DLHWC (Longshore) LS-267, Claimant's Statement: This report is required. A surviving spouse receiving death benefits must submit this form to state their current marital status and advise whether they have remarried. It is also submitted by or on behalf of a death benefits beneficiary as a student to state and advise whether the student continues to be enrolled in school full-time. The form is used to determine continuing eligibility for compensation benefits. Failure to submit the form may result in termination or loss of compensation benefits.
