Rhode Island Workers’ Compensation System (Part III)
This is the third 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.
In our previous articles we wrote about the basic foundation of the Rhode Island Workers’ Compensation system, and weekly benefits for injured workers in Rhode Island. In this piece, we will focus upon certain aspects of the medical treatment available to people injured at work in Rhode Island.
If you are injured at work and your injury falls within coverage of the Rhode Island Workers’ Compensation Act, you are entitled to receive reasonable medical treatment (including physical therapy, surgical treatment, dental treatment, optical treatment, hospital service, medicines, crutches and apparatus) for such a period as is necessary in order to “cure rehabilitate or relieve” you from the effects of the injury. Reasonable medical treatment, under Rhode Island law, is governed by whether the medical treatment is accepted at the national level. Medical bills related to the injury should be paid in full by the employer’s insurance company. There are no co-payments or deductibles.
The employer’s insurance company need not pay for major surgery until permission for the surgery is obtained from the Workers’ Compensation Court, the employer, or the employer’s insurance company. There is an exception to this rule in cases where compliance may prove fatal or detrimental to the injured employee.
You may choose your first medical care provider. Treatment at an emergency room after the accident or by a company physician does not count as the first medical care provider. Your first medical care provider may refer you to a specialist without prior approval from the employer’s insurance company.
If you decide to switch doctors, you must first find out if your employer’s insurance company has a "preferred provider network" (a list of approved doctors). If they do, you must either select a doctor from that list or get the approval of your insurer or self-insured employer before you see another doctor. If your employer’s insurance company does not have an approved list of doctors, you may choose the doctor of your choice.
This has been a brief introduction to medical benefits. In our future articles, we will discuss rehabilitation benefits, an injured workers’ right to return to work after an injury, and also the opportunities for settlement of workers’ compensation claims.