Reporting a workplace injury
As you know, medical treatment for a workplace injury must be reported to the insurer in order for the claim to be reviewed quickly.
Remember, submitting a complete, accurate form helps speed up the decision-making process (which means you may get paid sooner).
- Name of employer
- The provider's name
- The worker's work status (for the work release)
- The worker's DOB and SSN
- The insurance carrier at the time of the injury; You can find out who the carrier is on the Workers' Compensation Division website.
Once you verify that a worker's employer was covered by SAIF on the date of the injury—and the worker wants to file a workers' comp claim—fill out Attending Physician Form 827 and submit it to us.
Submitting the form
- New claims: Please fax the form to 800.475.7785, email it to email@example.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.
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 the 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 (Please send chart notes even though the 827 has other information about the injury.)
- 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
Please encourage injured workers to also submit an 801 form through their employers (it's required, even though an 827 is submitted).
We will notify you of acceptance or denial of the claim within 60 days of our receipt of your Form 827 or within 60 days of the date the injured worker reported the claim to his or her employer (whichever comes earlier). Learn more about billing SAIF.
If you have questions about filling out the form, please don't hesitate to call our FastTrack team at 800.285.8525, or email your question to firstname.lastname@example.org.