America Postal Workers Union, AFL-CIO
Broward County Area, Local 1201
Jeff Riddell, President
Address:      6500 W. Sunrise Blvd
                     Plantation, Florida 33313
Phone:         (954) 792-2161
Fax:              (954) 792-2162
Email:           apwu1201@bellsouth.net
Next Meeting:
General - Oct. 20, 2013 9:30 am
Stewards - Oct. 9, 2013 7:00 pm
Address:      6500 W. Sunrise Blvd
                     Plantation, Florida 33313
Phone:         (954) 792-2161
Fax:              (954) 792-2162
Email:           apwu1201@bellsouth.net
Next Meeting:
General - Oct. 20, 2013 9:30 am
Stewards - Oct. 9, 2013 7:00 pm
  Unity    Commitment    Strength


CA-1                Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation
CA-2                Notice of Occupational Disease and Claim for Compensation
CA-2a              Notice of Recurrence
CA-7                Claim for Compensation
CA-7a              Time Analysis Form, used for claiming compensation, including repurchase of paid leave
CA-7b              Leave Buy Back (LBB) Worksheet/Certification and Election
CA-10              What A Federal Employee Should Do When Injured At Work
CA-12              Claim For Continuance of Compensation Under the Federal Employees' Compensation Act
CA-17              Duty Status Report
CA-20              Attending Physician's Report
CA-35              Evidence Required in Support of a Claim for Occupational Disease
OWCP-5a        Work Capacity Evaluation Psychiatric/Psychological Conditions
OWCP-5b        Work Capacity Evaluation Cardiovascular/Pulmonary Conditions
OWCP-5c        Work Capacity Evaluation for Musculoskeletal Conditions
OWCP-915      Claim For Medical Reimbursement
OWCP-957      Medical Travel Refund Request

Form     OWCP Form Title Description

Step 1 Grievance Outline Worksheet
Step 2 Grievance Appeal form
Step 3 Grievance Appeal form
Appeal to Arbitration from Step 2 form
Appeal to Joint Safety Committee form
Grievant or Witness Statement form
Request for Information form

APWU  'Fillable' Grievance Forms

Family Medical Leave Act (FMLA) APWU Forms

For APWU members
For APWU family member
America Postal Workers Union, AFL-CIO
Broward County Area, Local 1201


Jeff Riddell, President
Sandra Munoz, Vice President
Sample Form for Employee's Absence Plus Treatment

Sample Form for Child with Chronic Condition

Sample Form for Chronic Condition

Sample Form for Hospital Stay

Sample Form for Long Term-Terminal Illness

Sample Form for Multiple Treatments

Sample Form for Pregnancy

Sample Completed APWU Forms

© 2012 APWU BCAL 1201
804!