Tools & Documents for Policyholders
ACH Form - One Time Draft
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- Last Updated
- 2023-07-26
Duties Should Injury Occur - TX
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- Last Updated
- 2023-07-26
First Fill Program Pharmacy Card
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- DOC
- Last Updated
- 2023-07-26
New Policyholder LUBA Care Information Sheet
LUBA Care is a department within LUBA Workers’ Comp and, like our organization, is dedicated to developing relationships with our providers in order to ensure that you, our insured, have a list of options available for medical care. Our staff is available for any assistance or information you may need.
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- Last Updated
- 2023-07-26
Online Self-Reporting ACH Form
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- Last Updated
- 2024-05-09
Payment Portal FAQ Document
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- Last Updated
- 2024-01-12
Policyholders - Do You Know Where to Bring an Injured Worker for Care?
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- Last Updated
- 2023-07-26
Prompt Return to Work Information Sheet - Policyholder
Prompt Return to Work (PRTW) is a team approach to getting an injured worker back to work as soon as possible. The team consists of the worker’s employer or supervisor, vocational rehabilitation counselor, LUBA’s claims adjuster, injured worker and the assigned physician.
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- Last Updated
- 2023-07-26
Prompt Return-to-Work Program Booklet
At LUBA Workers’ Comp, our intent in regard to Prompt Return to Work (PRTW) is to create a situation which benefits all parties involved. A PRTW Program is an effective tool in helping us create such a situation. This program is designed to help facilitate the return of an injured worker to the workplace.
- Type
- Last Updated
- 2023-07-26
Texas First Report of Injury Form
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- Last Updated
- 2023-07-26
Texas Sample Drug & Alcohol Policy
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- Last Updated
- 2023-07-26
Texas Sample Drug & Alcohol Policy - Spanish Version
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- Last Updated
- 2023-07-26
Vocational Rehabilitation Information Sheet
Vocational rehabilitation is a Workers' Compensation benefit designed to assist employers in returning their injured worker to work. This is defined as permanent or temporary employment and does not violate the restrictions imposed by the physician.
- Type
- Last Updated
- 2023-07-26