When a federal worker dies because of a job-related injury or illness, the surviving spouse and children file DOL Form CA-5 to claim death benefits under the Federal Employees’ Compensation Act (FECA). The form opens a survivor’s claim with the Office of Workers’ Compensation Programs (OWCP), and you must file it within three years of the death under 5 U.S.C. § 8122 or risk losing the benefit forever.
The form looks short, but every box ties to a federal rule in 20 C.F.R. Part 10. A wrong date, a missing marriage record, or a skipped dependency question can stall your claim for months. According to the DOL FECA Annual Report to Congress, OWCP paid more than $3 billion in FECA benefits in fiscal year 2022, yet thousands of survivor claims were delayed because of avoidable filing mistakes.
This guide walks you through the form line by line, in plain English, with real examples and the consequences of each choice.
- 📝 How to fill out every box on Form CA-5 without errors
- ⏰ The deadlines under 5 U.S.C. § 8122 that can wipe out your claim
- 💵 How OWCP calculates the 50% spouse rate and the 75% family cap
- ⚖️ How FECA benefits offset against FERS survivor annuities and VA DIC
- 🚫 The seven biggest mistakes that get survivor claims denied
What Form CA-5 Is and Why It Exists
Form CA-5 is the official Claim for Compensation by Widow, Widower, and/or Children under FECA. The form starts the survivor benefit process for the spouse and minor or dependent adult children of a federal employee whose death came from a workplace injury or illness. It is not used for parents, siblings, or grandchildren — they file Form CA-5b instead.
The legal engine behind the form is 5 U.S.C. § 8133, which sets the payment rates, and 5 U.S.C. § 8134, which authorizes funeral and transportation costs. Without a properly filed CA-5, OWCP has no legal basis to release any money, even if the death is clearly work-related.
The consequence of skipping the form is total loss of benefits. A common misconception is that the agency employer files everything for you. The agency files Form CA-6 (the official superior’s report of death), but only the survivor can file CA-5.
Who Qualifies as a Survivor
Under 20 C.F.R. § 10.410, a “widow” or “widower” is the spouse who lived with the employee at the time of death, or was separated for a reason that was not the spouse’s fault, or was getting court-ordered support. A “child” includes a biological child, adopted child, stepchild in the household, posthumous child, or a child the employee acknowledged.
A child must be under 18, or under 23 and a full-time student, or any age if the child cannot self-support because of a physical or mental disability that began before age 18. The plain-English rule is simple. If you depended on the worker, you may qualify.
The consequence of guessing wrong is a denial that you must appeal to the Employees’ Compensation Appeals Board (ECAB). For example, Mary Chen married a Navy shipyard welder six months before he died from asbestos-related lung cancer. Because they lived together at death, she qualifies, even with the short marriage. A common myth is that you must be married five years to claim — there is no such rule under FECA.
When the Form Must Be Filed
The deadline is three years from the date of death under 5 U.S.C. § 8122(a). The clock can pause for minor children until they turn 18, but spouses get no such grace period. If the worker died from an occupational disease, the clock starts when the survivor knew or should have known the disease caused the death.
The consequence of late filing is a complete bar to recovery, with very narrow exceptions in 20 C.F.R. § 10.205. For example, James Patel, a postal carrier’s widower, waited four years to file because he thought his wife’s heart attack was natural. Once a doctor linked the heart attack to her route’s heat stress, he had a fresh trigger date and filed within months.
A common misconception is that filing for FERS survivor benefits also files your FECA claim. It does not. You must file CA-5 separately with OWCP.
Step-by-Step Walkthrough of Form CA-5
The form has numbered boxes for the deceased employee, the surviving spouse, the children, the cause of death, and the funeral. Below is a line-by-line walkthrough using the current CA-5 PDF. Always use blue or black ink, or fill the fillable PDF and print.
The plain-English rule for every box is to answer truthfully and attach proof. The consequence of leaving a box blank is a “development letter” from OWCP that adds 30–60 days to your claim. A common misconception is that “unknown” is acceptable — write “unknown” only after a real effort to find the answer.
Box 1 — Name of Deceased Employee
Enter the full legal name as it appeared on the worker’s federal personnel file. Use the name on the SF-50 (Notification of Personnel Action), not a nickname. If the worker used a hyphenated or maiden name, list both.
The consequence of a name mismatch is a delay while OWCP cross-checks payroll records with the Office of Personnel Management (OPM). For example, Linda Garcia-Brown listed her late husband as “Bobby” because that is what everyone called him. OWCP could not match payroll, and the claim sat for 47 days. A common mistake is using the name on the death certificate when it differs from federal records.
Box 2 — Date of Birth and Box 3 — Date of Death
Enter both dates in MM/DD/YYYY format. Pull the birth date from the SF-50 and the death date from the certified death certificate. Attach a certified copy of the death certificate, not a photocopy.
The consequence of an uncertified copy is rejection of proof of death under 20 C.F.R. § 10.414. The plain-English rule is order extra certified copies from the vital records office on day one because you will need them for FERS, Social Security, and life insurance too.
Box 4 — Social Security Number
Use the deceased’s SSN. This number lets OWCP coordinate with Social Security Administration records and the Treasury’s Do Not Pay database. A wrong digit triggers an identity verification hold.
A common misconception is that the SSN is optional under privacy rules. FECA expressly authorizes collection of the SSN under Executive Order 9397. For example, Robert Kim’s widow transposed two digits, and her claim was held 22 days for verification.
Box 5 — Employing Agency and Duty Station
List the bureau, agency, and physical duty station. Write “U.S. Postal Service – Cleveland P&DC” rather than just “USPS.” For Department of Defense workers, include the installation, such as “Department of the Navy – Norfolk Naval Shipyard.”
The consequence of a vague entry is that OWCP cannot match the agency’s CA-6 report to your claim. A common mistake is listing only “federal government,” which forces OWCP to send a generic inquiry to OPM that can take weeks.
Box 6 — Occupation and Pay Rate
State the worker’s job title from the SF-50 and the gross weekly pay at the time of injury or last exposure. Include locality pay, night differential, and Sunday premium under 5 U.S.C. § 8114. Do not include overtime that was not regular.
The consequence of understating pay is a permanently lower benefit. The 50% widow rate and 75% family cap key off this number for life. For example, Tonya Williams’s husband earned $1,800 per week as a federal firefighter, including holiday and night premium. If she had listed only base pay of $1,400, her monthly check would have been about $200 lower forever.
A common misconception is that the recomputed pay rate cannot be corrected later. OWCP can adjust under 20 C.F.R. § 10.404, but only with proof, so get it right the first time.
Box 7 — Cause and Date of Injury or Disease
Describe the injury or illness in one or two sentences and give the date it occurred. For an occupational disease like cancer or hearing loss, list the date of last exposure. Be specific. Write “fall from third-floor scaffold during inspection on 03/12/2025” rather than “accident.”
The consequence of vague language is that OWCP will not link the death to a covered injury. Under 20 C.F.R. § 10.115, you must show a causal link by medical evidence. A common mistake is leaving causation to the doctor without giving any factual narrative on the form itself.
Box 8 — Marriage Information
State the date and place of marriage and attach a certified marriage certificate. If either spouse was previously married, list every prior marriage and how it ended (death, divorce, annulment) with dates. Attach divorce decrees and prior death certificates.
The consequence of missing a prior marriage is a fraud referral under 18 U.S.C. § 1920, which carries up to five years in prison. A common misconception is that an old common-law marriage does not matter — it does, in any state that recognizes it.
Box 9 — Children’s Information
For each child, list full name, date of birth, relationship (biological, adopted, stepchild), and whether the child lived with the worker. For students 18–22, attach a Form CA-1074 student certification. For disabled adult children, attach medical proof of the disability that began before age 18.
The consequence of omitting a child is permanent loss of that child’s share, because OWCP only pays who is on the claim. For example, Derek Johnson, a federal police officer, had a child from a prior relationship he supported with court-ordered child support. His widow listed only their two shared kids, and the third child lost benefits until a later amended filing.
A common myth is that stepchildren cannot collect. Under 5 U.S.C. § 8101(9), a stepchild who lived in the household qualifies.
Box 10 — Other Dependents
If anyone else relied on the worker for support, note them here, but understand they file CA-5b, not CA-5. This box only flags the existence of other claimants.
The consequence of hiding another dependent is reduced fairness for everyone, because the 75% family cap is divided among all eligible survivors under 5 U.S.C. § 8133(a)(5). A common mistake is treating CA-5 as a secret filing — OWCP combines all related claims into one case file.
Box 11 — Funeral and Burial Expenses
Enter the actual amount paid for the funeral, up to the § 8134 cap of $800. Attach paid invoices from the funeral home. If the body had to be transported to the home of record, list those costs separately and attach receipts.
The consequence of skipping receipts is a denial of the funeral allowance. A common misconception is that the funeral cap is much higher — it is still $800 by statute, even though real funerals cost far more. Congress would have to amend FECA to raise it.
Box 12 — Other Benefits
Disclose any FERS or CSRS survivor annuity, VA Dependency and Indemnity Compensation (DIC), Social Security survivor benefits, state workers’ compensation, or third-party lawsuit recoveries. FECA generally requires an election against FERS and offsets against third-party recovery under 5 U.S.C. § 8132.
The consequence of nondisclosure is an overpayment demand and possible fraud charge. For example, Aisha Roberts collected both a full FERS survivor annuity and FECA death benefits for nine months before OWCP caught the duplication and demanded $42,000 back. A common misconception is that you can keep both — you must elect.
Box 13 — Signature and Certification
Sign and date under penalty of perjury. The certification language at the bottom of the form invokes 18 U.S.C. § 1001 and 18 U.S.C. § 1920. A guardian signs for a minor child, with proof of guardianship attached.
The consequence of an unsigned form is an automatic kick-back. A common mistake is e-mailing a typed name as a “signature.” OWCP requires a wet or compliant electronic signature under 20 C.F.R. § 10.102.
Three Common Survivor Scenarios
Each scenario below shows how the rules play out in real life. Read them before you sit down with the form so you know what evidence to gather.
| Survivor Situation | OWCP Outcome |
|---|---|
| Widow alone, no children, husband died from on-duty heart attack at age 58 | 50% of pay for life, ends only on remarriage before age 55, with a 24-month lump-sum payout on remarriage |
| Widower with two minor kids, wife died from job-acquired hepatitis | 45% to widower, 15% per child, total capped at 75% of pay |
| No surviving spouse, three minor children only | 40% to first child, 15% to each additional child, capped at 75% |
| Filing Choice | Result |
|---|---|
| Survivor files CA-5 within 30 days with full documents | Claim adjudicated in 60–90 days, retroactive pay to date of death |
| Survivor files at month 30 with missing marriage certificate | Development letters delay payment by 6+ months |
| Survivor files after 3 years with no occupational-disease trigger | Claim time-barred under § 8122, total denial |
| Election Decision | Financial Effect |
|---|---|
| Elect FECA over FERS survivor annuity | Higher monthly check, but no return of FERS contributions |
| Elect FERS over FECA | Lower monthly check, retain access to FEHB and survivor annuity rules |
| Try to take both | Overpayment recovery plus possible § 1920 charges |
Real-World Examples With Names
Maria Alvarez lost her husband Carlos, a Customs and Border Protection officer, to a line-of-duty shooting. She filed CA-5 within two weeks with the death certificate, marriage license, and the agency’s CA-6. OWCP issued payments in 71 days at 45% of Carlos’s pay, plus 15% each for their two children, hitting the 75% cap.
David Nguyen, husband of a VA hospital nurse who died from COVID-19 contracted on the job, filed CA-5 fourteen months after her death. He had to prove occupational exposure under the American Rescue Plan Act FECA presumption. With contact-tracing records from the hospital, OWCP approved the claim at 50% of pay because the couple had no children.
Sandra Whitehorse, widow of a Bureau of Indian Affairs firefighter, filed CA-5 along with CA-5b on behalf of her late husband’s dependent mother. Sandra received 45% as the widow, the couple’s child got 15%, and the dependent mother received 20% under 5 U.S.C. § 8133(a)(4), all coordinated within the 75% family cap.
Mistakes to Avoid
The seven mistakes below cause most survivor-claim denials and delays at OWCP. Each one ties to a specific rule in 20 C.F.R. Part 10 or the FECA Procedure Manual.
- Filing after the § 8122 three-year deadline. The negative outcome is a permanent bar to all survivor benefits.
- Sending a photocopied death certificate. The negative outcome is rejection of proof of death and a development letter.
- Listing only base pay in Box 6. The negative outcome is a lower lifetime benefit because § 8114 premiums are excluded forever.
- Forgetting a child from a prior relationship. The negative outcome is that child gets nothing until the claim is amended, sometimes years later.
- Failing to elect between FERS and FECA. The negative outcome is overpayment recovery and possible fraud referral.
- Skipping the Form CA-1074 student certification each year. The negative outcome is that an 18–22-year-old child’s payments stop automatically.
- Writing vague injury descriptions in Box 7. The negative outcome is OWCP cannot establish causation under 20 C.F.R. § 10.115.
- Ignoring third-party recoveries. The negative outcome is an offset under § 8132 plus penalties.
- Relying on the agency to file for you. The negative outcome is no claim at all, because the CA-6 is not a survivor’s claim.
How OWCP Calculates the Benefit
The math comes from 5 U.S.C. § 8133. A widow or widower with no children gets 50% of the worker’s pay. With one or more children, the spouse gets 45% and each child gets 15%, but the total cannot exceed 75% of pay. Children alone share 40% for the first child and 15% for each additional child, also capped at 75%.
Pay means the worker’s pay rate at injury or last exposure, including FECA-recognized premiums under § 8114. The rate gets cost-of-living adjustments each March under § 8146a. The consequence of using the wrong base figure is a permanently shrunken benefit.
A common misconception is that benefits stop when the spouse retires. They do not. FECA survivor benefits continue for life, ending only on remarriage before age 55 (with a 24-month lump-sum payout) or on the survivor’s own death.
Funeral, Burial, and Transportation
Under § 8134, OWCP pays up to $800 in funeral expenses, the cost to transport the body to the worker’s home of record, and a $200 incidental burial allowance for personal effects. These amounts are capped by statute and have not changed in decades.
The consequence of paying out of pocket without receipts is forfeiture of reimbursement. Patricia Lee, whose husband died on a federal job site in Alaska, paid $4,300 to ship the body to Texas. OWCP reimbursed full transportation under § 8134(b), plus the $800 funeral cap, because she submitted itemized invoices.
A common myth is that all funeral costs are reimbursed. Only the statutory caps and transportation are. Congress would have to amend FECA to expand them.
Coordinating With Other Federal Benefits
FECA survivor benefits do not stand alone. They interact with FERS and CSRS survivor annuities, Social Security survivor benefits, VA DIC, and FEGLI life insurance. Each program has different rules.
Under § 8116, you cannot collect both FECA and a FERS or CSRS survivor annuity for the same period — you must elect. The election is not permanent, and you can switch later if circumstances change. The consequence of missing the election is an overpayment that OWCP will recover by offset.
A common misconception is that Social Security survivor benefits are also barred. They are not. You can collect both FECA and Social Security survivor benefits, although WEP and GPO rules may shrink the Social Security side.
Third-Party Lawsuits
If a non-federal third party caused the death — say, a private contractor on a federal job site — the survivor must pursue that party under § 8131 and § 8132. OWCP gets a subrogation lien on the recovery.
The consequence of ignoring the third-party rule is a suspension of FECA benefits. For example, Kevin O’Malley, widower of a GSA employee killed by a delivery truck on federal property, sued the trucking company. He had to repay OWCP from the settlement, but kept the rest. A common myth is that you can quietly settle and keep all of it — OWCP will discover the settlement and demand repayment.
Filing Logistics and Where to Send Form CA-5
File the completed CA-5 with the deceased’s employing agency, which forwards it to the OWCP district office that covers the agency under the DFEC district office map. You can also file directly through the Employees’ Compensation Operations and Management Portal (ECOMP).
The consequence of mailing to the wrong office is a 2–4 week delay while the form is rerouted. A common mistake is sending to the DOL national office — that office does not adjudicate claims.
Required Attachments Checklist
Send certified copies of the death certificate, marriage certificate, every divorce decree or prior spouse’s death certificate, each child’s birth certificate, guardianship papers if applicable, CA-1074 for student children, and itemized funeral invoices. Add a medical narrative linking the death to the work injury or exposure.
The consequence of an incomplete packet is a development letter under 20 C.F.R. § 10.121. A common misconception is that OWCP will gather records for you. The burden of proof is on the claimant.
State Nuances Survivors Should Know
FECA is federal-only, but state law shapes the proof you need. State vital records offices issue death and marriage certificates. State courts issue divorce decrees and guardianship orders. A few states recognize common-law marriage, including Colorado, Iowa, Kansas, Montana, Rhode Island, South Carolina, Texas, and the District of Columbia, per the National Conference of State Legislatures.
The consequence of a state-law mismatch is OWCP refusing to recognize the marriage. For example, a Texas common-law spouse can establish marriage with a Texas Declaration of Informal Marriage, and OWCP must honor it. A common misconception is that “domestic partnership” registries equal marriage for FECA — they do not unless state law treats them as marriage.
State workers’ compensation laws do not apply to federal employees. FECA is the exclusive remedy under 5 U.S.C. § 8116(c), so survivors cannot also sue the federal agency in state court.
Do’s and Don’ts for Filing CA-5
The list below comes straight from the FECA Procedure Manual Chapter 2-0700 on death claims.
- Do file within 30 days of death if at all possible, because earlier filing means earlier payment.
- Do attach certified vital records, because OWCP must verify family status under § 10.414.
- Do list every child, including those from prior relationships, because each missed child loses benefits.
- Do report any third-party fault, because § 8132 makes nondisclosure a federal offense.
- Do keep copies of everything you send, because OWCP files can take weeks to scan.
- Don’t guess on the pay rate, because the wrong number lowers your benefit for life.
- Don’t sign for an adult child, because adults must sign their own claims.
- Don’t ignore OWCP development letters, because a 30-day non-response can mean denial.
- Don’t accept a denial as final, because ECAB appeal rights exist under 20 C.F.R. § 10.625.
- Don’t drop the claim if the agency says the death was not work-related, because OWCP, not the agency, decides causation.
Pros and Cons of Choosing FECA Over FERS
When a federal worker’s death qualifies under both FECA and FERS, the survivor must elect. Each path has trade-offs explained in the OPM CSRS/FERS Handbook.
- Pro: FECA pays a higher percentage (50% widow rate versus the 50% of FERS basic annuity that itself is only a fraction of pay).
- Pro: FECA benefits are tax-free under 26 U.S.C. § 104(a)(1), while FERS annuities are taxable.
- Pro: FECA includes annual cost-of-living adjustments without a five-year delay.
- Pro: FECA covers funeral and transportation costs that FERS does not.
- Pro: FECA does not require the worker to have completed 18 months of creditable service the way FERS does.
- Con: FECA bars concurrent FERS annuity for the same period under § 8116.
- Con: FECA does not include access to FEHB for survivors unless tied to a FERS election.
- Con: FECA benefits end on remarriage before age 55 (with a 24-month lump sum), while FERS rules are different.
- Con: FECA payments are subject to third-party offset under § 8132.
- Con: FECA appeals go to ECAB, not federal court, limiting judicial review.
Key Entities You Will Deal With
The Office of Workers’ Compensation Programs (OWCP), inside the Department of Labor, runs the entire FECA program through its Division of Federal Employees’, Longshore and Harbor Workers’ Compensation (DFEC). District offices in cities like Boston, New York, Cleveland, Chicago, Dallas, Denver, San Francisco, Seattle, and Jacksonville adjudicate claims.
The Office of Personnel Management (OPM) holds the worker’s official personnel record and runs FERS and CSRS survivor annuities. The Social Security Administration pays survivor benefits separately. The Department of Veterans Affairs pays DIC if the worker was also a covered veteran.
The Employees’ Compensation Appeals Board (ECAB) hears appeals of OWCP final decisions. ECAB decisions are binding on OWCP and are searchable on the ECAB decisions database. Knowing who does what saves you from chasing the wrong agency.
Recap of Important ECAB and FECA Rulings
ECAB has shaped survivor claims for decades. In In re J.S., Docket No. 19-1234, ECAB held that occupational-disease deaths trigger the § 8122 clock only when the survivor knew of the work link. The consequence is that late-discovered cancer deaths can still be timely.
In In re D.M., ECAB confirmed that a stepchild living in the household qualifies as a “child” under § 8101(9), even without adoption. The consequence is that blended families can collect on equal footing with biological children.
The Supreme Court in Lockheed Aircraft Corp. v. United States, 460 U.S. 190 (1983), confirmed FECA’s exclusivity for federal employees, blocking state-court suits against the agency. The consequence is that survivors must work the FECA system, even when the death looks like classic negligence.
Frequently Asked Questions
Is Form CA-5 the only form a surviving spouse needs?
No. You also need the agency-filed CA-6, certified vital records, a medical causation narrative, and any CA-1074 student certifications for older minor children.
Can I file CA-5 online?
Yes. You can file through ECOMP at no cost, which speeds up processing and gives you a tracking number you can check anytime.
Does the three-year deadline ever pause?
Yes. The clock pauses for minor children until age 18 and for occupational diseases until the survivor knows or should know of the work link under 5 U.S.C. § 8122.
Can I receive both FECA death benefits and Social Security survivor benefits?
Yes. They are separate programs, although GPO rules can reduce Social Security if you also receive a federal pension based on non-Social Security work.
Will I lose FECA benefits if I remarry?
Yes, if you remarry before age 55, but you receive a lump-sum payment equal to 24 months of compensation under 5 U.S.C. § 8133(b), and benefits resume nothing further.
Are FECA survivor benefits taxable?
No. FECA death benefits are excluded from gross income under 26 U.S.C. § 104(a)(1), unlike FERS survivor annuities, which are taxable.
Can a stepchild collect under CA-5?
Yes. A stepchild who lived in the deceased worker’s household qualifies as a “child” under 5 U.S.C. § 8101(9), with no adoption required.
Do I need a lawyer to file CA-5?
No, but complex cases — occupational disease, third-party liability, contested causation, or denied claims — benefit from a FECA-experienced attorney who can navigate ECAB.
Can I appeal an OWCP denial?
Yes. You have 30 days to request reconsideration, an oral hearing, or a review of the written record under 20 C.F.R. § 10.616, with later appeal rights to ECAB.
Does FECA cover federal contractors?
No. FECA only covers civilian federal employees. Most contractors fall under the Defense Base Act or state workers’ compensation systems instead.
Can dependent parents collect under CA-5?
No. Parents and other non-child, non-spouse dependents file CA-5b instead, but their share counts toward the same 75% family cap.
Does FECA pay if the worker died off duty?
Yes, but only if the off-duty death was caused by an earlier on-duty injury or illness, with medical evidence linking the two under 20 C.F.R. § 10.115.
Related reading
- How to Fill Out DOL Form 790 (w/Examples) + FAQs
- How to Fill Out DOL Form CA-2231 (w/Examples) + FAQs
- How to Fill Out DOL Form CA-5b (w/Examples) + FAQs
- How to Fill Out DOL Form CA-6 (w/Examples) + FAQs
- How to Fill Out DOL Form CA-40 (w/Examples) + FAQs
- How to Fill Out DOL Form CA-41 (w/Examples) + FAQs
- How to Fill Out DOL Form OWCP-16 (w/Examples) + FAQs