Useful Forms
Important Forms For Claims
DLHWC (Longshore) LS-1, Request for Examination and/or Treatment
DLHWC (Longshore) LS-201, Notice of Employee's Injury or Death
DLHWC (Longshore) LS-200, Report of Earnings
OWCP-5c, Work Capacity Evaluation for Musculoskeletal Conditions
OWCP-5a, Work Capacity Evaluation For Psychiatric/ Psychological Conditions
DLHWC (Longshore) LS-203, Employee's Claim for Compensation
OWCP-5b, Work Capacity Evaluation For Cardiovascular/ Pulmonary Conditions
Travel Mileage Reimbursement Form
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