Workers' Compensation - How to File a Claim
Understanding your responsibility as a manager/supervisor or as an employee is critical to processing a Workers' Compensation claim as efficiently as possible. Please expand on the information below based on your role to learn more about the process of filing a claim and what to expect throughout the process. The Accident Reporting Process Flowchart is also a quick resource to help you visualize the initial process for reporting Workers' Compensation claims in one easy to read format.
- Train all your employees of their obligation to notify you immediately of any injuries or illnesses that arise out of their employment and occur during the course and scope of their employment with the University. Confirm no hazardous conditions exist.
- Complete a HR Advocate Public Incident Reporting Form for any injuries, illnesses or incidents on campus and fax to Insurance and Risk Management Services at 541-737-4855 within 24 hours of the incident.
- If the employee’s incident resulted in the need for medical treatment, have the employee complete the worker section of the SAIF 801 Form, then complete the employer section of the form. Fax the completed 801 to Insurance and Risk Management Servicesat 541-737-4855 within 24 hours of the incident. If the employee is not available to complete the worker section of the 801, complete the employer section, along with as much information as is known in the worker section and fax the form to Insurance and Risk Management Services within 24 hours of the incident.
- Before the employee seeks medical attention, notify the employee that they will need to provide written authorization from their doctor to document their return-to-work status. Provide them with the Employee Status Report Form for detailed documentation on their return-to-work status. Employees must also provide OSU with an updated release status every 30 days AND at any time the employee’s release status changes.
- If the employee is released to regular work (no restrictions), provide a copy of the release to Insurance and Risk Management Services for the Workers’ Compensation file.
- If the employee is released to work with restrictions, provide a copy of the release to Insurance and Risk Management Services for the Workers’ Compensation file, and work with Insurance and Risk Management Services to determine transitional work availability for the Early Return to Work Program.
- If the employee is not released to any form of work or if there is no transitional work available to meet the employee’s current restrictions, maintain weekly contact with the employee to confirm if any change in status has occurred. Update Insurance and Risk Management Services when any changes occur.
- Insurance and Risk Management Services may request additional assistance documenting physical requirements, assist with completion in an accurate and timely manner.
- Additional resources are available through the Environmental Health & Safety Office for managers and supervisors in regards to more detailed accident/incident reporting, accident investigation, and hazard identification and control.
- Report all injuries or illnesses that arise out of your employment and occurs during the course and scope of your employment with the University to your manager/supervisor immediately.
- If you need to seek medical care, fill out the worker section of the SAIF 801 Form and submit to your manager/supervisor, and fill out a form 827 with your doctor or nurse.
- For workers’ compensation claims, an Employee Status Report Form (or similar specific medical release) is required at initial treatment to verify release status.
- Employees must also provide OSU with an updated release status every 30 days AND at any time the employee’s release status changes. A release status change may include:
- If you were not released to any form of work, but have now been released to either regular work or released to return to work with specific restrictions,
- If you were previously released to regular work, and have been given new, specific restrictions,
- If you were previously released with specific restrictions, and have now been released to return to regular work,
- If your specific restrictions have changed, - or -
- When you become medically stationary (no further treatment or improvement of condition is expected).
- Schedule appointments to provide minimal disruption to your work schedule, and obtaining supervisor approval if time away from work during scheduled hours is necessary.
- Keep your medical appointments and follow your doctor’s or authorized nurse practitioner’s instructions.
- Maintain weekly contact with your manager/supervisor if you have not returned to work, so they may assist you with returning as soon as you are physically capable of doing so.
- Keep SAIF informed about your condition so benefits may be paid in a timely manner.
- Read all notices carefully. Contact SAIF if you have any questions about your claim or benefits.
- Respond to requests for information in a timely manner. Many laws have clear timeframes for responses on your part. Failure to respond by the due date may affect your claim.
- Provide your claim number to any medical provider who treats you for your accepted condition so that they may bill SAIF in a timely manner.
- Request reimbursements for out-of-pocket expenses such as prescriptions or mileage driven to and from your medical provider appointments. Submit these requests directly to SAIF within two years of the service date.
- If you believe SAIF needs to accept a new or different medical condition, please put your request in writing directly to SAIF, stating the medical condition you want accepted to your claim. SAIF cannot accept surgical procedures or treatment – it must be a medical condition. If you aren’t sure what to do, call SAIF for additional information.