Division of Longshore and Harbor Workers' Compensation (DLHWC)

The Jacksonville DLHWC Office will assign OWCP case numbers to all new cases, regardless of the location of the injury or the claimant's home address. The Jacksonville office is thus designated as the "Central Case Create" site. You should submit the following forms for the creation of a new case:

  • LS-201 (Notice of Employee's Injury or Death)
  • LS-202 (Employer's First Report of Injury or Occupational Illness)
  • LS-203 (Employee's Claim for Compensation)
  • LS-262 (Claim for Death Benefits)

Electronic submission of case create forms:

https://seaportal.dol.gov

Please use the SEAPortal to upload the above documents for the creation of cases.

or

Fax Submission of Case Create Forms

Fax: (202) 513-6814

or

Submission of documents via postal mail:

U.S. Department of Labor
Office of Workers' Compensation Programs
Office of Longshore & Harbor Workers' Compensation
Central Mail Receipt Site
400 West Bay Street, Room 63A, Box 28
Jacksonville, FL 32202

Submit case create forms to the Central Mail Receipt site in Jacksonville, Florida for creation of cases for all injuries/deaths under the Longshore and Harbor Workers' Compensation Act (LHWCA), and its extensions, for all compensation districts regardless of where the injury occurred or where the injured worker resides.

Click HERE to view Frequently Asked Questions

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