To access Vector Solutions training and information about claiming clock hours, please visit our Vector Solutions (SafeSchools) Training page. 

If you are injured on the job or diagnosed with an occupational disease, you must:

• Inform your supervisor immediately;
• Complete an Employee Incident Report.
  ESD 112                                             ESD 123

Note: Not all employee 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.

Need to seek medical treatment?

Inform your supervisor you are seeking medical attention right away.

Contact the Work Comp Claims Department at 360-750-7504 or 800-749-5861 beforehand to:

• Report the incident had occurred.
• Provide details of the incident.
• Obtain a claim number.

The Work Comp Claims Department will send you an SIF2 form and packet of information to complete.

If we are notified of your claim from someone else such as a medical provider, expect a phone call from the Work Comp Claims Department.

The Work Comp Claims Department will investigate each claim within 24 hours of notification of an injury. We will contact the injured employee, the employee’s supervisor and the initial medical provider. This communication gathers necessary information to determine benefit eligibility.

While at the medical provider’s office

Inform the medical provider that this is a work-related incident, your employer is self-insured and is a member of Work Comp for SW Washington Schools (ESD 112) or SE WA Worker’s Comp Trust (ESD 123).

Provide the medical provider with your claim number. If you do not have a claim number yet, please call the Work Comp Claims Department from the provider’s office to obtain one.

Instruct the medical provider to forward all claim information and authorization requests to:
ESD 112                                                                                              ESD 123
Work Comp for SW Washington Schools                                      SE WA Worker’s Comp Trust
c/o ESD 112                                                                                        c/o ESD 112
2500 NE 65^th Avenue                                                                       2500 NE 65^th Avenue
Vancouver, WA 98661-6812                                                            Vancouver, WA 98661-6812
Phone: 360-750-7504                                                                       Phone: 800-749-5861
Fax: 360-750-9836                                                                            Fax: 360-750-9836

Complete a Provider’s Initial Report. You will complete the top portion of it and sign it, giving the medical provider authority to release medical reports. The medical provider will complete the remainder and send it to the Work Comp Claims Department.

Obtain a work status note from the medical provider to provide to your supervisor and the Work Comp Claims Department.

Schedule a return appointment for follow-up as needed.

After each medical provider visit

Call the Work Comp Claims Department to report on your medical and return-to-work status.

Fax your return-to-work status note to the Work Comp Claim Department within 24 hours at 360-750-9836.

Report your return-to-work status to your supervisor within 24 hours. Provide your supervisor with a copy of your work status notes.

• Injured? What You Need to Know
• Find a Doctor
• F207-085-000 A Guide to Workers’ Compensation Benefits: For Employees of Self-Insured Businesses