Report an Injury

KESA

First Three Days

When an employee injury occurs, you should file a Report of Injury (IA-1) within 3 days of your awareness of 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.

Report of Injury Form (IA-1)

KESA

File Online

Already have your user name and password?
Simply click on the in the upper right corner to begin the process through our self-service portal.

First-time user?
To receive your user name and password, please email kesasupport@kesa.org or call (502) 894-8484.

KESA

File by Email or FAX

You may email your form to firstreports@kesa.org or fax to (502) 894-0066.

Report of Injury Form (IA-1)

KESA

File by Phone

You can call in your Report of Injury to (502) 894-8484.

KYOSHA 803 KAR 2:180 Recordkeeping; Reporting Workplace Fatalities, Amputations and Hospitalizations