All work-related injuries or illnesses 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 or illness, please fill out the “Workplace Injury Report” below and email to workinjury@uoregon.edu.
Contacts
- Trish Lijana, Workers' Compensation Program Manager (P) 541-346-2907
- Tiffany Lee, Workers' Compensation Claim Coordinator (P) 541-346-5807
Workers' Compensation Claims Process
Some injuries or illnesses may require medical attention. Employees who suffer a compensable injury/illness 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 or illness 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 or illness 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.
Forms
Workplace Injury Report (English)
Workplace Injury Report (Spanish)
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 illness. 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 (855-658-7729) or email to workinjury@uoregon.edu within 24 hours of notice of an incident or illness.
Workers' Compensation Claim Form (English 801) (Spanish 801)
This form is completed when an employee seeks medical attention for a work-related injury or illness 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 (855-658-7729) or email workinjury@uoregon.edu within 24 hours of the employee providing notice that medical attention has been sought.
Instructions for completing the 801 form
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
COVID-19
Workers who have been quarantined or isolated due to a workplace exposure or have contracted COVID-19 in the workplace may be entitled to have their lost wages and medical expenses covered by their employer’s workers’ compensation insurance. Employers cannot retaliate or discriminate against a worker for filing a workers’ compensation claim or for raising workplace safety concerns.
The Workers’ Compensation Division published the following industry notice:
File “COVID-19 and workers’ compensation informational flierFile 11-Step Process for Incident and Workers’ Compensation Reporting
Download this cheat sheet to help you navigate injury or illness reporting and the workers’ compensation process.
Medical Treatment Options
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.
State of Oregon Ombudsman for Injured Workers
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.
Safety Advisory Committee
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.
OSHA Correspondence
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.
Out of State Workers
Successful remote work arrangements require careful planning and consideration for workspace, equipment, and resource management. Out of state workers with approved remote work agreements can access posting flyers with coverage details and regulations based on their location.