Tools & Documents for Policyholders

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Arkansas First Report of Injury Form

Type
PDF
Last Updated
2016-06-14

Arkansas Sample Drug & Alcohol Policy

Type
PDF
Last Updated
2017-11-28

Duties Should Claims Occur - AR

Type
PDF
Last Updated
2020-01-15

EFT/ACH Premium Payment Form

Type
PDF
Last Updated
2020-04-02

First Fill Program Pharmacy Card

Type
DOC
Last Updated
2016-06-14

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.

Type
PDF
Last Updated
2016-09-13

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.

Type
PDF
Last Updated
2016-07-19

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
PDF
Last Updated
2016-07-18