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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What is a work-related injury?
There are many types of injuries covered by workers' compensation, but all of them have one thing in common: they are connected in some way to the victim's employment situation. However, employers and employees may have differing opinions on whether an injury can be considered “work-related.” The precise definition of “work-related” is important because it can affect eligibility for workers’ compensation benefits.
Work-Related Injuries Under RI Workers Compensation Laws
Under Rhode Island workers' compensation laws, the first qualification of a work-related injury is employment status. To collect benefits, you have to be an employee (rather than a day worker or independent contractor) who has suffered a compensable injury during the course of employment.
An injury may be considered “in the course of employment” if it occurs:
While on your regular shift.
Many on-the-clock injuries are related to employment because the employee is at the workplace and performing regular job duties. However, off-the-clock injuries can also qualify for workers’ compensation.
At the workplace.
If you were not officially working at the time of the injury (such as on a lunch break), the injury may still qualify as work-related if it took place on company premises.
On work-related travel.
Workers’ compensation provides payment for accidents suffered by workers traveling in company vehicles, performing errands for an employer, or traveling for work.
While at a company function.
Accidents at any event sponsored by the employer such as a company picnic or holiday party can qualify an employee for injury benefits.
As a result of your daily work activities.
Cumulative injuries (such as carpal tunnel syndrome, psychological injuries, or occupational illnesses) can take years to develop from the nature of the work you perform. Workers’ compensation can provide coverage for these conditions, as well as for injuries that were caused or worsened by a preexisting condition during employment.
While you were doing something on behalf of your employer.
As long as your injury can be connected in some way to your employment, there is a good chance you will qualify for benefits.
Have You Been Injured On The Job In Rhode Island?
If you've been hurt at work you need to speak with an experienced workers' compensation lawyer as soon as possible. Please contact us online or call our Cranston office directly at 401.946.3200 to schedule your free consultation. We help work injury victims in Providence, Warwick and all areas of Rhode Island.
Can I get a second medical opinion if the company doctor says my injury was not work-related?
Rhode Island workers’ compensation laws allow injured employees to select the medical provider of their choice for treatment of their injuries. However, if employees want to use a provider other than the one assigned by the employer, the costs may not be covered under workers’ compensation benefits—especially if the first doctor says that the injury was not sustained in the course of their work.
What to Do If a Doctor Says Your Injury Was Not Work-Related
You should know that your employer can compel you to attend an appointment with a medical provider to assess the nature of your injuries in the course of your workers’ compensation claim. However, that does not mean you have to treat with the employer’s physician for all of your injury care. If the employer’s chosen medical provider has said that the injury is not work-related, you have every right to select your own doctor for an impartial diagnosis.
Employees may need a second medical opinion in cases involving:
- Employer conflicts. If the doctor you are seeing relies on referrals from your employer, he may claim that you can return to work as soon as possible or that your injuries are not serious. This is a conflict of interest and warrants a second opinion.
- Occupational illnesses. A doctor may have difficulty determining how much of your condition was caused by your lifestyle versus a hazard at work. For example, if you are a smoker and work in a factory that produces hazardous chemicals, your doctor may deem that your respiratory condition was caused by smoking rather than inhaling noxious fumes.
- Previous injuries. A doctor may wrongly believe that your current injury was influenced by your previous medical history, or even that your injury is just a “flare up” of your condition and unrelated to your work. You may need to consult with a specialist to determine the link between prior and existing injuries.
If you are unable to work because of an accident on the job, it is always worth considering whether someone could be held liable for a work-related injury. 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, call us, or fill out the online contact form on this page.
Can I sue a coworker for negligence?
Workers' compensation laws create an "exclusive remedy" for employees to recover damages from an employer after an accident at work. Thus, an injured worker may not make a negligence claim against his or her employer or any fellow employee engaged by the same employer—even if an employer or coworker’s negligence caused the injury. However, employees who collect workers’ compensation benefits may be eligible to file an injury claim against a negligent third party.
Parties That May Be Sued After a Work Injury
While employees can collect payment for medical treatment and disability through workers’ compensation, these benefits may not be enough to cover the full cost of their injuries. A third-party claim allows an injured worker to recover medical expenses and lost wages, along with pain and suffering damages to cover the full costs of a severe injury.
Other than an employer or co-worker, employees can file a lawsuit against any negligent individual or company such as:
- Independent contractors. If an employee was injured by a coworker who is classified as an independent contractor or who works for a different employer, the workers’ compensation exclusive remedy provision does not apply.
- At-fault drivers. If an employee is injured in a car accident while performing work duties, he or she can file a lawsuit against the at-fault driver.
- Manufacturers. Workers who are hurt due to a defective piece of equipment may sue the product’s manufacturer for negligence.
- Contractors. If an employee is injured while working on a construction site, he or she may have a claim against the general contractor or a sub-contractor.
- Property owners. If the injury was caused by a defective condition on the property, the owner of the land, building owner, or the company responsible for maintenance may be sued for negligence.
If you are unable to work because of an accident on the job, it is always worth considering whether someone could be held liable for a work-related injury. 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.
Are part-time employees eligible for workers’ compensation?
In Rhode Island, employees are eligible for workers’ compensation even if they do not work a standard 40-hour workweek. A part-time employee (someone who typically works less than 20 hours per week) is owed the full amount of necessary medical payment for his injuries, as well as a living accommodation based on his Average Weekly Wage (AWW).
Workers’ Compensation Considerations for Part-Time Workers
To calculate an injured part-time worker’s AWW, insurers are required to calculate earnings for the 26 consecutive weeks prior to the date of incapacity (not including the week of injury or the week of hire). If an employee works multiple part-time jobs, the AWW will be calculated based on wages earned from all employers for 26 weeks prior to injury.
Although wage calculations may differ slightly for other types of employees, being a part-time worker does not affect eligibility for workers’ compensation. In general, you will qualify for medical and wage loss benefits through workers’ compensation if you:
- Are an employee. As long as you are considered an employee rather than an independent contractor, it does not matter whether you are a full-time, part-time, or seasonal worker.
- Were injured in the scope of employment. Only injuries that have been sustained “in the course and scope of employment” will be covered by workers’ compensation. This can include a wide range of occupational injuries such as a sudden accident, repeated physical strain or trauma, or an illness caused by the conditions of the work environment.
- Have been out of work for at least three days. The Rhode Island Workers’ Compensation Act states that an insurer does not have to pay any wage losses for the first three consecutive days post-injury. However, the insurer is still liable for any medical expenses related to the injury incurred on those days.
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.
I was hurt during my break, in the lunchroom, or at a company picnic. Could I have a workers’ comp claim?
An employer’s insurance company is compelled to cover any employee injuries that happen in the normal course of the workday. However, it may also be liable for injuries that are not so straightforward, such as when an employee is on a break, drinking alcohol, or miles away from the workplace.
Workers’ Compensation for Injuries Outside of Normal Working Hours
Rhode Island laws generally allow employees to collect workers’ compensation for any injuries suffered “in the course of employment.” This definition is extremely broad and allows for the majority of injuries to qualify for medical costs and lost wages as long as there is a causal link between employment and injury.
For example, employees may be owed workers’ compensation for injuries that were sustained:
- On the employer’s premises. An injury on a lunch break may be considered work-related if it happens on employer-owned grounds (such as in a dedicated break room or cafeteria).
- In close proximity to the job site. While an employee’s daily commute is usually not covered by workers’ compensation, workers may collect benefits if they are hurt while walking into or out of the workplace. If you were injured just before or just after your shift (such as in the parking lot or sidewalk), you are likely still covered.
- At a work-sponsored event. In many cases, employee intoxication is an exception to workers’ compensation coverage. However, if alcohol was provided by the employer—such as at a party, mandatory work event, or lunch with a client at a restaurant—the employer may be liable for the costs of injury despite the worker’s intoxication.
- Over several months or years. If a stroke, heart attack, or panic attack occurred on your day off, you may still collect workers’ compensation if your job contributed to high stress levels, anxiety, or physical and mental exhaustion.
- While not fully released from job duties. Even if you had clocked out and were away from the worksite, you may be covered for an injury if you were picking up lunch for others or running an errand for the employer (such as buying additional supplies on a busy day) while on your own lunch break.
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 call us toll-free at (888) 591-9976.
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.