Worker's Compensation

The University provides worker's compensation insurance for injuries and illnesses incurred on the job. There is a deduction for this insurance from your paycheck. All job related injuries or illnesses experienced by staff, faculty, or student workers must be reported immediately to your supervisor. The Human Resource Office will explain your responsibilities and assist you in completing the necessary paperwork.

Worker’s Compensation – Employee and Supervisor Reporting Responsibilities

Employees are covered by worker's compensation insurance, which provides compensation, for employees injured at work. Pacific University is concerned about your on-the-job-injury. Listed below is information to help you understand the necessary procedures.

  • When you have an on-the-job accident, injury or serious near miss, it must be reported immediately to your supervisor. Failure to do so could result in your claim being delayed or denied. Your supervisor will notify Campus Public Safety who will investigate the accident and arrange for professional medical assistance if needed.
  • If professional medical assistance was required you must fill out a form 801 - Employer's Report of Occupational Injury or Illness within 24 hours and return it to the Human Resource Office. If immediate medical care was required form 801 should be filled out as soon as possible following the injury. Forms are available in Human Resources and Campus Public Safety.
  • Additionally, employees seeking professional medical attention must take a “Medical Status Report” with them to be filled out by the treating physician. You must also notify the physician that there are light-duty jobs available.
  • If your Doctor releases you to return to work (temporary, light duty, part-time or regular duties), you must report to work immediately if possible and no later than your next scheduled workday. You must inform your supervisor and provide documentation from your physician about your condition and any physical restrictions you may have.
  • If the physician determines that you are unable to perform any kind of work you are responsible, if possible, to call Human Resources to inform them of your condition. The Medical Status Report must be returned along with a statement providing the dates you are unable to work immediately after the physician visit.
  • If you are off work for more than three calendar days you must call your supervisor at a predetermined time to report your status. You must call in weekly until you are able to return to work. You may be required to take certain forms to your physician on follow-up appointments. You must return the completed forms to your supervisor.
  • Any bills or questions regarding your claim should be directed to:

    SAIF Corporation
    400 High Street SE 
    Salem, OR 97312-1801 
    1-800-475-7785 (fax) 



Employee Accident Form

Employee Accident Form (Spanish)

Student Accident Form 

Form 801-Workers Compensation Claim

Form 801-Workers Compensation Claim (Spanish)