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View ESA-OWCP-DLHWC's Form 1215-0031 Online 
| Agency: |
ESA-OWCP-DLHWC |
| Title: |
DLHWC (Longshore) LS-202, Employer's First Report of Injury or Occupational Illness |
| 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 employer to report an injury or occupational illness when the employer becomes aware of such injury or illness and/or the injured worker loses one or more shifts of work due to the injury/illness. It is a reporting tool, not an admission of liability. |
| OMB Control Number: |
1215-0031 |
| OMB Expiration Date: |
Friday, December 31, 2010
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