Compliance with State and Federal Requirements
|On-The-Job Incidents and Workers' Compensation|
The following information explains what an agency should do in the event of an injury, how to manage a workers’ compensation claim, and the requirements of returning an injured employee to work. Human Resources (HR) is there to ensure the employee is not lost in the process. Read more information about Risk Management and Workers’ Compensation. For questions, contact DAS Risk Management.
The State Accident Insurance Fund (SAIF) Corporation is Oregon’s not-for-profit, state-chartered workers’ compensation insurance company. The DAS Risk Management Unit works closely with SAIF and the agency when an employee is injured.
If there has been an on-the-job incident, the agency should inform the employee that if medical treatment is obtained, a claim Form 801 must be filed with SAIF. (Either a SAIF or OR-OSHA Form 801 can be used.) The “SAIF Report of Injury and Illnesses,” Form 801 and instructions can be downloaded from the SAIF Form Library website.
The agency documents applicable injuries and illnesses on the worksite’s OSHA Form 300 Log of Work-Related Injuries and Illnesses. At the end of the year an OSHA Form 300A Summary of Work-Related Injuries and Illnesses is used to summarize the annual listing of injuries and illnesses recorded on the OSHA 300 log. The OSHA Form 300 and Form 300A can be downloaded at the OSHA website under Recordkeeping Forms.
If the employee reports an on-the-job injury or illness, the agency:
It is important to have a clear reporting requirement:
- Ensures appropriate medical care is provided
- Secures the scene of the accident to preserve key evidence. Takes photographs if the area needs to be put back in order quickly
- Interviews witnesses to the accident and those involved in the accident. Delays interviews if the employee is seriously injured
- Analyzes the information to determine the cause of the accident and how to prevent recurrence
- Completes required reports
- Takes corrective action to eliminate or abate the hazard.
Notification guidelines for employees to file a claim:
- Have a documented process for employees to report incidents
- If an employee is injured, have the employee complete the required paperwork as soon as possible (Form 801 as a minimum)
- Employees must notify the agency immediately of an accident resulting in injury. If the injured worker does not file, the agency should contact SAIF to determine if a claim must be filed. Agencies complete only the employer’s portion of the form. Any Form 801 that bears an employee signature is a claim and must be filed with SAIF
- When the employee of an on-the-job injury or illness requiring medical treatment notifies the agency of the incident, notify SAIF promptly by submitting a Form 801. If an employee is unavailable to complete the employee portion of the form, the agency submits the incomplete Form 801 to SAIF.
- The claim must be in writing
- The claim must describe when, how and where the injury occurred (Form 801 is the most commonly used form for filing a claim for state workers)
- The claim must be made by the employee or by someone on the employee’s behalf within 90 days of the accident
- Claim notice may be provided within one year of the accident if the agency had knowledge of the injury, or the agency had knowledge of the incident within 180 days of the incident or the employee’s death.
- The employee must notify OR-OSHA when it is not possible to notify the agency
- For occupational disease, the employee must notify the agency within one year of
- discovering the disease
- being notified by a physician of the disease
- Upon discovering the cause of death was an occupational disease, the worker’s beneficiary must notify the agency within one year.
An agency accepts all employee reports of injuries and limitations.
Contact the agency’s designated workers’ compensation specialist or SAIF’s Return-to-Work consultant to discuss the possibilities of modified work for the employee. It is in the best interest of agency and employee to offer modified duty if necessary, until a compensability decision is made to set the employee on the path of recovery and return to full duty. DAS Risk Management is consulted when a:
When an employee is released to perform regular, modified or transitional work, the best practices are:
- Claim becomes complex
- Claim is for a fatality
- Claim involves substantial cost incurrence or claim reserves
- Denial of a claim may be litigated. If the denial is over-turned, back benefits may be due.
- To receive a work status note or SAIF’s Release to Return to Work after each visit with the medical practitioner
- To complete and submit to the medical practitioner for approval, a modified duty work plan or SAIF’s Release to Return to Work Job Description form prior to assigning duties to an injured worker
- To have a work release from the medical practitioner that includes work restrictions, limitations, or abilities to ensure the employee can safely perform the duties that the agency would like to assign (a treating physician’s prescription pad release is not advised due to its minimal information about work restrictions or limitations)
- To review any applicable CBA or policy for return to work provisions related to workers’ compensation.
Injured workers have specific protections against discrimination and rights to continued employment. The agency may not discriminate or retaliate against an employee because they filed a claim.
Claim denials do not mean the employee does not have the injury or health condition. The agency must address the health condition on its merits and use the appropriate leave policy.
Most on-the-job injuries do not result in disability.
Absence due to an on-the-job injury may qualify for Family and Medical Leave.
The agency must comply with State HR Policy 50.020.03 Reinstatement and Reemployment of Injured Workers and State HR Policy 50.020.05 Early Return to Work of Injured Workers.
During the entirety of the claim, the agency maintains contact with their designated SAIF Workers’ Compensation Claim Specialist. Consult DAS Risk Management on complex claims that, for instance, involve severe injuries or illnesses, will be costly, or may involve legal proceedings. Send copies of all treating physician’s notes directly to SAIF.
The forms listed above may be accessed at the SAIF’s form library website.