- Printer Version

Office of Workers' Compensation Programs (OWCP)

Division of Longshore and Harbor Workers' Compensation (DLHWC)

LS-513 instructions

INSTRUCTIONS FOR SUBMITTING FORM LS-513, REPORT OF PAYMENTS, FOR DETERMINATION OF ASSESSMENT UNDER THE LONGSHORE AND HARBOR WORKERS' COMPENSATION ACT, AND EXTENSIONS

GENERAL - Pursuant to Section 44 of the Longshore and Harbor Workers' Compensation Act, all authorized insurance carriers and self-insured employers under the Longshore Act and extensions, including the District of Columbia Compensation Act, are required each year to complete and file with the Office of Workers' Compensation Programs the attached Form LS-513. The form must be completed to show the number of cases and all compensation and medical payments made under the Act(s) during calendar year 2007.

NOTE: A detailed listing must be submitted with the LS-513 supporting the figures and it must contain the following: (1)Claimants Name (2)OWCP File Number (3)Social Security Number (4)Date of Injury (5)Indemnity/Medical paid in CY 2007. This report must be mailed to the Washington D.C. address (on page #2) and should not be sent to the post office box. This report may also be submitted in an electronic version.

* DEFINITION OF WHAT MUST BE REPORTED ON FORM LS-513

All categories of compensation (under Sections 6,8,9, and 44(c)(1) ) paid during calendar year 2007 and reportable on an LS-208 must be reported on the LS-513. This includes additional compensation under Section 14(e) and (f). Compensation is considered paid when a check is issued and not when the check is cashed.
Attorney's fees assessed against the employer/carrier under Section 28(a) & (b) are NOT considered compensation; however, attorney's fees which are a lien on compensation under 28(c) are reportable.
All penalties and interest payable to the claimant ARE considered compensation and therefore reportable.
Section 8(i) settlements, (including annuities) are fully reportable as compensation and/or medical in the year paid.
Reimbursement to employer/carriers on cases where Section 8(f) relief is ultimately granted are NOT to be deducted from total payments.
Medical payments should include impartial medical examinations ordered by OWCP but paid by the employer/carrier. Compensation may NOT be reduced or credited due to actual or anticipated subsequent events, reversal on appeal, salary continuance, or credit under a State Act. .
Third party recoveries may NOT be deducted from payments.
Compensation may NOT be reduced or credited due to actual or anticipated subsequent events, reversal on appeal, salary continuance, or credit under a State Act.
Under the DISTRICT OF COLUMBIA COMPENSATION ACT only compensation and medical payments made during calendar year 2007 where the injury date is prior to 7/26/82 should be reported.
All payments for reimbursement from an excess/reinsurance Carrier or a national/state assigned risk pool MUST BE REPORTED by the primary employer/carrier.
Any payments made directly to claimants by an excess or reinsurance carrier MUST BE REPORTED by the primary employer/carrier.
Any payments made under a so-called "deductible" policy provision MUST BE REPORTED by the insurance carrier that issued the policy.
Payments made under the DEFENSE BASE ACT must be reported. No credit is allowed for cases which may be recoverable under the War Hazards Compensation Act.
When an employer continues to pay full salary to an employee, the amount of compensation which is due the claimant must be reported. Payments must be reported for employees who are disabled and given sheltered employment during the period of recovery.
All payments made under state compensation statutes to concurrent longshore workers must be reported. If the state amount exceeds that due under Longshore only the lesser amount is reportable. If the state amount is less than that due under Longshore than both must be reported. Such payments must be reported even if a formal claim has not been filed under the Longshore Act and also must be reported if subject to a state assessment formula.
The employer/carrier is ultimately responsible for reporting payments correctly. Third party adjusters or other agents are responsible to their principals for accurate reports. When a third party supplies the data the principal must sign and attest to the correctness of the LS-513.
Medical payments must be reported on all lost time claims, including hearing loss claims, closed cases, and claims paid under Section 8(f) and claims where only compensation has been settled under Section 8(i).
A CORRECT and ACCURATE LS-513 is due by March 5, 2008. Amendments are discouraged and must submitted by July 1, 2008. Late amendments may not result in an assessment change.
If the employer/carrier reports zero ($0) payments a report must be submitted showing the total payroll for covered Longshore employees during the calendar year. If there is no payroll the report must confirm this.

REQUIREMENT FOR CERTIFICATION OF LS-513

Form LS-513, Report of Payments, must be certified as to the accuracy of the information submitted. This certification must be signed by an independent certified public accountant. The certification must conform to the attached format (Attachment #1). The certifying individual cannot be: (1) an employee of the company submitting the Form LS-513; (2) any subsidiary or affiliate of that company; (3) anyone affiliated with an organization who provides claims services to a self insured employer. The certification must be submitted on the letterhead of the individual or firm performing the audit

The certification need not accompany the filing of Form LS-513. It must however be submitted no later than 12/31/08 to allow for certification during each company's annual financial audit.

EXEMPTIONS

The certification requirement applies to all Forms LS-513, except the following:

(1) Forms LS-513 showing compensation payments less then $200,000 which need only be signed on the form.

(2) Forms LS-513 submitted by self-insured nonappropriated fund instrumentalities need not be certified, other than by an official on the Form LS-513.

Attachment #1

(NAME OF COMPANY)

We have audited the compensation and medical payments (as defined in the Longshore and Harbor Workers' Compensation Act, and extensions) included on the accompanying Form LS-513, Report of Payments, of the above Company for the year ended December 31, 2007. Form LS-513 is prepared for the purpose of complying with the Longshore and Harbor Workers' Compensation Act (the "Act") and is the responsibility of the Company's management. Our responsibility is to express an opinion on Form LS-513 based on our audit.

We conducted our audit in accordance with generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether Form LS-513 is free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in Form LS-513. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation. We believe that our audit provides a reasonable basis for our opinion.

In our opinion, Form LS-513 referred to above presents fairly, in all material respects, the compensation and medical payments made by the above Company during the year ended December 31, 2007, as defined in the Act referred to in the first paragraph.

This report is intended solely for the information and use of the board of directors and management of the above company and the Division of Longshore and Harbor Workers' Compensation and should not be used for any other purpose.

_____________________
Signed

_____________________
Date