Insurers and Adjusters
Become an Adjuster
The RI Department of Business Regulation (DBR), Insurance Division, handles testing and licensing of Workers' Compensation Adjusters for the State of Rhode Island.
The following items are offered as study materials
- Adjuster Licensing Information from the Dept. of Business Regulations
- General Exam Information
- Exam Content Outlines
- Exam Statutes
- Study Outline
- The Claim Filing Instructions document outlines the requirements for first reports and legal documents and provides brief information on EDI (Electronic Data Interchange) transactions.
- Claim Reporting Requirements is a comprehensive training presentation covering RI workers’ compensation claim requirements.
- The Education Unit conducts training on claim reporting. Please contact the Education Unit at DLT.WCEdcUnit@dlt.ri.gov or (401) 462-8100.
EDI Transaction Information
RI requires that both legal agreements and electronic EDI transactions be filed over the duration of a claim. Legal agreements are submitted on paper. See Claim Forms for information on filing legal documents. See EDI website for more information on EDI transactions.
- RI DLT uses the national standard, Claims Release 3, established by The International Association of Industrial Accident Boards and Commissions (IAIABC).
- RI DLT mandated electronic filing on March 1, 2015.
- The insurer or claim adjusting company handling the claim is known as the claim administrator. The claim administrator gathers information on the claim and sends it electronically to RI DLT.
- Injured workers and employers do not send a paper first report to RI DLT. A worker reports an injury to the employer. The employer reports the injury to the claim administrator. The claim administrator reports electronically to RI DLT.
- RI DLT has contracted with Insurance Services Office, Inc. (ISO) to manage electronic FROI and SROI reporting. ISO will register trading partners, conduct testing, collect EDI data and submit data to RI DLT.
- Claim Administrators must register with ISO as a trading partner. Please complete a Trading Partner Profile.
- For more information, visit the or contact ISO at firstname.lastname@example.org.
- First Report of Injury (FROI)
- An injury must be reported if medical treatment is needed, if the injured worker is unable to earn full wages for at least 3 days, or if the injury is fatal.
- Injured workers and employers do not send a paper first report to RI DLT. A worker reports an injury to the employer. The employer reports the injury to the claim administrator handling the claim. The claim administrator reports injuries electronically to RI DLT.
- No first report forms are accepted on paper.
- Subsequent Report of Injury (SROI)
- A SROI is required when indemnity benefits START, STOP or CHANGE.
- A SROI is required every 6 months to report the status of the claim (open or closed).
- A SROI reports the amount of benefits (indemnity and other) paid to date.
- Registration: Each Claim Administrator must register as a trading partner. Please complete a Trading Partner Profile.
- Requirements: RI DLT publishes EDI requirement information in the Implementation Guide.
- More Information
Report Policy Information
Insurance carriers are required to electronically report the start of, end of, and any changes to each workers' compensation policy in Rhode Island. Paper filings are not accepted. Notice of the issuance of a policy or reinstatement of a policy must be made within 5 days of the effective date. Cancellations or non-renewals must be reported immediately and are not effective until received by the Department. Carriers that fail to report as required are subject to a penalty of $250 per transaction.
Insurance carriers are required to report policy information electronically to the Department's designated agent.Carriers should contact NCCI at 800-NCCI-123 (800-622-4123) or ncci.com with questions regarding electronic reporting.
Reporting Rhode Island Unemployment Number (UI Number).The RI UI Number (also known as the ERN) is required when reporting policy information. If the UI Number is not available, use these default codes
- Not available - When the insurer cannot get the UI Number for an established employer, use the default code "0000000001". Coverage may not be denied if an agent or employer fails to provide the UI Number.
- New employer - The UI Number is issued by the RI Division of Taxation after the employer has payroll. For new employers waiting for assignment of a UI Number, use code "0000000002".
- Exempt employer - For employers exempt per RIGL Section 28-42-8 that are not eligible for a UI Number, use code "0000000003".
- "If any policy" - Employers without employees in RI are not eligible for a UI Number. Use code "0000000004".
- Exposure without payroll - For an employer with RI exposure and without RI payroll, use code "0000000004".
Spendable Base Wage
A worker's base weekly compensation rate is calculated as seventy-five percent (75%) of the worker's spendable earnings or spendable base wage capped at a maximum weekly rate. Spendable base wage approximates a worker's earnings less withholdings. Withholding amounts take into account the maximum number of personal exemptions allowed to the employee, not the employee's actual net earnings.
Select the year to view the spendable base wage information (PDF)
The Division of Workers' Compensation publishes information annually on spendable base wage calculations. The worker's date of incapacity determines which set of calculations to use.
For more information, please contact the Education Unit at:
Rates are effective from May 10th of each year. See the Workers’ Compensation Act for determining eligibility requirements.
|Effective date||COLA Rate|
Maximum Compensation Rates
|Effective date||Maximum Weekly Rate|
The Director of the Department of Labor and Training establishes a medical fee schedule of rules and rates of reimbursement for workers' compensation medical services.
The 2018 medical fee schedule effective October 1, 2018 is now available online.
Hospital services are subject to the Hospital Rates instead of the medical fee schedule.
View or order a copy (printed or electronic) of the RI Medical Fee schedule online at Rising Medical Solutions, Inc. ®
The Medical Advisory Board (MAB) adopts and reviews protocols of treatment for work-related injuries and provides notice of impartial medical exams required at 26 and 39 weeks of incapacity. The MAB also records complaints against and is authorized to disqualify medical care providers. You can reach the Medical Advisory Board at One Dorrance Plaza Providence, RI 02903. Phone: (401) 458-3460 | Email: John F. McBurney, Administrator
For more information abut the medical fee schedules, please contact: