In accordance with state law, the State of Rhode Island provides workers’ compensation insurance. This insurance covers an injury or illness sustained in the course of employment that required medical, surgical, or hospital treatment. Subject to applicable legal requirements, workers’ compensation insurance provides benefits after a short waiting period.
The University of Rhode Island’s Workers Compensation carrier is the State Employees Workers’ Compensation. The information below should be supplied to the health care provider where you seek medical attention for your work related injury:
State Employees Workers’ Compensation
One Capitol Hill
Providence, RI 02908
Contact Leslie Cronan in HR at 874-2684 with any questions on your work related injury, or to get your claim number to give to your health care provider. Fax forms and medical documentation to Leslie at 874-5530.
- 24 Hour Notification Form to be completed by Supervisor
- Sick Leave / URI Payroll Discharge Form
- Employees Certificate of Dependency Status
- Authorization for Release of Confidential Information
- URI Incident/Injury Report (USP-14A) – to be completed for a work injury
- W-9 (to be completed by a student worker or/and Internal payroll workers only)
The URI Injury/Incident Report USP-14A is a carbonless form. You can get these forms by calling Leslie Cronan at 874-2684; or you can print out a form from the link above.