Read these frequently asked questions about claims after a workplace injury.
What benefits does Beacon Mutual provide if I am injured on the job or have an occupational disease?
If your claim is accepted by Beacon Mutual, you might qualify to receive the following types of benefits:
- Medical benefits, which cover treatment that is reasonable and necessary to cure, relieve, and rehabilitate you from the effects of your work-related injury or occupational disease.
- Indemnity benefits, which is coverage that might pay you for lost wages if you are medically disabled for more than 3 calendar days. A note or disability slip from a doctor is needed to support your time out of work and needs to be provided at regular intervals to support the ongoing disability and eligibility for wage replacement benefits.
I was hurt on the job - what do I do?
You must report the injury or occupational disease promptly to your employer. Seek treatment if needed. If you are treated by a medical provider, or are out of work for more than three days, your employer must report your claim to Beacon Mutual either by phone or online.
I am not able to work - who pays me?
If you are disabled from working (according to a medical provider) for more than 3 calendar days as a result of your work related injury and your claim is accepted, you will receive your wage replacement benefit from Beacon Mutual. There is a mandatory 3-day waiting period under the RI Workers’ Compensation Act and Beacon Mutual does not pay you for that time. Payment for the first three days may be available directly from your employer.
What should I expect after my claim is reported?
If your claim is only for work-related medical treatment, you are usually not contacted unless Beacon has a question. The billing for your work-related injury treatment will be processed and payment will be made directly to the medical provider.
If we are made aware that you have lost more than 3 days from work, you will be contacted by a claim representative within 24 hours after Beacon received notification of your claim. Your claim representative will obtain more information from you about your work-related injury and will verify the information that was reported. If you are losing time from work and have not been contacted, please contact our office at 401-825-2667 to speak to a claim representative.
Can I go to my own doctor for treatment?
Yes. By law, you initially have the freedom of choice to obtain health care from any qualified health care provider. This provider may refer you to a specialist without prior approval from your employer’s medical provider. Your first visit to an emergency facility is not considered your first choice. However, if you see a provider more than once and then decide to change doctors, you must select a provider from the Beacon Mutual Preferred Provider Network (PPN).
How do I pay for my medical treatment and/or prescriptions?
If you had to pay out of pocket for any prescribed medications for your accepted work-related injury, you can submit the prescription details and receipt to your claim representative for reimbursement. For accepted claims with work-related medical treatment, you will receive a card from the Beacon Mutual pharmacy benefit management company, Mitchell Script Advisor. This card provides access to quality pharmaceutical care through a trusted network of more than 67,000 pharmacies nationwide. Fill a Prescription.
My doctor said I need to see a specialist, need medical testing, or physical therapy - what should I do?
If you are in treatment with a provider in the Beacon Mutual Preferred Provider Network (PPN), the medical provider can refer you to a specialist within the PPN. All treatment referrals, authorizations to see a specialist, diagnostic testing or physical therapy should be requested directly by the provider from Beacon Mutual’s Managed Care Unit at 401-825-2989, or the provider can fax the request to Beacon at 401-825-2854. If the type of specialist you need is not listed in the PPN, the provider should contact the Beacon Mutual claim representative for further instruction on how to make the referral.
I have not received my weekly check - what do I do?
You can contact your claim representative at 401-825-2667 between 7:45 p.m.-5:00 p.m., Monday through Friday. There might be a delay if there is a holiday during the week that you expect your check.
When should I expect to receive my first check?
Our goal is to pay accepted claims within 10 days of our notification of a work-related injury.
How do I get a claim number?
You should receive your claim number when the Beacon Mutual claim representative contacts you. Your claim number is also noted on forms that you will receive from Beacon Mutual for work-related injuries for which you have lost time from work. You can also call 401-825-2667 and ask for Claims to request your claim number.
Can I get a second opinion?
If you wish to get another medical opinion to confirm a diagnosis or treatment options communicated by your treating physician, call your claim representative to discuss at 401-825-2667.
What is an independent medical exam?
Beacon Mutual might ask you to have an Independent Medical Examination for an independent opinion. This request might result if there is a question on the cause of the injury, a question about the ongoing disability or the injury being claimed, or questions on the treatment plan. The Independent Medical Examiner cannot and will not treat your injury.
What if I move to a new address while receiving workers’ compensation benefits?
You should notify Beacon Mutual of any change to your address as soon as possible. This will ensure that you receive your benefit checks or other important information about your claim, in a timely manner. To notify us of any address change, call 401-825-2667. We also suggest that you submit a change of address form with the US Postal Service. For additional information about changing your address, visit the US Postal Service website.
How are my wage replacement benefits calculated?
Are workers’ compensation benefits considered taxable income?
You do not receive a W2 or 1099 form from Beacon Mutual for your weekly wage replacement checks. For specifics on any personal tax-related reporting questions, it is recommended that you contact a tax professional.