Longshore Program






This page is designed for Medical Providers to assist them in all matters of compliance with the LHWCA and its extensions. Medical Providers will find information about our program and services, your rights and responsibilities under the law, and how to contact us if you need assistance.


Forms - below is a listing of Longshore forms that may be of interest to Medical Providers
Form NumberOWCP's Form Title/Description
LS-1Request for Examination and/or Treatment
LS-204Attending Physician's Supplementary Report
OWCP-5aWork Capacity Evaluation (Psychiatric/Psychological Conditions)
OWCP-5bWork Capacity Evaluation (Cardiovascular/Pulmonary Conditions)
OWCP-5cWork Capacity Evaluation (Musculoskeletal Conditions)



Frequently Asked Questions (FAQ's)