When an employee injury occurs, you should file a Report of Injury (IA-1) within 3 days of your awareness to the incident. Even if you think the claim is not legitimate, file the Report of Injury anyway. The report is NOT committal - it is simply an alert to KESA that a claim needs to be investigated. Submitting the report does not bind you to paying a claim.

The fastest, easiest way to submit a Report of Injury is online.  If you already have a member login and password, click on the Member Login or Report Injury button below.  If you do not have a member login and password, please contact kesasupport@kesa.org. 

From the Member Login button, click on the Claims tab and the Enter/Modify Notice of Injury button.  You will see the first page of the form and will be prompted through.  From the Report Injury button, you will see the first page of the form immediately and will be prompted through.  

You may also call in a Report of Injury to 800-367-5372, fax to 502-894-0066, or email etimmerman@kesa.org.

 Download IA-1 Report of Injury Form