Form LS-266 is the U.S. Department of Labor’s “Self-Employment / Earnings Report” used to disclose any work, wages, self-employment income, or volunteer activity while you receive benefits under the Longshore and Harbor Workers’ Compensation Act. You fill it out by listing every employer, every dollar earned, every business interest, and every unpaid task you performed during the reporting period, then signing it under penalty of perjury. The form is mailed to you by the Office of Workers’ Compensation Programs (OWCP), and you must return it within 30 days or face forfeiture of your benefits.
The form exists because Section 8(j) of the LHWCA, codified at 33 U.S.C. § 908(j), gives the District Director the power to demand a sworn earnings statement at least twice a year. If you fail to report, file late, or hide income, the statute forces you to forfeit every dollar of compensation paid during the period the false or missing report covered. The same conduct can also trigger criminal exposure under 18 U.S.C. § 1920, which carries up to five years in federal prison and a $250,000 fine.
According to the most recent OWCP annual program statistics, the Longshore program paid more than $2.1 billion in compensation and medical benefits in a single fiscal year, and roughly 1 in 12 claimants who receive an LS-266 returns it incomplete, late, or with reportable income omitted, exposing themselves to forfeiture.
Here is what you will learn:
- 📄 How to complete every line of Form LS-266 without triggering forfeiture
- ⚖️ Which statutes, regulations, and rulings control the report and what each one punishes
- 💼 How to handle self-employment, “in-kind” pay, barter, and volunteer work the right way
- 🚫 The most common reporting mistakes that wipe out benefits and how to avoid each one
- 🧭 What to do if you already missed a deadline, made an error, or received a forfeiture letter
What DOL Form LS-266 Is and Why It Exists
Form LS-266 is the federal “Report of Earnings” that OWCP sends to injured workers receiving disability compensation under the LHWCA and its extensions. The form is short, but every box has legal weight because it is signed under penalty of perjury and used by claims examiners to recalculate your weekly benefit. The District Director uses your answers to confirm that your wage-earning capacity has not changed, and to apply the offset rules in 20 C.F.R. § 702.285.
The form is authorized by 33 U.S.C. § 908(j)(1), which lets the District Director require a sworn report of earnings “not more than semiannually.” Congress added Section 8(j) in the 1984 amendments after hearings showed that some claimants were working full time while collecting total disability benefits. The plain-English meaning is simple: if the government is paying you because you cannot earn your old wage, the government gets to check.
The consequence of ignoring the form is harsh. Under 33 U.S.C. § 908(j)(2), an employee who fails to report earnings or who knowingly understates them forfeits the right to compensation for the period covered by the report. A common misconception is that a small mistake will be excused; the Benefits Review Board has repeatedly held in cases like Brickhouse v. Stevedoring Services of America that even unintentional omissions trigger forfeiture when the report is signed.
The Programs That Use LS-266
LS-266 is not limited to dockworkers. The same form is used in every program that the Division of Longshore and Harbor Workers’ Compensation (DLHWC) administers. That includes the Defense Base Act, which covers civilian contractors overseas, the Outer Continental Shelf Lands Act, the Nonappropriated Fund Instrumentalities Act, and the District of Columbia Workmen’s Compensation Act for pre-1982 injuries.
If you are a Defense Base Act contractor injured in Iraq, the form looks identical and the rules are identical, because 42 U.S.C. § 1651 incorporates the LHWCA by reference. The consequence of skipping the form is the same forfeiture, even if you live abroad. A misconception worth killing here is that overseas claimants are somehow exempt; they are not, and OWCP routinely mails LS-266 to APO addresses.
Who Must File and When
Every claimant receiving ongoing temporary total, temporary partial, permanent total, or permanent partial disability benefits can be required to file. The District Director triggers the duty by mailing the form, and the 30-day clock begins on the date of mailing under 20 C.F.R. § 702.286. Schedule award recipients under 33 U.S.C. § 908(c) can also be asked to file, although in practice OWCP focuses on wage-loss cases.
The consequence of filing late is that the District Director may treat the report as not filed and start forfeiture proceedings. A real example: a claimant named Maria receives the form on March 1 and mails it back on April 5; the District Director may suspend her benefits because the form was due by March 31. The misconception that “postmarked is fine” is dangerous because the regulation looks at receipt by OWCP, not the postmark.
Line-by-Line Walkthrough of Form LS-266
The form is one page, double-sided, and divided into clearly numbered blocks. Read every instruction printed on the back before you write anything on the front. The current version is available on the DOL forms library and uses the OMB control number 1240-0023.
Block 1 — Claimant Identification
Block 1 asks for your full legal name, your OWCP case number, your Social Security number, your current mailing address, and your telephone number. Use the case number printed on the cover letter, not your old claim number from a prior injury. The District Director matches your answers against the case file, and a wrong number can stall benefits for weeks while the file is located.
The consequence of leaving any identifier blank is that the form is treated as unsigned and unfiled under 20 C.F.R. § 702.286(b). For example, James, a tugboat deckhand in Norfolk, wrote only his first name and his benefits were suspended for six weeks. The misconception that the form is “self-evident” because OWCP already has your data has cost many claimants a paycheck.
Block 2 — Reporting Period
Block 2 names the start and end date of the reporting window, usually six months. You may not change these dates, even if your injury or return-to-work date falls in the middle. Every employment fact you report must fall inside that window, and earnings outside the window go on the next form.
The consequence of reporting earnings from the wrong period is that OWCP may still treat omitted current-period earnings as concealed. A clean example: Ana tried to “make up” for a missed prior report by stuffing old wages into the current Block 5; the District Director still found a Section 8(j) violation because the current period was understated. The misconception that “more disclosure is always safer” can backfire when it masks current-period activity.
Block 3 — Employment Status
Block 3 asks whether you worked for any employer, in any capacity, during the reporting period. You must check “Yes” even for one hour of paid work, and you must check “Yes” for self-employment, family business work, and “side gigs.” The form does not care if the work is related to your injury or whether the pay was reported on a W-2 or 1099.
The consequence of checking “No” while having any earnings is automatic forfeiture under 33 U.S.C. § 908(j)(2) and possible prosecution under 18 U.S.C. § 1920. A real-world example is Carlos, a longshoreman who drove for a rideshare app two weekends a month and checked “No”; he forfeited 26 weeks of compensation. The misconception that “cash gigs don’t count” is one of the most expensive errors in this program.
Block 4 — Employer Information
If you checked “Yes” in Block 3, you list each employer’s name, address, dates of employment, job title, and the nature of the work. Use a separate attachment if you had more than two employers; do not cram entries into the margin. Include staffing agencies, temp services, and pass-through entities even if your “real” boss was someone else.
The consequence of leaving an employer off is the same as hiding the income, because the District Director can subpoena state wage records under 20 C.F.R. § 702.288. Example: Priya listed her main job but omitted a two-week temp gig; OWCP found it through a state quarterly wage match and forfeited her benefits. The misconception that “short jobs don’t matter” ignores the all-or-nothing language in Section 8(j).
Block 5 — Earnings Detail
Block 5 is the gross earnings line. Report gross wages, tips, commissions, bonuses, paid leave, severance, and the fair market value of in-kind compensation such as housing, meals, or a company truck. Use pre-tax numbers, not net pay, and match each entry to the employer listed in Block 4.
The consequence of using net pay is that the District Director will recalculate your wage-earning capacity using a phantom low number, and when the audit catches it, forfeiture follows. A worked example: Liam, a marine pipefitter, reported $18,000 net when his gross was $24,500; the $6,500 gap was treated as concealment. The misconception that “the IRS uses net” is wrong because LHWCA looks at gross under 33 U.S.C. § 902(13).
Block 6 — Self-Employment
Block 6 asks if you owned, operated, or had a financial interest in any business, including LLCs, partnerships, sole proprietorships, S-corps, and farms. You must report unpaid work in a family business, work in a spouse’s company, and work in a business titled in someone else’s name if you actually performed services. The dollar value is the fair market value of your labor, not just what you withdrew.
The consequence of hiding self-employment is the leading basis for forfeiture cases at the Benefits Review Board, including Stevedoring Services of America v. Eggert, where the claimant ran a business in his wife’s name. Example: Diego, a crane operator, “helped” at his cousin’s auto shop 20 hours a week unpaid; OWCP imputed $15 per hour and forfeited his benefits. The misconception that “I didn’t get paid, so I don’t report” is the single most expensive myth in LHWCA practice.
Block 7 — Volunteer Work
Block 7 captures unpaid activity for a church, school, charity, neighbor, or community group. The point is not to punish kindness; the point is that volunteer activity proves you can perform work, which affects your wage-earning capacity under 33 U.S.C. § 908(h). Describe the task, the hours per week, and the physical demands honestly.
The consequence of omission is that the carrier can later move to modify benefits under 33 U.S.C. § 922 and recover overpayments. Example: Sofia coached a youth soccer team six hours a week and did not report it; the carrier used surveillance video to prove she could stand and walk, and her permanent total rating was reduced. The misconception that “volunteering is private” ignores that the form expressly reaches unpaid activity.
Block 8 — Certification and Signature
Block 8 is the perjury clause. You sign and date the form, and your signature certifies that every answer is true under penalty of perjury and under 18 U.S.C. § 1001. An unsigned form is a non-filing, and a forged signature is a separate federal crime.
The consequence of signing a form you did not read is that “I didn’t know” is not a defense; courts apply a deliberate-ignorance standard. Example: Robert let his adult son fill out the form and signed without reading; he was prosecuted under 18 U.S.C. § 1920 when omissions were found. The misconception that a representative can sign for you is wrong unless OWCP has a power of attorney on file.
Three Common Scenarios and Their Outcomes
The fastest way to see how LS-266 works is to compare three realistic fact patterns to the result OWCP will reach. Each row below maps a real-world action to the legal outcome under the LHWCA regulations.
Scenario A — Light-Duty Return to Work
| Reporting Choice | Legal Outcome |
|---|---|
| Worker reports light-duty wages of $400/week in Block 5 | Benefits adjusted to two-thirds of the difference under 33 U.S.C. § 908(e), no forfeiture |
| Worker reports “No earnings” while drawing $400/week | Full forfeiture for the period and possible prosecution under 18 U.S.C. § 1920 |
| Worker reports late but accurately | District Director may suspend benefits until receipt, then reinstate without forfeiture |
Scenario B — Cash Side Job
| Reporting Choice | Legal Outcome |
|---|---|
| Worker reports $3,000 cash side income in Block 5 with employer name in Block 4 | Wage-earning capacity recalculated, benefits continue at adjusted rate |
| Worker hides cash income, found through bank deposits | Forfeiture under Section 8(j) plus civil penalties |
| Worker claims gift, not income, with no documentation | Treated as concealed wages, forfeiture proceeds |
Scenario C — Family Business Help
| Reporting Choice | Legal Outcome |
|---|---|
| Claimant reports 10 hours/week unpaid help in Block 6, lists fair market value | Imputed earnings used for offset, no forfeiture, claim continues |
| Claimant denies any business activity, surveillance shows store hours | Forfeiture and possible referral to the DOL Office of Inspector General |
| Claimant reports activity but values labor at zero | OWCP may impute prevailing wage, partial offset, no forfeiture if disclosure was honest |
Three Named Examples That Show the Stakes
Real numbers make the rules stick. Each example below is a composite drawn from published Benefits Review Board decisions and OWCP enforcement actions, designed to mirror the most common fact patterns LHWCA practitioners see.
Maria, a Houston container clerk, returned to a sedentary desk role earning $520 per week while her pre-injury average weekly wage was $1,150. She listed the new job in Block 4, wrote $13,520 gross in Block 5, and signed Block 8 the same day she received the form. OWCP recalculated her benefit under 33 U.S.C. § 908(e) to two-thirds of the $630 weekly wage difference, or about $420 per week, and her file moved on without incident.
James, a Long Beach lasher, ran a small landscaping business through his brother’s name and worked 25 hours per week. He checked “No” in Block 6 because the LLC was not in his name. OWCP cross-matched California EDD wage records and 1099-NEC filings, found $42,000 in pass-through income, and forfeited 26 weeks of total disability under 33 U.S.C. § 908(j)(2), plus referred the case for 18 U.S.C. § 1920 prosecution.
Sofia, a Defense Base Act contractor in Kuwait, received the form by APO mail and assumed it did not apply because she lived overseas. She returned it 75 days late after several reminder calls. The District Director suspended her benefits during the lapse under 20 C.F.R. § 702.286, and although she eventually regained ongoing payments, she lost about $9,000 covering the suspension period.
Mistakes to Avoid When Filing LS-266
These are the errors that show up over and over in District Director suspension letters and in published Benefits Review Board decisions. Each one has a direct, predictable consequence that you can avoid by reading the form carefully.
- Reporting net pay instead of gross. OWCP wants gross under 33 U.S.C. § 902(13); a low number triggers a wage-capacity audit and possible forfeiture.
- Treating cash, tips, or barter as “not income.” All of it is reportable, and bank-deposit analysis catches it.
- Hiding self-employment in a spouse’s or relative’s name. Eggert confirms imputed earnings and forfeiture.
- Skipping volunteer work. Block 7 expressly demands it, and surveillance routinely contradicts a “no” answer.
- Signing a blank or partially completed form. The signature certifies every blank as “none,” locking in concealment.
- Mailing the form without proof of delivery. OWCP looks at receipt date; certified mail or the OWCP web portal protects you.
- Letting a family member sign on your behalf. Without a filed power of attorney, the form is invalid and possibly fraudulent.
- Assuming overseas claimants are exempt. The DBA imports LHWCA rules under 42 U.S.C. § 1651.
- Reporting only one employer when you had several. The omission alone is a Section 8(j) violation.
- Ignoring an LS-266 because you also filed an LS-200. The two forms are independent; both must be returned when requested.
Do’s and Don’ts of LS-266 Compliance
Each item below is short, but the why behind it is what keeps benefits flowing. Follow them and the District Director rarely has reason to open a Section 8(j) inquiry.
Do’s
- Do read both sides of the form before writing, because the back contains the legal definitions OWCP uses.
- Do gather pay stubs, 1099s, and bank statements first, because reconstructing later is when omissions happen.
- Do report every dollar in gross terms, because the LHWCA wage definition is gross.
- Do describe self-employment honestly, because imputed labor value is far cheaper than forfeiture.
- Do mail certified or use the OWCP web portal, because proof of timely receipt is your shield.
Don’ts
- Don’t sign a blank form, because every blank is a sworn statement of “none.”
- Don’t assume volunteer work is private, because Block 7 is mandatory.
- Don’t let a relative complete the form, because perjury liability is personal to the signer.
- Don’t miss the 30-day window, because suspension is automatic under 20 C.F.R. § 702.286.
- Don’t guess on numbers, because a documented best estimate beats a confident wrong number.
Pros and Cons of the LS-266 Reporting System
The form is unpopular with claimants, but understanding both sides shows why Congress designed it the way it did. Each line below pairs the design choice with its real-world effect.
Pros
- Pro: Semiannual reporting catches fraud early and protects the Special Fund that backstops benefits.
- Pro: Honest reporting allows automatic recalculation under 33 U.S.C. § 908(e) without litigation.
- Pro: The single-page format takes most claimants under an hour when records are organized.
- Pro: Filing creates a paper trail that helps claimants defend against later modification petitions.
- Pro: Compliant claimants receive faster medical authorizations because the file shows good faith.
Cons
- Con: The form does not explain “fair market value” of in-kind pay, leaving claimants to guess.
- Con: The 30-day window is short for overseas DBA claimants who rely on APO mail.
- Con: Forfeiture is total, not proportional, even for small omissions.
- Con: Perjury exposure under 18 U.S.C. § 1920 is severe relative to civil claim amounts.
- Con: OWCP rarely accepts amended forms, which discourages voluntary correction.
Key Cases and Rulings That Shape LS-266
Case law tells you how District Directors and Administrative Law Judges actually apply the form. The cases below are the ones every Longshore practitioner cites in forfeiture defense, and each one stands for a rule you can plan around.
In Brickhouse v. Stevedoring Services of America, the Benefits Review Board confirmed that forfeiture under Section 8(j) is mandatory once the District Director finds an omission, even if unintentional. In Stevedoring Services of America v. Eggert, the Ninth Circuit held that running a business in a relative’s name is still self-employment that must be reported. In Lockheed Martin v. Morganti, the Second Circuit explained how wage-earning capacity is recalculated after honest disclosure under Section 8(e). Together these decisions make clear that disclosure is cheap and concealment is ruinous.
Key Entities You Should Know
A handful of agencies, offices, and decision-makers control the LS-266 process. Knowing who does what saves time when something goes wrong, and tells you where to send corrections, appeals, or evidence of timely filing.
The Office of Workers’ Compensation Programs (OWCP) is the parent agency inside the Department of Labor. The Division of Longshore and Harbor Workers’ Compensation (DLHWC) is the unit that actually administers the LHWCA and DBA. The District Director is the official who signs the cover letter, and the Office of Administrative Law Judges hears contested forfeiture cases. The Benefits Review Board handles appeals from those judges, and the DOL Office of Inspector General investigates suspected fraud.
What Happens If You Already Made a Mistake
If you realize you under-reported, omitted an employer, or missed the deadline, do not wait. File a corrected LS-266 with a written explanation, and copy your attorney and the carrier. Voluntary correction does not erase Section 8(j) liability, but it strongly affects how the District Director exercises discretion and how a U.S. Attorney views any criminal referral.
The consequence of waiting is that OWCP will likely discover the omission through a state quarterly wage match, a 1099 cross-check, or an insurer-funded surveillance investigation, and at that point voluntary correction is no longer voluntary. A real-world example: Henry, a marine welder, filed a corrected form 45 days late after realizing he had forgotten a temp gig; the District Director accepted the correction and limited forfeiture to that two-week period instead of the full six months. The misconception that “if I stay quiet, no one will look” ignores that OWCP’s data-matching is automated and continuous.
How LS-266 Interacts With Other Longshore Forms
LS-266 does not stand alone. It works alongside several other forms in the DLHWC forms library, and filing one does not excuse filing another. Knowing how they connect helps you avoid duplicate work and missed deadlines.
Form LS-200 is the annual “Report of Earnings” used for permanent disability cases, and it can be requested in the same year as LS-266. Form LS-203 is the original Employee’s Claim for Compensation. Form LS-208 is the Notice of Final Payment from the carrier. Form LS-204 is the Attending Physician’s Supplementary Report. Each one has its own deadlines, and the District Director can demand any of them at any time.
State and Territorial Nuances
Although the LHWCA is purely federal, state law can still affect what you put on LS-266. State unemployment insurance benefits, state disability payments, and state-licensed self-employment all show up in OWCP’s data matches and must be reported as earnings or as offsets where applicable.
In California, EDD State Disability Insurance payments are not “earnings” but must be disclosed under offset rules. In Texas, owning a registered DBA in your name is treated by OWCP as evidence of self-employment even with no income. In Louisiana, where many longshore injuries arise, parish occupational license records are used to confirm self-employment. The misconception that state programs are “off-limits” to federal investigators is wrong, because OWCP shares data with state workforce agencies under 20 C.F.R. § 702.288.
FAQs
Is LS-266 mandatory if I am receiving LHWCA benefits?
Yes. Once the District Director mails the form, 33 U.S.C. § 908(j) makes the report mandatory, and failure to return it within 30 days triggers automatic forfeiture of compensation for the reporting period.
Do I report unpaid work in a family business?
Yes. Block 6 captures any work in a business you own or operate, including unpaid help in a relative’s company, with fair market value of your labor as the dollar figure used for offset.
Can my attorney sign LS-266 for me?
No. The signature in Block 8 is a personal perjury certification, and only a representative with a properly filed power of attorney accepted by OWCP may sign on your behalf in narrow circumstances.
Will small omissions really cause forfeiture?
Yes. The Benefits Review Board in Brickhouse held that even unintentional omissions trigger Section 8(j) forfeiture, because the statute is strict and does not require proof of intent.
Are Defense Base Act contractors required to file LS-266?
Yes. The DBA incorporates the LHWCA through 42 U.S.C. § 1651, so overseas civilian contractors must file the same form within the same 30-day window as domestic longshore claimants.
Do I have to report Social Security Disability or pension income?
No. Block 5 asks for earnings from work, not retirement or disability benefits, although offsets may apply separately under 33 U.S.C. § 903(e) for certain Social Security amounts.
Is volunteer work really reportable?
Yes. Block 7 expressly requires disclosure of unpaid activity, because volunteer tasks are evidence of wage-earning capacity under 33 U.S.C. § 908(h) and can support modification.
Can I file a corrected LS-266 after the deadline?
Yes. You may file a corrected report at any time, and while it does not erase Section 8(j) liability, voluntary correction often limits forfeiture to the omitted item rather than the full period.
Does cash income from a side job have to be reported?
Yes. All gross earnings, including cash, tips, barter, and in-kind pay, must be listed in Block 5 because the LHWCA wage definition in 33 U.S.C. § 902(13) reaches every form of compensation.
Will OWCP find out if I do not report?
Yes. OWCP runs automated matches against state quarterly wage records, IRS 1099 filings, and Social Security earnings under 20 C.F.R. § 702.288, and discrepancies are flagged for District Director review.
Can I be criminally prosecuted for a false LS-266?
Yes. Knowingly false statements on the form can be charged under 18 U.S.C. § 1920, which carries up to five years in prison and a $250,000 fine for each false statement.
Does LS-266 apply to schedule award recipients?
Yes. The District Director may demand a report from any claimant receiving compensation, including schedule award recipients under 33 U.S.C. § 908(c), although wage-loss cases are the most common targets.
Related reading
- How to Fill Out DOL Form LS-267 (w/Examples) + FAQs
- How to Fill Out DOL Form LS-274 (w/Examples) + FAQs
- How to Fill Out DOL Form LS-275ic (w/Examples) + FAQs
- How to Fill Out DOL Form LS-276 (w/Examples) + FAQs
- How to Fill Out DOL Form LS-9 (w/Examples) + FAQs
- How to Fill Out DOL Form OWCP-16 (w/Examples) + FAQs