Wednesday, December 11, 2019

Sample legal forms and business documents

YOU ARE HERE Home Legal Forms Department of Labor (DOL) Office of Workers' Compensation Programs DLHWC (OWCP-DLHWC)

Office of Workers' Compensation Programs DLHWC (OWCP-DLHWC)

Form TitleCoverage
DLHWC (Longshore) LS-1, Request for Examination and/or Treatment All States
DLHWC (Longshore) LS-18, Pre-Hearing Statement All States
DLHWC (Longshore) LS-200, Report of Earnings All States
DLHWC (Longshore) LS-201, Notice of Employee's Injury or Death All States
DLHWC (Longshore) LS-202, Employer's First Report of Injury or Occupational Illness All States
DLHWC (Longshore) LS-203, Employee's Claim for Compensation All States
DLHWC (Longshore) LS-204, Attending Physician's Supplementary Report All States
DLHWC (Longshore) LS-205, Physician's Report on Impairment of Vision All States
DLHWC (Longshore) LS-206, Payment of Compensation Without Award All States
DLHWC (Longshore) LS-207, Notice of Controversion of Right to Compensation All States
DLHWC (Longshore) LS-208, Notice of Final Payment or Suspension of Compensation Payments All States
DLHWC (Longshore) LS-210, Employer's Supplementary Report of Accident or Occupational Illness All States
DLHWC (Longshore) LS-262, Claim for Death Benefits All States
DLHWC (Longshore) LS-265, Certification of Funeral Expenses All States
DLHWC (Longshore) LS-266, Application for Continuation of Death Benefit for Student All States
DLHWC (Longshore) LS-267, Claimant's Statement All States
DLHWC (Longshore) LS-271, Application for Self-Insurance All States
DLHWC (Longshore) LS-274, Report of Injury Experience of Insurance Carrier or of Self-Insured Employer All States
DLHWC (Longshore) LS-275ic, Agreement and Undertaking(Insurance Carrier) All States
DLHWC (Longshore) LS-275si, Agreement and Undertaking (Self-Insured Employer) All States
DLHWC (Longshore) LS-276, Application for Security Deposit Determination All States
DLHWC (Longshore) LS-33, Approval of Compromise of Third Person Cause of Action All States
DLHWC (Longshore) LS-426, Request for Earnings Information All States