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Month: September 2019

What’s workers’ compensation insurance?

What's workers' compensation insurance?

Question

What is the purpose of workers’ compensation insurance?

Answer

The purpose is to pay injured workers’ the benefits they are entitled to under the workers’ compensation laws of the jurisdiction that applies. 

title-amp

What's The Purpose of Workers' Compensation Insurance?​

Workers’ compensation insurance is a type of insurance that employers can and usually have to purchase by law and carry.  Failure to carry workers’ compensation insurance can subject employers to severe penalties.  

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). 

The payments are typically handled by the workers’ compensation insurance company (or a company hired by the insurance company to administer workers’ compensation claims).

Win Your Workers' Comp or Personal Injury Case

What’s workers’ compensation?

What's workers' compensation?

Question

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

Answer

Workers’ compensation are benefits paid by insurance that injured workers may receive and must be carried by their employer.

title-amp

Workers' Compensation Defined

Workers’ compensation is a system created by your state legislature to provide for injured workers. Prior to the creation of a workers’ compensation system, injured workers often had no remedy or benefits to sustain them when they were unable to work and earn.  In limited cases, prior to the creation of the workers’ compensation system, injured workers’ only remedy might be to sue their employer and prove that the employer was somehow negligent or at fault for the injuries.  

As a result of the workers’ compensation system, however, workers no longer have to sue their employers, or prove fault, on account of their injuries. Rather, injured workers may receive benefits paid by insurance that must be carried by their employer. These benefits can include partial weekly wage replacement while you are hurt and out of work, medical treatment, and other payments.

Prove You Were Hurt at Work

Therefore, instead of having to show that someone negligently caused their injuries as a prerequisite to recovery, injured workers need only show that they were hurt at work.  No fault need be shown. Each state has different rules and features of their workers’ compensation system, and how long you can collect, what you can collect, and what you are entitled to various on a state-to-state basis.  You are best served by consulting with a local workers’ compensation attorney to better understand your rights.

Win Your Workers' Comp or Personal Injury Case

What will workers’ compensation cover?​

What will workers' compensation cover?

Question

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

Answer

Worker’s compensation will pay you a weekly benefit during times you are unable to work due to your injury.

what-will-workers-compensation-cover

General Workers' Comp Payments

Worker’s compensation will pay you a weekly benefit during times you are unable to work due to your injury.  The amount of this benefit is calculated using a statutory formula that is generally based on your earnings during the 13 weeks prior to your injury, your overtime/bonuses for the 52 weeks prior to your injury, and your dependency status (i.e. single/married/children, etc.).

This formula is used to arrive at your “average weekly wage” for workers’ compensation purposes. Your average weekly wage amount is then used to determine your “spendable base wage,” which can be ascertained by using the RI Department of Labor’s spendable base wage tables in effect as of the date of your injury.

What you actually receive in your weekly workers’ compensation check will typically be 75% of your spendable base wage. Although there are exceptions, generally, you may collect for up to 6 years, provided you remain partially disabled from your job as a result of the injury.

In Addition to your Check

In addition to your weekly benefit check, workers’ compensation will pay for all medical treatment, devices, and prescriptions which are reasonable and necessary to treat you.  This can include doctor’s visits, physical therapy, injections, MRI or other imaging studies/tests, surgery, etc.

There are also additional specific amounts of money that you may be entitled to under the Rhode Island Workers’ Compensation system for scarring/disfigurement related to the injury or surgery for the injury, as well as for “loss of use” or “permanency rating” if there are permanent injuries. You may also receive mileage reimbursement for certain trips to doctor’s/therapy appointments.

Win Your Workers' Comp or Personal Injury Case

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.

how-long-workers-compensation-last

The Workers' Comp Payment Period

Generally, you may collect weekly workers’ compensation for up to six (6) years, i.e., 312 weekly checks.  We say “generally” because most people out on workers’ compensation are considered “partially disabled,” and the maximum those who are “partial” can collect weekly benefits is 312 weeks.  This time limit, however, does not apply to your rights to have medical treatment for the injuries paid for.

That right continues beyond any 6-year time period. As long as medical treatment is “reasonable and necessary to cure, rehabilitate, or relieve the employee” from the effects of his/her work-related injuries, it shall be paid for under the Rhode Island workers’ compensation system.

The "Total" Exception

There are more exceptional cases where an employee may be deemed “total” in terms of their disability from working.  The significance of being “total” in terms of how long you may remain out on workers’ compensation is that there is no time limit for those who are totally disabled.  A better way of putting this is to say that the six (6) year (312 week) clock for collecting workers’ compensation is not ticking while the employee is “totally disabled” as a result of the work injury. 

“Total” cases are exceptional, difficult to prove, and fiercely contested, however, they tend to have significant settlement value, the reason being that the employer/insurer could theoretically have to pay weekly benefits for the rest of the employee’s natural life – which amounts to significant potential exposure.

Win Your Workers' Comp or Personal Injury Case

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.

how-workers-compensation-settlement-paid

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 listen and make sure you are voluntarily entering into the settlement (i..e that you understand you do not have to settle your case and that no one is forcing you to settle), that you understand the terms of the settlement (i.e. what you will receive as your net settlement amount after any attorney’s fees or costs), and most importantly, that you understand the consequences of the settlement (i.e. that your case is going to be over forever and all time).

When You Get Paid for Your Case

Once you do this, and the judge approves the settlement, the judge will typically enter a court order right then and there approving the settlement before you leave. It is from that point that the employer/insurance company has fourteen (14) days to pay you your settlement money. 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.

Win Your Workers' Comp or Personal Injury Case

September 2019 - Simone & McCahey LLP Skip to content

Month: September 2019

What’s workers’ compensation insurance?

What's workers' compensation insurance?

Question

What is the purpose of workers’ compensation insurance?

Answer

The purpose is to pay injured workers’ the benefits they are entitled to under the workers’ compensation laws of the jurisdiction that applies. 

title-amp

What's The Purpose of Workers' Compensation Insurance?​

Workers’ compensation insurance is a type of insurance that employers can and usually have to purchase by law and carry.  Failure to carry workers’ compensation insurance can subject employers to severe penalties.  

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). 

The payments are typically handled by the workers’ compensation insurance company (or a company hired by the insurance company to administer workers’ compensation claims).

Win Your Workers' Comp or Personal Injury Case

What’s workers’ compensation?

What's workers' compensation?

Question

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

Answer

Workers’ compensation are benefits paid by insurance that injured workers may receive and must be carried by their employer.

title-amp

Workers' Compensation Defined

Workers’ compensation is a system created by your state legislature to provide for injured workers. Prior to the creation of a workers’ compensation system, injured workers often had no remedy or benefits to sustain them when they were unable to work and earn.  In limited cases, prior to the creation of the workers’ compensation system, injured workers’ only remedy might be to sue their employer and prove that the employer was somehow negligent or at fault for the injuries.  

As a result of the workers’ compensation system, however, workers no longer have to sue their employers, or prove fault, on account of their injuries. Rather, injured workers may receive benefits paid by insurance that must be carried by their employer. These benefits can include partial weekly wage replacement while you are hurt and out of work, medical treatment, and other payments.

Prove You Were Hurt at Work

Therefore, instead of having to show that someone negligently caused their injuries as a prerequisite to recovery, injured workers need only show that they were hurt at work.  No fault need be shown. Each state has different rules and features of their workers’ compensation system, and how long you can collect, what you can collect, and what you are entitled to various on a state-to-state basis.  You are best served by consulting with a local workers’ compensation attorney to better understand your rights.

Win Your Workers' Comp or Personal Injury Case

What will workers’ compensation cover?​

What will workers' compensation cover?

Question

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

Answer

Worker’s compensation will pay you a weekly benefit during times you are unable to work due to your injury.

what-will-workers-compensation-cover

General Workers' Comp Payments

Worker’s compensation will pay you a weekly benefit during times you are unable to work due to your injury.  The amount of this benefit is calculated using a statutory formula that is generally based on your earnings during the 13 weeks prior to your injury, your overtime/bonuses for the 52 weeks prior to your injury, and your dependency status (i.e. single/married/children, etc.).

This formula is used to arrive at your “average weekly wage” for workers’ compensation purposes. Your average weekly wage amount is then used to determine your “spendable base wage,” which can be ascertained by using the RI Department of Labor’s spendable base wage tables in effect as of the date of your injury.

What you actually receive in your weekly workers’ compensation check will typically be 75% of your spendable base wage. Although there are exceptions, generally, you may collect for up to 6 years, provided you remain partially disabled from your job as a result of the injury.

In Addition to your Check

In addition to your weekly benefit check, workers’ compensation will pay for all medical treatment, devices, and prescriptions which are reasonable and necessary to treat you.  This can include doctor’s visits, physical therapy, injections, MRI or other imaging studies/tests, surgery, etc.

There are also additional specific amounts of money that you may be entitled to under the Rhode Island Workers’ Compensation system for scarring/disfigurement related to the injury or surgery for the injury, as well as for “loss of use” or “permanency rating” if there are permanent injuries. You may also receive mileage reimbursement for certain trips to doctor’s/therapy appointments.

Win Your Workers' Comp or Personal Injury Case

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.

how-long-workers-compensation-last

The Workers' Comp Payment Period

Generally, you may collect weekly workers’ compensation for up to six (6) years, i.e., 312 weekly checks.  We say “generally” because most people out on workers’ compensation are considered “partially disabled,” and the maximum those who are “partial” can collect weekly benefits is 312 weeks.  This time limit, however, does not apply to your rights to have medical treatment for the injuries paid for.

That right continues beyond any 6-year time period. As long as medical treatment is “reasonable and necessary to cure, rehabilitate, or relieve the employee” from the effects of his/her work-related injuries, it shall be paid for under the Rhode Island workers’ compensation system.

The "Total" Exception

There are more exceptional cases where an employee may be deemed “total” in terms of their disability from working.  The significance of being “total” in terms of how long you may remain out on workers’ compensation is that there is no time limit for those who are totally disabled.  A better way of putting this is to say that the six (6) year (312 week) clock for collecting workers’ compensation is not ticking while the employee is “totally disabled” as a result of the work injury. 

“Total” cases are exceptional, difficult to prove, and fiercely contested, however, they tend to have significant settlement value, the reason being that the employer/insurer could theoretically have to pay weekly benefits for the rest of the employee’s natural life – which amounts to significant potential exposure.

Win Your Workers' Comp or Personal Injury Case

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.

how-workers-compensation-settlement-paid

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 listen and make sure you are voluntarily entering into the settlement (i..e that you understand you do not have to settle your case and that no one is forcing you to settle), that you understand the terms of the settlement (i.e. what you will receive as your net settlement amount after any attorney’s fees or costs), and most importantly, that you understand the consequences of the settlement (i.e. that your case is going to be over forever and all time).

When You Get Paid for Your Case

Once you do this, and the judge approves the settlement, the judge will typically enter a court order right then and there approving the settlement before you leave. It is from that point that the employer/insurance company has fourteen (14) days to pay you your settlement money. 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.

Win Your Workers' Comp or Personal Injury Case

Angelo Simone and Shelagh McCahey’s dream was a law firm truly built upon a core value of excellence, without compromise. This law firm is the result of that dream. It is also the result of many long conversations about what is truly best for the client, what actually drives truly excellent results, and why many lawyers—even those who have done quite well for themselves—simply don’t hit the target.

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