Uh, it’s a good idea to, whether through a calendar or a diary, at least, um, take some basic notes about when you had an appointment and who it was with, because your lawyer may need to know that from time to time, and he may call you up and ask you—or she may ask you—when’s the last time you saw the doctor, or often more importantly, when’s the next time you have an appointment to see your doctor, which doctor is it, because once, for example, I know that I can mark my calendar and say, well, you know, John Smith just went to the doctor today, let’s send a request for that medical report so that we can put it in the file, so that when we have a court date or some hearing or some other requirement to show your disability or show something else medically to get you what you need in your workers comp case, it’s there and we don’t have to have any unnecessary delays in getting that.

Uh, there’s two ways of looking at this—uh, obviously doctors in, uh, in the medical field have their own requirements in terms of medical documentation—we won’t get into that—but from a workers comp perspective, your ability to receive weekly workers compensation checks depends on, uh, medical evidence, medical proof that you remain incapacitated, whether partially or totally, from the job you were doing when you were hurt. So the documentation that should be in a medical report should start always with the doctor, uh, describing or taking what we call a history, which is you reporting to the doctor how you’re feeling, what your complaints are, how it happened. Uh, in terms of the original medical that you go for—the first time you go to the doctor after you’re hurt—it’s very important to completely, um, and accurately give the doctor a history that the doctor will then document in the report of the fact that it happened at work, how it happened, what your symptoms are, and what body part or parts are injured or affected by the injury. The next thing, the doctor will perform a physical exam or perhaps take some imaging and review those and discuss them and come up with a treatment plan that, that is reasonable and necessary to, to treat you for your injuries. Lastly, the medical documentation should contain some statement about your ability to work and, um, say, for example, that the patient is partially disabled or totally disabled, uh, or, uh, can work but has restrictions. If you are, uh, restricted in any way from doing your full duties, you can be considered partially disabled and entitled to workers comp benefits, and that’s all important medical documentation that we, workers compensation lawyers, rely upon and need to do our job on your behalf.

You need to keep records of any earnings you make while you’re out on workers comp, and you should also keep, uh, records of your workers comp payments so that your lawyer can see them or look at them from time to time when the need arises. Besides that, I would also say it’s important to keep your out-of-work notes that you get, uh, from time to time from your doctor. If you keep your out-of-work notes, your lawyer may call you up and say, “Hey, can I—can you shoot me over a copy of your most recent out-of-work note?” so that’s an important record to keep as well.

A Report of Earnings form is a document that an employee who is out on workers comp can use to fulfill the employee’s duty of reporting any earnings that he or she receives while out on workers compensation. If you’re out on workers comp and you’re getting a weekly workers comp check, um, there’s no prohibition from earning, uh, money doing something else that you can do physically while you’re out on comp; however, you have to report it—you’re, uh, legally obligated and required to report all earnings that you receive when you’re out on workers comp, and the Report of Earnings form is a pretty simple form to comply with that requirement. So, if in a given week you earned \$200, uh, delivering for, uh, you know, Uber Eats or what have you, you would fill out on that form that for the week ending such and such a date, I earned \$200, sign it, send it in to the workers comp adjuster or insurance company, and then they know what to do with it. Um, if you are only, uh, if you’re working at the same employer only, let’s say in a light duty capacity or fewer hours or whatever, due to your restrictions because of your injury, then the employer is deemed, uh, to know what you’ve earned in their employment in that regard and will report it to workers comp for you. Uh, the Report of Earnings form is generally used only for earnings that you have from a source other than the employer in whose employ you were injured.

In workers compensation in Rhode Island, we have, fortunately, one of the most efficient and fastest-moving, fastest-working courts in the nation—we’re really, um, sort of the gold standard in that regard. Now, things still take time; there is a turnaround time for everything. But let’s say, um, really whatever the issue is—it can be anything from are you entitled to workers comp or not in the first place, or it can be a situation where you’re on workers comp, that’s not disputed, but there’s a dispute over whether you should be paid, uh, a certain amount for your scarring, or whether you’re entitled to a form of medical treatment, or any issue—when you get to that point and you have to file a petition, the turnaround time, uh, kind of looks like this essentially: um, for many things like medical treatment, you first have to ask for it, and legally you have to ask for it in writing, and if the insurance company, uh, receives your request in writing for something, uh, you typically have to give them 21 days to respond before you can file that petition. So you have the first period of time you’re looking at in terms of turnaround time—21 days from when you ask for what you want to when the insurance company has to pay it or approve it or deny it. Once you get to that 21-day point, you can file a petition. Um, obviously, you don’t go into court the same day you file the petition—you file the petition on that 22nd day, let’s say, and now the court schedules a hearing so you can talk to the judge and make your case for what you want. That hearing, from the point you file it, is typically 21 days as well away. So you’ve got 42 days in terms of a typical turnaround time. And this all assumes that the parties can’t work it out in the interim—or, or once—sometimes once you file that petition, the insurance company will see it and retreat or say, “You know, here’s the authorization, go ahead and get that treatment, we don’t even have to bother going to court.” But worst-case scenario, if we’re going to have a judge decide a petition or an issue, you’re looking at 21 days for a hearing from when you file the petition. And more times than not, most disputes are resolved at that first hearing at the pretrial level, um, after 21 days. So that’s, um, a good turnaround time compared to other systems and other courts and other legal disputes that can come up.

When you file—or when we file—a petition in Workers Compensation Court in Rhode Island on behalf of an injured worker, it can mean, uh, or can be about any number of things. Basically, every issue that comes up in the course of your workers compensation case, uh, can be the subject of a petition. What do I mean by that? Well, let’s say your weekly check all of a sudden stops, uh, let’s say for no reason—uh, what do you do? You would file a petition called a Petition to Enforce, uh, in the Workers Compensation Court and ask for a court order to pay you what they owe you retroactive to when they stopped, and to potentially pay you a penalty on top of that, or to pay your lawyer a fee. Um, but petitions can take the form or be regarding other issues as well. Pretty much any issue—for example, if you need an MRI or you need a surgery or some form of treatment and the insurance company just will not voluntarily approve it or pay for it or they outright deny it—that’s an issue that you need the Workers Compensation Court to address. And in Rhode Island, fortunately, we have one of the fastest working Workers Compensation Courts in the country—it’s a fairly quick system—and so you can file a petition called a Petition to Review, uh, over whether or not you should be entitled to and have the insurance company pay for that form of treatment that they’re denying. So there’s a lot of other issues that can come up in workers compensation that cause a petition to be filed on your behalf by your lawyer in the Workers Compensation Court—which, unfortunately for our firm, is right across the street—and have a court decide it and decide it promptly so that you can move on with the treatment you need or get the money that you’re entitled to, and these petitions are filed every day over myriad issues in Workers Compensation Court no matter really what they are.

So, appeals in the workers compensation context typically look like this: if, uh, you hired a lawyer or you attempted to bring a petition on your own to recognize your injuries, and the judge at the pretrial hearing decided that, for whatever reason, uh, they weren’t prepared to grant your petition, uh, then and there, but rather they need to hear more evidence—they need a full hearing with testimony and witnesses and the like—then that, in itself, is a form of an appeal that we typically see in workers compensation. Um, your claim is denied at the pretrial level, and by claiming a trial—claim for trial is another word for, uh, another word for appeal—you get to a level of the, um, review process by the court where, like a trial, uh, a full trial, you can depose doctors, you can call witnesses, you can have testimony under oath, and the judge receives and hears and considers all of the evidence and then makes a final, um, determination about whether or not your claim is compensable or not. Now, if it’s not, you still have appellate rights beyond, um, the hearing judge or the, or the trial judge, to the Appellate Division of the Workers Compensation Court or potentially even the Supreme Court. But typically, an appeal, um, indicates that a judge either needs to hear more robust forms of evidence or that perhaps there’s some problem with the, with the claim legally, uh, or evidentiary, uh, that requires an appeal, and, you know, it’s a very difficult thing to handle on your own. That’s a—that’s something a lawyer would almost always have to be involved in.

If your claim is denied, uh, you would file a petition in Workers Compensation Court to have a judge hear and decide whether the denial was appropriate or, on the other hand, if you are entitled to workers compensation benefits and the claim shouldn’t have been denied. If you promptly consult with a workers compensation lawyer, that lawyer will file that petition the first second they can so that there’s no unnecessary delays in getting you what you’re entitled to and, and getting your rights recognized. So when they do deny your claim—and they often do—it doesn’t mean your claim doesn’t have merit, it just means that they’re not gonna voluntarily give you what you’re entitled to. So you need a lawyer to file what they have to file to legally get you what you’re entitled to.

A lot of reasons can result in delay of your claim. Uh, sometimes the insurance company or the employer refuses to, uh, allow you the claim because they don’t want to pay. Uh, they may have nothing to do with the merits of your claim—they can just deny it. Or perhaps they have some question or they legitimately dispute the validity of the claim. Doesn’t mean you’re not entitled to benefits, but you’re going to have to fight them to get it, and, and of course, you will be wise to hire a lawyer to do that for you. Uh, other reasons for delay—and perhaps one of the most important reasons or things to know about why claims get delayed—is, under the system, if the insurer wants to, they can delay or put it off or start paying you but not, not properly, uh, grant your claim, and that’s something you want to avoid. And the way to avoid it is to promptly consult with a workers comp lawyer who knows exactly how quickly they can memorialize your claim so that your rights are officially protected and written in stone, so that they can’t pull the rug out from under you when you least expect it. Because again, what workers comp insurance companies can do is start paying you right away and make you feel as if everything is well and your claim must, of course, be approved if you’re getting paid—and it turns out that’s not the case legally. The law gives them a certain window of time, which they don’t really tell you about, to pay you without really accepting the claim, and they can decide at any time up to 13 weeks after your injury to stop paying you, to deny the claim, to pull the rug out from underneath you, and leave you scrambling with this interruption in your income stream, uh, as well as a—now a delay in getting medical treatment that you may be entitled to.

Approval of a workers compensation claim can be instant—as soon as you’ve missed more than three days from work. Or, um, sometimes the insurance company can delay or deny or put off, uh, memorializing your claim in the way that they should. If this happens, then, uh, again, consult with a workers compensation lawyer about that, and we’ll do what we have to do to get your claim approved. If we’re talking about filing a petition in Workers Compensation Court to officially establish and recognize your claim, then the, um, pertinent laws that apply are, first, that you can’t file that petition until the earliest, uh, 21 days after the injury. And typically, we don’t file these petitions in cases where you haven’t lost any time from work—you do need to be incapacitated or lose time to officially have your claim mature and before you can seek to recognize it or memorialize it. So, um, while an insurance company or the employer can do the right thing instantly and recognize your claim and open it and process it and start paying you, you can imagine that in many, uh, instances that doesn’t happen, or it doesn’t happen in a timely way, or it happens, uh, and you start getting paid but it’s not, uh, properly documented. You really haven’t been given any rights that you can exercise if they stop paying you. And again, this all goes back to one of the most important things to do in a workers compensation case, or in the case of a workplace injury, which is have it legally memorialized the right way—which is what your workers comp lawyer is—one of the chief reasons you hire them and one of the first things they do.