COLA Reimbursement
COST OF LIVING
ADJUSTMENT REIMBURSEMENT RULES AND PROCEDURES
In acknowledgement of the burden placed on insurers who were required to
provide Cost of Living Adjustment (COLA) payments pursuant to RI General
Laws sections 28-33-17 and 28-33-18.3, 1990 RI Public Laws chapter 332,
articles 1, 3 and 4, the following Rules and Regulations are hereby
promulgated pursuant to RI General Laws section 42-16-2 for the purpose
of affording relief in the form of reimbursement for COLA payments to
qualifying insurers:
I. Definitions.
As used in these Rules and Regulations:
A. “Assessments” means those payments made by insurers pursuant to
R.I.G.L. section 28-37-13, et seq.
B. “COLA” means the cost of living adjustment as that index is
formulated and computed by the Bureau of Labor Statistics of the United
States Department of Labor.
C. “Court” means Workers’ Compensation Court, unless otherwise
indicated.
D. “Director” means the Director of the Department of Labor and Training
or his/her designee.
E. “Fund” means the Workers’ Compensation Administrative Account.
F. “Insurers” means those organizations licensed and regulated by the
Department of Business Regulation to write workers’ compensation
insurance in the State of Rhode Island, exclusive of self- insurers,
group self- insurers, and entities exempt from regulations pursuant to
R.I.G.L. section 45-5-20.1.
G. “Person” means any individual, partnership, corporation, association,
governmental subdivision or public or private organization of any
character other than an agency.
H. “Necessary Filing Requirements” include, but are not limited to:
- Court orders, decisions, decrees
- Interim and final reports of payment
- Memorandum of agreement, non-prejudicial agreement
- Termination of benefits, suspension agreements, mutual agreements
- Wage statements, dependency forms
- Proof of payment
II. Eligibility
A. Only insurers, who are deemed current with the Workers’ Compensation
Administrative Fund Assessments and have paid all assessments due,
including penalties may be reimbursed from the Fund pursuant to R.I.G.L.
section 28-37-13(f).
B. Reimbursement will be made only for claims with injury dates prior to
September 1, 1990 pursuant to 28-37-1(8). The initial claim for
reimbursement must be made prior to June 30, 1996. Reimbursement
requests are to be submitted on form DWC-39 prescribed by the Department
of Labor and Training.
C. Liability must be established on all claims for Cost of Living
Adjustment reimbursement by Memorandum of Agreement or Order of the
Workers’ Compensation Court. Final decision for reimbursement will be
held on claims for which litigation is pending regarding the liability
of the claim.
D. Once an application submitted has been approved for reimbursement
continuing reimbursement requests are to be submitted on an individual
claim basis on form (DWC-40) prescribed by the Department of Labor and
Training. Reimbursement will not be considered until all the necessary
filing requirements have been met.
E. Request for Cost of Living Adjustment reimbursement should be
addressed to the Rhode Island Department of Labor and Training, Workers’
Compensation Administrative Account.
F. Proof of payment must accompany all requests for reimbursement to the
Fund. The Department of Labor and Training may accept a list including
check date, check number, payee name, dates covered by payment, and
amount of payment, signed by an authorized representative of the insurer
verifying that the list is a true and accurate accounting of the
payments made as proof of payment. When deemed necessary the Department
of Labor and Training may require actual check copies as proof of
payment.
G. Once a claim is accepted for reimbursement of the COLA benefits,
continuing reimbursement requests must be submitted to the Department of
Labor and Training on a semi-annual basis until the employee is no
longer eligible for COLA benefits. If an insurer fails to file its
requests by the deadline, stated in III(c) below, with the Department of
Labor and Training, those requests that are not filed within the stated
deadline will be considered delinquent by the Fund.
III. Forfeiture
of Benefits.
A. Requests will be reviewed and a letter will be sent, if necessary,
notifying the applicant of the status of their requests. If the
information supplied is incomplete, the applicant shall have sixty (60)
days to comply with all necessary filing requirements. A claim will be
deemed delinquent if the applicant has failed to supply the additional
information requested within sixty (60) days. Once a claim is deemed
delinquent, the file will be closed.
B. The Department will only reimburse the actual cost of living increase
payments that are appropriate under the Workers’ Compensation Act. The
Department will not reimburse for overpayment errors paid by the
insurer.
C. A semi-annual claim for cost of living adjustment reimbursement shall
be submitted on or before August 15 for the period from January 1 though
June 30 of the current year. Claims must be submitted on or before
February 15 of the current year for the period from July 1 through
December 31 of the prior year.
D. Delinquent requests will not be reimbursed by the Department of Labor
and Training.
IV. Appeals.
A. Any party disputing an initial denial by the claims unit may file an
objection within thirty (30) days of the mailing date with the Director
of the Department of Labor & Training for a determination of the claim
for reimbursement. Upon receipt of a written objection, proper hearing
notice shall be sent to all parties. Failure to file an objection within
thirty (30) days will constitute a waiver of said party’s right to
object, and the Director/designee will proceed with the final decision.
B. The Director/designee on its own motion may schedule a pre-hearing
conference in order to reduce the issues in dispute and to arrange a
hearing schedule. The pre- hearing conference will be scheduled within
thirty (30) days of the request and proper notice will be sent.
C. Continuances shall be addressed to the sound discretion of the
Director/designee assigned to the hearing. The Director/designee shall
give due regard to provide prompt hearings. No continuances will be
granted without good cause.
D. If any party, or an officer or agent of a party, without good cause
fails to appear for hearing after being served with proper notice, the
Director/designee may make such orders in regard to the failure,
including, but not limited to (1) entering orders adverse to that party
and (2) requiring that party to pay the reasonable costs associated with
the hearing.
E. The Department will arrange for a stenographer to be present at all
Administrative Account hearings.
F. If any party disagrees with the final decision of the
Director/designee, the party may file a petition to review at the
Workers’ Compensation Court together with a copy of the decision and
order to be reviewed. Appeal of the final agency decision shall be made
pursuant to the Workers’ Compensation Rules of Procedure, section 2.32.
