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State of Rhode Island Department of Labor and Training Division of Workers Compensation 1511 Pontiac Avenue Cranston RI 02920 Forms Revised January 2003 Form Number Title DWC-01 Employer s First Report of Alleged Occupational Injury or Disease Memorandum of Agreement DWC-03F Wage Statement Full Time Employee s Certificate of Dependency Status Suspension Agreement and Receipt Non-Prejudicial Agreement DWC-22 Report of Indemnity Payment Mutual Agre.

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DWC-1 Workers Compensation Claim Form. This is the form you will complete and send to EMPLOYERS to initiate the claim process for your employee. This form must be completed and provided to EMPLOYERS within one working day from you becoming aware of a work-related injury or occupational disease.

The RI workers' compensation system is a form of no fault insurance designed to provide assistance to employees injured at work for medical expenses and lost wages. The employer buys an insurance policy to cover accidents to employees in the workplace.

If your injury is not listed on the state workers' compensation injury schedule, you may collect a percentage of your average weekly wages for up to 312 weeks. If your injury involves permanent disfigurement, your benefits may continue for up to 500 weeks.

This range can be three to seven years. That said, there is not usually a limit on permanent disability benefits. However, some states do stop weekly benefits when employees reach the age of 65. Also keep in mind that not all states will provide permanent partial disability benefits.

The RI workers' compensation system is a form of no fault insurance designed to provide assistance to employees injured at work for medical expenses and lost wages. The employer buys an insurance policy to cover accidents to employees in the workplace.

Coverage requirements in Rhode Island say you must have workers' compensation insurance if you have employees. There are workers' comp exemptions for some employees, including: Sole proprietors. Partners.

Up to 260 weeks or 5 years. However, you are entitled to 7 years of benefits when combining Temporary Total and Temporary Partial Disability. For example, if you receive 3 years of temporary total disability benefits, you cannot receive an additional 5 years of partial disability benefits.

If your injury is not listed on the state workers' compensation injury schedule, you may collect a percentage of your average weekly wages for up to 312 weeks. If your injury involves permanent disfigurement, your benefits may continue for up to 500 weeks.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232