What’s workers’ compensation insurance?

What's workers' compensation insurance?

Question

What is the purpose of workers’ compensation insurance?

Answer

Workers’ compensation insurance is a type of insurance that employers must purchase and carry under state law. Its purpose is to pay injured workers the benefits they are entitled to under the workers’ compensation laws of the jurisdiction that applies. Employers who fail to carry this insurance may face severe penalties. Our law firm for workers compensation can help explain how this coverage works and what protections it provides for injured employees. You can also learn more by reviewing our RI workers’ comp benefits, which outlines how workers’ comp is administered in Rhode Island.

The purpose of workers’ compensation insurance is to pay injured workers the benefits they are entitled to under the workers’ compensation laws of the jurisdiction that applies (usually state law). These payments typically include medical treatment, weekly indemnity benefits, and other statutory entitlements. Understanding related topics like types of benefits provided or how benefits are calculated can also help you see how workers’ comp insurance functions in practice.

The payments are typically handled by the workers’ compensation insurance company, or sometimes by a third-party company hired by the insurer to administer claims.

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What’s workers’ compensation?

What's workers' compensation?

Question

I was injured at work – What’s workers’ compensation?

Answer

Workers’ compensation is a system created by state legislatures to provide benefits to injured workers. Prior to the creation of this system, injured employees often had no remedy or financial support while unable to work. In rare cases, the only option was to sue an employer and prove negligence. With the modern system, injured workers no longer need to prove fault. Instead, they may receive benefits paid by insurance that employers are legally required to carry. Our workman’s compensation attorneys can help explain how these benefits operate in Rhode Island and what protections are available. You can also learn more by reviewing our denied claim appeal in RI, which outlines how the system functions and what to do when issues arise.

Workers’ Compensation Defined

As a result of the workers’ compensation system, injured workers may receive benefits such as partial weekly wage replacement, medical treatment, and other payments without filing a lawsuit or proving negligence. These benefits are paid by the employer’s workers’ compensation insurance. Understanding related topics like what types of benefits are included or how long benefits can last can help clarify what support may be available to you.

Prove You Were Hurt at Work

Instead of proving fault, injured workers need only demonstrate that they were hurt at work. No negligence needs to be shown. Each state has different rules regarding what is covered, how long benefits last, and what you may be entitled to. You are best served by consulting a local workers’ compensation attorney to fully understand your rights under your state’s system.

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What will workers’ compensation cover?​

What will workers' compensation cover?

Question

I have a workers’ comp case- what costs will it cover?

Answer

Workers’ compensation will pay you a weekly benefit during the time you are unable to work due to your injury. The amount is determined by your wages before the injury and several statutory factors. For help understanding exactly what benefits you qualify for, a consultation with a Rhode Island workers compensation attorney can provide clarity. You can also explore our RI workers’ comp benefits for a full overview of how benefits are applied in Rhode Island.

General Workers’ Comp Payments
Workers’ compensation will pay you a weekly benefit during periods when you are unable to work because of your injury. The amount of this benefit is calculated using a statutory formula based on your earnings during the 13 weeks before your injury, your overtime and bonuses for the 52 weeks before your injury, and your dependency status (single, married, children, etc.).

This formula determines your “average weekly wage” for workers’ comp purposes. Your average weekly wage is then used to calculate your “spendable base wage,” which is found using the Rhode Island Department of Labor’s wage tables in effect on the date of your injury.

What you actually receive in your weekly check is typically 75% of your spendable base wage. While there are exceptions, most injured workers may collect weekly benefits for up to six years, provided they remain partially disabled due to the injury. You can learn more about how these amounts are determined by reviewing related topics like workers’ comp payment calculations or average weekly wage determinations.

In Addition to Your Check
Besides weekly wage replacement, workers’ compensation covers all reasonable and necessary medical treatment, devices, and prescriptions related to your injury. This includes doctor’s visits, physical therapy, injections, MRI or imaging studies, surgery, and more.

Additionally, you may be entitled to specific payments under Rhode Island law for scarring or disfigurement, as well as for “loss of use” or a “permanency rating” if you sustained permanent injuries. Mileage reimbursement is also available for approved travel to medical or therapy appointments.

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How long will workers’ compensation last?​

How long will workers' compensation last?

Question

How long can I expect my workers’ comp payments to last?

Answer

Generally, you may collect weekly workers’ compensation for up to six (6) years, i.e., 312 weekly checks.

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The Workers' Comp Payment Period

Generally, you may collect weekly workers’ compensation for up to six (6) years, or 312 weekly checks. We say “generally” because most people receiving workers’ compensation are considered “partially disabled,” and the maximum duration for partial disability benefits is 312 weeks. This time limit, however, does not apply to your right to have medical treatment paid for. Our Rhode Island workers compensation lawyers can help explain how long weekly benefits may last based on your disability status. You can also review our RI workers’ comp benefits for more detail about long-term coverage rights.

Your right to medical care continues beyond the six-year period. As long as treatment is “reasonable and necessary to cure, rehabilitate, or relieve the employee” from the effects of the work-related injury, it will be paid for under Rhode Island’s workers’ compensation system. Understanding related areas like what benefits are included or how payments are calculated can also help clarify how long benefits may continue.

The "Total" Exception

There are more exceptional cases in which an employee may be deemed “total” in terms of their disability from working. The significance of being “total” is that there is no time limit for collecting weekly benefits. In other words, the six-year (312-week) limit does not apply while the employee remains totally disabled due to the work injury.

“Total” disability cases are exceptional, difficult to prove, and heavily contested; however, they typically have significant settlement value because the employer or insurer may be obligated to pay weekly benefits for the rest of the employee’s natural life.

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How will my workers’ compensation settlement be paid?​

How will my workers' compensation settlement be paid?

Question

I have a workers’ comp case- how will my settlement be paid?​

Answer

Once the judge approves the settlement and enters a court order, the company typically has fourteen (14) days to pay.

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How the Judge Approves a Settlement

If you settle your workers’ compensation case, you will have to go to court for a brief hearing for a judge to approve the settlement. This will generally consist of your lawyer asking you questions about the settlement in front of the judge so that the judge can make sure you are voluntarily entering into the agreement (i.e., that you understand you do not have to settle your case and that no one is forcing you to do so), that you understand the terms of the settlement (including your net settlement amount after attorney’s fees or costs), and most importantly, that you understand the consequences of the settlement—specifically, that your case will be over forever. Our workcover compensation lawyers can guide you through this process and help ensure the judge receives all required information. For additional clarity on how settlements work in Rhode Island, you may also want to review our RI workers’ comp benefits.

When You Get Paid for Your Case

After the hearing, once the judge approves the settlement, the judge will typically enter a court order right away before you leave. From that point forward, the employer or insurance company has fourteen (14) days to pay your settlement. Typically, the insurer will send one check directly to you for your net settlement amount and send a second check directly to your attorney for the attorney’s fee. For more insight into the settlement process, you may find related topics helpful, such as how long settlements take or whether benefits stop after settlement.

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