Can a Workers’ Compensation Claim Be Reopened?

Can a Workers' Compensation Claim Be Reopened?

Question

Can I reopen my workers’ compensation claim?

Answer

It depends if you received any settlement to end the workers’ compensation case or if you get injured again while you are working.

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When can the claim be reopened?

It depends on how it was “closed,” so to speak.  If you received any type of “settlement” to end your workers’ compensation case (i.e. a lump sum commutation or a denial and dismissal), then the answer is no, you cannot reopen your case, and indeed you would have had to have stated to a judge at the settlement hearing that you understand the case is over forever and all time and that you can never come back to reopen it.  

If on the other hand, you returned to work and began having problems again or you injury reappeared or worsened and you have to come out of work again, then yes, you may “reopen” your case in that sense.

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Can Workers’ Compensation Be Retroactive?

Can Workers' Compensation Be Retroactive?

Question

If I was injured at work, Can my workers’ compensation benefits be reatroactive?

Answer

Yes, you will receive benefits retroactive to your first date of disability.

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Can workers' compensation be retroactive?

Yes, once your work injury is accepted and/or memorialized as entitling you to workers’ compensation benefits, you will receive benefits retroactive to your first date of disability, minus any amounts you may have received in TDI or other wages.  

Keep in mind, however, that there is a statute of limitaitons in Rhode Island that provides you must file your case no later than two (2) years from the date of injury. If your date of injury and first date of lost time are different, consult with a lawyer regarding any questions you have regarding the statute of limitations.

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Can Workers’ Compensation Be Taxed?

Can Workers' Compensation Be Taxed?

Question

Are my workers’ compensation benefits taxed?

Answer

No, however it is important to consult with an accountant.

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Consult an accountant for taxes topics

You should always consult with an accountant for this and any question regarding taxes.  However, workers’ compensation benefits are not taxable.

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Can Workers’ Compensation Be Garnished For Child Support?​

Can Workers' Compensation Be Garnished For Child Support?

Question

Can child support be garnished from my workers’ compensation?

Answer

Yes. If child support costs are not paid, they can be garnished from your workers’ compensation.

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Can Workers' Compensation Be Garnished For Child Support?

Yes.  Liens for unpaid child support can and will attach to your workers’ compensation case.

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Can Workers’ Compensation Be Denied?

Can Workers' Compensation Be Denied?

Question

Can the insurance company or the employer deny me the workers’ compensation even when they are paying it to me?

Answer

Yes. They can do this for months, and then inform you they are not accepting your claim. 

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Can Workers' Compensation Be Denied?

Yes.  Insurance company claims reps and/or your employer can deny your claim for workers’ compensation benefits.  This leaves you in the position of having to go to court to fight for your rights. More importantly, in Rhode Island, the insurance company or the employer can begin paying you workers’ compensation and lead you to believe your claim is accepted and everything is fine (i.e. that you don’t need a lawyer). They can do this for several months, and then suddenly inform you they are not accepting your claim.

Consult An Expert In Advance

This can leave you in a precarious and uncertain position. This is why it is always better to consult with a workers’ compensation lawyer ahead of time, even if you believe the claim is being “accepted.”

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How Is Workers’ Compensation Calculated?

How Is Workers' Compensation Calculated?

Question

How can I calculate the amount of my compensation if I got injured at work?

 

Answer

You can calculate your workers’ compensation by using the average weekly wage formula from the R.I. department of labor. 

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The Weekly Indemnity Formula

The amount you receive in your weekly workers’ compensation benefit check (sometimes referred to as “weekly indemnity”) is calculated using a statutory formula that is based on your average straight gross earnings during the 13 weeks immeadiately prior to your injury, plus an average of your overtime/bonuses for the 52 weeks prior to your injury, and your dependency status (i.e. single/married/children, etc.).  

How To Determine Your Spendable Base Wage?

This formula is used to arrive at your “average weekly wage” (AWW) for workers’ compensation purposes. Your average weekly wage amount (AWW) 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. 

Find your average weekly wage on the left-most column on the applicable wage table, and then go across that row to find your status on the applicable table columns (i.e. single-2 or married-3, etc.), that number will be your “spendable base wage.”  Once you have that number, what you actually receive in your weekly workers’ compensation check will be 75% that number, i.e. you weekly check will amount to 75% of your spendable base wage.

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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. 

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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).

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

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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.

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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

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

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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.

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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, 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.

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