Working Together to Serve You.
The Southwest Washington Workers’ Compensation Trust provides industrial injury accident insurance coverage for its membership. Twenty nine school districts and ESD 112 are part of the Trust, which is administered through ESD 112. As a self-insurer, the Trust is fully funded by member school district participants.
The Trust was formed January 1, 1983 when school districts in southwest Washington joined together by signing an Interlocal Governmental Agreement to pool their self-insured losses and jointly purchase excess insurance and administrative services. An agreement to form a pooling arrangement was made pursuant to the provisions of RCW 39.34, the Interlocal Cooperation Act and RCW 51.14, Industrial Insurance, Self-Insurance.
The Trust is an Enterprise Fund established for the purpose of providing group self-funding, group purchase of excess insurance, claims management and loss control services for industrial injury accident liabilities of its members.
The Southwest Washington Workers’ Compensation Trust is governed by a Board of Directors, which is comprised of one designated representative from each participating member, with delegated authority to a five member Executive Committee. The Executive Committee is responsible for conducting the business affairs of the Trust.
How to Submit a Workers’ Compensation Claim
To Report a Workers Compensation Claim please fill out the on-line form and call the ESD 112 Workers’ Compensation Department at 800-749-5861 or 360-750-7504.
What to do if an employee is injured at work
1. Inform the employee’s supervisor
If an employee is injured on the job or diagnosed with an occupational disease, the employee must inform his/her supervisor immediately.
2. Complete an employee incident report
Not all incidents become workers’ compensation claims, but all employee incidents need to be recorded to retain the facts of the injury and to gather information for loss prevention purposes. Complete the on-line Employee Incident Report form. Paper copies of the previous employee incident form will still be accepted.
3. If the employee requires medical attention
If medical attention is required contact ESD 112 Workers’ Compensation Claims Department at 1-800-749-5861 to report the incident. If medical care is provided you must obtain a claim number to submit a claim.
4. What the employee needs to tell the medical provider
Inform the medical provider that this is a work related incident and that the district is self-insured as a member of the Southwest Washington Workers’ Compensation Trust. A Provider’s Initial Report (PIR) should be completed at the medical provider’s office. Provide the medical provider with the assigned claim number. If a claim number has not been assigned, contact ESD 112 Workers’ Compensation Claims Department immediately. Instruct the medical provider to forward all claim information and authorization requests to:
ESD 112 Workers’ Compensation Claim Department
2500 NE 65th Avenue, Vancouver WA 98661-6812
Phone: 360-750-7504 | Fax: 360-750-9836
5. What to do after each medical provider visit
Contact ESD 112 Workers’ Compensation Claims Department following each visit to report medical and return to work status. Copies of all work status notes must be provided to both the employee’s supervisor and ESD 112 Workers’ Compensation Claims Department within 24 hours of receipt.
6. Expect a follow up phone call from ESD 112 Workers’ Compensation Claims staff
ESD 112 Workers’ Compensation Claims Department will investigate each claim within 24 hours of notification of an injury. A three point contact will be completed with:
- The injured employee
- The injured employee’s supervisor
- The attending medical provider
The purpose of these calls is to gather the legally mandated information to submit and process a workers’ compensation claim.
ESD 123 Workers' Comp
ESD 123 Workers’ Compensation
ESD 123 has contracted with ESD 112 in Vancouver to perform claims handling services for the member districts of the Southeast Washington Workers’ Compensation Trust. This partnership is a great example of how ESDs are truly working together to serve Washington schools.
To Report a Workers Compensation Claim please call the ESD 112 Workers’ Compensation Department at 800.749.5861 and follow the claim instructions.
Who to Contact
Workers' Compensation Program Manager
Notice to Employees
Workers’ Compensation Filing Information
Return to Work Program
Return to Work (RTW) Reimbursement Program
The Southwest Washington Workers’ Compensation Trust Executive Committee recognizes the importance of encouraging member districts to return injured employees to transitional duty job assignments while they recover from a work-related injury. The US Bureau of Labor Statistics indicates that workers absent for more than six (6) months due to a work-related injury have approximately a 50% probability of not returning to work of any kind and those absent for more than a year a less than a 25% chance of returning to gainful employment. Those workers absent for more than two (2) years have virtually no chance of returning to work of any kind (US Department of Labor, Industry Injury & Illness Data 2002).
While many member districts return their injured employees to transitional duty job assignments, there are additional opportunities that could be taken advantage of to help reduce workers’ compensation expenses for all member districts. The most common reason given by districts for not returning their injured employees to transitional work is due to a lack of funds to pay for both the injured employee and the substitute. To offset this concern as well as the impact time away from work has on injured employees, the Trust Executive Committee approved a Workers’ Compensation Return-to-Work Reimbursement Program, effective September 1, 2014.
The Workers’ Compensation Trust Executive Committee designated funds for a Return-to-Work Reimbursement Program earmarked specifically to partially reimburse wages paid to injured employees working transitional duty jobs. Reimbursements will be for 50% of the employee’s regular rate of pay for up to 90 calendar days, capped at $10,000 per claim. Reimbursement covers half of the salary only – benefits are not included. Districts will complete and submit a one-page reimbursement form with required documentation within 45 days of the transitional duty start date. The Workers’ Compensation Trust will reimburse the district for half of the qualifying wages.
Who to Contact
Workers' Compensation Program Manager
Workers' Comp Claims Adjuster
Lisa K. Alexander
Insurance Specialist I
If you have a question about the insurance programs or services we offer to districts, please reach out to:
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