Submit a Claim

Please follow the process below for submitting a claim.

Claims Notification Process

Workers' Compensation Report of Job Injury or Illness

 
Call our Rapid Care Hotline to report a work-related injury or illness.
 

24/7 Rapid Care Hotline

For medical emergencies call 911.
 
Due to the number of potential COVID-19 related work comp claims. The CIS WC Team asks for your support by only submitting a COVID-19 claim after exposure is confirmed with a positive test result.
 
Immediately following a workplace injury/illness, call to speak with a registered nurse who specializes in occupational injuries. The nurse will connect you with the quality care that you need. The nurse will also collect the state-required 801 information, so you don’t have to complete the form later.
 
By calling the hotline, you are filing a legal claim for Workers’ Compensation Benefits. Call the hotline immediately when work accident/injury requires medical treatment or causes missed time from work.
 
 
NOTE: If a worker has a previously accepted Workers’ Compensation Claim and they would like to file an aggravation, they will need to contact their attending physician (MD, DO or Oral Surgeon) and complete form 827 for Notice of Claim for Aggravation. A new 801 form should not be completed for claim reopening.
 

Property & Liability Claim Reporting Form

 
Submit a General Liability Claim, Automobile Crash Report, or Property Damage Claim.
 
 

 

Emergency Claim Notification Process

Please utilize the following procedures when reporting serious incidents* or fatalities.

* Serious incidents would include accidents involving injuries requiring admittance to a hospital, police incidents involving use of firearms, public allegations of sexual misconduct involving public officials, or other "high profile" incidents involving potential civil liability.
 
  1. Contact local emergency response personnel to handle immediate threats to life or property.
  2. Secure the scene.
  3. Follow your Emergency Policy/Procedure for internal response, reporting notification.
  4. Notify CIS Claims at 1-800-922-2684 and ask to be directed to Jim McWilliams (Claims Manager). If you are calling after hours and this is a true emergency, call the emergency claims number, 503-763-3897, and your call will be forwarded to the on-call claims examiner.
  5. Contact your Employee Assistance Program (EAP) for counseling and critical incident debriefing as needed.
  6. Conduct an internal investigation, document facts and submit the appropriate claim form to CIS Claims. Workers’ Compensation claim forms are available online.
  7. If news media are requesting comment, be sure to follow your entity’s policy regarding media contact and public information. If you need assistance in developing such a policy, please contact CIS. Please note to call OR-OSHA at 1-800-922-2689 if a fatality or serious disabling injury requiring hospitalization has occurred. Fatalities must be reported within 8 hours and in-patient hospitalization of an employee within 24 hours.
An incident report may be used if the injured worker is not planning to seek medical treatment. The 801 Claim Form must be completed when medical treatment or time off work occurs and should be forwarded to CIS Claims within five working days at the following address:

CIS Claims
PO Box 1469
Lake Oswego, OR 97035

After hours or on weekends, leave a voice message with CIS for a return call during business hours.