Injured Workers
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Employee Certificate of Compliance (Form LWC-WC-2025.EE)
The Employee Certificate of Compliance (Form LWC-WC-2025.EE) is a legal form released by the Louisiana Workforce Commission - a government authority operating within Louisiana. Injured workers are statutorily required to fill out this form and return to their Claims rep for Lost Time Claims.
Claims Resources
Policyholder Education
Injured Worker Education
Injured Worker First Fill Prescription Form (English & Spanish)
In the event of a workplace injury that requires medication, completing this form can assist in providing the injured eligible prescriptions for first-fill at no cost of their own.
Policyholder Education
Claims Resources
Injured Worker Education
Medical Provider Education
Medical Resources