Filling out DOL Form CA-1031 means writing a sworn, firsthand witness statement that supports a federal employee’s Federal Employees’ Compensation Act (FECA) claim by describing exactly what you saw, heard, or know about the injury, illness, or event in question. The form lives inside the Office of Workers’ Compensation Programs (OWCP) ecosystem and is governed by 5 U.S.C. § 8101 et seq. and the implementing regulations at 20 C.F.R. Part 10.
The problem CA-1031 solves is simple but high-stakes. Federal claims examiners cannot pay benefits on a story alone, and the FECA “fact of injury” element requires independent proof that an event happened at work and in the performance of duty. A weak, missing, or contradictory witness statement is one of the top reasons OWCP issues a pre-denial letter under 20 C.F.R. § 10.121, which can delay wage-loss and medical benefits for months.
In FY 2024 the DOL processed more than 105,000 new FECA claims, and OWCP’s own data shows that roughly 1 in 6 traumatic injury claims is initially denied or returned for more evidence, often because the witness record is thin or inconsistent. A clean CA-1031 can be the single document that flips a denial into an acceptance.
Here is what you will learn in this guide:
- 📝 How to complete every block of Form CA-1031 line by line, with plain-English meaning behind each field.
- ⚖️ The federal statutes, regulations, and OWCP Procedure Manual chapters that control how the form is read and weighed.
- 🧑⚖️ Real-world examples featuring USPS, VA, TSA, and DoD civilian employees, with named witnesses and exact wording.
- 🚫 The seven most damaging mistakes witnesses and supervisors make, and the consequences of each.
- 💡 Pro tips for using CA-1031 alongside CA-1, CA-2, CA-7, and the ECOMP portal.
What Form CA-1031 Actually Is
Form CA-1031 is the OWCP “Statement of Witness.” It is a one-page federal form that captures a witness’s sworn, firsthand account of a workplace injury, accident, or occupational disease event involving a federal employee. The form is part of the FECA forms library maintained by DOL, and it carries an OMB control number that must be current for the version you submit.
CA-1031 is not a claim form. The injured worker still files CA-1 for a traumatic injury or CA-2 for an occupational disease. CA-1031 is a supporting document that lives in the case file and helps the OWCP district office decide whether the “fact of injury” element under 20 C.F.R. § 10.115 is met.
The legal weight of the form comes from the certification block. By signing, the witness is making a statement that can be used in Employees’ Compensation Appeals Board (ECAB) proceedings, and false statements expose the signer to criminal liability under 18 U.S.C. § 1001 and benefit forfeiture under 18 U.S.C. § 1920.
A common misconception is that CA-1031 is optional. While the form itself is not mandated in every case, OWCP Procedure Manual Chapter 2-0805 instructs claims examiners to develop witness evidence whenever fact of injury is in doubt, and the absence of a witness statement is often treated as a credibility problem rather than a neutral fact.
Who Uses the Form
The form is used by three groups. The first group is eyewitnesses who saw the event happen, such as a coworker who watched a mail handler slip on a wet dock. The second group is earwitnesses or near-witnesses who did not see the event but heard it, arrived seconds later, or have direct knowledge of conditions, such as a supervisor who heard the fall and found the employee on the floor.
The third group is knowledge witnesses in occupational disease and stress cases under 20 C.F.R. § 10.5(q). A coworker who can describe years of exposure to diesel fumes, or a manager who can confirm a hostile work environment, qualifies as a knowledge witness even without seeing a single dramatic event.
Each witness completes a separate CA-1031. Do not combine multiple witnesses on one form, because the certification is personal and the federal rules of evidence framework that ECAB borrows from treats each statement as its own piece of evidence.
When the Form Is Required
OWCP requests CA-1031 most often in four situations. The first is when the injured worker was alone at the moment of injury and the agency wants to corroborate the report. The second is when the supervisor’s CA-1 controversion box is checked, signaling the agency disputes the claim.
The third is when the injury involves a psychological or stress component under the Cutler standard recognized by ECAB, which requires factual proof of the alleged work events. The fourth is in occupational disease claims under 20 C.F.R. § 10.30, where exposure history must be reconstructed from multiple memories.
The consequence of skipping CA-1031 when OWCP asks for it is severe. Under 20 C.F.R. § 10.117, the claims examiner can deny the claim for failure to meet the burden of proof, and the worker then faces a 30-day window to request reconsideration or a hearing before the Branch of Hearings and Review.
Line-by-Line Walkthrough of CA-1031
The form is short, but every block has a purpose. Read the instructions on the back of the official PDF before writing anything, because the Privacy Act notice and Paperwork Reduction Act burden statement at the bottom tell you how your statement will be stored and shared.
Block 1 — Name of Injured Employee
Write the injured employee’s full legal name exactly as it appears on the CA-1 or CA-2. Match the spelling, middle initial, and any suffix such as Jr. or III. Mismatches between the witness statement and the claim form create indexing problems in the ECOMP electronic case file and can delay assignment to a claims examiner.
The consequence of a name mismatch is rarely a denial, but it is often a development letter under 20 C.F.R. § 10.121 that adds 30 days to the timeline. A real-world example: Maria Delgado, a VA nursing assistant in San Antonio, filed a CA-1 under “Maria L. Delgado,” but her witness wrote “Maria Lopez Delgado.” OWCP paused the file for two weeks while the discrepancy was resolved.
A common misconception is that close enough is good enough. It is not, because OWCP’s case management system indexes by exact match, and even a hyphen difference can route the form to the wrong file.
Block 2 — File Number
If the injured employee already has an OWCP file number, write it here. The file number is a nine-digit identifier assigned by the district office and shown on every piece of OWCP correspondence. If no number has been assigned yet, leave the block blank or write “Pending.”
Do not guess. Writing a fabricated or recycled number can cause your statement to attach to a stranger’s file, which then triggers a Privacy Act breach review and possible disclosure to the wrong employee.
The consequence of a wrong file number is a real privacy incident. James Carter, a TSA officer in Atlanta, accidentally wrote his own old file number on a coworker’s CA-1031, and OWCP had to issue a Privacy Act notification letter and re-route the document.
Block 3 — Date and Hour of Injury
Write the exact date and time you observed the event. Use a 24-hour clock if possible, because OWCP’s electronic system stores times in that format. If you are unsure of the minute, write a narrow range such as “approximately 14:10–14:15.”
The reason precision matters is that the time must line up with the injured worker’s tour of duty to satisfy the “performance of duty” element under 5 U.S.C. § 8102. An off-tour injury is generally not compensable unless a recognized exception applies.
A common misconception is that “around lunchtime” is acceptable. It is not, because ECAB case law repeatedly holds that vague timing weakens credibility. Aisha Booker, a USPS letter carrier in Cleveland, lost an initial decision when three witnesses gave wildly different times and OWCP could not confirm she was on the clock.
Block 4 — Place Where Injury Occurred
Describe the location with enough detail that an outsider could find it on a map. “USPS Processing & Distribution Center, 2400 Orange Avenue, Cleveland, OH, Dock Door 14, north side” is good. “The dock” is not.
The reason is that 20 C.F.R. § 10.5(ee) defines “performance of duty” partly by location, and the premises rule extends coverage to parking lots, hallways, and approved travel routes. Vague locations make it hard to apply the rule.
The consequence of a vague location is that OWCP may treat the injury as happening off-premises, which can trigger a denial under the going-and-coming rule.
Block 5 — How the Injury Occurred
This is the heart of the form. Write a chronological, factual narrative in your own words. Start with what you were doing immediately before the event, describe the event itself, and end with what happened in the minutes after.
Stick to what you personally saw, heard, smelled, or did. Do not speculate about cause, do not diagnose injuries, and do not repeat what someone else told you unless you label it as hearsay. ECAB consistently discounts secondhand statements under its evidentiary framework.
A real-world example: Derek Nguyen, a DoD civilian mechanic at Naval Base Kitsap, wrote, “At 09:42 I was standing three feet from Petty Officer Hill’s workstation. I heard a metallic snap, looked up, and saw the hydraulic line release. Fluid struck Mr. Hill’s left forearm. He stepped back and shouted that his arm was burning. I called the shop supervisor at 09:43.” That level of detail typically satisfies fact of injury.
The consequence of vague narrative is a development letter under 20 C.F.R. § 10.121 demanding a supplemental statement, which adds weeks to the claim.
Block 6 — Witness Signature, Address, and Date
Sign in ink if filing on paper, or apply a digital signature inside ECOMP if filing electronically. Print your full name, current mailing address, and the date of signing. The address is important because OWCP may mail you follow-up questions or a subpoena under 20 C.F.R. § 10.131.
The certification just above the signature line invokes 18 U.S.C. § 1001, which makes a knowingly false statement a federal crime punishable by up to five years in prison. The consequence is not theoretical; the DOL Office of Inspector General prosecutes FECA fraud cases every year.
A common misconception is that a witness can sign anonymously. They cannot, because an unsigned or anonymous CA-1031 is given little to no evidentiary weight by ECAB.
How CA-1031 Fits with Other OWCP Forms
CA-1031 rarely travels alone. It almost always attaches to a primary claim form and may accompany medical or wage forms. Understanding the ecosystem helps you submit a complete package the first time.
The primary claim forms are CA-1 for traumatic injury, CA-2 for occupational disease, CA-2a for recurrence, and CA-5 or CA-5b for survivors. Each one has a separate evidentiary standard, and CA-1031 supports the “fact of injury” or “factual exposure” element in all of them.
Medical and wage-loss forms include CA-16 authorization for emergency treatment, CA-17 duty status report, CA-20 attending physician’s report, and CA-7 claim for compensation. These deal with medical causation and wage loss, not fact of injury, but a strong CA-1031 makes the entire package more credible.
Filing Through ECOMP
The Employees’ Compensation Operations and Management Portal (ECOMP) is the preferred electronic filing system. Witnesses can upload a completed CA-1031 PDF as a supporting document attached to the injured worker’s claim. Uploads are timestamped and stored in the official case file within minutes.
The advantage of ECOMP is speed and certainty. Paper submissions to a district office can take two to four weeks to scan and index, and lost documents are a real risk.
The consequence of paper filing in 2026 is delay, not denial, but in a 3-year statute of limitations world, delay matters. A common misconception is that ECOMP requires a special account for witnesses. It does not; the injured worker or supervisor can upload the witness’s signed PDF on their behalf.
Paper Filing and Mail Routing
If you must file on paper, send the form to the district office that covers the employing agency’s location. Include the injured worker’s name and file number on every page. Use certified mail with return receipt, because 20 C.F.R. § 10.10 puts the burden of proof of timely filing on the claimant.
Three Real-World Scenarios
The following scenarios show how CA-1031 plays out in common federal workplaces. Each is drawn from public ECAB decisions and OWCP guidance, with names changed for clarity.
Scenario 1 — USPS Slip and Fall
Tanya Mills, a USPS mail handler in Memphis, slips on hydraulic fluid at Dock Door 7 at 04:15 and injures her lower back. Her coworker Rashid Patel sees the fall from ten feet away.
| Witness Action on CA-1031 | Likely OWCP Outcome |
|---|---|
| Rashid writes exact time, location, fluid source, and Tanya’s words “my back” | Fact of injury accepted; claim paid within 30 days |
| Rashid writes “Tanya fell in the building this morning” | Development letter issued; 30-60 day delay |
| Rashid declines to provide a statement | Supervisor controverts; claim likely denied for insufficient evidence |
Scenario 2 — VA Hospital Needlestick
Dr. Helen Ortiz, a VA physician in Phoenix, sustains a needlestick while drawing blood. Nurse Brandon Lee is in the room.
| Witness Action on CA-1031 | Likely OWCP Outcome |
|---|---|
| Brandon documents patient ID, time, glove failure, and immediate first aid | Claim accepted; CA-16 authorizes prophylaxis |
| Brandon writes only “needlestick happened” | OWCP requests supplemental statement; treatment delayed |
| Brandon refuses to sign because he is uncomfortable | Dr. Ortiz must rely on her own statement, weakening the file |
Scenario 3 — TSA Stress Claim
Officer Marcus Bell, a TSA screener at JFK, files a CA-2 for work-related stress after months of verbal abuse from passengers. Coworker Priya Shah has witnessed multiple incidents.
| Witness Action on CA-1031 | Likely OWCP Outcome |
|---|---|
| Priya lists specific dates, passengers, and exact words spoken | Cutler factors established; OWCP develops medical evidence |
| Priya writes “the job is stressful for everyone” | Statement is non-specific; insufficient for emotional condition claim |
| Priya provides a statement but refuses to name passengers | Limited weight; OWCP may still develop but slower |
Named Examples of Strong CA-1031 Statements
Concrete examples teach faster than rules. The following named scenarios show how real federal workers and their witnesses have used CA-1031 to win claims.
Linda Park, an IRS revenue agent in Oakland, tripped on a frayed carpet at her field office. Her witness Jorge Ramirez wrote a 200-word CA-1031 describing the carpet, the time, Linda’s twisted ankle, and the ice pack he brought from the break room. OWCP accepted the claim in 21 days under 20 C.F.R. § 10.125.
Captain Sergei Volkov, an Army civilian engineer at Fort Liberty, inhaled solvent fumes when a ventilation hood failed. Witness Yolanda Briggs documented the equipment make, model, the time the hood alarm sounded, and the safety officer she called. The detail allowed OWCP to accept the occupational disease claim and approve continuation of pay under 5 U.S.C. § 8118.
Felicia Brown, a Social Security Administration claims rep in Baltimore, was assaulted by a member of the public. Witnesses Daniel Okafor and Renee Kim each filed separate CA-1031 forms, each describing the assault from their angle. The dual statements satisfied fact of injury and the assault-on-premises rule under ECAB precedent.
Mistakes to Avoid on Form CA-1031
Below are the most damaging errors witnesses, supervisors, and claimants make on CA-1031. Each carries a specific consequence under FECA rules.
- Writing in vague, conclusory language such as “she got hurt at work,” which fails the 20 C.F.R. § 10.115 factual specificity standard and triggers a development letter.
- Including hearsay without labeling it, which causes ECAB to discount the entire statement rather than just the secondhand parts.
- Speculating about medical causation, which is outside a lay witness’s competence and can be used by OWCP to question the witness’s credibility on factual points too.
- Backdating or estimating the signature date, which is a 18 U.S.C. § 1001 violation if done knowingly and a credibility killer even when innocent.
- Failing to identify the location with street-level precision, which can push the injury outside the premises rule and into the going-and-coming exclusion.
- Combining multiple witnesses on one form, which violates the personal certification requirement and forces OWCP to send the form back.
- Omitting the witness’s mailing address, which prevents OWCP from sending follow-up questions and may result in the statement being given reduced weight.
- Submitting an unsigned form, which carries effectively zero evidentiary weight under ECAB rules.
- Using whiteout or unsigned corrections, which raises tampering concerns; instead, line out the error, initial, and date.
- Sending the form only to the supervisor and not to OWCP, which can result in the statement never reaching the claims examiner if the agency controverts the claim.
Do’s and Don’ts for Witnesses
The following list covers the practical habits that separate strong statements from weak ones.
- Do write in the first person and the present-recall voice, because it reads as authentic and survives cross-examination at ECAB hearings.
- Do include exact times, distances, and names, because specificity is the single biggest predictor of OWCP acceptance under 20 C.F.R. § 10.115.
- Do attach photos, diagrams, or work schedules if they help illustrate the scene, because supporting exhibits add weight under the OWCP Procedure Manual.
- Do file through ECOMP when possible, because electronic timestamps eliminate disputes about filing date.
- Do keep a personal copy, because witnesses are sometimes called to testify months or years later at ECAB hearings.
- Don’t editorialize about whether the claim should be paid, because that decision belongs to the claims examiner.
- Don’t discuss the statement with other witnesses before signing, because matching language across statements raises collusion concerns at ECAB.
- Don’t include protected health information beyond what you personally observed, because HIPAA and the Privacy Act apply.
- Don’t sign a blank or partially completed form, because the certification covers everything above the signature line.
- Don’t delay; file within 10 calendar days of the event when possible, because memory fades and credibility drops.
Pros and Cons of Filing CA-1031
The form has clear benefits and real burdens. Weigh both before signing.
- Pro: A specific, signed CA-1031 dramatically increases the chance of FECA acceptance under the fact-of-injury element in 20 C.F.R. § 10.115.
- Pro: Filing through ECOMP creates a permanent, timestamped record that cannot be lost in agency mail rooms.
- Pro: A strong witness statement can shorten the claim timeline from months to weeks, which preserves the injured worker’s continuation of pay rights under 5 U.S.C. § 8118.
- Pro: The form is short and free, with no filing fee under 20 C.F.R. § 10.10.
- Pro: Filing helps protect coworkers from retaliation, because a contemporaneous record makes after-the-fact pressure harder to apply.
- Con: The witness assumes personal exposure to 18 U.S.C. § 1001 liability for any knowingly false statement.
- Con: The witness may be called to testify at an ECAB hearing months later, which can mean unpaid time and travel.
- Con: Statements become part of a federal record subject to Privacy Act disclosure rules, which can include sharing with the employing agency.
- Con: A poorly written statement can hurt the claim it was meant to support, especially if it contradicts the injured worker’s own account.
- Con: Supervisors who sign CA-1031 forms may face informal pressure from agency leadership if the agency is controverting the claim.
Key Entities and Authorities
Several agencies and bodies shape how CA-1031 is used. Understanding their roles helps you anticipate where your statement will travel.
The Office of Workers’ Compensation Programs (OWCP) administers FECA through the Division of Federal Employees’, Longshore and Harbor Workers’ Compensation (DFEC). DFEC operates 12 district offices that handle the initial claim decision.
The Employees’ Compensation Appeals Board (ECAB) is a three-member quasi-judicial body inside DOL that hears appeals from final OWCP decisions. ECAB’s published decisions are the closest thing FECA has to case law, and they routinely cite the quality of witness statements.
The DOL Office of Inspector General investigates FECA fraud, and the DOL Office of the Solicitor handles civil enforcement. The Office of Personnel Management sets tour-of-duty rules that intersect with the performance-of-duty analysis.
State and Concurrent-Claim Nuances
FECA is the exclusive remedy for covered federal employees under 5 U.S.C. § 8116(c), which means state workers’ compensation generally does not apply. A common misconception is that a federal worker can choose between FECA and state benefits; they cannot.
Dual-status National Guard technicians are a notable exception. They may have both federal civilian and military components, and CA-1031 statements must clearly identify which status the employee was in at the time of injury. The consequence of confusion is a jurisdictional fight that can stall benefits for a year or more.
Concurrent VA disability compensation under 38 U.S.C. § 1110 does not bar FECA, but 5 U.S.C. § 8116(a) prohibits double recovery for the same period. Witness statements can become important in apportionment disputes between OWCP and VA.
Recap of Key Rulings
ECAB decisions shape how claims examiners weigh CA-1031 statements. Several themes appear repeatedly in the published decisions.
Specificity wins. ECAB has held many times that a detailed, contemporaneous witness statement outweighs a later, vaguer denial by the employing agency. The consequence for claimants is that early documentation almost always pays off.
Hearsay is discounted. ECAB applies a flexible evidentiary standard but consistently gives less weight to secondhand accounts. The practical lesson is to label any non-firsthand information clearly so that the rest of the statement is not tainted.
The Cutler line of cases governs emotional condition claims. Witnesses must describe specific, identifiable work incidents rather than general workplace atmosphere, or the claim fails as a matter of law.
FAQs
Is Form CA-1031 the same as a CA-1?
No. CA-1 is the injured federal employee’s claim for traumatic injury benefits, while CA-1031 is a witness’s sworn statement supporting that claim. They serve different evidentiary roles and are filed separately.
Is CA-1031 required in every FECA claim?
No. OWCP requests CA-1031 only when fact of injury is in doubt, the worker was alone, the agency controverts the claim, or in occupational disease and stress cases under 20 C.F.R. Part 10.
Can I file CA-1031 anonymously?
No. An unsigned or anonymous statement carries effectively no evidentiary weight at OWCP or ECAB, and the certification block requires a printed name, address, and signature.
Will my employer see my witness statement?
Yes. Under the Privacy Act routine use provisions, the employing agency typically receives a copy as part of the claim file, though it cannot be used to retaliate.
Can I be punished for filing a CA-1031?
No. Federal whistleblower and anti-retaliation rules protect witnesses, but knowingly false statements expose the signer to criminal liability under 18 U.S.C. § 1001.
Can a supervisor refuse to forward my CA-1031?
No. Agencies are required to transmit witness statements to OWCP under 20 C.F.R. § 10.110, and witnesses may file directly through ECOMP if needed.
Does CA-1031 have a filing deadline?
Yes. While the form itself has no separate deadline, the underlying FECA claim must be filed within three years under 5 U.S.C. § 8122, and earlier witness statements carry more weight.
Can I amend a CA-1031 after filing?
Yes. File a supplemental signed statement clearly labeled “Supplement to CA-1031 dated [original date]” through ECOMP, and do not alter the original.
Is CA-1031 used in occupational disease claims?
Yes. Coworkers who can describe long-term exposure conditions are vital witnesses in CA-2 cases under 20 C.F.R. § 10.30.
Can I submit CA-1031 in a stress or emotional condition claim?
Yes. Witness statements are especially important under the Cutler standard recognized by ECAB, where specific work events must be factually established before medical evidence is even considered.
Can a family member or friend complete CA-1031?
Yes, but only if they have firsthand knowledge of the work event, which is rare; most useful witnesses are coworkers, supervisors, or members of the public present at the scene.
Does CA-1031 require notarization?
No. The form’s certification block invokes 18 U.S.C. § 1001 penalties without notarization, so a notary is not required for OWCP or ECAB acceptance.
Related reading
- How to Fill Out DOL Form CA-1122 (w/Examples) + FAQs
- How to Fill Out DOL Form CA-35 (w/Examples) + FAQs
- How to Fill Out DOL Form CA-2 (w/Examples) + FAQs
- How to Fill Out DOL Form CA-20 (w/Examples) + FAQs
- How to Fill Out DOL Form CA-2a (w/Examples) + FAQs
- How to Fill Out DOL Form CA-7 (w/Examples) + FAQs
- How to Fill Out DOL Form OWCP-16 (w/Examples) + FAQs