- NOTIFY YOUR EMPLOYER IMMEDIATELY. If possible, complete Form LS-201, Notice of Injury, available from your employer.
- MEDICAL TREATMENT. Request authority from your employer for treatment by the physician you choose. In an emergency or if you are unable to contact your employer, go to the nearest hospital or physician, but be sure to let your employer know as soon as possible.
- DISABILITY. If you are disabled more than 3 days, contact your employer or the insurance company for payment of compensation, payable 14 days after your employer has knowledge of injury.
- IMPORTANT! The law requires you to give written notice of injury (Form LS-201) to your employer and to the Office of Workers’ Compensation Programs (OWCP) within 30 days. Additional time may be allowed for certain hearing loss and occupational disease claims. Notice should be sent to the District Director at one of the following addresses:
OWCP/DLHWC,P.O. Box 249, New York, NY 10014-0249, USA, or
OWCP/DLHWC, 300 Ala Moana, Box 50209, Honolulu, HI 96850, USA
Important Notice:
Section 31 (a)(1) of the Longshore Act, 33 U.S.C. 931(a)(1), provides as follows: Any claimant or representative of a claimant who knowingly and willfully makes a false statement or representation for the purpose of obtaining a benefit or payment under this Act shall be guilty of a felony, and on conviction thereof shall be punished by a fine not to exceed $10,000, by imprisonment not to exceed five years, or by both.
