TL;DR: A knee hurt in one shift is a CA-1 traumatic injury; a knee worn down over more than one shift is a CA-2 occupational disease. The distinction decides whether you can get continuation of pay — up to 45 days, available on CA-1 only, and contingent on filing the written claim within 30 days of the injury. A CA-16 from your agency authorizes initial treatment and is valid for 60 days from the date of injury. And under FECA, a physician assistant is not a “physician”: a PA’s report is not competent medical evidence unless a physician co-signs it.
Knee injuries are among the most common federal workers’ compensation claims, and they are also among the easiest to file badly. Innovare Tx accepts OWCP claims. We do not accept Texas state workers’ compensation.
CA-1 or CA-2: get this right first
CA-1 — traumatic injury. The knee was injured by an identifiable event or series of events occurring within a single workday or shift. A fall on a loading dock, a twist stepping off a vehicle, a collision. One shift.
CA-2 — occupational disease. The condition developed from exposure or activity over more than one shift. Years of kneeling, stairs, climbing, or repetitive load.
The label is not a formality, because continuation of pay attaches to one and not the other. People whose knee genuinely gave out on a specific day sometimes file a CA-2 because the knee “had been bothering them for months,” and lose the COP entitlement in the process. If there was a discrete event, the discrete event is the claim.
Continuation of pay: 45 days, and a 30-day gate
On an accepted traumatic injury, continuation of pay covers up to 45 days of wage loss paid by your agency rather than by OWCP. The statutory condition is that the written claim is filed within 30 days of the injury. Miss that window and COP is gone even if the claim itself is later accepted.
Two further points people trip on. COP is for traumatic injury — it does not apply to CA-2 occupational disease claims. And the broader time limit for filing a FECA claim is three years, with the exception that written notice given within 30 days, or your immediate supervisor having actual knowledge within 30 days, can preserve a claim filed later. Do not plan around the exception.
The CA-16 and its 60-day clock
A CA-16 is the form by which your agency authorizes medical treatment, and it is the difference between walking into a clinic with authorization and walking in hoping. The mechanics are worth knowing precisely:
- Where treatment is needed urgently, the agency may authorize it verbally and should issue the CA-16 within four hours of the request.
- A written form should follow a verbal authorization within 48 hours.
- The agency is not required to issue a CA-16 more than one week after the injury.
- Once issued, it is valid for 60 days from the date of injury.
- If your treating provider refers you on for a consultation or a diagnostic study, that referral is covered without a second CA-16 being issued.
That one-week point is the one to act on. Ask for the CA-16 immediately, not after you see how the knee settles over the weekend.
The co-signature rule, and why it matters for a knee
FECA defines “physician” by statute, and the definition covers surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors (limited to spinal subluxation demonstrated by X-ray) and osteopathic practitioners. Physician assistants and nurse practitioners are not in that list. The FECA Procedure Manual is explicit that a report prepared by a physician assistant is not competent medical evidence unless it is co-signed by a qualified physician.
This is not academic. Claims are denied on exactly this point every year, because the clinic did excellent clinical work and submitted it under the wrong signature. Legislation that would change it has been introduced in Congress and has moved through committee, but it is not law — so the current rule is the rule.
Innovare Tx is structured around this. Charles Ortega, PA-C, MPAS performs the clinical work, and Dr. Nathan V. Nguyen, MD serves as treating physician on OWCP cases, so the medical evidence leaves this clinic in a form the program accepts.
What the medical evidence has to do
A knee claim is won or lost on a report that connects the dots explicitly. It needs a diagnosis, and it needs a reasoned medical explanation of how the accepted work event or exposure caused or aggravated that diagnosis. A report that says the knee is arthritic and stops there has not made the argument.
Two more things worth getting into the file early: any pre-existing knee condition, described honestly along with how the work event changed it — aggravation of a pre-existing condition is a recognized basis, and concealing the history is what damages credibility — and work restrictions written in terms a supervisor can act on rather than in generalities.
Schedule awards for a knee
FECA schedule awards are paid on permanent impairment of a listed member. A knee is rated through the leg, for which the statute assigns 288 weeks. Compensation runs at two-thirds of monthly pay, or 75% with an eligible dependent. Impairment is rated under the sixth edition of the AMA Guides to the Evaluation of Permanent Impairment, and you have to reach maximum medical improvement before a rating is meaningful.
You claim it on a CA-7. There is a great deal of material online referring to a “CA-9” for schedule awards — that form does not exist. The full detail is in how OWCP schedule awards are rated.
Getting the knee itself treated
The claim mechanics and the clinical plan are two different jobs, and both have to happen. The knee still needs evaluating, and a structured program still needs to run — see the Knee Program and knee physical therapy. Our OWCP-specific pages are the OWCP guide, the federal employee’s guide and the mistakes that sink claims.
Do you take Texas state workers’ compensation?
No. Innovare Tx accepts federal workers’ compensation through OWCP only. If your injury falls under the Texas state system, we are not the right clinic for the claim side of it.
Can I choose my own doctor on an OWCP claim?
Yes — FECA allows an injured federal worker an initial choice of treating physician, subject to the program’s rules on qualified providers and on changing physicians later. What you cannot do is choose a provider whose reports the program will not accept as medical evidence, which is the co-signature issue above.
