Report an Injury by Email
Do any of the following conditions apply to your claim?
- Death
- Amputation
- Blindness or loss of eye
- Brain Injury
- Paraplegia
- Burns of more than 20 percent of the body
- Quadriplegia or severe paralysis
Due to the severity of the claim, this must be reported via telephone to LUBA at 1-888-884-5822.
Note: if the call is after hours, the answering service will contact the LUBA claims department immediately.
Please be aware that if an injury involves a fatality, amputation, or loss of an eye, it must be reported to OSHA immediately. Please call their free and confidential number at 1-800-321-OSHA (6742) to report.
Choose the appropriate state below, complete the form, save, and email us at FROI@lubawc.com. We will complete all necessary forms and handle the filings with the Office of Workers’ Compensation or respective commission.
*Note: If no return to work date is listed the claim will be considered a lost time claim
Please be aware that if an injury involves a fatality, amputation, or loss of an eye, it must be reported to OSHA immediately. Please call their free and confidential number at 1-800-321-OSHA (6742) to report.