Division of Longshore and Harbor Workers' Compensation (DLHWC)
Region IV Carrier Requirements
When the employer submits the Form LS-202, First Report of Injury, to the U. S. Department of Labor within 10 days of their knowledge of an injury or alleged injury, the employer should also send a copy of Form LS-202 to the insurance carrier so that payment can be made or a controvert notice can be filed within 14 days to avoid assessment of a 10% penalty. The carrier still pays a penalty even if the reason they did not pay or controvert within 14 days is because the employer failed to advise them promptly of an injury. So you must work closely with each insured to be sure they submit the Form LS-202 to the U. S. Department of Labor and to the carrier right away.
After the carrier receives Form LS-202 from the employer, the first thing they should look for is any question of jurisdiction.
If a carrier is not sure if jurisdiction properly falls under the Longshore Act, contact our Office or submit Form LS-207, Controvert Notice, stating the basis for your initial denial of the claim, and send the form to the U. S. Department of Labor within 14 days. This filing will protect the carrier from a 10% penalty in the event it is later determined that Longshore jurisdiction is proper.
If after reviewing the LS-202, the carrier has no objection to jurisdiction, but has investigated the claim; discussed it with the employer, witnesses, and the claimant's doctor; and now disputes that the condition is related to the claimant's employment, the carrier, again, should file Form LS-207 stating their reasons for denial and send it to the U. S. Department of Labor.
At the same time that compensation is paid initially to the claimant, Form LS-206 must be completed and submitted to the U. S. Department of Labor to confirm payment has begun.
It is the carrier's responsibility under the Longshore Act to obtain and submit periodic medical reports to the U. S. Department of Labor. We ask that they do this routinely to avoid our having to ask for the reports. Our regulations require monthly medical reports and a Final Medical Report with a return to work date and an indication as to whether there is any permanency.
If the permanency is to one of the extremities, eyes, or ears as listed in Section 8, the percentage of Permanent Partial Disability must be obtained from the doctor based on the fourth edition of the AMA guide to the Evaluation of Impairment.
When a claimant returns to work, the carrier is responsible for completing Form LS-208 and sending the original and two copies to the U.S. DOL. We will review the carrier's payments, and if we agree, we will send a copy of the Form to the claimant.