Form CA-1122 Short Form Statement of Recovery

What Is Form CA-1122?

This is a legal form that was released by the U.S. Department of Labor - Office of Workers' Compensation Programs on February 1, 2022 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

• Released on February 1, 2022;
• The latest available edition released by the U.S. Department of Labor - Office of Workers' Compensation Programs;
• Easy to use and ready to print;
• Yours to fill out and keep for your records;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a fillable version of Form CA-1122 by clicking the link below or browse more documents and templates provided by the U.S. Department of Labor - Office of Workers' Compensation Programs.