ls 201
ls-206
workers compensation first report of injury form california
ls-204
ls-203
form ls-210
ls 207 form
form ls-1
When printing these forms, Please use the PRINT BUTTON on the form itself. Report of Earnings. LS-201. Notice of Employee's Injury or Death. LS-202. Include form number on all reproductions. FORM APPROVED- SW., STOP 0249. Washington, D.C. 20250-0249. FAX - (202) 720-1125. LS-45-R. Print Form. completes part B. Immediately or within. 24 hours after the injury. Step 3: Supervisor reports the injury on Form. LS-202. Within 3 days after injury or illness. NAF. 25 Jun 2013 The employer must send Form LS-202 to the appropriate DOL district office within 10 days of a lost time injury, or 10 days from the date that it 36. Employer's. 38. Official title and phone number of person signing this report. 39. Date of this report. (mm/dd/yyyy). Form LS-202. Rev. April 2012. First Name. 7 Mar 2016 LS 202 Incident Form Help Sample Form The LS 202 Form The LS 202 was released Sunday, 7-17-2011. This form will be activated upon You must submit the Form LS-202, Employer's First Report of Injury, to the OWCP within 10 days of your knowledge of any injury which causes loss of one or 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 Form LS- 202, Employer's First Report of Injury or. Occupational Illness. The U.S. Department of Labor has announced its intention to “scrutinize more closely”
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