CA-2: Occupational Disease Claim Form

Filing a CA-2, Notice of Occupational Disease (NIH-specific guide)

You must report any workplace-related illness as soon as possible to Occupational Medical Service (OMS). OMS will provide you will further instructions on how to complete the form needed in the ECOMP system

This form is used if the employee has sustained an occupational disease as a result of job duties.

Occupational Disease - A condition produced in the work environment over a period longer than one work day or shift. May result from systemic infection, repeated stress or strain, exposure to toxins, poisons or fumes, or other continuing conditions of the work environment.

For further guidance on using ECOMP:

Procedures after completing the CA-2

Once the forms are completed in ECOMP, they must be submitted to you (please note- a wet signature is required). The original copy of the completed and signed CA-2 form must be sent to the NIH Workers’ Compensation Program. Please note that this employee is not eligible for any special leave categories. The use of personal leave and LWOP should be discussed with a Specialist in the NIH Workers’ Compensation Program.

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