Defense Base Act Forms

All The Forms in One Place

Download commonly Used Forms in DBA Claims

For questions on how to complete these forms, contact us for free tips from one of our lawyers.

LS-18

Pre-Hearing Statement

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LS-200

Report of Earnings

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LS-201

Notice of Employee's Injury or Death

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LS-202

Employer’s First Report of Injury or Occupational Illness

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LS-203

Employee’s Claim for Compensation

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LS-204

Attending Physician’s Supplementary Report

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LS-205

Physician’s Report on Impairment of Vision

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OWCP-5a

Work Capacity (Psychiatric/Psychological Conditions)

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OWCP-5b

Work Capacity (Cardiovascular/Pulmonary)

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OWCP-5c

Work Capacity (Orthopedic)

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Defense Base Act Forms

Download commonly Used Forms in DBA Claims

LS-18

LS-200

LS-201

LS-202

LS-203

LS-204

LS-205

OWCP-5a

OWCP-5b

OWCP-5c

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