Workers Compensation

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What is Workers’ Compensation?

Rhode Island Workers’ Compensation Basics

Massachusetts Workers’ Compensation Basics

Workers’ Compensation Injuries

What to do After You Are Injured?

What is a Third Party Action?

Why do I Need a Workers’ Compensation Attorney?

If you have been injured at work and believe that you are entitled to workers’ compensation, the right attorney can make all the difference in recovering the maximum benefits you deserve under the law. A workers’ compensation attorney will be able to advise clients in the procedures for protecting their workers’ compensation benefits and guard against the early termination of benefits. For example, a workers’ compensation lawyer can assist an injured employee if they are being denied benefits, which they are entitled to receive. A workers’ compensation attorney can also help an employee who is told to return to work before they are able. Please call us for a free consultation at 1-800-992-6878, or CLICK HERE to complete a contact form.

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What is Workers’ Compensation?

Workers’ compensation is an employee insurance program. It is designed to provide monetary assistance to employees who are injured while at work. Workers’ compensation also covers occupational related illnesses or diseases, such as mesothelioma (caused by asbestos). Coverage can be provided for a pre-existing condition, if the workplace aggravated or worsened the condition. In addition, the employee does not have to physically be at the workplace to be covered under workers’ compensation. So long as the employee is doing something for the benefit of their employer they are covered. There are some instances where employees are not covered; generally driving to and from the workplace, intentional or self-inflicted injuries or injuries incurred when not working.

The advantage of workers’ compensation is the employee does not have to prove the employer was at fault or somehow liable for their injury. The employee will receive money to pay for medical bills, lost wages, rehabilitation and vocational training. However, in return for not having to prove the employer is liable for their injuries, the employee gives up the right to sue their employer. Workers’ compensation is meant to benefit both employers and employees. Employees are able to receive help at the time they need it. They are not waiting one to two years and spending money on an attorney to legally resolve or prove their employer is liable while they pay for medical bills and lost wages. Employers benefit because they are not fearful of large lawsuits from employees that would bankrupt their businesses and can instead obtain insurance to provide their workers with the necessary coverage.

Death benefits are also covered for workers’ compensation. Workers’ compensation will cover funeral expenses for the deceased employee. Benefits are payable to surviving spouses and children.

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Rhode Island Workers’ Compensation Basics

Who is covered?

Rhode Island workers’ compensation is compulsory, which means employers are required to have the coverage for their employees. However, there are exceptions to this rule. Sole proprietors, partners, agricultural and domestic services employees and some real estate employees are not covered. Firefighters, police and federal employees are covered under a separate system. Municipal employees are only covered under workers’ compensation if the municipality chooses to be covered. Independent contractors are also not covered.

What is covered?

Workers’ compensation provides funds for medical bills, lost wages, rehabilitation and vocational training. An employee can receive funds once their injury makes them unable to earn full wages for three consecutive days or their injury requires medical attention. The amount they receive is roughly 75% of their spendable earnings per week.

Employees typically receive vocational rehabilitation if they have a permanent injury that is disabling and prevents them from returning to their old job. The training they receive can include resume development, training classes, certification courses and assistance with job placement. Additional funds are available, regardless of level of disability, for disfigurement, scarring and loss of use.

Medical treatment:

In terms of medical treatment, in Rhode Island, the injured employee is permitted to choose his or her own doctor. All medical payments are covered; there are no deductibles or co-pays. You are allowed to switch doctors. However, if you do, you must find out if your employer has a pre-approved list of doctors. If they do, you have to pick a doctor from the list or get permission from the insurance company to see your choice of doctor.

What If I Return to Work?

If you are able to return to work, you have a duty to do so. Generally, you have the right to return to your old job if your injuries do not prevent you from performing your job duties. This is called your right to reinstatement. Your employer may be required to make reasonable accommodations in order for you to perform your job. If your job is no longer available, you are entitled to another suitable and available position.

Helpful Link:
Rhode Island Division of Workers’ Compensation:http://www.dlt.state.ri.us/wc/

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Massachusetts Workers’ Compensation Basics

Who is covered?

Massachusetts has a compulsory workers’ compensation program. Employers are required by law to have workers’ compensation for their employees, with the exception of the federal government, shipyards, maritime and railroads. Agricultural workers are covered, as are any domestic workers who are employed for more than 16 hours per week. In addition, once an employee begins work, they are automatically covered.

What is covered?

Massachusetts allows workers to recover benefits once they are unable to earn full wage for 5 or more days. The five days do not need to be consecutive. The amount of money they receive is based on their weekly earnings for the past year. A one-time payment is given to an employee who was disfigured or scarred on their hands, face or neck. Death benefits are paid to dependent family members. A dependent spouse will receive 2/3 of the average weekly pay of the worker so long as they do not remarry.

Medical Treatment

In terms of their medical care, the employer can require the employee to see the employer’s healthcare provider. After their first visit with the healthcare provider, the employee then has the option of going to the doctor of their choice. This change in providers is allowed once. Any other change in medical provider requires insurance company approval. However, workers’ compensation does pay mileage for travel to and from medical visits.

If an employee is unable to return to work because of their injury, vocational rehabilitation will provide them with testing, counseling, workplace modifications, resume development, enrollment in training or certification programs.

What If I Return to Work?

If you are able to return to work, you have a duty to do so. Generally, you have the right to return to your old job if your injuries do not prevent you from performing your job duties. This is called your right to reinstatement. Your employer may be required to make reasonable accommodations order for you to perform your job. If your job is no longer available then, you are entitled to another suitable and available position.

Helpful Link:
Massachusetts Department of Industrial Accidents: http://www.mass.gov/dia/

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Workers’ Compensation Injuries

The most common types of workers’ compensation injuries are back injuries and repetitive motion injuries, such as carpal tunnel. Workers’ compensation covers all work injuries and industrial illnesses. This includes, traumatic injuries, wounds, diseases and bodily reactions or allergies to substances/chemicals at the workplace. Very often mental or emotional harm will also be covered under workers’ compensation.

As an injured worker, it will be determined whether you are partially or totally disabled. The difference being, as a partially disabled worker, your ability to earn full wages is affected, but you are still able to do some work. If totally disabled, your injuries prevent you from doing any work. Determining whether you are partially or totally disabled is not based solely on your injury, but includes factors like your age, education, work experience and English fluency.

If totally disabled, you are entitled to receive 75% of your weekly spendable wages. Total disability benefits can be indefinite, so long as the disability continues to prevent work. Partial disability benefits are 60% of your weekly wages and will cease after six years. Another difference is payments for dependents. If totally disabled, your dependents receive payments each week, whereas if partially disabled, your dependents receive nothing.

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What to do After You Were Injured?

1. Report your injury/disease to your employer. Remember to keep a record for yourself and give one to your employer of all the documentation associated with your injury (medical bills, doctor’s reports, etc).

2. Write down the names, addresses and telephone numbers of any person who witnessed your injury.

3. Seek medical attention for any injury, which you have suffered.

4. If you are a member of a union, report the injury to your union representative.

5. The employer must then notify the insurance company within 10 days of being told of injury/injury occurred. If the injury was fatal, the employer must report it within 48 hours.

6. The insurance company has 14 days to decide to pay the claim or investigate it.

7. The insurance company then has two options.

a. Send a Memorandum of Agreement (MOA) which states the company will accept liability for the harm and the money is then sent within 14 days.

b. Send a Non-Prejudicial Agreement, the insurance company agrees to pay for up to 13 weeks of benefits but the company does not accept liability. The insurance company can cease payments at any time. If you receive benefits for more than 13 weeks, the insurance company should then send you an MOA.

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What is a Third Party Action?

Even if you receive the maximum amount of workers’ compensation benefits, it may not be enough to cover all the expenses you have incurred as a result of your injury. A third party may also be liable for your injuries. A third party action is separate from your workers’ compensation claim that you file with your employer. A third party action is a lawsuit against a third party who may also be responsible for your work-related injury. Third parties may include a manufacturer, contractor or someone whose actions were negligent or careless. In a third party action, you can recover loss for medical bills, lost wages, future wages and pain and suffering.

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Why do I Need a Workers’ Compensation Attorney?

You need a workers’ compensation attorney who can work to protect your rights. If you were injured on the job, and need workers’ compensation, you should consider contacting an attorney who specializes in worker’s compensation claims and can get you the benefits you deserve. Although you do not need an attorney to file a workers’ compensation claim, you do need an attorney if you are being denied benefits. A workers’ compensation lawyer will be able to answer your questions and help you make important legal decisions.

Please contact the law offices of d'Oliveira & Associates at 1-800-992-6878 or fill out a contact form for a free legal consultation.

Remember, we never charge you any fees or expenses, unless your case is successful.

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