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At Workers' Compensation Shop.com we attempt to offer free access to all of Rhode Island's workers' compensation forms, applications and guides. We strive to keep our library as up to date as possible.
As with all information we provide, please verify the accuracy of this information with the Rhode Island Division of Workers' Compensation.
If you have questions about a workers' comp form feel free to contact a specialist at 888-611-7467. We want to be your source for workers' compensation information, rates and quotes in Rhode Island.
RI Acord 130 Workers' Compensation Application.
The standard Acord 130 application form for workers' comp coverage in Rhode Island.
Rhode Island First Report of Injury Form.
RI First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
Rhode Island Application for Exclusion of Officers and Stockholders
Owners and Officers of corporations should complete this form to exclude themselves from a workers' compensation policy.
Rhode Island Application for Inclusion of Officers
Officers of corporations should complete this form to include themselves from a workers' compensation policy.
Rhode Island Application for Exemption for Workers' Compensation Insurance
Complete this form if you are a sole-proprietor, partnership with no employees or an sole officer of a corporation and would like to be exempt from coverage.
Notice of RI Independent Contractor
Complete this form if you are an independent contractor and wish to be exempt from workers' compensation benefits.
Facts for Injured Workers In Rhode Island
This poster contains important insurance information and should be posted in full view for employees.
Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers' compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.
A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.
A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.
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State Resources for Rhode Island
RI Dept of Labor and Training
Division of Workers' Compensation1511 Pontiac AvenueBuilding 69, Second FloorPO Box 20190Cranston, RI 02920-0942401-462-8100 www.dlt.ri.gov/wc/
National Council on Compensation Insurance (NCCI)
901 Peninsula Corporate CircleBoca Raton, FL 33487-1362800-622-4123 www.ncci.com/
Workers' compensation insurance is required by law for Rhode Island employers.
Rhode Island forms and applications such as owners inclusion or exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers' compensation form your need for Rhode Island.
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