DLHWC (LONGSHORE) Forms

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On This Page Longshore Forms How to Complete a Form How to Submit a Form Electronically

OWCP’s Division of Longshore and Harbor Workers' Compensation (DLHWC/Longshore) has made the following forms available online. Some of these forms are available in Adobe PDF® format. In order to view and/or print PDF documents you must have a PDF viewer. It is highly recommended that you have the most current version of Adobe Reader® available on your workstation. When printing these files, please use the Adobe Acrobat Reader® print icon or the "Print" button on the form itself, NOT your browser's print icon on the browser toolbar.

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How to Complete a Form

Longshore forms can now be completed using any one of the three options below including electronic submission for selected forms (LS-18, LS-202, LS-206, LS-207 and LS-208 forms). See below for detailed instructions:

OPTION 1 — Print form

• Select form
• Print form using the "Print" button on or near the top of the form
• Write/type in the required information
• Authorize the form (if applicable) by providing a hand-written signature
• Mail/fax to the appropriate Longshore District office

OPTION 2 — Form-fill

• Select form
• Complete the form using your computer keyboard and the <TAB> key or your mouse to navigate between form fields
• Print the form using the "Print" button on or near the top of the form
• Authorize the form (if applicable) by providing a hand-written signature
• Mail/fax to the appropriate Longshore District office

OPTION 3 — Submit form electronically

• Certain Longshore forms (noted with an asterisk (*)) may be completed electronically and submitted to Longshore. To do so, you must have Adobe Reader 6.x installed on your PC. Electronic form submission is limited to the appropriate Longshore District office destination only. If there are additional requirements to submit a copy of the Longshore form to other parties then these must be satisfied using existing distribution methods.

How to Submit a Form Electronically

To electronically submit a Longshore form to a District office, follow these simple steps:

1. Upon opening the form you will be prompted to go to the IdenTrust Inc. Web site to obtain an electronic signature. Please be patient as it may take a few minutes for this prompt/box to appear. The entire process of obtaining the electronic signature will take 5-10 business days. You only have to do this one time, and, thereafter, you will use the same signature.

• Fill out the form completely, making sure to fill in the required fields (marked with a red asterik (*)). You must fill in the required fields in order to submit the form.

• Click on the "Submit" button on or near the top of the form. Select the appropriate district office. More information regarding jurisdiction.

• Click on the "Submit" button again, you will be prompted to provide your electronic signature. Click anywhere in the signature box.

• Click on the "Print" button to print a hard copy of the form for your records, then click the "Submit" button one last time to submit the form. A pop up box will appear noting that the form has been received and will provide an identification number. Please be patient, this pop-up box could take up to 2-3 minutes depending on your type of Internet connection. We recommend that you record the ID number on your hardcopy.
  
  If you have questions about filling/submitting these forms or need other forms assistance, you can send Longshore a question via e-mail at DLHWC-Public@dol.gov. Longshore will respond to your question via e-mail.