To be completed to document all OSU (employee and non-employee) accidents injuries and work-related illnesses. Should be completed for all OSU sponsored activities, and for incidents occurring at OSU owned or leased property. This form is to be completed by the manager/supervisor in cases of employee injury or work-related illness.
For employee injuries where medical attention is sought, the SAIF 801 form would be completed within 24 hours by the employee and supervisor (utilizing the manager/supervisor instructions for 801 below) and returned to Heidi Melton in Insurance and Risk Management Services. If the employee is unavailable to complete this form within 24 hours (for example, if they are hospitalized), the supervisor is responsible for completing as much of the while form as they can based on the information available and returning it to Heidi Melton in Insurance and Risk Management Services.
To be read by manager/supervisor before completing the “employer” portion of the SAIF 801 form. Please note that specific information is needed in the employer portion of the form, carefully read these instructions to verify what information goes in each field of the form prior to completion.
Specific medical release form to be taken by employee to each appointment with their Attending Physician in workers’ compensation claims. Attending Physician should complete this from at each appointment to verify the employees return-to-work status, expected duration of restrictions (if restricted) and if they are medically stationary, or if not, the date of their next appointment.
Instructions for injured workers and their managers/supervisors on how to report time away from work associated with work-related injury claims, including details on how to document missed time on the date of injury when leaving for medical treatment, SAIF temporary disability benefits and their impact on OSU timesheet leave reporting, as well as other potentially concurrent protected leaves.
OREGON STATE UNIVERSITY
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