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Office of Workers' Compensation Programs
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Division of Longshore and Harbor Workers' Compensation (DLHWC)

Medical Provider Page

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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 use by Medical Providers

Form Number

OWCP's Form Title/Description


Request for Examination and/or Treatment


Attending Physician's Supplementary Report


Work Capacity Evaluation (Psychiatric/Psychological Conditions)


Work Capacity Evaluation (Cardiovascular/Pulmonary Conditions)


Work Capacity Evaluation (Musculoskeletal Conditions)



Frequently Asked Questions (FAQ's)