Employer's First Report of Injury or Occupational Disease; Employer's Supplementary Report of Accident or Occupational Illness

Employer's First Report of Injury or Occupational Disease; Employer's Supplementary Report of Accident or Occupational Illness

OMB: 1240-0003

IC ID: 13653

Documents and Forms

Document Name Document Type
Form LS-210 Employer's First Report of Injury or Occupational Disease; Employer's Supplementary Report of Accident or Occupational Illness Form
Form LS-210 Employer's First Report of Injury or Occupational Disease; Employer's Supplementary Report of Accident or Occupational Illness Form
LS-210 Employer's Supplementary Report of Accident or Occupational Illness ls-210 (002).pdf www.dol.gov/owcp/dlhwc/ls-210.pdf Form
LS-202 Employer's First Report of Injury or Occupational Illness ls-202 3-19-24.pdf www.dol.gov/sites/dolgov/files/owcp/dlhwc/ls-202.pdf Form and Instruction
DLHWC Seaportal.pdf DLHWC SEA Portal IC Document