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.

Choose the appropriate state below, complete the form, save, and email us at 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.