis.
When might OWCP need an updated CA-20 or a narrative report?
There is no universal rule requiring a new CA-20 at every visit. Current 20 CFR 10.331 permits CA-20 for initial and subsequent reports, while the timing and level of detail depend on what OWCP requests and whether the medical condition, work capacity, treatment plan, or prognosis has materially changed.
For a serious injury or disease, especially one involving hospitalization or prolonged care, 20 CFR 10.332 says OWCP will request detailed narrative reports at periodic intervals. Follow the written request and deadline for the individual case rather than assuming a fixed update schedule.
A practical CA-20 appointment checklist
- Bring the OWCP claim number and any written request or development letter.
- Prepare an accurate timeline of the work event, symptoms, and treatment.
- Bring a current job description or a clear list of regular physical duties.
- Provide relevant prior records, imaging, test results, and medication information.
- Disclose other injuries or conditions that may affect the medical analysis.
- Review identifying and job information for accuracy without changing the physician’s answers.
- Submit the completed report according to the claim instructions and keep a copy.
How NuThera supports OWCP medical documentation
NuThera provides clinical evaluation and documentation for the care it delivers. Federal employees can start with the NuThera OWCP resource center and forms directory, or review the Las Vegas and North Las Vegas clinic pages before an appointment. NuThera does not decide claim eligibility or replace individualized advice from OWCP or a qualified representative.
Sources
- 20 CFR 10.300 and 10.330–10.332, Electronic Code of Federal Regulations; Title 20 current through September 8, 2026 and last amended August 20, 2026; accessed September 10, 2026: https://www.ecfr.gov/current/title-20/chapter-I/subchapter-B/part-10/subpart-D
- Federal Employees’ Compensation Act FAQ, U.S. Department of Labor, Office of Workers’ Compensation Programs; publication date not listed; accessed September 10, 2026: https://www.dol.gov/agencies/owcp/FECA/fec-faq
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Common questions.
What is Form CA-20 used for?
Form CA-20 is an Attending Physician’s Report that may be used for an initial or later medical report in a FECA claim. It organizes the physician’s findings, diagnosis, treatment, causation opinion, work-disability information, and prognosis.
Who fills out OWCP Form CA-20?
The attending physician completes and signs the medical report. Current regulations allow either the employee or the physician to submit it directly to OWCP.
Does CA-20 file an OWCP claim?
No. CA-20 supplies medical evidence. Employees generally use CA-1 for a traumatic-injury notice or CA-2 for an occupational-disease notice, depending on the facts.
Is CA-20 the same as CA-17?
No. CA-20 is an attending physician’s medical report. CA-17 is the employing agency’s interim duty-status report and includes the agency’s description of job demands.
Can a narrative medical report replace CA-20?
Yes, in appropriate circumstances. Current 20 CFR 10.331 says the forms are not required and a narrative report on the physician’s letterhead may be submitted, although OWCP may require an original signature.
Does a diagnosis alone satisfy OWCP’s medical-report requirements?
Not necessarily. Current regulations call for supporting history, findings, test results, treatment information, medical reasoning about causal relationship, disability information, and prognosis when applicable.
How often should Form CA-20 be updated?
There is no universal every-visit schedule. Use the timing in OWCP’s or the employing agency’s written request and update the medical evidence when the condition, treatment, work capacity, or prognosis materially changes.