adobe-pdf-icon LS-203 Web Form

adobe-pdf-iconDLHWC (Longshore) LS-1, Request for Examination and/or Treatment

adobe-pdf-icon DLHWC (Longshore) LS-201, Notice of Employee’s Injury or Death

adobe-pdf-icon DLHWC (Longshore) LS-200, Report of Earnings

adobe-pdf-icon DLHWC (Longshore) LS-203, Employee’s Claim for Compensation

adobe-pdf-icon OWCP-5a, Work Capacity Evaluation For Psychiatric/ Psychological Conditions

adobe-pdf-icon OWCP-5b, Work Capacity Evaluation For Cardiovascular/ Pulmonary Conditions

adobe-pdf-icon OWCP-5c, Work Capacity Evaluation for Musculoskeletal Conditions

adobe-pdf-icon Travel Mileage Reimbursement Form