The Answers You Need for the Questions You’re Forced to Ask
One of the worst aspects of pursuing a case—whether you’re fighting for injury compensation or trying to settle a divorce—is not knowing what to expect. Before you get yourself knee deep in the details of your case allow us to answer some of your questions first. We’ll help you be more fully prepared and more confident as you move forward.
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Can I get workers’ comp for a pre-existing condition that was aggravated at work?
It is not uncommon for a worker with a pre-existing injury to be reinjured due to an incident on the job. When this happens, Rhode Island laws allow employees to collect workers’ compensation for a pre-existing injury that has been accelerated or aggravated by workplace conditions. However, these claims tend to be more complicated than others because it may be difficult to separate the previous condition from the current injury.
Pre-Existing Injuries That May Qualify for Workers’ Comp
Insurance companies that provide workers’ compensation benefits will not want to cover an injury if the employer is not liable. For this reason, the insurer may deny coverage if there is more than one cause of injury, forcing the employee to prove that an injury is work-related in order to receive benefits.
Rhode Island workers’ compensation laws allow employees to recover benefits for prior injuries in the following cases:
- An aggravated injury to an impaired part of the body. If you previously suffered a back injury, ankle sprain, broken bone, or other injury before employment, workers’ compensation will not cover treatment for that injury. However, if the injury was made worse as a result your current employment, you may be able to collect benefits to treat the aggravation.
- A re-injury. If you injured a part of your body and collected benefits for that injury through your current employer and then re-injure the same part of your body, the second injury is still covered by workers’ compensation. You should be covered for the full amount of your new medical costs, but your previous awards may be used when calculating the financial amount you receive.
- Illnesses and diseases. Some employees are more at risk of certain illnesses from environmental hazards such as employees with severe allergies. Employees may have a claim for workers’ compensation if workplace hazards caused a flare-up of symptoms or made the extent of the condition worse.
If you are unable to work because of an injury on the job, the attorneys at Kirshenbaum & Kirshenbaum can examine the details of your case, answer your questions, and help you through your next steps. To speak with a member of our team, simply fill out the online contact form on this page, or give us a call.
What happens to my workers’ comp benefits if my insurance provider goes bankrupt?
Although most injured employees eventually return to work, the workers’ compensation system provides benefits that could potentially last for the rest of an employee’s life. If your benefits suddenly stop because the insurance company is no longer in business, you still have options. Talking with a workers’ compensation attorney about those options is beneficial for continuing compensation.
Collecting Workers’ Comp After an Insurer Goes Bankrupt
Employees who are receiving permanent partial disability benefits can be forced into serious physical and financial difficulties if an insurer can no longer provide benefits. If your workers' compensation benefits have been suspended due to bankruptcy, you can seek payment through:
- A new insurance provider. According to the law, it is your employer’s responsibility to secure workers’ compensation insurance. If your old insurer has gone out of business, it is the employer’s duty to secure a new policy or self-insure, meaning the company itself would be liable for your injury payments.
- Your employer. If your employer has allowed insurance to lapse and has not secured a new policy, employees can sue the employer directly to recover the costs of an injury. If the employer and insurer have both filed for bankruptcy, employees can seek compensation from the Uninsured Protection Fund.
- The Uninsured Protection Fund. In March, Rhode Island lawmakers passed an amendment to the Rhode Island Uninsured Protection Fund (UPF) guaranteeing injury payments for employees of uninsured employers. The fund provides payment for disability (incapacity) and reimburses the employee for any court costs needed to pursue the case. However, the UPF does not pay for past or future medical expenses, loss of function, or disfigurement.
The attorneys at Kirshenbaum & Kirshenbaum can answer your questions and help you through the claims process at no cost to you. To speak with a member of our team, simply fill out the online contact form on this page, or give us a call.
How long do I have to be employed to be eligible for workers’ compensation?
In Rhode Island, all workers who are classified as non-exempt employees are entitled to workers’ compensation medical and wage loss benefits. If you are covered under the law, you qualify for benefits even if you are injured on the first day of the job. However, if you’re employed under another worker classification, it may affect whether you are covered under Rhode Island Workers' Compensation laws.
Employees Exempt From Rhode Island Workers' Comp
To qualify for Rhode Island workers’ compensation benefits, you don’t need to be employed for any specific length of time, be a United States citizen, or be properly documented to work in the U.S. However, you do have to qualify as a covered employee.
Employees who may not be covered under workers’ compensation include:
- Independent contractors or workers who are performing certain contracted tasks or do not meet the definition of an employee
- Agriculture employees, including farmers, nursery operators, or farm laborers whose employers do not employ 25 or more farm laborers or agricultural employees for at least 13 consecutive weeks
- Domestic service employees such as babysitters, housekeepers, or nannies
- Any licensed real estate broker or salesperson whose payment is earned through a salary or commission (rather than payment for the number of hours worked)
In some cases, covered employees may be told that they are exempt from workers’ compensation benefits when this is not the case. For example, large scale agricultural employees (who work for a person or company with 25 or more workers) who receive pay for growing or harvesting fruit and vegetable crops, working in orchards, harvesting lumber, participating in dairy farming, or raising livestock may be eligible for benefits. The best way to determine eligibility is to discuss your case with an experienced workers’ compensation attorney.
If you have suffered a work injury, the legal team at Kirshenbaum & Kirshenbaum can help. Simply fill out the online contact form on this page, or call us to set up a consultation with us.
How can I be sure my employer has workers’ compensation insurance?
It is up to each individual employer in Rhode Island to contact an insurance agent and select workers' compensation coverage that meets the requirements of state law. Employees can quickly and easily determine whether an employer has an insurance policy in place or if an employer is non-compliant. Additionally, an employee can report the employer to the Department of Labor & Training.
Exemptions to RI Workers' Compensation Requirements
Under Rhode Island Workers' Compensation law, every person, firm, public service, or private corporation that has regular employees is required to carry workers’ compensation insurance. Employees can check the Rhode Island database of insured employers at the Director of the Department of Labor & Training to verify that their company has workers' compensation insurance in place.
However, there are employers and organizations that may not be required to carry workers’ compensation insurance, and there are employees who may not be covered. These include:
- Sole proprietors and partnerships. If you work for an organization that is registered with the state as a sole proprietorship or business partnership, the company may not be required to carry workers' compensation coverage.
- Government employees. Federal employees (such as postal workers, police, and firefighters) are covered under federal compensation programs, while municipal employees may only be covered if the municipality has elected to purchase insurance.
- Special services employees. In Rhode Island, certain real estate, agricultural, and domestic service employees are not covered by workers' compensation.
- Self-insured employers. Some employers may pay for the costs of a work injury out of their own profits instead of purchasing workers’ compensation insurance, while others may not be listed due to limitations with the policy information.
- Employers who are breaking the law. If employees are unable to verify coverage, the employer may be noncompliant or committing worker’s compensation fraud. Employees can check by emailing [email protected]
If you have suffered a work injury, the workers’ compensation attorneys at Kirshenbaum & Kirshenbaum can help. Simply fill out the online contact form on this page, or call us to set up a consultation with our legal team.
Is it legal that my employer self-insures instead of purchasing workers’ compensation insurance?
All employers who are subject to the Workers' Compensation Act are required to carry workers’ compensation insurance under Rhode Island law. However, it is possible for employers to pay for the costs of a work injury out of their own profits instead of purchasing workers’ compensation insurance (known as self-insuring). These employers must meet eligibility requirements and go through a certification process in order to legally provide benefits to injured workers.
Rules for Self-Insured Employers in Rhode Island
There are a few different ways an employer can offer its own workers’ compensation benefits, such as self-insuring by statute (applies to municipalities), or to become certified by the Department of Business Regulations as part of a self-insurance group. The most common way for businesses to self-insure is to be certified by the state Division of Workers' Compensation (DWC). The certification process takes approximately 60 days and requires:
- Proof of financial guarantee. Every applicant for workers’ compensation self- insurance must be financially secure and must provide evidence of guarantee of coverage with minimum limits of several thousand dollars. Applicants may also be required to carry commercial stop-loss insurance during their first five years of self- insurance to ensure all employee claims will be paid.
- DWC investigation. A DWC investigation may include employer site inspections, feasibility studies, financial obligation requirements, records from a parent guarantor; bonding and payment facilities, and other requests necessary to satisfy the DWC that the employer is eligible for approval or re-certification.
- An administrative hearing. Initial approval will only be granted after a hearing before the Director of the Department of Labor & Training to review the results of the DWC investigation.
- Adherence to workers’ compensation rules and regulations. Self-insured employers are still required to comply with all requirements of workers’ compensation laws, including data processing regulations, workers’ compensation procedures, and the rules and orders of the Workers’ Compensation Court.
- Commitment to payment and reporting standards. Employers are responsible for paying application fees and yearly assessments to the RI Workers’ Compensation Fund, submitting payroll records and other documents to the DWC in a timely fashion, and renewing certification every year to prevent lapses, revocation, or expiration.
If you need help accessing your workers’ compensation benefits, simply fill out the online contact form on this page, or call Kirshenbaum & Kirshenbaum to set up a consultation with our work injury attorneys.
Should I accept a workers’ compensation settlement?
Rhode Island workers’ compensation settlements are usually final decisions. That means, once you and the workers’ compensation insurance company agree to a settlement, you are unlikely to get any future compensation for your workplace injuries. Thus, you need to make sure that the settlement fairly compensates you for all of your injuries before you accept it.
Types of RI Workers’ Compensation Settlements
In Rhode Island, you may agree to one of the following types of workers’ compensation settlements:
- Denial and Dismissal Settlement. This type of settlement is used in disputed claims and settles before liability is determined. The injured worker agrees that his claim will be denied and dismissed in exchange for payment. The insurance company pays out a lump sum to the employee but doesn’t acknowledge liability, and the employee must pay all medical bills as a result of the injury. Often, the employee will be asked to resign from his position as a condition of the settlement.
- Commutation Settlement. In this type of settlement, the insurance company has already admitted liability and has paid your workers’ comp benefits for at least six months. The settlement will be for all the rest of the workers’ comp benefits you may receive.
Both types of settlements are final, and you give up your right to receive any future workers’ comp benefits, including medical coverage, beyond what is included in the settlement that you sign.
We Can Help With Your Workers’ Comp Settlement
It’s important that you understand the extent of your injuries before accepting a workers’ compensation settlement. Thus, your doctor should determine that you’ve reached maximum medical improvement for your injuries or illness.
Before you accept any settlement, you should consult with our experienced Rhode Island workers’ compensation attorneys. We will review your medical records and the proposed settlement amount to make sure that the settlement provides you with fair compensation under Rhode Island law. Call us, or reach out to us via this website today to learn more.
Can an employer fire me for filing a workers’ compensation claim?
While most people know that workers' compensation provides medical and lost income benefits to workers who suffer an injury on the job, they may not know of the additional employment protection it affords a worker after filing a claim. Some employers may be tempted to threaten or harass an employee to discourage him from filing a claim, or the employer may simply want to fire the employee. If this happens, employees can take action against the employer to recover civil damages for unfair treatment.
Protection From Employer Retaliation
To ensure that employees are able to collect their work injury benefits without punishment, workers’ compensation laws prohibit employers from taking adverse action against a worker who has brought a claim in good faith. The employee is protected from retaliation immediately after the qualifying injury occurs, even before the claim is filed or the employer notified of the accident.
Under workers' compensation laws, employers are forbidden from retaliating against workers in the following ways:
- Termination. Workers' compensation laws typically prevent an injured worker from suing an employer. However, if the employee was laid off or fired because he sought workers’ compensation benefits, he may bring a retaliatory discharge lawsuit against the employer.
- Workplace harassment. Employers may make threats against employees who file claims, including blacklisting them from future job opportunities.
- Discriminatory treatment. Discrimination can come in many forms, including disciplinary action, salary reduction, demotion, being passed over for promotion, or being assigned a new title or another position.
- Forced leave. Employers cannot force an employee to use or forfeit accrued paid time off, paid medical leave, pension benefits, or other earned income in lieu of workers’ compensation income replacement benefits during recovery.
If you believe you have been discriminated against or discharged in retaliation for seeking workers’ compensation benefits, we can examine the details of your case and help you get what you’re owed for your injury. Simply fill out the easy online contact form on this page, or call Kirshenbaum & Kirshenbaum to set up a consultation with our work injury attorneys.
What penalties can an employer face for not having workers’ compensation insurance?
Employers can face significant penalties for failing to protect their employees with workers’ compensation insurance. First, the employer can be ordered to pay a fine of up to $1,000 per day for each day insurance is not provided. Employers can also face criminal felony charges, which carry a sentence of up to two years imprisonment and/or a fine of up to $10,000 upon conviction. Finally, if the failure to secure workers’ compensation insurance is determined to create a significant danger to employees, business operations can be suspended until workers' compensation and employers' liability insurance is secured.
When Your Employer Doesn’t Provide Workers’ Comp
If you suspect your employer does not have insurance, you can report Rhode Island workers’ compensation fraud to the Fraud Prevention and Compliance Unit. As long as you make a complaint to the Fraud Unit in good faith, the employer cannot take any legal action against you for making the report.
The Fraud Unit can help in a variety of matters concerning bad faith on the part of an employer, including:
- Premium fraud. Employers may not have sufficient insurance to cover work-related injuries due to premium fraud such as underreporting the number of employees in order to pay less for insurance. Premium fraud is a criminal offense.
- Falsifying claims information. Any employer who intentionally makes false statements to prevent an employee from filing a claim or obtain benefits may be prosecuted.
- Encouraging fraud. Employers may be charged with a criminal offense if they encourage workers not to file claims or command workers to report any work-related injuries they suffer as happening outside the workplace.
- Penalties. Any person convicted of workers’ compensation fraud may be ordered to pay monetary penalties up to $50,000 and face imprisonment for up to five years.
If your employer did not secure workers’ compensation insurance, you and your fellow employees are not prohibited from filing lawsuits against the employer. For this reason, you should speak to an attorney as soon as possible after an injury at work. Simply fill out the easy online contact form on this page, or contact Kirshenbaum & Kirshenbaum at 401-946-3200 to set up a consultation with our work injury attorneys.
Is workers’ compensation paid under state or federal law?
In Rhode Island, any worker employed by a private employer, state agency, or local government is owed benefits under the state workers' compensation board. However, there are some Rhode Island residents—such as federal workers or maritime employees—who may qualify for workers' compensation under a federal law.
Qualifying for Federal Workers’ Comp Benefits
While the majority of workers’ compensation programs are administered under state law, some workers are exempt from state workers’ compensation due to the location, risks, or injuries associated with their work. In these cases, injured workers can collect wage replacement benefits, medical treatment, vocational rehabilitation, and disability payments through the U.S. government.
Federal laws make compensation for a work-related injury or an occupational disease payable to:
- Federal and postal employees. The Federal Employees' Compensation Act grants workers' compensation benefits to millions of federal employees, including postal workers. Injured federal employees can make a claim for benefits through the nearest district office of the Division of Federal Employees' Compensation (DFEC).
- Maritime employees. Employees who work on open water, oil rigs, or offshore platforms can collect injury benefits under federal maritime laws, including the Longshore and Harbor Workers' Compensation Act (LHWCA), Defense Base Act (DBA), and Jones Act.
- Energy employees. The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) provides compensation to current or former employees of the Department of Energy (DOE) who have been diagnosed with a radiogenic form of cancer after exposure to radiation, beryllium, or silica during their term of employment. The EEOICPA also provides survivors’ benefits to families of employees who have died as a result of work-related radiogenic cancers.
If you are seeking compensation after an injury at work, our attorneys can examine your situation and help determine how much you’re owed for lost wages, medical bills, and other accident costs. Simply fill out our easy online contact form, or call Kirshenbaum & Kirshenbaum to set up a consultation with our work injury attorneys.
Can the family sue for wrongful death if their loved one received workers’ comp death benefits?
Rhode Island workers’ compensation statutes guarantee benefits to injured workers regardless of fault, which is beneficial to both workers and employers. In exchange for these guaranteed benefits, an injured employee is prohibited from suing an employer for any costs related to the accident. However, there may be exceptions to this rule for the survivors seeking compensation after the wrongful work death of a loved one.
How Survivors Get Compensation After a Wrongful Work Death
If your spouse or loved one died in a wrongful work death, you may experience many different kinds of loss. You may face economic problems caused by lost income and financial difficulties due to medical bills and funeral costs. But surviving family members may obtain compensation through:
- Workers’ compensation. Workers’ compensation should pay for any medical bills that were incurred due to a work-related death. In addition, workers’ comp death benefits provide up to $15,000 to the deceased employee’s dependents to help with funeral and burial expenses, as well as weekly wage payments to the deceased employee’s spouse. However, workers’ compensation does not allow for non-economic damages such as pain and suffering and punitive damages.
- A lawsuit against a negligent employer. Workers’ compensation death benefits often provide far less than the surviving family members need to recover. For this reason, Rhode Island law allows family members to sue employers in cases where an employer directly or deliberately caused the action that resulted in their loved one’s death. These kinds of cases take extensive legal knowledge to win, since survivors must prove that a company deliberately and knowingly placed their loved one in unreasonable danger.
- Third-party cases. If you are barred from suing your loved one’s employer, you can still sue another party whose negligence contributed to the death. These third-party claims involve someone other than the employer (such as a property owner, maintenance company, project manager, or defective product manufacturer), and there are no limits on the types of damages that may be collected.
If your loved one died in a work accident, our attorneys can gather evidence on your behalf and help get you the compensation and justice you deserve. Contact Kirshenbaum & Kirshenbaum via our online contact form to schedule an initial consultation at no cost to you.