Rhode Island law requires employers with one or more employee to have workers’ compensation coverage. Employers often fulfill this obligation by purchasing a workers’ comp policy from an insurance company, which reviews and pays out claims. The Rhode Island Division of Workers’ Compensation oversees the administration of workers’ compensation in the state.
Workers’ compensation covers injuries that happen in the course and scope of employment. Injuries that happen at work, or that happen off-site while the employee is performing work-related tasks, are typically covered. Although workers’ comp is a no-fault system, injuries caused by certain misconduct are typically not covered. For example, injuries caused by the worker’s own intoxication or by initiating a fight with a coworker are not covered. (For more information, see Workers’ Compensation: Is Your Injury or Illness Work-Related?)
To start your workers’ compensation claim, you should report your injury to your employer right away. While you have 30 days by law, it’s best to give notice as soon as you know you have a work-related injury. The sooner you make your claim, the sooner you can receive medical treatment and benefits.
Once your employer has received notice, it must notify its insurance company. The insurance company will fill out a First Report of Injury and submit it to the Division of Workers’ Compensation. The insurance company will then evaluate your claim. While there is no specific deadline, the insurance company usually makes a decision within 21 days.
Workers’ compensation pays for all reasonable and necessary medical treatment related to your work injury. This includes the cost of doctors’ visits, hospital stays, prescriptions, and medical equipment. In Rhode Island, employees are allowed to choose their own initial treating doctors. However, if you want to switch doctors at a later time, you will need to check with the insurance company first.
If you need time off work due to your injury, you may be eligible for temporary total disability benefits. These are weekly payments based on a percentage of your average wages before you were injured. If you are able to do some work while recovering from your injury, you will receive partial benefits. If it turns out that you have a permanent disability as a result of your work injury, you can also receive a lump sum award.
If the insurance company denies your claim, or if you haven’t heard from the insurance company within 21 days of giving notice, you can petition the Rhode Island Workers’ Compensation Court for benefits. (For common grounds for a denial, see Denied Workers’ Compensation Claims.) You must do so within two years of the date of your injury; otherwise, you will lose your right to collect benefits.
Many workers can handle the initial workers’ comp claim process on their own. However, if the insurance company denies your claim or disputes the amount of benefits you are entitled to, you should consider hiring a lawyer. This is especially true if you need to attend a workers’ comp hearing, which follow complex procedural rules. For more information, see Should I Hire a Workers’ Comp Attorney or Can I Handle My Own Case?