Forms

Click on any of the following to download a PDF.

Longshore & Defense Base Act Claim Forms
Employee's Claim for Compensation (LS-203)
Claim for Death Benefits (LS-262)
      Mailing your forms: Find your local District Office 

Authorizations
Medical Information Authorization 
Mariner's Authorization to U.S. Coast Guard
Information Release
Request for Copy of Tax Return
Request for Social Security Earnings Informaion

Client Interview Questionnaires
Seamen (Jones Act)
Longshore (LHWCA) Workers
Cruise Ship Passengers
Defense Base Act (DBA) Workers
Federal Employers Liability Act (FELA) / Railroad
Auto Accidents
General Personal Injury

Additional Information Forms
Witness Information
Cruise Ship Itinerary

State Disability Forms
California EDD Claim for Disability Insurance Benefits


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