A workers’ compensation lawyer can help your case in many different ways, starting from the very beginning. One of the most important things a workers’ comp lawyer does is make sure your claim is properly memorialized—meaning it’s officially recognized under the law and recorded in a way that makes it “written in stone,” so the insurance company can’t later deny your claim or say you’re no longer entitled to benefits. This is something not only the average person, but even most lawyers unfamiliar with workers’ comp wouldn’t know how to do or recognize if it’s been done correctly. Usually, within 30 seconds of meeting you—whether in person or on Zoom—I can figure that out, or at the very least confirm it within days by checking with the Department of Labor and reviewing the documents the insurance company has filed about your injury and claim. We interpret those documents and quickly determine whether your claim was properly established and if you’re being treated correctly. If not, we know what steps to take immediately. That’s just one reason to have a workers’ comp lawyer. As your case progresses, there are many other points where legal help becomes crucial. While you’re disabled, you’re entitled to weekly benefits, but sometimes those payments suddenly stop—with or without explanation. Your lawyer will know exactly what to do in that situation. Or, you might be sent to a doctor appointed by the insurance company, who then states you’re no longer disabled—even when you know that you are. Suddenly, your benefits are terminated or you receive notice of a court date to end your payments based on that doctor’s opinion. That’s not the time to start searching for a lawyer. Ideally, you already have one, someone who has prepared you in advance, explained what the Independent Medical Examination (IME) means, and guided you on how to protect yourself if the employer tries to use their doctor’s opinion against yours. This is where an experienced lawyer who understands the system can make all the difference. Lastly, there are many other benefits you might be entitled to, like compensation for scarring or disfigurement. Even if you know you qualify, you may not know how much your scar, burn, or other disfigurement is worth. I’ve seen many people come to me after already signing paperwork for a settlement, only for me to realize they received far less than they should have. The reasons to have a workers’ comp lawyer go on and on—and it’s always a smart move to involve one from the beginning, not after problems arise.

Well, in Rhode Island—and I’m sure in all other jurisdictions—the workers’ compensation system is a creature of statute, and there are provisions in the Workers’ Compensation Act that even most lawyers who don’t practice in this area are very unfamiliar with. There are countless examples I could give of what you don’t know, even if everything seems fine. Maybe they start paying your weekly benefit and your natural reaction is, “What do I need a lawyer for? I’m already getting my check.” But that situation can quickly change, and by the time you are hiring a lawyer, I’ll be starting from square one—and you’ll probably wish you had just hired me from day one to get it right. For example, you might be getting paid, everything seems okay, and then eight, nine, ten weeks go by and you’re still not able to work. Suddenly, your check stops, or you get a notice in the mail saying they’re going to stop paying and are now denying your claim—a claim you assumed was always accepted. We can talk about how and why the insurance company is allowed to do that, but the point for now is this: you’ll be scrambling to find a lawyer then, when you should’ve had one from the beginning to ensure your claim was properly established from day one. That way, it’s written in stone and you’re protected against the rug being pulled out from under you. Another reason to hire a lawyer early is because there are so many unique benefits beyond just the weekly check that you might be entitled to under the workers’ comp act—benefits you wouldn’t know about or how to access. A lawyer who knows the system well can recognize when you’re entitled to something you didn’t even realize was possible, or spot when you’re not being treated the way you should be by the insurance company or your employer. They can take care of all the little things that protect you along the way. I like to analogize a workers’ comp lawyer as a kind of guardian angel over your claim—maybe everything is fine now and there isn’t a lot to do, but when a problem arises, you don’t want to be scrambling to find the right lawyer in the middle of a crisis. It’s far better to have someone already in place, ready to tackle the problem head-on as soon as it arises—or better yet, know how to prevent it from ever happening in the first place.

It depends—when we say a claim is denied, that can mean a few different things. First, your employer may deny or disagree that anything happened at all or may simply not believe you, and they might communicate that to their insurance company, which can certainly influence how the insurance company handles your case. The insurance company itself is another level where your claim may be “denied”—but just because the insurance company denies your claim doesn’t mean you don’t have one or that it’s not a valid claim; it just means they’re choosing not to pay it voluntarily. What do you do about that? That’s where filing a petition comes in—hiring a lawyer and filing a petition in workers’ compensation court to get a judge’s ruling on whether you qualify for benefits. Certainly, not reporting your injury to your employer in a timely manner can be a problem, and it’s important to report it as soon as possible. But there can be many explanations for why someone didn’t report it right away. Often, people get hurt at the end of the day and think they’ll go home, rest, ice the injury, and feel fine the next day—and when that doesn’t happen, they report it later. That can still be okay. While we always recommend reporting it as soon as you know something’s wrong, reasonable explanations for delays do exist. However, that delay can still be used by an employer or insurance company as a reason to deny your claim and avoid paying you. Ultimately, it comes down to why it wasn’t reported immediately—if there’s a reasonable explanation and you eventually report it, you can still qualify for workers’ comp benefits. Often, when you go to the doctor right away, the medical records will show that you reported it as a work-related injury, including details of what you were doing when it happened. That kind of documentation can be very supportive of your claim. Still, it’s essential to let your employer know as soon as it’s practical.

Absolutely, and that goes back to one of the main purposes of creating the Workers’ Compensation Act—you no longer have to show that anyone was at fault. More importantly, with very few exceptions, even if the injury was your fault—because you were negligent or perhaps just not being as careful as you should have been—that has absolutely no bearing on your ability to receive workers’ compensation benefits for having injured yourself or suffered an injury at work. The only real exception would be if you were doing something so forbidden by your employer or so far outside the scope of your work that your injury had nothing to do with work-related activities. But if you were injured simply because you tripped on something at work—something you arguably should have seen or been more careful around—that alone does not preclude you from receiving workers’ comp benefits. You would still be entitled to those benefits, assuming you met the other necessary factors.

Yes, there is a time limit—what we call a statute of limitations. Before I tell you what it is, I’ll say this: you don’t want to wait anywhere near that long. But theoretically, you have two years from the date of injury to file a petition in workers’ compensation court to recognize your work-related injury. That’s not to say you’d ever want to wait two years, but there can be situations where it’s still possible. However, don’t confuse this with timely reporting the injury to your employer—you certainly wouldn’t want to wait two years for that. In fact, if you did, you likely wouldn’t even have a case. But in terms of the time frame to take legal action, also known as the statute of limitations, it is two years in Rhode Island.

In terms of reporting your injury, and this is no surprise—do it as soon as possible, because one of the first things you’re going to be asked, or if you hire us, what we’re going to be asked is: when did they report it? Did they report it at all? The insurance company or their lawyers will look to see if there’s any issue about timely reporting the injury, and that can be used as one of many defenses to your claim—or, as often happens, as a basis for the insurance company to deny your claim entirely. If your claim is denied and you have to go to court to get on workers’ comp, the judge is going to want to know if it was reported and when, and they will look long and hard at that aspect of your claim. So, I would err on the side of reporting incidents, even if you think you might be fine, because it could later theoretically come back to harm you. There’s absolutely no real downside to letting your employer know that something happened, documenting it, and leaving it at that. If it’s nothing—fine. But if it turns out to be a problem that gets worse and reaches a point where you’re not able to work full duty, then you’re best off being able to show that you reported it timely, right away, and there’s no issue in that regard.

Workers’ comp provides, first and foremost, a weekly check called indemnity benefits, which is 62% of what you were making on average in the time before you got injured. Typically, the most important and immediate benefit is that weekly check while you’re out. Second, of course, are medical benefits—meaning if you’re hurt and require medical treatment, whether it’s an X-ray, MRI, physical therapy, or surgery, it is the workers’ comp insurance company or your employer, if they’re self-insured, who has to pay for that—not your health insurance, not you out of pocket, and not anyone else. So, there’s the weekly check, there’s medical benefits and coverage—those are the two principal forms of benefits. But there’s also specific compensation for other things like disfigurement, a scar, or a burn—there’s money, aside from your weekly check, that is there to compensate you for that. We can talk more about the specifics, but if you have a permanent loss of use of an arm, leg, or another body part, that’s another specific form of compensation available under the workers’ comp system. There are also certain vocational rehabilitation services you may qualify for as well. But those are the principal benefits.

It’s different, certainly. Workers’ compensation is insurance, and like health insurance, it can and does provide payment of medical expenses, doctor’s bills, and entitles you to get treatment and have it paid for. Unlike health insurance, which could theoretically cover various injuries that have nothing to do with your work, workers’ comp insurance only covers medical treatment that’s related to your injury and that is reasonable and necessary to relieve, cure, or rehabilitate you from your injuries. Also, unlike health insurance, workers’ compensation is not just insurance; it’s a system that has a menu of specific benefits you’re entitled to beyond just getting your doctor’s bills paid. If you’re out of work because of your injury, there’s a weekly benefit check you’re entitled to receive. If you have disfigurement, scarring, burns, loss of use, or some sort of permanent aspect to your injury, then you’re entitled to additional payments—what we call specific compensation. There are also vocational benefits and other potential benefits you could be entitled to under the act, if you qualify. So, that’s just a long way of saying it’s not just health insurance. It’s not just there to pay your medical bills; it’s there to help you through the unfortunate situation of being hurt at work and unable to work for a period of time. And of course, there are cases where people are hurt to a point where they can’t get back to that job—sometimes they can’t get back to any job—but in either case, it’s a system that’s there to assist and give you something to either rehabilitate you to get back to work in some form, or, if you can’t, it’s there to provide some sort of income protection depending on the circumstances of your case and your injuries.

Physical injuries, obviously—whether you strain your back, break an arm, or suffer a traumatic brain injury—the list goes on and on. But the act also covers psychiatric or mental injuries. Today, I represented a gentleman who had a very serious post-traumatic stress disorder injury that prevented him from working. So the act does cover illnesses or injuries like that, in addition to physical ones. Again, it all comes down to being able to show, typically through competent medical evidence, that you were in fact injured, that you do have the injuries you allege, and more importantly, that those injuries are incapacitating you from your full earning capacity or from performing your full work duties.

It can happen in a few different ways. Sometimes the employer or their insurance company will, um, reach right out and get the process started. Um, they essentially control the means by which you get placed on workers compensation benefits. Um, there’s no application per se, but, uh, typically what can happen is, if you’re hurt at work and no one’s getting back to you or no one’s explaining anything to you, um, you would have to file a petition in the Workers Compensation Court—at least that’s what you would do in Rhode Island. Um, and that’s usually the point in time you would need, for sure, a lawyer, unless you wanted to go about it on your own, attempt to represent yourself. But we find that workers compensation, particularly in Rhode Island, is a bit of a strange creature. Um, most lawyers don’t know much about the system, the, the Workers Compensation Act, or how to go about doing it. So, um, if—as I think we’ll talk about in a little bit—you’re always best off consulting with a lawyer who practices workers compensation in Rhode Island, No. 1. But if you’re not placed on workers compensation by your employer or their insurance company, uh, your first call should be to someone who knows what they’re doing and knows how to, how to practice.