U.S. Department of Labor Office of Workers’ Compensation Programs
Divsion of Longshore and
Harbor Workers’ Compensation
Washington, D.C. 20210

File Number:

July 10, 2012

INDUSTRY NOTICE No. 140 TO INSURANCE CARRIERS AND SELF- INSURED
EMPLOYERS LONGSHORE AND HARBOR WORKERS’ COMPENSATION
ACT AND EXTENSIONS

SUBJECT: CY 2012 ASSESSMENT FOR THE SPECIAL FUND, SECTION 44
OF THE LONGSHORE AND HARBOR WORKERS’
COMPENSATION ACT

On January 23, 2012, pursuant to Section 44 of the Longshore and Harbor Workers’
Compensation Act, a Notice was sent to all insurance carriers and self-insured
employers authorized under the Act and its extensions (including the District of
Columbia Compensation Act) , requesting a report of the amount of all compensation
and medical payments made during calendar year 2011. Form LS-513, Report of
Payments, was attached to the Notice.

All payments made during calendar year 2011 by insurance carriers and self-insured
employers have now been reported. A total of $773,656,732 in compensation payments
has been reported under the Longshore Act and three extensions, the Defense Base Act,
the Outer Continental Shelf Lands Act, and the Nonappropriated Fund Instrumentalities
Act. A total of $3,090,518 has been reported under the District of Columbia
Compensation Act for compensation and medical payments in cases where the date of
injury arose prior to July 26, 1982.

This Office has determined that for calendar year 2012, a total of $124,000,000 is
needed for the Special Fund under the Longshore Act and extensions (excluding the
D.C. Act) and a total of $8,000.00 is needed for the Special Fund under the District of
Columbia Act. Proceeds from the Special Fund assessment are used for payments

under Sections 8(f), 10(h), and 18(b) plus other payments provided for under Section 44
of the Act.

This notice accompanies the bill for final amounts owed on your CY 2012 assessment.
The attached billing form shows the calculation on which your assessment is based.
Under the Longshore Act and extensions (except the D.C. Act) the assessment is based


on (1) the ratio of the amount each carrier or self-insurer paid during the prior calendar
year for compensation benefits in relation to the amount all such carriers and self-
insurers paid during that period, and (2), the ratio of the amount of payments made by
the Special Fund attributable to each carrier or self-insurer for cases being paid under
Section 8(f) of the Act during the preceding calendar year in relation to the total of such
payments. The resulting sum is divided by two and multiplied by the estimated
expenses of the Fund. The amount paid for the advance assessment is credited against
the total assessment and the amount now due is shown as the last figure.

Under the District of Columbia Compensation Act the ratio of the amount each carrier
or self-insurer paid during the prior calendar year for compensation and medical
benefits in relation to the amount all such carriers and self-insurers paid during that
period is multiplied by the estimated expenses of the Fund.

PLEASE MAKE YOUR CHECK PAYABLE TO THE U.S. DEPARTMENT OF
LABOR, OFFICE OF WORKERS’ COMPENSATION PROGRAMS, AND MAIL IT
TO:

U.S. DEPARTMENT OF LABOR

Division of Longshore and Harbor Workers’ Compensation

200 CONSTITUTION AVE. N.W. — Room C-4315

Washington D.C. 20210

TAX ID# 61-1609381

Payment must be received no later than August 24, 2012. Please provide the Sequence
No. and bill No. with any payments and include a copy of the bill with all checks.
Please direct any inquiries concerning your assessment to Ms. Kathy Blackwell of this
office at (202) 693-0590 or FAX (202) 693-1380.

Hc We

MIRANDA CHIU
Director, Division of
Longshore and Harbor
Workers' Compensation