Once you verify that a worker's employer was covered by SAIF on the date of injury, and if you believe the injury or occupational disease is a result of the employee's work, fill out
Attending Physician Form 827 and submit it to us. (Our mailing address is 400 High St SE, Salem, OR 97312 or fax to 800.475.7785.)
Timelines
File a
Form 827 for a workplace injury:
- Within 72 hours of treatment for a new injury or occupational disease (not including weekends and holidays)
- Within five days of first treatment if you are a new attending physician
- Within five days of treatment for a worsening of an already accepted claim
Also use Form 827 in the following situations:
- To transmit chart notes or a progress report
- To submit a palliative care request
- To file a closing report to the insurer within 14 days of the date the worker is declared medically stationary
Next step
Within 60 days of our receipt of your Form 827 or within 60 days of the date the injured worker reported the claim to their employer (whichever comes earlier), we will notify you of acceptance or denial of the claim. Learn more about billing SAIF.
If you have questions about reporting a workplace injury, please don't hesitate to call us at 800.285.8525 or email your question to providerquestions@saif.com.