Para la traducción hacer clic en el cuadro de arriba
Para tradução em Português, por favor clique a caixa em cima

Skip to Main Content

Home Unemployment/TDI Workforce Development Governor's Workforce Board Regulation & Safety Workers' Comp Labor Market Information

 

I have been injured at work - What should I do?

Information for Workers Injured on the Job

 

Report your injury to your employerREPORT YOUR INJURY to your Employer's workers' compensation designee or human resource department. At this time, your employer must file a claim with their workers' comp. insurance carrier.


Your employer's insurance company will file a first report of injury and determine if your injury is work related and if you are eligible for workers' compensation.

 

 

 

 

 

 

 

 


The RI Workers' Compensation System is a form of no fault insurance designed to provide assistance to employees injured at work for medical expenses and/or lost wages. The employer buys an insurance policy to cover accidents to employees in the workplace. The employer's insurance company pays claims that are covered under the employer's insurance policy.

Employers with one or more workers are required to carry workers' compensation insurance. Sole proprietors, partners, certain real estate, agricultural and domestic service employees are not covered. Police, firefighters, and federal employees are covered under different compensation programs. Municipal employees are only covered if the municipality has chosen to be covered. Independent contractors are not covered.

Covered employees who are injured at work or who become ill from working may be eligible to collect workers' compensation benefits. If your injury or illness is not work-related, a different program, such as Temporary Disability Insurance or Social Security Disability may provide benefits.

Frequently Asked Questions:
Click the question to display the answer

1. How do I file a Workers' Compensation (WC) Claim?
If you are injured on the job, or have an illness caused by your workplace, you must notify your employer. Your employer will notify their WC Insurance Company. The insurer will file a First Report of Injury to start the process.

2. Who is covered by Workers' Compensation insurance?
By law, employers with 1 or more employees must carry workers' compensation insurance.

Sole proprietors, partners, certain real estate, agricultural and domestic service employees are not covered. Police, firefighters, and federal employees are covered under different compensation programs. Municipal employees are only covered if the municipality has chosen to be covered. Independent contractors are not covered.


3. Who can collect Workers' Compensation benefits?
Covered employees who are injured at work or who become ill from working may be eligible to collect workers' compensation benefits. If your injury or illness is not work-related, a different program, such as Temporary Disability Insurance or Social Security Disability may provide benefits.

4. What are the injured worker's responsibilities?
Seek immediate medical attention and report the injury or illness to your employer immediately or as soon as you realize it is work related. If the injury incapacitates you from earning full wages for at least 3 consecutive days or requires medical treatment, your employer is required by law to notify the insurer to file a First Report of Injury form with the Division of Workers' Compensation within 10 days of the actual injury or knowledge of it. The employer must file within 48 hours if the injury is fatal.

5. What are workers' compensation benefits and how are they determined?
Workers' compensation monetary benefits may begin on the fourth day from the date of injury. You may also be entitled to medical treatment, benefits for disfigurement or loss of use, and/or participation in rehabilitation. Dependents of employees who suffer a work-related fatality may also receive benefits.

There are several types of weekly benefits paid under workers' compensation:
Total disability benefits apply if the employee is physically unable to earn any wages in any employment. The weekly compensation rate for total incapacity is equal to 75% of your spendable base wage. Supplemental earnings and bonuses are considered in determining your benefit rate. 

Partial disability benefits apply if the employee's ability to earn full wages is affected but the employee is not totally disabled. When the employee reaches maximum medical improvement, the Workers' Compensation Court may reduce the employee's compensation rate. 

Dependency allowance benefits are $15.00 per dependent per week for total disability, and $40 per dependent per week for fatality benefits. There is no dependency allowance for partial disability.


6. Who chooses my medical care provider? May I change doctors?
You may choose your first medical care provider. Treatment at an emergency room after the accident or by a company physician does not count as the first medical care provider. Your first provider may refer you to a specialist without prior approval from the insurer. No matter who your treating physician is, you are entitled to receive a report from him or her within 10 days of each visit.

If you decide to change doctors, you must first find out if your insurer or self-insured employer has an approved list of physicians, known as a "preferred provider network". If so, you must either select a physician from that list or get the approval of your insurer or self-insured employer before you see another doctor. To find out if a list of physicians exists, contact your employer/insurer. If your employer or insurer does not have an approved list of physicians, these restrictions do not apply.

7. Who pays the medical bills?
Medical bills related to the injury should be paid in full by the employer's insurance company. There are no co-payments or deductibles.

8. How do I find my employer's insurer? Will I receive written notice from the insurer?
The name of your employer's insurer should be posted on the Workers' Compensation Act poster in accordance with RI General Law §28-29-13. If you need help in determining the name of your employer's insurer, contact the Fraud and Compliance Unit at (401) 462-8100 or email DLT.WCFraud@dlt.ri.gov.

The insurance company may offer you a Memorandum of Agreement (MOA), sent by certified mail, return receipt requested. The MOA means the insurance company accepts liability for your injury and should start sending you weekly benefits payments within 14 days. Or, the insurance company may offer you a Non-Prejudicial Agreement. This allows the insurer to begin paying you weekly benefit payments without accepting liability for the injury for up to 13 weeks. The insurer can stop benefits at any time.

Within 10 days of when benefits stop, the insurer must send you a notice called a Termination of Benefits. If you receive weekly payments for more than 13 weeks, the insurer should issue a Memorandum of Agreement. If the insurer stops payments or you return to work before 13 weeks has passed, you have two years from the date of injury to file a petition with the Workers' Compensation Court to determine if the insurer is liable for the injury.

If you have not received any notice from the insurer within 21 days from the date you notified the employer of the injury, you may file a petition for weekly benefits at the Workers' Compensation Court. The insurer is not obligated to file anything or to do anything to let the employee know if the claim is contested.


9. Are there limits on medical care?
There are palliative care limits: After maximum medical improvement has been reached, treatment to alleviate the effects of the injury is limited to 12 visits or care rendered within 60 days, whichever comes first. Any additional palliative care must receive prior approval from the insurer.

10. What rehabilitation benefits are provided?
You are entitled to any necessary rehabilitation services to help you regain the ability to return to work. The Arrigan Rehabilitation Center provides physical, vocational, and psychological rehabilitation services for people injured at work. If you have questions about rehabilitation, call the Arrigan Center at (401) 243-1200.

11. What is the Medical Review/Impartial Medical Exam?
If you receive weekly incapacity benefits for 26 weeks, the Administrator of the Medical Advisory Board will schedule an examination for you by an impartial medical examiner or a comprehensive independent health care review team. The results of the exam will be provided to you within 14 days. Failure to appear for this exam may be reason for suspension and termination of benefits. Repeat examinations will be scheduled every 13 weeks while your are receiving weekly benefits.

12. What is the Anniversary Review?
The Workers' Compensation Court schedules an anniversary review once a year for all employees who continue to receive ongoing weekly benefits.

13. What is a Suspension Agreement?
If the insurer made payments to you under a MOA, you may be asked to sign a Suspension Agreement. Signing a Suspension Agreement means that you agree to end weekly benefits payments. The insurer continues to be responsible for all reasonable medical expenses relating to your injury. The law allows you up to10 years to reopen your claim.

14. Can I return to my job?
In most cases, you have the right to return to your former job if you can perform your job duties with reasonable accommodation by your employer. This is known as your right to reinstatement. You must claim your right to reinstatement within 10 days from the date you are notified by mail that the treating physician has released you for work. You are entitled to reinstatement even if the job has been filled by a replacement. If that position is unavailable, you are entitled to reinstatement to any other vacant and suitable position.

If you have been denied this right, or if you would like additional information, contact the Education Unit at (401) 462-8100, or DLT.WCEdcUnit@dlt.ri.gov. These requirements are subject to union contract and to the Americans with Disabilities Act.

15. What is Coordination of Benefits?
There may be an offset (a reduction) of weekly compensation benefits for people who are entitled to retirement benefits. This offset will not include any benefits derived exclusively from the employee's contribution. There will be no offset for those collecting retirement who are injured before age 55 and are injured more than five years before their retirement date. No workers' compensation benefits can be collected after retirement for persons who are injured less than 2 years before retirement.
16. Can I collect Unemployment Insurance (UI) while collecting Workers’ Compensation Benefits?
No. You cannot collect both programs at the same time. In order to collect UI benefits you must be able, available and actively looking for work.

17. When released from Workers’ Compensation, can I file for UI Benefits?
Yes. You can file for UI Benefits once you are able and available for full time work and released from your doctor with written authorization to return to work. Eligibility will be determined after you file a UI claim.

18. What is the Fraud and Abuse provision?

Fraud and abuse provisions include penalties of up to $50,000 or double the amount of the fraud, imprisonment of up to 5 years or both:

- imposed on attorneys and clients for willful abuse of court proceedings
- for obtaining benefits through fraud or misrepresentation
-
for obtaining workers' compensation insurance through fraud or misrepresentation
- for making false statements to discourage a lawful compensation claim

False statements include:
- endorsement of a benefit check if benefits were obtained through fraud or misrepresentation
- false bills
-
misrepresentation on application for insurance

Employees entitled to weekly compensation benefits must report any earnings so that the amount of benefit can be calculated properly.


19. Who can I contact if I have more questions about workers' compensation?
If you have problems or questions about workers' compensation, call the Education Unit at (401) 462-8100 or email the Education Unit at DLT.WCEdcUnit@dlt.ri.gov














































 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WC Home | Find Coverage | Injured Workers | Insurers/Adjusters | Employers | Independent Contractors | Medical Providers | Education | Forms | Report Fraud | Frequent Questions


 

Labor Market Info | Temporary Disability/Caregivers | Unemployment | Workers' Comp | Workforce Development | Workforce Regulation Safety

RI.gov | R.I. Government Agencies | Privacy Policy |
Rhode Island State Seal An Official Rhode Island State website.

DLT is an equal opportunity employer/program - auxiliary aids and services available upon request. TTY via RI Relay: 711

   

4/18/20