Notify your supervisor or human resource department immediately.

After your employer reports the injury to our office, a claim representative is assigned. You will be contacted directly within 24 hrs to review information and begin the claim process.

A Dependency form confirms your marital status and number of dependent children. If you are out of work, this information is used to calculate benefits on claims.

Injured workers are reimbursed at a state mandated rate, which is approximately 75% of the net weekly wage, with slight changes due to your marital status and number of exemptions/dependents.

Every September 1st, the maximum rate for benefits changes. This information is posted on the Department of Labor and Training website.

If you lose time from a second job due to a work injury at your primary job, then you are also entitled to receive benefits from the second job. A wage form is sent to your second employer, and your earnings are included in the calculation of your benefit rate.

The 3-day waiting period is state-mandated.

Yes. You are entitled to benefits for any permanent disfigurement you receive as a result of a work-related injury. Contact your claim representative for further information regarding scarring benefits.

Yes. If you desire a second medical opinion, contact your claim representative who can assist you in coordinating the second opinion and explain the process.

No. TDI payments are for non-work related injuries or illnesses. Workers’ compensation payments are for work-related injuries.

Workers’ compensation does not reimburse you for pain or suffering. You are entitled to a lost wage benefit until you are able to return to work. Workers’ compensation also pays for medical expenses related to the work injury, as well as scarring and loss of use if appropriate to your injury.

We have nurses on staff to assist you with receiving appropriate medical treatment, and ergonomic specialists that work with you and your employer to aid in your return to work. Your claim representative helps you and your employer coordinate these services.

Submit the pharmacy receipts to your claims representative or employer, and you will be reimbursed for any out-of-pocket costs.

Our goal is to pay accepted claims within 7 to 10 days of notification of a work related injury.

Effective January 1, 1999 every person firm, public service or private corporation, including the State, that employs employees regularly in the same business is subject to the Workers’ Compensation Law.

The Beacon has an approved preferred provider network comprised of providers that are experienced in treating work-related injuries. This directory contains a listing of physicians and other health care providers participating in The Beacon Preferred Provider Network. Click Here to view and print a copy or call your claim representative and ask for a copy to be sent to you.

Send in wage statements, full duty job descriptions, assist in identifying modified duty jobs and implement a return-to-work policy or program.

Injured employees are reimbursed at a state-mandated rate, which is approximately 75% of the net weekly wage, based upon a calculation of their average weekly wage prior to the injury. The employer is required to complete a state wage statement to determine the average weekly wages. Overtime and bonuses are used in the computation of the average weekly wage.

Yes. You are required to continue paying private health coverage for two years from the time the employee begins to receive workers' compensation. The employee is required to continue to maintain their weekly contribution amount. Your company is not required to maintain private health benefits if your company is subject to the Employee Retirement Income Security Act (ERISA).

No. You are not required to pay injured employees during the 3-day waiting period but you can if you so choose.

It is not recommended that you make any type of benefit payments to an injured employee. By doing so, this could result in the injured employee receiving “double” payments and medical providers receiving more than required by the RI Fee Schedule.

You are required to take an injured employee back to work as stated in the Right to Reinstatement, if the injured employee returns to work within one year of their date of injury. There are exceptions and it is recommended that you speak to your claim representative to determine if you meet any of the exceptions.

You can minimize the cost by educating your work force, prompt reporting of injuries and offering modified duty. You are not required to offer modified duty. However, this is a great way to control the costs on a claim, thereby reducing your exposure. An employee is entitled to their job with reasonable accommodations per the American Disabilities Act and according to the right to reinstatement as listed in the Workers’ Compensation Act.

SAE is a formal offer of employment that mutually protects the injured employee and the employer. SAE is an offer of employment that an employee is physically capable of performing without exacerbating the medical condition. The employee is protected if the job does not meet the conditions of the SAE offer and the employer is protected if the employee does not perform the SAE as it is offered.

It is treated the same as if the employee was working regular duty.

An injured employee has the first choice to treat with whomever they choose. Any change in physician after the first choice must be within the PPN. However, all of your employees should be familiar with and encouraged to use Beacon’s Preferred Provider Network (PPN). Physicians listed in the PPN are more familiar with Workers’ Compensation and the paperwork required to process a claim.

If an injured worker is dissatisfied with the medical treatment he or she is receiving and wishes to see another physician to confirm or dispute the appropriateness of that treatment, a second opinion can be coordinated with the help of the claim representative. A second opinion is a great tool to assist an employee in directing their medical care that might not otherwise be achieving its goal.

The employee may be asked to submit to an independent medical examination, at the insurer’s expense, for an independent opinion. This is generally used when there is a dispute in the disability, injury or question of the treatment plan. Independent Medical Examiners cannot treat an injured worker.

If the identity of the insurer is unknown, contact the Department of Labor and Training at 1-401-462-8116.

Bill on the HCFA1500 using code 99080 for special reports.

We recommend obtaining the information from the injured worker regarding the health insurance carrier when the injured worker initially completes the paperwork. If the claim is denied you can then bill the injured worker’s regular health insurance for the visit(s).

No. That would be considered “balance billing”, which is not allowed under workers’ compensation law. Direct any questions that you have to the Department of Labor and Training at 1-401-462-8100.

Please notify The Beacon claims representative as soon a possible.

No. But if a patient becomes non-compliant according to your office policy, the DWC27/28 can be used to notify The Beacon that a patient has been discharged for non-compliance. List the missed appointment dates. Bill on a HCFA 1500 using the 99080 code for special reports.

Assists the injured worker to achieve the highest level of medical improvement, and facilitates a successful return to work in the safest, most cost effective manner. NCM is provided on a case-by-case basis. NCM provides patient advocacy. Facilitation of communication and education. Provides an overview of the “Big Picture” Provides access to appropriate and timely resources.

Click Here for Answer

Click Here for Answer

Click Here for Answer