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5500 Series (Form Number – 5500; Agency – Employee Benefits Security Administration)
Administrative Subpoena to Appear & Testify at a Deposition (Form Number – N/A; Agency – Office of Administrative Law Judges)
Administrative Subpoena to Appear & Testify at a Hearing (Form Number – N/A; Agency – Office of Administrative Law Judges)
Administrative Subpoena to Produce Documents, Information or Objects, or to Permit Inspection of Premises (Form Number – N/A; Agency – Office of Administrative Law Judges)
Agreement and Activities Report (Form Number – LM-20; Agency – Office of Labor-Management Standards)
Agreement and Undertaking (Insurance Carrier) (Form Number – LS-275ic; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Agreement and Undertaking (Self-Insured Employer) (Form Number – LS-275si; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Agreement to Mediate (Form Number – N/A; Agency – Office of Administrative Law Judges)
Agricultural and Food Processing Clearance Order (Form Number – 790; Agency – Employment and Training Administration)
Appeal Form (Form Number – AB-1; Agency – Employees’ Compensation Appeals Board)
Application for Alien Employment Certification – Part A (Form Number – 750A; Agency – Employment and Training Administration)
Application for Alien Employment Certification – Part B (Form Number – 750B; Agency – Employment and Training Administration)
Application for Approval of a Representative’s Fee in a Black Lung Claim Proceeding Conducted by The U.S. Department of Labor (Form Number – CM-972; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Application for Authority to Employ Full-Time Students at Subminimum Wages in Retail or Service Establishments or Agriculture Under Regulations 29 C.F.R. Part 519 (Form Number – WH-200; Agency – Wage and Hour Division)
Application for Authority to Employ Six or Fewer Full-Time Students at Subminimum Wages in Retail or Service Establishments or Agriculture Under Regulations 29 C.F.R. Part 519 (Form Number – WH-202; Agency – Wage and Hour Division)
Application for Authority to Employ Workers with Disabilities at Subminimum Wages (Form Number – WH-226 ; Agency – Wage and Hour Division)
Application for Certificateto Employ Homeworkers (Form Number – WH-46; Agency – Wage and Hour Division)
Application for Continuation of Death Benefit for Student (Form Number – LS-266; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Application for Permanent Employment Certification (Form Number – 9089; Agency – Employment and Training Administration)
Application for Prevailing Wage Determination (Form Number – 9141; Agency – Employment and Training Administration)
Application for Prevailing Wage Determination (Form Number – 9141C; Agency – Employment and Training Administration)
Application for Security Deposit Determination. State Guarantee Fund Longshore Security Factor Chart (Form Number – LS-276; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Application for Self-Insurance instructions (Form Number – LS-271; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Application for Special Industrial Homeworker Certificate (Form Number – WH-2; Agency – Wage and Hour Division)
Application For Special Relief Fund (Form Number – LS-5; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Application to Employ Student-Learners at Subminimum Wages (Form Number – WH-205; Agency – Wage and Hour Division)
Application to write Longshore Insurance (Carriers) (Form Number – LS-272; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Approval of Compromise of Third Person Cause of Action (Form Number – LS-33; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Attending Physician’s Report (Form Number – CA-20; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Attending Physician’s Supplementary Report (Form Number – LS-204; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Attorney Fee Approval Request (Form Number – LS-4; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Authorization For Release Of Medical Information (Black Lung Benefits) (Form Number – CM-936; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Black Lung Benefits Act Evidence Summary Form (Form Number – N/A; Agency – Office of Administrative Law Judges)
Carrier’s Report of Issuance of Policy (formerly Card Report of Insurance) (Form Number – LS-570; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Certificate of Electrical/Noise Training (Form Number – 5000-1; Agency – Mine Safety and Health Administration)
Certificate of Medical Necessity (Form Number – CM-893; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Certificate of Physical Qualification for Mine Rescue Work (Form Number – 5000-3; Agency – Mine Safety and Health Administration)
Certificate of Training (Form Number – 5000-23; Agency – Mine Safety and Health Administration)
Certificate of Training Form (Form Number – WH-5; Agency – Wage and Hour Division)
Certificates of Achievement in Safety (Form Number – N/A; Agency – Mine Safety and Health Administration)
Certification by School Official (Form Number – CM-981; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Certification of Funeral Expenses (Form Number – LS-265; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Claim for Compensation (Form Number – CA-7; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Claim for Compensation by Parents, Brothers, Sisiters, GrandParents, or GrandChildren (Form Number – CA-5b; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Claim for Compensation by Widow, Widower, and/or Children (Form Number – CA-5; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Claim For Continuance of Compensation Under the Federal Employees’ Compensation Act (Form Number – CA-12; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Claim for Death Benefits (Form Number – LS-262; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Claim For Medical Reimbursement (Form Number – OWCP-915; Agency – Office of Workers’ Compensation Programs)
Claim for Reimbursement Assisted Reemployment (Form Number – CA-2231; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Claim for Reimbursement of Benefit Payments and Claims Expense Under the War Hazards Compensation Act (Form Number – CA-278; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Claim for Survivor Benefits Under the Federal Employees’ Compensation Act Section 8102a Death Gratuity (Form Number – CA-41; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Claimant’s Statement (Form Number – LS-267; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Commutation Application (Form Number – LS-6; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Complaint/Apparent Violation Form (Form Number – 8429; Agency – Employment and Training Administration)
Contractor ID Request (Form Number – 7000-52; Agency – Mine Safety and Health Administration)
CW-1 Application for Temporary Employment Certification (Form Number – 9142C; Agency – Employment and Training Administration)
DBRA Certified Payroll Form (Form Number – WH-347; Agency – Wage and Hour Division)
DBRA Report of Construction Contractor’s Wage Rates (Form Number – WH-10; Agency – Wage and Hour Division)
Description Of Coal Mine Work and Other Employment (Form Number – CM-913; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Designation of a Recipient of the Federal Employees’ Compensation Act Death Gratuity Payment under 5 U.S.C. § 8102a (Form Number – CA-40; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Domestic Agricultural In- Season Wage Report (Form Number – 232; Agency – Employment and Training Administration)
Domestic Agricultural In-season Wage Finding Process (Form Number – 385; Agency – Employment and Training Administration)
Duty Status Report (Form Number – CA-17; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Electrically Operated Equipment Field Approval Application (Coal Only) (Form Number – 2000-38; Agency – Mine Safety and Health Administration)
Electronic Training Plan Advisor (Form Number – N/A; Agency – Mine Safety and Health Administration)
Employee’s Claim (Form Number – EE-1; Agency – Office of Workers’ Compensation Programs – Division of Energy Employees Occupational Illness Compensation)
Employee’s Claim for Compensation (Form Number – LS-203; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Employer Report (Form Number – LM-10; Agency – Office of Labor-Management Standards)
Employer-Provided Survey Attestations to Accompany H-2B Prevailing Wage Determination Request Based on a Non-OES Survey (Form Number – 9165; Agency – Employment and Training Administration)
Employer’s First Report of Injury or Occupational Illness (Form Number – LS-202; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Employer’s Supplementary Report of Accident or Occupational Illness (Form Number – LS-210; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in the State of Alaska (Form Number – 9033-A; Agency – Employment and Training Administration)
Employers’ Attestation to Use Alien Crewmembers for Longshore Activities in U.S. Ports Form ETA 9033 (Form Number – 9033; Agency – Employment and Training Administration)
Employment History (Form Number – CM-911a; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Employment History (Form Number – EE-3; Agency – Office of Workers’ Compensation Programs – Division of Energy Employees Occupational Illness Compensation)
Employment History Affidavit (Form Number – EE-4; Agency – Office of Workers’ Compensation Programs – Division of Energy Employees Occupational Illness Compensation)
EPPA Notice to Examinee (Form Number – WH-1481; Agency – Wage and Hour Division)
Evidence Required in Support of a Claim for Occupational Disease (Form Number – CA-35; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Federal Contractor Discrimination Complaint (Form Number – N/A; Agency – Office of Federal Contract Compliance Programs)
Federal Contractor Reporting – Veteran Hiring (Form Number – VETS-4212; Agency – Veterans’ Employment and Training Service)
Federal Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation (Form Number – CA-1; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
FMLA Certification for Serious Injury or Illness of a Veteran for Wage and Hour Division Military Caregiver Leave (Form Number – WH-385V; Agency – Wage and Hour Division)
FMLA Certification for Serious Injury orIllness of Covered Servicemember — for Military Family Leave (Form Number – WH-385; Agency – Wage and Hour Division)
FMLA Certification of Health Care Providerfor Employee’s Serious Health Condition (Form Number – WH-380-E; Agency – Wage and Hour Division)
FMLA Certification of Health Care Providerfor Family Member’s Serious Health Condition (Form Number – WH-380-F; Agency – Wage and Hour Division)
FMLA Certification of Qualifying Exigency For Military Family Leave (Form Number – WH-384; Agency – Wage and Hour Division)
FMLA Designation Notice (Form Number – WH-382 ; Agency – Wage and Hour Division)
FMLA Notice of Eligibility and Rights & Responsibilities (Form Number – WH-381; Agency – Wage and Hour Division)
Foreign Labor Certification Quarterly Activity Report (Form Number – 9127; Agency – Employment and Training Administration)
H-1B Nonimmigrant Information (Form Number – WH-4; Agency – Wage and Hour Division)
H-2A Application for Temporary Employment Certification (Form Number – 9142A; Agency – Employment and Training Administration)
H-2B Application for Temporary Employment Certification (Form Number – 9142B; Agency – Employment and Training Administration)
Hazardous Condition Complaint (Form Number – N/A; Agency – Mine Safety and Health Administration)
Health Activity Certification or Hoisting Engineers Qualification Request (Form Number – 5000-41; Agency – Mine Safety and Health Administration)
Health Insurance Claim Form (Form Number – OWCP-1500; Agency – Office of Workers’ Compensation Programs)
Higher Education to Employ its Full-time Students at Subminimum Wages Under Regulations 29 C.F.R. Part 519 (Form Number – WH-201; Agency – Wage and Hour Division)
Homeworker Handbook (Form Number – WH-75; Agency – Wage and Hour Division)
Homeworker Handbook (Spanish) (Form Number – WH-75; Agency – Wage and Hour Division)
Inspector General Hotline (Form Number – N/A; Agency – Office of Inspector General)
Instructions For Completion of Form CM-921 (Form Number – CM-921; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Labor Organization Annual Report (Form Number – LM-2; Agency – Office of Labor-Management Standards)
Labor Organization Annual Report (Form Number – LM-3; Agency – Office of Labor-Management Standards)
Labor Organization Annual Report (Form Number – LM-4; Agency – Office of Labor-Management Standards)
Labor Organization Information Report (Form Number – LM-1; Agency – Office of Labor-Management Standards)
Labor Organization Officer and Employee Report (Form Number – LM-30; Agency – Office of Labor-Management Standards)
LCA Online Application (Form Number – 9035; Agency – Employment and Training Administration)
Leave Buy Back (LBB) Worksheet/Certification and Election (Form Number – CA-7b; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Legal Identification Report (Form Number – 2000-7; Agency – Mine Safety and Health Administration)
Letter to Dependants to Verify Claimant Support (Form Number – CA-1031; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Letter to Parents in Death Claim Development (Form Number – CA-1074; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
LHWCA Prehearing Statement Form (Form Number – N/A; Agency – Office of Administrative Law Judges)
LHWCA Uniform Stipulations Form (Form Number – N/A; Agency – Office of Administrative Law Judges)
Manage/Update Diesel Inventory (Form Number – N/A; Agency – Mine Safety and Health Administration)
Medical History and Examination for Coal Mine Workers’ Pneumoconiosis (Form Number – CM-988; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Medical Requirements (Form Number – EE-7; Agency – Office of Workers’ Compensation Programs – Division of Energy Employees Occupational Illness Compensation)
Medical Travel Refund Request (Form Number – OWCP-957; Agency – Office of Workers’ Compensation Programs)
Mine Accident, Injury and Illness Report (Form Number – 7000-1; Agency – Mine Safety and Health Administration)
Mine ID Request (Form Number – 7000-51; Agency – Mine Safety and Health Administration)
Miner’s Claim For Benefits Under The Black Lung Benefits Act (Form Number – CM-911; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration (Form Number – WH-530; Agency – Wage and Hour Division)
MSPA Application for a Farm Labor Contractor or Farm Labor ContractorEmployee Certificate of Registration (Spanish) (Form Number – WH-530; Agency – Wage and Hour Division)
MSPA Doctor’s Certificate (Form Number – WH-515; Agency – Wage and Hour Division)
MSPA Housing Occupancy Certificate (Form Number – WH-520; Agency – Wage and Hour Division)
MSPA Housing Terms and Conditions (Form Number – WH-521; Agency – Wage and Hour Division)
MSPA Vehicle Mechanical Inspection Report for Transportation Subjectto Department of Transportation Requirements (Form Number – WH-514; Agency – Wage and Hour Division)
MSPA Wage Statement (Form Number – WH-501; Agency – Wage and Hour Division)
MSPA Wage Statement (Spanish) (Form Number – WH-501; Agency – Wage and Hour Division)
MSPA Worker Information – Terms of Employment (Form Number – WH-516; Agency – Wage and Hour Division)
MSPA Worker Information – Terms of Employment (Haitian Creole) (Form Number – WH-516; Agency – Wage and Hour Division)
MSPA Worker Information – Terms of Employment (Spanish) (Form Number – WH-516; Agency – Wage and Hour Division)
Multiple Employer Welfare Arrangements (MEWAs) Annual Report (Form Number – M-1; Agency – Employee Benefits Security Administration)
Notice of Controversion of Right to Compensation (Form Number – LS-207; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Notice of Employee’s Injury or Death (Form Number – LS-201; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Notice of Final Payment or Suspension of Compensation Payments (Form Number – LS-208; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Notice of Law Enforcement Officer’s Death (Form Number – CA-722; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Notice of Law Enforcement Officer’s Injury Or Occupational Disease (Form Number – CA-721; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Notice of Occupational Disease and Claim for Compensation (Form Number – CA-2; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Notice of Recurrence (Form Number – CA-2a; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Notice of Termination, Suspension, Reduction or Increase in Benefit Payments (Form Number – CM-908; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Official Notice of Employees’ Death for Purposes of FECA Section 8102a Death Gratuity (Form Number – CA-42; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Official Supervisor’s Report of Employee’s Death (Form Number – CA-6; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Operator Response to Notice of Claim (Form Number – CM-2970a; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Operator Response to Schedule for Submission of Additional Evidence (Form Number – CM-2970; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Operator’s Annual Certification of Mine Rescue Teams Qualifications (Form Number – 2000-224; Agency – Mine Safety and Health Administration)
Order Appointing Mediator (Form Number – N/A; Agency – Office of Administrative Law Judges)
Overpayment Recovery Questionnaire (Form Number – OWCP-20; Agency – Office of Workers’ Compensation Programs)
Payment of Compensation Without Award (Form Number – LS-206; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Physician’s/Medical Officer’s Statement (Form Number – CM-787; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Pre-Hearing Statement (Form Number – LS-18; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Provider Enrollment form (Form Number – OWCP-1168; Agency – Office of Workers’ Compensation Programs)
Quarterly Mine Employment and Coal Production Report (Form Number – 7000-2; Agency – Mine Safety and Health Administration)
Receipts and Disbursements Report (Form Number – LM-21; Agency – Office of Labor-Management Standards)
Record of Individual Exposure to Radon Daughters (Form Number – 4000-9; Agency – Mine Safety and Health Administration)
Rehabilitation Action Report (Form Number – OWCP-44; Agency – Office of Workers’ Compensation Programs)
Rehabilitation Maintenance Certificate (Form Number – OWCP-17; Agency – Office of Workers’ Compensation Programs)
Rehabilitation Plan And Award (Form Number – OWCP-16; Agency – Office of Workers’ Compensation Programs)
Report Commencement/Closure of Operation – Metal and Nonmetal Mines (Form Number – N/A; Agency – Mine Safety and Health Administration)
Report of Arterial Blood Gas Study (Form Number – CM-1159; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Report of Changes That May Affect Your Black Lung Benefits (Form Number – CM-929; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Report of Changes That May Affect Your Black Lung Benefits (Form Number – CM-929P; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Report of Earnings (Form Number – LS-200; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Report of Injury Experience of Insurance Carrier or Self-Insured Employer (Form Number – LS-274; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Report of Payments. (Form Number – LS-513; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Report of Ventilatory Study (Form Number – CM-2907; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Report on Selection of Delegates and Officers (Form Number – LM-15A; Agency – Office of Labor-Management Standards)
Representative of Miners Designation Form (Form Number – 2000-238; Agency – Mine Safety and Health Administration)
Representative Payee Report (Form Number – CM-623; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Representative Payee Report (Form Number – CM-623S; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Request an MSHA Individual Identification Number (MIIN) (Form Number – 5000-46; Agency – Mine Safety and Health Administration)
Request for Appointment of Mediator (Form Number – N/A; Agency – Office of Administrative Law Judges)
Request for Earnings Information (Form Number – LS-426; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Request for Examination and/or Treatment (Form Number – LS-1; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Request for Intervention (Form Number – LS-7; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Request To Be Selected As Payee (Form Number – CM-910; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Roentgenographic Interpretation (Form Number – CM-933; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Roentgenographic Quality Rereading (Form Number – CM-933b; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Safety and Health Complaint (Form Number – N/A; Agency – Occupational Safety and Health Administration)
Self Contained Self Rescuer (SCSR) Inventory and Report (Form Number – 2000-222; Agency – Mine Safety and Health Administration)
Settlement Approval Request Section 8(i) (Form Number – LS-8; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Settlement Judge Request (Form Number – N/A; Agency – Office of Administrative Law Judges)
Statement of Recovery Letter with Long Form (Form Number – CA-1108; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Statement of Recovery Letter with Short Form (Form Number – CA-1122; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Stipulation Approval Request (Form Number – LS-9; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Supplemental Data Sheet for Application for Authority to Employ Workers with Disabilities at Subminimum Wages (Form Number – WH-226A; Agency – Wage and Hour Division)
Surety Company Annual Report (Form Number – S-1; Agency – Office of Labor-Management Standards)
Survivor’s Claim (Form Number – EE-2; Agency – Office of Workers’ Compensation Programs – Division of Energy Employees Occupational Illness Compensation)
Survivor’s Form For Benefits Under The Black Lung Benefits Act (Form Number – CM-912; Agency – Office of Workers’ Compensation Programs – Division of Coal Mine Workers’ Compensation)
Terminal Trusteeship Report (Form Number – LM-16; Agency – Office of Labor-Management Standards)
Time Analysis Form, used for claiming compensation, including repurchase of paid leave (Form Number – CA-7a; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Trusteeship Report (Form Number – LM-15; Agency – Office of Labor-Management Standards)
Uniform Billing Form (Form Number – OWCP-04; Agency – Office of Workers’ Compensation Programs)
Wage Complaints (Form Number – N/A; Agency – Wage and Hour Division)
Wage Survey Interview Record (Form Number – 232A; Agency – Employment and Training Administration)
Waiver of Service by Registered or Certified Mail for Claimants and Authorized Representatives (Form Number – LS-802; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Waiver of Service by Registered or Certified Mail for Employers and/or Insurance Carriers (Form Number – LS-801; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
What A Federal Employee Should Do When Injured At Work (Form Number – CA-10; Agency – Office of Workers’ Compensation Programs – Division of Federal Employees’, Longshore and Harbor Workers’ Compensation)
Work Capacity Evaluation Cardiovascular/Pulmonary Conditions (Form Number – OWCP-5b; Agency – Office of Workers’ Compensation Programs)
Work Capacity Evaluation for Musculoskeletal Conditions (Form Number – OWCP-5c; Agency – Office of Workers’ Compensation Programs)

Work Capacity Evaluation Psychiatric/Psychological Conditions (Form Number – OWCP-5a; Agency – Office of Workers’ Compensation Programs)