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Your Right to Benefits

With a few exceptions, if you are employed in Rhode Island and suffer a work-related injury or an occupational illness, you have a right to workers’ compensation benefits under the Rhode Island system.

The Rhode Island workers’ compensation program is a “no-fault” insurance program. An injured or ill employee eligible for benefits does not have to show that the employer caused or was at fault for the employee’s injury or illness.

Availability of Workers’ Comp Benefits

In Rhode Island, the workers’ compensation program provides money to help injured workers to pay medical and rehabilitation expenses. It also can replace lost wages during their recovery.

The recovering worker has the right to choose his or her own health care, diagnosis and treatment from any qualified health care provider initially. The employer may compel the worker to see the employer’s preferred medical providers for subsequent care, but this does not restrict the worker from seeing the doctor, therapists, etc., he prefers on his own.

Workers’ compensation also provides disability payments for workers who will not be able to resume employment, and death benefits to families of workers who have died in workplace accidents.

The various benefits are paid according to formulas set by the Rhode Island Department of Labor and Training’s Division of Workers’ Compensation. An injured employee’s employer files the benefits claim, since it is a claim against insurance the employer holds.

The Workers’ Compensation Court handles legal disputes, or appeals of benefit denials or awards. The Medical Advisory Board provides oversight and guidance for medical treatment provided for injuries covered by workers’ compensation. The Department of Business Regulations regulates the rates and licenses of insurers who write workers’ compensation insurance.

Challenging the Rhode Island Workers’ Compensation System

It isn’t difficult to see how disagreements can arise if benefits are denied or the amount of benefits that are awarded do not meet the needs of a worker recovering from an on-the-job injury or of the surviving family of someone who has died after suffering a workplace injury. It is also easy to see how a worker struggling to recover from a debilitating injury could become overwhelmed by a government bureaucracy deciding his financial fate.

Filing a workers’ compensation claim after a workplace injury and then receiving benefit checks is not always as simple as it may sound. Like any insurance program, it is not in the insurer’s financial interest to pay claims. In some cases, an employer has not obtained the workers’ comp coverage the law requires.

Even when an injury clearly occurred while a worker was on the job, workers’ compensation insurers can and often do dispute the idea that the worker’s injury was related to his or her job. Various complicated court cases in Rhode Island have revolved around the relationship between the worker’s injury and their job.

When a worker’s claim for workers’ compensation benefits is denied, or benefits that are approved are not satisfactory, the worker has the right to file an appeal challenging that decision.

The Workers’ Compensation Court requires a nominal fee to file an appeal, and the court itself recommends that workers who appeal workers’ compensation decisions hire an attorney. Once notice of appeal is filed with the court, a pre-trial hearing will be scheduled within 21 days.

The appeals process has several levels of decisions, and the injured worker has several options for appealing decisions that are not satisfactory, including a courtroom trial and, if necessary, appealing the outcome of the trial to a three-judge panel.

As a workers’ compensation case makes its way to court, the workers’ compensations system assumes that the injured worker will have obtained legal help. For instance, a worker appealing a workers’ compensation ruling is not allowed to speak to the judge about their case. “All correspondence should be made through your lawyer,” the Workers’ Compensation Court says.

Contact Our Rhode Island Workers’ Compensation Lawyers Today

Because they must address any likely circumstance involving an on-the-job injury or illness, the regulations and procedures of the Rhode Island workers’ compensation system are complex and voluminous. Trying to work your way through them for the first time, on your own, can easily overwhelm anyone.

The Rhode Island workers’ compensation attorneys of Gemma Law Associates, Inc., represent workplace injury victims and their families in workers’ compensation claims across Rhode Island. We help workers in Providence, Pawtucket, Warwick, Newport, Cranston, Bristol and Woonsocket. If you are an out-of-state worker injured at a Rhode Island jobsite, we can help you, too.

Contact our Rhode Island workers’ compensation lawyers today at our toll-free number or through our online form. We will provide a free and confidential evaluation of your case and help you determine your legal options.