Compensation for Leave without Pay

You may request wage loss payments from the Department of Labor following a workplace injury or illness using Form CA-7, Claim for Compensation. The following conditions must be met for the claim to be approved:

  1. You have exhausted all 45 days of Continuation of Pay (COP) and are still unable to return to work, or you are not eligible for COP.
  2. You have elected to use Leave Without Pay* (LWOP) during your absence.
    *Note that LWOP can affect employee status. See further details at the end of this guide.
  3. You are losing (or expect to lose) pay for more than three (3) days.
  4. You have medical documentation for any period of claimed disability.

If you prefer to use your own paid leave available in lieu of LWOP, please contact an Workers’ Compensation Specialist using the contact information included at the end of this guide.