Ls 202 form 2025

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  1. Click ‘Get Form’ to open the ls 202 form in the editor.
  2. Begin by filling in the OWCP No. and Carrier's No. at the top of the form. These are essential for tracking your report.
  3. Enter the date and time of the accident, ensuring accuracy for record-keeping purposes.
  4. Provide the name and address of the injured employee, including their telephone number for follow-up communication.
  5. Indicate under which act the injury is reported by marking one option from section 6.
  6. Specify where the injury occurred in section 7, selecting from options relevant to maritime employment.
  7. Continue filling out sections regarding the nature of injury, lost time, and any medical attention authorized, ensuring all details are complete.
  8. Finally, review all entries for accuracy before signing and submitting your report through our platform.

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2012 4.4 Satisfied (46 Votes)
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ls-203 - Employees Claim for Compensation. Page 1. U.S. Department of Labor. Office of Workers Compensation Programs.
The Department of Labors LS-202 is used to report workplace injuries and illnesses. It must be submitted any time a workers injury or illness leads to the loss of one or more shifts of work.
The employee must report the claim event to the employer, who in turn notifies the insurance company. The claim is formally initiated by the employers notice, launching the claim process. the employees name, date or birth or personal identity code, and contact information.
Survivors Benefits A surviving spouse with no eligible children is entitled to one-half of the deceased workers wage at the time of death under the LHWCA. A surviving spouse with one or more eligible children is entitled to two-thirds of the deceased workers wage at the time of death.
ls-202 - Employers First Report of Injury or Occupational Illness.
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People also ask

A Notice of Controversion is, simply put, a denial of your workers compensation claim under the Defense Base Act (or a claim under the Longshore and Harbor Workers Compensation Act).
Overuse. This is the most common claim for workers compensation. Overuse or overexertion happens when a person strains or pulls a muscle or joint or slips a disk from overextending to lift, pull, push, or turn an item.
What You Shouldnt Tell Your Workers Comp Doctor Never lie about prior injuries, pre-existing conditions, or medical history. Never lie about the extent of your workplace injury or how it happened. Do not exaggerate your symptoms, including pain or functionality.

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