A guide for workers recently hurt on the job
The following information is provided by SAIF Corporation
at the request of the Workers’ Compensation Division
400 High St. SE, Salem, OR 97312
440-3283 (01/16/DCBS/WCD/WEB) for distribution with X801 SAIF Corporation 3/16
Do I have to provide my Social Security number on Forms 801 and 827? What will it be used for?
You do not need to have an SSN to get workers’ compensation benets. If you have an SSN, and don’t provide it, the Workers’
Compensation Division (WCD) of the Department of Consumer and Business Services will get it from your employer, the
workers’ compensation insurer, or other sources. WCD may use your SSN for: quality assessment, correct identication and
processing of claims, compliance, research, injured worker program administration, matching data with other state agencies to
measure WCD program effectiveness, injury prevention activities, and to provide to federal agencies in the Medicare program
for their use as required by federal law. The following laws authorize WCD to get your SSN: the Privacy Act of 1974, 5 USC
§ 552a, Section (7)(a)(2)(B); Oregon Revised Statutes chapter 656; and Oregon Administrative Rules chapter 436 (Workers’
Compensation Board Administrative Order No. 4-1967).
How do I le a claim?
• Notify your employer and a health care provider of your
choice about your job-related injury or illness as soon as
possible. Your employer cannot choose your health care
provider for you.
• Ask your employer the name of its workers’ compensation
• Complete Form 801, “Report of Job Injury or Illness,”
available from your employer and Form 827, “Worker’s
and Physician’s Report for Workers’ Compensation
Claims,” available from your health care provider.
How do I get medical treatment?
• You may receive medical treatment from the health care
provider of your choice, including:
– Authorized nurse practitioners
– Medical doctors
– Oral surgeons
– Osteopathic doctors
– Physician assistants
– Other health care providers
• The insurance company may enroll you in a managed care
organization at any time. If it does, you will receive more
information about your medical treatment options.
Are there limitations to my medical treatment?
• Health care providers may be limited in how long
they may treat you and whether they may authorize
payments for time off work. Check with your health care
provider about any limitations that may apply.
• If your claim is denied, you may have to pay for your
If I can’t work, will I receive payments for
• You may be unable to work due to your job-related
injury or illness. In order for you to receive payments
for time off work, your health care provider must send
written authorization to the insurer.
• Generally, you will not be paid for the rst three
calendar days for time off work.
• You may be paid for lost wages for the rst three
calendar days if you are off work for 14 consecutive
days or hospitalized overnight.
• If your claim is denied within the rst 14 days, you
will not be paid for any lost wages.
• Keep your employer informed about what is going on
and cooperate with efforts to return you to a modied-
or light-duty job.
What if I have questions about my claim?
• SAIF Corporation or your employer should be able
to answer your questions. Call SAIF Corporation at
• If you have questions, concerns, or complaints, you may
also call any of the numbers below:
Ombudsman for Injured Workers:
An advocate for injured workers
Workers’ Compensation Compliance Section