Workplace injuries and deaths can happen anywhere at any time. In 2021 alone, employers in the country’s private sector reported 2.6 million instances of nonfatal occupational injuries and illnesses. While the number of reported illnesses was lower compared to the previous year, injury reports climbed from 2.2 to 2.3 cases per 100 workers. The rate of occupational deaths also rose, from 3.4 to 3.6 per 100,000 workers.
In Rhode Island, the industries with the highest rate of workplace injuries in 2021 were transportation and warehousing, retail trade, public administration, and healthcare. In terms of workplace deaths during the same year, it had the lowest rate among the states, with one death per 100,000 workers.
If you are one of the workers who have acquired an injury or illness from your job in Rhode Island, the law allows you to submit a workers' compensation claim. It is a type of no-fault insurance that compensates a worker for injuries and losses caused by a work-related accident or an occupational disease.
However, filing a claim and collecting benefits can be a tough procedure to understand, especially for someone undergoing the process for the first time. In this article, we'll go over Rhode Island's workers' compensation laws, including what kind of policy employers are required to have, what kind of benefits an employee can claim, and what actions you, your employer, and their insurance company must take for you to receive compensation.
We will also go over what you can do if your claim is refused and provide a list of resources that can help you throughout the process.
Rhode Island Workers’ Compensation Insurance Requirements
Rhode Island, like other states, has workers' compensation laws. Under the state’s Workers' Compensation Act, employees should receive benefits in the event they sustain an injury while on the job.
In general, full-time employees are eligible for compensation even if they were negligent, were harmed as a result of the negligence of another person, or recognized the risk of a situation that led to their injury. However, different rules may apply to different worker categories, such as the following:
Municipal employees are only covered if their municipality has elected to be covered, whereas firefighters, members of the police force, and federal personnel are covered under distinct compensation systems.
Farmers are covered if their employer hires at least 25 agricultural employees or farm laborers for 13 consecutive weeks.
Domestic service providers (except workers engaging in hazardous occupations) are also not covered by workers' compensation insurance.
An employee is covered by workers' compensation insurance if their employer has such a policy. Employers in the state — which may refer to people, firms, public service and private corporations, and the government — are required to have workers' compensation insurance from a licensed insurer if they have one or more employees.
In accordance with the Workers' Compensation Act, a poster displaying the employer's insurance company must be shown in the workplace. Failure to do so translates to a $250 fine.
Additionally, employers without workers' compensation insurance will be fined $1,000 every day until they obtain it. They will also face a felony charge with penalties that include a $10,000 fine and two years in prison.
Rhode Island Workers’ Compensation Benefits
In Rhode Island, various benefits are available under the workers’ compensation program. Depending on one’s circumstances, these may include:
Healthcare services such as medical, dental, surgical, and optical treatments, as well as hospital bills and medicine costs.
Benefits for partial and total disability, including permanent total disability from the loss of eyesight and limb amputation.
Death benefits for the dependents of workers who passed away on the job.
Burial expenses up to $20,000.
While medical expenses are generally covered, there are still some limitations, notably with regard to palliative care. If you have reached maximum medical improvement, treatment is restricted to either 60 days of care or 12 visits to a medical facility, whichever comes first. If you want to receive additional palliative care, the insurer must approve your Request for Additional Palliative Care.
How to File a Workers’ Compensation Claim in Rhode Island
If you are hurt on the job, the first thing you should do is seek medical attention. You must also notify your employer of your injury before they can file a claim. In the event that your injuries have rendered you unable to work and earn income, your employer is required by law to notify their insurer.
When Is the Deadline for Workers’ Compensation Claims in Rhode Island?
A workers' compensation claim in Rhode Island must be submitted within two years of a worker’s injury or death. The employer must also be informed about the incident within 30 days. It is important not to miss these deadlines to avoid being barred from filing a claim.
If a work-related injury leaves a person physically or mentally disabled, the time to file does not begin until the later of these events:
The worker claiming benefits is aware of, or should have been aware of, their injury.
The worker’s period of disability has ended.
If an employee provides false information to their employer before filing a claim, they will be prevented from obtaining benefits for two years from the date of their employment.
A Step-By-Step Guide on Filing a Workers’ Compensation Claim in Rhode Island
1. Seek Medical Attention
If you are injured on the job, you should seek medical assistance immediately. You must get medical help and have your injuries evaluated by a medical professional to establish the extent of your injuries, the medical procedures to treat them, and how they will impact your ability to work.
When it comes to medical providers, you have the right to choose who will deal with your condition during the first treatment or consultation. However, note that they will not count as your initial medical provider.
2. Report Your Injury or Illness to Your Employer
You must then report your injury or illness to your employer, who should submit a First Report of Injury form to their insurer (also referred to as the claims administrator). A Notification of Claim of Compensable Injury must also be submitted to the insurer within three days of the initial visit.
Take note of these rules when reporting an incident to your employer:
All your on-the-job injuries must be recorded, including the ones that can prevent you from receiving full pay for at least three days or necessitate medical treatment, regardless of the length of your incapacity.
Your report must be submitted to your employer within 10 days of getting injured or experiencing incapacity due to an occupational disease.
For workers with fatal injuries (whether immediate or proven later), a report must be submitted within 48 hours after death.
If your employer fails to fulfill their responsibilities, they will be fined $250 for each refusal or failure to make a report.
After receiving the required form from your employer, the insurer should send a copy to the Rhode Island Department of Labor and Training electronically.
3. Wait for the Insurer's Decision
When the insurer receives the claim, they can accept or deny it. If they accept it, they must demonstrate their acceptance of responsibility by filing the necessary documentation with the Department of Labor and Training.
The type of document submitted depends on how the insurance company will decide to pay your benefits:
Non-Prejudicial Agreement form (DWC-20): This is submitted if the insurer refuses to assume legal responsibility for your injury. Because this is merely a temporary arrangement, they may only pay your benefits for up to 13 weeks and then terminate it any time after the said period.
Memorandum of Agreement form (DWC-02): This is submitted if the insurer decides to accept legal liability for your injuries. In this case, payments cannot be stopped without your agreement.
If the insurer agrees to continue paying compensation after the initial 13-week term, it constitutes an admission of accepting responsibility. A Memorandum of Agreement is required in this scenario to bind the agreement and continue the payments legally. The employer must file it within 10 days after the first payment by the employer or insurer. It must include the required information, such as:
Your name and your employer’s names.
Information related to your injury, such as the date, location, nature, and location of the injury on your body.
The rate at which compensation is calculated.
Your average weekly wages earned for 13 consecutive weeks before the injury and the amount of overtime pay included in the calculation.
The names of your other employers or a statement saying you have no multiple employers, whichever is applicable.
Other information required by the director of the Department of Labor and Training.
4. Receive Compensation
If there are no issues and your claim is approved, your employer and/or their insurance company must deliver your compensation by check or electronically. Your benefits are given on a weekly basis, and you may be compensated from the fourth day since your injury.
Important Procedures While Receiving Workers' Compensation Benefits
If you receive incapacity benefits for 26 consecutive weeks, you will be subjected to a medical review. Some of the things that an impartial medical examiner will examine include:
Your degree of functional disability and/or impairment.
The extent and nature of your disability.
The expectation of further medical improvement.
Any additional medical care and/or rehabilitation services that may be required to achieve maximum improvement.
You and your employer’s insurer will receive the results of the medical review within 14 days. If you fail to appear for the examination, your benefits may be stopped or canceled. Meanwhile, if you continue to get weekly benefits after the first medical review, you will be required to attend a medical evaluation every 13 weeks.
If you receive weekly benefits for at least 52 weeks, you will be subjected to an anniversary review.
Can You Go Back to Your Job After Recovering from Your Illness or Injury?
According to Rhode Island's workers' compensation laws, you have the right to return to your job if you are finally able to work reasonably. Even if a replacement has filled the post while you are recovering from your injuries, the position is still deemed "available" to you.
If the position is no longer available, you can return to work in another suitable and unoccupied role. You must claim that you are available to work within 10 days after your physician has released you for work.
It is deemed an unlawful employment practice if your employer decides to break this provision by refusing to let you return to work. In case you are involved in such a situation, you can reach out to the Department of Labor and Training's Education Unit via DLT.WCEdcUnit@dlt.ri.gov or 401-462-8100.
It should be noted that the right to reinstatement does not apply to workers hired temporarily, on probation for less than 91 days, in a seasonal occupation, or with an employer with fewer than 10 workers at the time of their injury.
Moreover, a Physician's Notice of Release to Work must be submitted to your employer and their insurer within three days after you have been released by your doctor.
What Should One Do If a Workers’ Compensation Claim in Rhode Island Has Been Denied?
File a Petition with the Rhode Island Workers' Compensation Court
You have 20 days to submit a petition with the Rhode Island Workers' Compensation Court if:
Your employer fails to make a workers' compensation claim for you.
Your employer’s insurer denies your claim.
You are unable to receive benefits after having your claim approved.
Filing a petition costs $40.75 ($20 for the filing fee and $20.75 for the electronic filing fee), which should be paid to the Workers' Compensation Court administrator. A copy of the petition must be sent to your employer and their insurance carrier within 10 days of filing.
After submitting the petition, the court will schedule a pre-trial hearing within 21 days of document receipt. This hearing aims to resolve your issue through a settlement. If you fail to attend this hearing, the judge handling your petition has the right to grant, refuse, or dismiss your petition with or without prejudice.
If no agreement can be reached, the court will hold an initial hearing to work on the issues surrounding the dispute. These may include discussions on wages and disability benefits.
After the initial hearing, your dispute will go to trial. You will present your argument during this time. Gather evidence, such as medical documents and test findings, to establish a compelling case for why your claim should not be refused. Witness testimonies may also be presented. The judge will then decide whether to grant or deny your petition.
File an Appeal to the Appellate Division of the Workers' Compensation Court
If your petition has been denied, you can make an appeal to the Appellate Division of the Workers' Compensation Court within five days following the decision. Filing an appeal costs $45.75 ($25 for the filing fee and $20.75 for the electronic filing fee).
The chief judge will assemble a panel of three judges to investigate the dispute. Following the review, the panel may either reverse the trial court's ruling and enter a new decree in accordance with their decision, dismiss the appeal, or partially reverse the decision and alter the earlier decree.
File a Writ of Certiorari with the Rhode Island Supreme Court
If your appeal has been denied, you can file a Writ of Certiorari with the Rhode Island Supreme Court as your last resort. The Supreme Court can choose to deny or accept it and review the decision of the Appellate Division.
Legal Resources for Injured Workers in Rhode Island
Rhode Island Department of Labor and Training
The Rhode Island Department of Labor and Training offers various services to employees and employers, including workforce training, development, and protection. It has a Workers' Compensation Division that regulates the state's workers' compensation system, ensuring that injured workers are protected, employers have insurance coverage, and claims are handled and paid correctly. The division oversees the Chief Judge Robert F. Arrigan Rehabilitation Center, a nonprofit outpatient rehabilitation facility that treats workers' injuries.
Employees who believe their employer has no workers' compensation insurance should contact the Fraud Unit by calling 401-462-8100 or emailing firstname.lastname@example.org.
Rhode Island Bar Association
Since 1898, the Rhode Island Bar Association has been providing legal services to the general public. Its Lawyer Referral Service program helps people connect with a lawyer based on their type of case, region, and, if applicable, additional language spoken. Workers' compensation, civil litigation, personal injury, and insurance are among the legal matters the program handles.
The group’s website also has a section on legal resources and background information that can assist site visitors with their legal issues. Call 401-421-7799 for more information.
Rhode Island Legal Services, Inc.
Rhode Island Legal Services, Inc. caters to individuals and families from low-income households throughout the state. It offers legal counsel and representation in various practice areas, including employment law, consumer law, public benefits, and healthcare. Its Public Benefits Group, in particular, concentrates on aiding clients with issues regarding government benefits, including denials or terminations in appellate courts and administrative tribunals. Residents who are interested in its services can submit an application online.
It also has the Volunteer Lawyer Program, through which over 1,000 private attorneys from across the state provide free legal assistance to qualified individuals. You can learn more about the service by calling 421-7758 or 1-800-339-7758.
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