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| DOL Home > Find It! By Form > DOL Form |
DOL Form LS-202
Agency: |
OWCP-DLHWC |
Title: |
DLHWC (Longshore) LS-202, Employer's First Report of Injury or Occupational Illness |
Form Description: |
DLHWC (Longshore) LS-202, Employer's First Report of Injury or Occupational Illness: This is a required form which is submitted by the employer to report an injury or occupational illness when the employer becomes aware of such injury or illness and/or the injured worker loses one or more shifts of work due to the injury/illness. It is a reporting tool, not an admission of liability. |
OMB Control Number: |
1215-0031 |