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Rhode Island Workers’ Compensation System (Part II)

This is the second entry of a series on the Rhode Island Workers’ Compensation system. The purpose of this series is to inform our readers about the basics of the Rhode Island Workers’ Compensation law. This series will also address certain aspects of the Longshoreman and Harbor Workers’ Compensation Act.

ARTICLE I: Rhode Island Workers’ Compensation Law

In our previous article we wrote about the basic foundation of workers’ compensation and the Rhode Island Workers’ Compensation system. In this piece, we will focus upon the weekly benefits available to people injured at work in Rhode Island.

Weekly Benefits

Assuming you are employed and/or injured while working in the State of Rhode Island, there is a very good chance that your injury falls within coverage of the Rhode Island Workers’ Compensation Act. If the injury causes you to miss time from work, you

are entitled to weekly benefits which help replace your regular earnings.

Prior to the 1990 and 1992 Rhode Island Workers’ Compensation reforms, everyone who was out of work for a work-related injury received two-thirds (2/3) of their average gross weekly earnings prior (“AWW”) to their disability. Now, disabled workers’ are paid 75% of their net (“spendable base”) earnings which for many people (especially those with higher earnings and smaller families) means that they receive less than two-thirds (2/3) of their gross pay while on workers’ compensation. The spendable base is determined by tables published annually by the Rhode Island Department of Labor and Training.

We could talk for quite a while about how a persons gross earnings or “average weekly wage” is calculated in Rhode Island but suffice to say that for a full-time employee, your earnings up to 40 hours are averaged over the 13 weeks before you became disabled and are combined with any overtime or bonus compensation received over the prior year.

One of the first questions we are asked by most injured workers is how long will it be before I start receiving my weekly benefits. Fortunately, the Rhode Island Workers’ Compensation Act is quite efficient in this regard. After a worker is injured and goes out of work with adequate notice to the employer and medical documentation, the employer or its insurance carrier has 21 days to decide what to do with this claim. They may legally accept the claim in a binding fashion, begin payments in a non-binding (non-prejudicial) way, deny the claim or do nothing. After the 21 days lapse and unless the employer/insurance carrier has accepted the claim, the employee may file a claim for benefits (a petition) with the Workers’ Compensation Court. Pre-trial Conference’s are generally held within 30 days of the filing and in most cases, decisions are rendered at that time. The employee may also file for and receive Temporary Disability Insurance (TDI) through the State of Rhode Island Department of Employment Security while the workers’ compensation claim is pending.

Weekly benefits are payable for two types of disability in Rhode Island. Total disability means that a person is unable to perform any work activity at all for a period of time. Partial disability is defined as a person who cannot perform all of the duties of the job they held at the time of the injury but can perform light duty work. Weekly workers’ compensation benefits are the same for total and partial disability in Rhode Island except that when an injured person is totally disabled, they receive an additional $15.00 per week for each dependent (generally a non-working spouse and/or dependent children) although their weekly workers’ compensation rate can not exceed 80% of their average weekly wage regardless of how many dependents they have.

Perhaps the most significant change in the revision of the Rhode Island Workers’ Compensation Act in 1990 and 1992 involved the duration of weekly benefits. Prior to the revisions, there was no limit as to how an injured worker who was partially disabled could receive weekly workers’ compensation benefits. As long as they remained unable to do their former job and did not return to work, their benefits would continue.

Under the present law, benefits for total disability are unlimited so that a totally disabled employee can receive weekly workers’ compensation benefits with Cost of Living Adjustments as long as they remain totally disabled. However, a partially disabled worker is limited to six years of weekly benefits unless he or she can prove that at the end of the six years, they are unemployable.

It is rare that a partially disabled worker remains on weekly benefits for six years. First, it is difficult for many to survive financially for an extended period of time on workers’ compensation benefits. Second, many employers will offer the injured worker light duty work (suitable alternative employment) in order to get him or her back to work. Finally, if a partially disabled employee who has been out of work for an extended period reaches a point where his doctors feel his or her condition is permanent and stable (maximum medical improvement), the insurance company may request a 30% reduction in the workers’ weekly benefits.

It is clear from this brief summary that there are many issues and potential hurdles involved with a claim for weekly benefits under the Rhode Island Workers’ Compensation Act. In our next article, we will cover medical and rehabilitation benefits, an injured workers’ right to return to work after an injury and also the opportunities for settlement of workers’ compensation claims.

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