Report of Injury by Mail or Fax

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

No

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.

You may also complete an employer report of injury/illness by fax. Download the appropriate state’s form below, complete the form and fax the report to (225) 389-9300, Attn: Claims Intake. We complete all necessary forms and handle the filings with the Office of Workers’ Compensation or respective Commission.

If phone or fax is unavailable, you can print and complete the employer report and mail to:
LUBA Workers’ Comp
Attn. Claims Intake
P.O. Box 98082
Baton Rouge LA 70898-9082

Timely reporting allows us to conduct a prompt investigation. Prompt reporting also enables us to handle the claim from the beginning, which often saves employers money. Once our investigation is complete, we pay the claims we owe and defend the claims not owed under workers’ compensation. Timely reporting of every work-related accident saves you money!