U. S. Department of Labor Office of Workers’ Compensation Programs 

Division of Longshore and 

Harbor Workers’ Compensation 

200 Constitution Avenue, Room C-4319 

Washington, DC 20210

INDUSTRY NOTICE No. 150 

January 16, 2015 

NOTICE TO INSURANCE CARRIERS AND SELF-INSURED EMPLOYERS 

LONGSHORE (LS) AND HARBOR WORKERS' COMPENSATION ACT AND DISTRICT 

OF COLUMBIA (DC) COMPENSATION ACT 

 

SUBJECT: 2015 Advance Assessment for the Special Fund pursuant to Section 44 of the 

Longshore Act – Payment Due February 20, 2015

 

Section 44 of the Longshore and Harbor Workers' Compensation Act provides for an annual 

assessment of each authorized insurance carrier and self insurer for payment into the Special 

Fund, to provide for payments described under Section 44(i). Separate accounts are maintained 

for the District of Columbia Act and the Longshore Act and its extensions. Separate instructions 

apply for reporting payments under the DC Act and the Longshore Act and its extensions 

(Defense Base Act, Outer Continental Shelf Lands Act and Nonappropriated Fund 

Instrumentalities Act). 

PLEASE READ ALL INSTRUCTIONS CAREFULLY. 

 

FORM LS-513, REPORT OF PAYMENTS - LONGSHORE 

 

This notice transmits Form LS-513, Report of Payments. The instructions for completion and 

return of this form are also posted on http://www.dol.gov/owcp/dlhwc. This report, along with your 

share of the Special Fund's costs during calendar year 2014 under Section 8(f), will serve as the 

basis for determining the final amount of your company's 2015 assessment. Please make sure 

that the report is correct in accordance with the instructions provided. 

 

ADVANCE ASSESSMENT - LONGSHORE 

 

This notice also transmits your Longshore Act advance assessment billing, calculated using your 

reported compensation payment figure for calendar year (CY) 2013, the total of all compensation 

payments reported for CY 2013 (the latest data available at this time), plus CY 2014 Section 8(f) 

costs, the total of all CY 2014 Section 8(f) costs, and the estimated CY 2015 Longshore Act 

Special Fund expenditures. The amount due for your CY 2015 advance assessment is shown at 

the bottom of the billing form. 

 FORM LS-513, REPORT OF PAYMENTS - DC 

 

This notice transmits Form LS-513, Report of Payments. The instructions for completion and 

return of the form are also posted on http://www.dol.gov/owcp/dlhwc. This report, along with your 

share of the total compensation and medical payments reported during calendar year 2014 will 
 

serve as the basis for determining the final amount of your company's 2015 DC assessment. 

Please report only compensation and medical payments where the date of injury was prior to July 

26, 1982 under the DC Act and make certain that the report is correct in accordance with the 

instructions provided. 

 ADVANCE ASSESSMENT - DC ONLY 

 

This notice also transmits your District of Columbia Compensation Act advance assessment 

billing, calculated using your reported compensation and medical payments for calendar year 

(CY) 2013, and the total of all compensation and medical payments reported for CY 2013 (the 

latest data available at this time), and the estimated CY 2015 District of Columbia Special Fund 

expenditures. 

ADVANCE ASSESSMENT PAYMENTS 

 

(1) The U.S. Treasury has mandated that payments to the Federal government be conducted by 

FedWire/ACH credit to the greatest extent possible. Also you may now consolidate all bills for 

8130 (Longshore) in one payment and 8134 (DC) in one payment. 

 

(2) Forward the BILL and CHECK and the completed LS-513, Report of Payments, to this 

address but do not combine Longshore and DCCA:

 

U.S. DEPARTMENT OF LABOR - Longshore 

 200 Constitution Avenue N.W. – Room C-4319 

 Washington, D.C. 20210 

Please note your check will be converted to an electronic fund transfer and electronically 

debited to your account. The original check will be destroyed but a copy will be retained. 

(3) You may also process a Fed Wire with TREASURY New York. 

Bank: Federal Reserve Bank of New York 

Routing number: 021030004 

Account number: 16150003 

You must FAX a copy of the bill and your wire instructions with the sequence number and 

bill number to (202) 354-9635 or (202) 693-1380 prior to the transaction. 

 

All payments are due February 20, 2015 and LS-513 reports must be submitted no later than 

March 20, 2015. For any questions pertaining to this year's advance notice please contact Kathy 

Blackwell directly by telephone or fax at (202) 354-9635 or office fax (202) 693-1380 or (email) 

blackwell.kathy@dol.gov . 

ANTONIO RIOS 

Director, Division of Longshore and Harbor 

Workers' Compensation 
 

INSTRUCTIONS FOR SUBMITTING FORM LS-513, REPORT OF PAYMENTS, FOR 

DETERMINATION OF ASSESSMENT UNDER THE LONGSHORE AND HARBOR 

WORKERS’ COMPENSATION ACT, AND EXTENSIONS. 

 

GENERAL - Pursuant to Section 44 of the Longshore and Harbor Workers' Compensation Act, 

all authorized insurance carriers and self-insured employers under the Longshore Act and 

extensions, including the District of Columbia Compensation Act, are required each year to 

complete and file with the Office of Workers' Compensation Programs the attached Form LS513. The form must be completed to show the number of cases and all compensation and 

medical payments made under the Act(s) during calendar year 2014. For DBA cases, the number 

of cases and all compensation and medical payments must be reported separately by Contracting 

Agency. For example, the total number of cases and payments for the Department of Defense 

must be reported in the fields indicated on the form and cannot be combined with cases and/or 

payments from any other agency. 

 

NOTE: A detailed listing must be submitted with the LS-513 supporting the figures and it 

must contain the following: 

(1) Claimants Name (2) OWCP File Number (3) Social Security Number (4) Date of 

Injury (5) State or Country of Injury (6) Act under which payments made (7) 

Indemnity/Medical paid in CY 2013. (8) For DBA cases only, the Contracting Agency as 

entered on the Employer’s First Report of Injury or Occupational Illness (LS-202) 

The detailed listing report may be submitted in an electronic version. 

 * DEFINITION OF WHAT MUST BE REPORTED ON FORM LS-513 

 

- All categories of compensation (under Sections 6, 8, 9, and 44(c) (1) ) paid during calendar 

year 2014 and reportable on an LS-208 must be reported on the LS-513. This includes additional 

compensation under Section 14(e) and (f). Compensation is considered paid when a check is 

issued and not when the check is cashed. 

 

- Attorney's fees assessed against the employer/carrier under Section 28(a) & (b) are NOT 

considered compensation; however, attorney's fees which are a lien on compensation under 28(c) 

are reportable. 

 

- All penalties and interest payable to the claimant ARE considered compensation and therefore 

reportable. 

- Section 8(i) settlements, (including annuities) are fully reportable as compensation and/or 

medical in the year paid. 

 

- Reimbursement to employer/carriers on cases where Section 8(f) relief is ultimately granted 

are NOT to be deducted from total payments. 

 

- Medical payments should include impartial medical examinations ordered by OWCP but paid 

by the employer/carrier. Compensation may NOT be reduced or credited due to actual or 
 

anticipated subsequent events, reversal on appeal, salary continuance, or credit under a State 

Act. 

 

- Under the DISTRICT OF COLUMBIA COMPENSATION ACT only compensation and 

medical payments made during calendar year 2014 where the injury date is prior to 7/26/82 

should be reported. 

 

- All payments for reimbursement from an excess/reinsurance Carrier or a national/state assigned 

risk pool MUST BE REPORTED by the primary employer/carrier. 

- Any payments made directly to claimants by an excess or reinsurance carrier MUST BE 

REPORTED by the primary employer/carrier. 

-Reports should include gross amounts paid and should not be offset to reflect receipt of any 3rd

party recoveries or subrogation actions. 

 

-Any payments made under a so-called “deductible” policy provision must be reported by the 

insurance carrier that issued the policy 

-All payments made under the DEFENSE BASE ACT must be reported and segregated by 

Contracting Agency. No credit is allowed for cases which may be recoverable in the future 

under the War Hazards Compensation Act (WHA). Once a case is accepted by the WHA claims 

staff under the WHA, those claims need not be reported for the calendar year in which they are 

actually accepted or any year in the future. No credit will be given for amounts reimbursed from 

the WHA. 

-When an employer continues to pay full salary to an employee, the amount of compensation 

which is due the claimant must be reported. Payments must be reported for employees who are 

disabled and given sheltered employment during the period of recovery. 

-All payments made under state compensation statutes to concurrent longshore workers must be 

reported. If the state amount exceeds that due under Longshore only the lesser amount is 

reportable. If the state amount is less than that due under Longshore then both must be reported. 

Such payments must be reported even if a formal claim has not been filed under the Longshore 

Act and also must be reported if subject to a state assessment formula. 

-The employer/carrier is ultimately responsible for reporting payments correctly. Third party 

adjusters or other agents are responsible to their principals for accurate reports. When a third 

party supplies the data the principal payer must sign and attest to the correctness of the LS-513. 

-Medical payments must be reported on all lost time claims, including hearing loss claims, closed 

cases, and claims paid under Section 8(f) and claims where only compensation has been settled 

under Section 8(i). 

-A CORRECT and ACCURATE LS-513 is due by March 20, 2015. Amendments are 

discouraged and must be submitted by May 1, 2015. Late amendments may not result in an 

assessment change. 
 

- If the employer/carrier reports zero ($0) payments a report must be submitted showing the total 

payroll for covered Longshore employees during the calendar year. If there is no payroll, the 

report must confirm this. 

An independent certification is no longer required. Instead the Department of Labor will 

conduct periodic random audits on a sample of employers and carriers each year. In 

support of this all employers and carriers must maintain claims detail data which verify the 

figures reported on the LS-513. Numerous companies have undergone audits in the past 

which has resulted in improved and more accurate reporting under the Act.

For clarification or questions, please contact: 

Kathy Blackwell 

Branch of Financial Management Insurance and Assessments 

(202) 354-9635 direct telephone and fax 

(202) 693-1380 office fax 

blackwell.kathy@dol.gov