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Get Dol Form Ls-1 2023-2025
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How to fill out the DOL Form LS-1 online
Filling out the DOL Form LS-1 online can facilitate the request for examination and treatment under the Federal Workers' Compensation Act. This guide provides a step-by-step approach to help users navigate the form efficiently.
Follow the steps to complete the DOL Form LS-1 online.
- Click the ‘Get Form’ button to access the form electronically, which will allow you to fill it out with ease.
- In Part A, provide your details along with the name and address of the physician or medical facility authorized to provide services. Complete all necessary fields, including the specific act under which you're filing.
- Enter the employee's name, phone number, date of injury, and occupation. Make sure to give a brief description of how the accident or illness occurred in the designated field.
- Indicate authorization for medical services in section 7 by choosing either A or B based on the physician's assessment of the relationship between the condition and employment.
- Complete the signature and title of the authorizing official, as well as the name and address of the employer.
- Provide the telephone number of the authorizing official, followed by the date authorized in the specified format.
- For the physician’s report in Part B, ensure all necessary medical information is filled out, including findings, diagnosis, treatment history, and physical capabilities of the employee.
- Confirm that the physician’s signature and contact information, including their federal tax identification number, are included at the end of the report.
- Once all sections are filled out, you have the option to save your changes, download the completed form, print a copy for your records, or share it with relevant parties.
Start completing your DOL Form LS-1 online today for a streamlined process.
DOL stands for the Department of Labor, a federal agency that governs labor laws and regulations in the United States. The DOL focuses on ensuring fair labor standards and protecting the rights of workers across different industries. Understanding the role of the DOL is crucial for both employers and employees to navigate workplace regulations effectively.
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