CLAIM NO. 400 High Street, S.E., Salem, OR 97312-1801 For SAIF Customer Use Area Dept. Shift CC Toll Free Phone: Toll Free FAX: SUBJECT DATE 1-800-285-8525 1-800-475-7785 CLASS Report of Job Injury.
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How to fill out the Saif 801 online
Filling out the Saif 801 form is an essential step in reporting a job-related injury or illness. This comprehensive guide will walk you through each section of the form, ensuring you understand what information is needed and how to submit it correctly online.
Follow the steps to accurately complete your Saif 801 form.
- Press the ‘Get Form’ button to obtain the Saif 801 document and open it in the editor.
- Begin by entering the claim number for your report of job injury or illness. This information is crucial for tracking your claim.
- Fill in the date of injury or illness. Ensure this reflects the actual date it occurred.
- Indicate the date you left work due to the injury, specifying both the time (a.m./p.m.) you left and the shift you were working.
- List your regularly scheduled days off to provide context about your normal work schedule.
- Detail the reason for your injury or illness. Clearly describe the activity you were engaged in and any equipment involved.
- Provide personal details including your legal name, birthdate, mailing address, and social security number. Be accurate to avoid delays.
- Complete the section about your illness or injury, specifying the affected body part and whether you have experienced a prior injury in this area.
- If applicable, check the box regarding multiple employers and provide details on your occupation and work phone number.
- Conclude by signing the form to provide official notice of your claim for workers’ compensation benefits, confirming the information is accurate to your knowledge.
- Once finished, save your changes, and utilize the options to download, print, or share the form as necessary.
Complete your Saif 801 form online today to ensure your workers' compensation claim is handled efficiently.
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Get answers to your most pressing questions about US Legal Forms API.
Can I quit my job while on workers comp in Oregon?
This could also jeopardize your employment. If you quit your job while receiving time loss benefits, or are fired for reasons unrelated to your injury, the insurer may stop paying you. The insurer must mail your first time loss check within 14 days of its notice that you are missing work with a doctor's note.
How do I file a Saif claim in Oregon?
New claims: Please fax the form to 800.475. 7785, email it to saif801@saif.com, or mail it to: SAIF, 400 High St SE, Salem, OR 97312. All other information, such as chart notes: Please fax to 877.584. 9802.
What is the employer liability law in Oregon?
Oregon's Employer Liability Law requires Oregon's employers to provide the safest possible work environment when the work being performed involves a risk or danger to the employee or the public. This includes constructing a building. See ORS 654.305; 654.310.
What is an 801 report?
Fair Political Practices Commission Form 801 is used to report certain payments received by state and local government agencies that are used for agency purposes and paid by a third party.
How long do you have to file a workers comp claim in Oregon?
By Jodie Anne Phillips Polich, P.C. Oregon has no time limit on how long a worker can collect compensation, or what is more frequently referred to as lost wages, time loss, or temporary disability payments. There are requirements to obtain such compensation.
What is the exclusive remedy for workers comp in Oregon?
The exclusive remedy provision states that an employee injured on the job is entitled to workers' compensation benefits but may not sue the employer for damages. Partly in response to these decisions, the 1995 Legislature passed SB 369.
What is an 801 form Oregon?
Tell your employer about your work-related injury or illness right away. Fill out Form 801 “Report of Job Injury or Illness” and turn it in to your employer. Your employer should send it to its workers' compensation insurance carrier within five days of your notice.
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