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The Second Injury Board (SIB) administers claims filed by a self-insured employer, their insurance company, a third party administrator responsible for administering the employer's workers' compensation claims, or an attorney representing either the employer or their insurance company.
A Notice of Claim form is completed and submitted to the Second Injury Board at the address provided at the top of the form. Enclose as much of the information requested on the form as possible when filing the claim. At the least, submit the first report of injury with the Notice of Claim form. Completed forms can be mailed, faxed to (225) 219-5968, or emailed to email@example.com.
The employer, or if insured, his insurer, must file a Notice of Claim form within 52 weeks after the first payment of any benefit (indemnity or medical) by mailing, faxing, or emailing the form to the Second Injury Board.