All work-related injuries require reporting, regardless of severity, as soon as reasonably possible; within 24 hours. Injury reporting assists in identifying potential hazards, abatement of hazards, and delivery of safety training. To report a work injury, please fill out the “Workplace Injury Report” below and email to firstname.lastname@example.org.
- Safety and Risk Services: Trish Lijana, Workers' Compensation Program Manager (P) 541-346-2907
- Safety and Risk Services: Haily Griffith, Occupational Health and Safety Manager (P) 541-346-2962
- Safety and Risk Services: Michelle Gillette, Ergonomic & Safety Coordinator, (P) 541-346-8084
Workers' Compensation Claims Process
Some injuries may require medical attention. Employees who suffer a compensable injury/disease in the course and scope of employment and who need medical attention for their injury are covered by workers’ compensation insurance.
If your work injury is requiring medical attention and you choose to file a workers’ compensation claim, please fill out the “Report of Job Injury/Illness Workers’ Compensation Claim Form” also referred to as the “801 Form.” This begins the insurance claims process, and is facilitated by timely notification of the work-related injury as described in the previous section describing injury reporting. State Accident Insurance Fund (SAIF) is the University’s workers’ compensation insurance carrier, and determines the compensability of all claims.
Workers’ compensation coverage at the University does not extend to the general student population, visitors, temporary agency employees, volunteers, or faculty on a courtesy appointment.
This form replaces the previous SIAR (Safety Incident/Accident Report form). It must be completed by the supervisor and employee any time an employee suffers a work-related injury or disease. A Workplace Injury Report must be completed for any injured employee, including temporary workers, student employees, and limited duration employees.
Return the completed form to Safety and Risk Services by fax (541-346-7008) or email to email@example.com within 24 hours of notice of an accident or incident.
This form is completed when an employee seeks medical attention for a work-related injury and the employee wishes to file a workers' compensation claim. The employee completes the top portion of the form and the supervisor completes the bottom portion of the form.
Return the completed 801 form to Safety and Risk Services by fax (541-346-7008) within 24 hours of the employee providing notice that medical attention has been sought.
The employee takes this form to doctor appointments for the physician to complete every 30 days.
This form should be filled out by employees who have been exposed to blood or other potentially infectious materials, which could contain bloodborne pathogens. More information on bloodborne pathogens can be found here.
Information and Resources
Download this cheat sheet to help you navigate injury reporting and the workers’ compensation process.
Available options for advice or treatment of an occupational injury.
Download and use this chart as a guide when determining what level of medical treatment is required following a workplace injury.
This office was created by the Oregon Legislature to be an independent advocate for Oregon's injured workers. They may be able to help you informally resolve any problems or disputes that might arise between the parties involved in a claim, and they can answer your questions about the workers' compensation system. There is no charge for their services.
The purpose of the Safety Advisory Committee is to assist the University administration in providing a safe and healthy workplace for all faculty, staff and student workers by making recommendations for change on health and safety issues.
The Occupational Safety and Health Administration (OSHA) is the main federal agency charged with the enforcement of safety and health legislation. The university continuously works to comply with OSHA rules, and also consults with OSHA on periodically on compliance issues and best practices.