U.S. Department of Labor Forms

52
total templates

Documents

52

Form CA-7a "Time Analysis Form"

Rate (4.3 / 5) 93 votes
Size: 133 KB
2 pages

This form is supposed to be used when a federal worker claims reimbursement for more than one consecutive period of leave. The application can be submitted by federal workers during their compensation cases.

Form CMS-1500 "Health Insurance Claim Form"

Rate (4.4 / 5) 28 votes
Size: 1 MB
4 pages

Physicians and other healthcare providers and professionals may use this legal document to submit claims for medical services. Form CMS-1500 provides information about the patient and insured, their diagnosis, treatment, and insurance details.

Form WH-4 "Nonimmigrant Worker Information Form"

Rate (4.5 / 5) 42 votes
Size: 183 KB
4 pages

Form EE-3 "Employment History for a Claim Under the Energy Employees Occupational Illness Compensation Program Act"

Rate (4.3 / 5) 48 votes
Size: 2 MB
3 pages

Form CA-1 "Federal Employee's Notice of Traumatic Injury and Claim for Continuation of Pay/Compensation"

Rate (4.4 / 5) 70 votes
Size: 57 KB
4 pages

Form CA-6 "Official Superior's Report of Employee's Death"

Rate (4.8 / 5) 44 votes
Size: 27 KB
2 pages

Form M-1 "Report for Multiple Employer Welfare Arrangements (Mewas) and Certain Entities Claiming Exception (Eces)", 2015

Rate (4.8 / 5) 22 votes
Size: 1 MB
83 pages

Instructions for Form M-1 "Report for Multiple Employer Welfare Arrangements (Mewas) and Certain Entities Claiming Exception (Eces)"

Rate (4.3 / 5) 19 votes
Size: 139 KB
11 pages

Form OWCP-17 "Rehabilitation Maintenance Certificate"

Rate (4.5 / 5) 164 votes
Size: 1 MB
2 pages

Form OWCP-44 "Rehabilitation Action Report"

Rate (4.3 / 5) 63 votes
Size: 1 MB
2 pages

Form CA-5B "Claim for Compensation by Parents, Brothers, Sisiters, Grandparents, or Grandchildren"

Rate (4.3 / 5) 14 votes
Size: 1 MB
5 pages

Form LS-33 "Approval of Compromise of Third Person Cause of Action"

Rate (4.6 / 5) 27 votes
Size: 65 KB
1 page

Form CA-7b "Leave Buy Back (Lbb) Worksheet/ Certification and Election"

Rate (4.4 / 5) 63 votes
Size: 48 KB
4 pages

Form CM-911 "Miner's Claim for Benefits Under the Black Lung Benefits Act"

Rate (4.5 / 5) 52 votes
Size: 1 MB
4 pages

Form CM-910 "Request to Be Selected as Payee"

Rate (4.5 / 5) 56 votes
Size: 1 MB
2 pages

Form LS-208 "Notice of Payments"

Rate (4.8 / 5) 75 votes
Size: 201 KB
2 pages

Form LS-207 "Notice of Controversion of Right to Compensation"

Rate (4.6 / 5) 64 votes
Size: 115 KB
2 pages

Form LS-801 "Waiver of Service by Registered or Certified Mail for Employers and/Or Insurance Carriers"

Rate (4.8 / 5) 57 votes
Size: 180 KB
2 pages

Form LS-206 "Payment of Compensation Without Award"

Rate (4.8 / 5) 92 votes
Size: 116 KB
2 pages

Form LS-513 "Report of Payments"

Rate (4.4 / 5) 78 votes
Size: 330 KB
1 page

Form CM-972 "Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by the U.S. Department of Labor"

Rate (4.6 / 5) 60 votes
Size: 1 MB
2 pages

Form SF-308 "Request for Wage Determination and Response to Request"

Rate (4.8 / 5) 93 votes
Size: 1 MB
1 page

Form LS-204 "Attending Physician's Supplementary Report"

Rate (4.7 / 5) 84 votes
Size: 395 KB
2 pages

Form LS-262 "Claim for Death Benefits"

Rate (4.3 / 5) 50 votes
Size: 136 KB
2 pages

Form LS-267 "Claimant's Statement"

Rate (4.8 / 5) 57 votes
Size: 408 KB
2 pages

Form LS-426 "Request for Earnings Information"

Rate (4.3 / 5) 40 votes
Size: 68 KB
2 pages

Form LS-271 "Application for Self-insurance"

Rate (4.3 / 5) 74 votes
Size: 92 KB
2 pages

Form LS-265 "Certification of Funeral Expenses"

Rate (4.6 / 5) 28 votes
Size: 1 MB
1 page

Form LS-570 "Carrier's Report of Insurance of Policy"

Rate (4.5 / 5) 68 votes
Size: 74 KB
1 page

Form 201 "Notice of Employee's Injury or Death"

Rate (4.5 / 5) 63 votes
Size: 389 KB
2 pages

Form LS-200 "Report of Earnings"

Rate (4.7 / 5) 70 votes
Size: 411 KB
2 pages

Form CA-35A "Evidence Required in Support of a Claim for Occupational Disease"

Rate (4.6 / 5) 51 votes
Size: 131 KB
17 pages

Form LS-272 "Application to Write Longshore Insurance"

Rate (4.3 / 5) 65 votes
Size: 74 KB
1 page

Form CM-911A "Employment History"

Rate (4.4 / 5) 36 votes
Size: 1 MB
3 pages

Form CA-1108 "Long Form Statement of Recovery"

Rate (4.6 / 5) 33 votes
Size: 1 MB
6 pages

Form CA-1122 "Short Form Statement of Recovery"

Rate (4.5 / 5) 42 votes
Size: 1 MB
4 pages

Form 1-65 "Emergency Information"

Rate (4.3 / 5) 18 votes
Size: 229 KB
1 page

Form 1010 "Request of Authorization/Carrier or Self Insured Employer Response"

Rate (4.6 / 5) 7 votes
Size: 354 KB
2 pages

Instructions for Form ETA-9141C "Application for Prevailing Wage Determination"

Rate (4.7 / 5) 6 votes
Size: 284 KB
5 pages