All on-the-job injuries and job-related illnesses must be reported to your supervisor and the Office of Human Resources as soon as possible.
3550 N. Interstate Ave.
Portland, OR 97227
Completion of Form 801 initiates a workers' compensation claim. You will receive notifications from our workers' compensation insurance carrier, Empire Pacific. If Empire Pacific determines that your injury or illness is work-related, they will accept your claim and notify you. If you claim is accepted, medical treatment for this injury or illness will be paid by Empire Pacific.
Notify your supervisor and human resources immediately if your medical care provider instructs you not to work or provides you with work restrictions. Keep your supervisor and human resources apprised of any changes in your return to work date or any changes in your work restrictions. If you miss work, you will need to provide documentation from your medical care provider to your supervisor and human resources that you have been released to return to work.
During the first three days that you miss work, you will use sick time. If you have no sick time, you will use vacation time and if neither are available, these days will be unpaid.
Starting on the fourth consecutive day that you miss work, should your claim be accepted, you will receive time loss payments from Empire Pacific. These payments are equal 66 2/3 percent of your normal wages. Payment does not begin until your claim is accepted.
While on an approved workers' compensation leave, you will continue to receive benefits provided you continue to pay your portion of the cost.
Periods of employee disability resulting from a compensable on-the-job injury or illness will qualify as OFLA (Oregon Family Leave Act) if the injury or illness is a serious health condition, as defined by Oregon law.
OFLA leave will not be reduced by and will not run concurrently with any period the employee is unable to work because of a disabling compensable injury; however, if the injury or illness is a serious health condition and the employee has refused a bona fide offer of light-duty or modified employment, OFLA leave will commence.