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In this video we're going to be covering how to fill out your CA to or as you can see here notice of occupational disease and claim for compensation a CA to injury is defined as an injury developing over two or more work ships all that being said usually it takes months years and sometimes even decades to go ahead and develop these injuries the most common are going to be things like carpal tunnel syndrome plantar fasciitis worn out knees rotator cuff injuries back injuries that took time to develop arthritis and osteoarthritis neck problems and any other injuries that took time to develop and did not happen on one work shift there's a lot of confusion when it comes to this form and that's largely because of this area right here boxes 11 in box 12 we're going to get to those in a second what we're going to cover in this video is not only how to fill out this form but the required information that you need to print addition to just filling out this form before we start I want to let you know that there are several pages to this form page one we're looking at here everything on this page you're required to fill out page two as you can see right here is for your supervisor to fill out everything on page two your supervisor fills out page three has information that we'll come back to here shortly and this receipt I'm going to stress over and over and over again the importance of getting this receipt back getting this receipt back is not a request it is your right page four is the information, or we'll call supplemental information that OCP will need in order to get your claim accepted going to the doctor and getting a narrative report written is simply not enough if you do not pr them this information found right here the claim will not get accepted no matter how good the doctors report is there's info that your supervisor has to brand down here these are instructions which I will explain to you back up top so let's go ahead and start right here with page one obviously we're gonna start with employee data you're going to put your name here date of birth gender telephone number now it specifically says home phone here if you do not have a home phone please put in your cell phone or whatever is the best way for them to contact you box six is asking you for your level and step this is referring to your grade of pay as of the date of last exposure the date of last exposure is going to be your last work shift if you know those you would go ahead and put those in however if you do not know your level and step not a big deal it's not a hundred percent necessary in order to get the ball rolling.