Background:

In two consolidated cases, the employees filed petitions and were awarded benefits under the Federal Longshore and Harbor Workers’ Compensation Act. St. Mary’s chose instead to file a Petition for Payment of its services under the State of Maine Workers’ Compensation Act, which contains a more generous fee schedule. The Hearing Officer granted the Hospital’s Petitions under the Workers’ Compensation Act and Bath Iron Works appealed.

Court ruling:
The Court held that healthcare providers are free to proceed under the Federal Longshore Act or the Maine Workers’ Compensation Act. The Court noted that in certain circumstances, jurisdiction between the Longshore Act and Workers’ Compensation Act is concurrent and that healthcare providers are not bound by an employee’s choice to proceed under one Act or the other as long as there is no double recovery or contradictory claim.

View complete text of St. Mary’s Regional Medical Center v. Bath Iron Works

Background:
This case involved an employee with a partial work capacity and permanent impairment below the threshold for continued partial benefits. She reached her durational limit (364 weeks) as of February 23, 2007. In a November 29, 2007 Decree, the Board found the employee had received all benefits to which she was entitled. The employee did not appeal that decision, making it final.

Five days later the Board amended its Rules, extending the durational limit an additional 52 weeks. The effective date of the amendment was January 1, 2007. The employee filed a Petition for Review claiming entitlement to the extension and the Hearing Officer granted the Petition. Tambrands appealed.

Court ruling:

In this case, the Court had an opportunity to answer a question that was not before it inAbbott v. School Administrative District No. 53, 2000 ME 201, 762 A.2d 546. In that case the Court held that only employees who are still entitled to benefits on the date of the extension are entitled to the additional weeks. However, in that case the employee’s entitlement ran before both the date the extension was adopted and the retroactive effective date. The Court therefore did not specifically address whether it was the adopted date or effective date that controlled.

In the present case, the employee’s entitlement ran before the date the extension was adopted in December 2007 but after the retroactive effective date, which was January 2, 2007. The Court held that it is the effective date that controls. As long as an employee has a right to receive benefits after the effective date of the extension, they are entitled to the extension.

View complete text of Carol Beaudoin v. Tambrands, Inc., et al.

Background:
In March 2006, the employee injured his back while at work for Re-Harvest. He was unable to work even light duty following the injury and less than 4 weeks later, he was terminated. It was more than a year later that the employee regained some work capacity and was able to secure full-time employment. The employer voluntarily paid total incapacity benefits during that period of time.

The employee filed a Petition to Remedy Discrimination which was granted by the Hearing Officer. He ordered the employer to pay the employee’s reasonable attorneys fees as well as the amount he paid out of pocket for health insurance while he was between jobs. Re-Harvest appealed.

Court ruling:

The Court overruled the Hearing Officer’s decision. The Court acknowledged that a short period of time between a claim for workers’ compensation benefits and termination can be circumstantial evidence of discriminatory intent. However, the Court went on to note that there was no requirement that an employer retain an employee for long periods of time during which the employee is totally unable to work. In this case, there was no question that Lavoie was unable to perform any work functions for weeks after the injury and there was no indication that his health was likely to change in the near future. In fact, it was more than a year before Lavoie regained work capacity and returned to work for another employer. Unless there is some indication that the employee has a recoverable work capacity, there is no provision in the Workers’ Compensation Act that would require employers to maintain employees who are completely unable to work in their employment roles.

View complete text of Raymond Lavoie v. Re-Harvest, Inc., et al.

Background:
Smart suffered a work-related mental stress injury in the course of his employment as a Maine state trooper. The employer sought to establish permanent impairment below the statutory threshold in order to discontinue his partial benefits pursuant to the weekly limitation on partial benefits in Section 213(4).

Smart was evaluated by a Section 312 independent medical examiner, who established 40 to 45% permanent impairment as a result of work-related major depressive disorder, anxiety disorder and obsessive-compulsive personality disorder. However, instead of using the 4th Edition of the AMA Guides as prescribed by Board Rule, the examiner used the 2nd Edition of the AMA Guides.

The employer appealed, contending that it was error to assign permanent impairment to Smart’s mental injuries because the 4th Edition of the AMA Guides does not contain specific numerical ratings for mental and behavioral conditions. They also argued that it was error for the independent medical examiner to rely on a source other than the 4th Edition of the AMA Guides to arrive at a percentage of permanent impairment. 

Court ruling:

The Court quickly disposed of the employer’s first argument. The Court had recently ruled that it was proper to assign permanent impairment to the mental sequella of a physical injury. See Harvey v. H.C. Price, 2008 ME 161, 957 A.2d 960. The Court found that the reasoning used in Harvey applies equally to Smart’s injury, a mental injury resulting from work-related stress.

On the other hand, the Court agreed that it was error for the hearing officer to adopt the permanent impairment rating given by the independent medical examiner. Use of the 4th Edition of the AMA Guides is mandated by Workers’ Compensation Board Rule. The independent medical examiner’s opinion regarding permanent impairment, because it was based on the 2nd Edition, was therefore insufficient to establish the level of permanent impairment. The case was remanded to the hearing officer for a redetermination of permanent impairment.

View complete text of Arnold Smart v. Department of Public Safety

Background:
Tucker injured his back at work in 2002. After the injury, he returned to school and obtained his high school diploma. In 2006, he enrolled as a full-time student at a community college. Despite having a full-time, light duty work capacity, Tucker looked for part-time work only, as he intended to work only part-time while going to school. He found a part-time job in March 2007.

Tucker filed a Petition for Review seeking 100% partial benefits through the date he found part-time work and then ongoing partial benefits thereafter. His Petition was granted and Associated Grocers of Maine (AGM) appealed, contending they should not be held responsible for a higher level of partial incapacity benefits due to Tucker’s election to attend school full-time.

Court ruling:

The Court agreed with AGM and remanded the case to the hearing officer for a recalculation of benefits imputing a full-time earning capacity. It was undisputed that Tucker had a full-time earning capacity and Tucker himself conceded that he looked only for part-time work. While Tucker may have had good reason to do so (he was attending school full-time), the Court reasoned that an employer is responsible only for loss of earning capacity related to the work injury and an employee’s election to attend school has no such connection. The Court stopped short of saying that by electing to attend school full-time the employee has voluntarily withdrawn him or herself from the labor market. Tucker may still be entitled to ongoing partial benefits, but it will be based on a full-time rather than a part-time earning capacity.

View complete text of Randall K. Tucker v. Associated Grocers of Maine, Inc., et al.

Background:
Sprague suffered a 1999 low back injury and underwent surgical procedures in 1999 and 2003. Lucas sought to establish permanent impairment below the 11.8% threshold applicable to Sprague’s date of injury. The Act requires that permanent impairment be determined according to the 4th Edition of the AMA Guides to the Evaluation of Permanent Impairment (“the Guides”). Chapter 3 of the Guides applies to spine injuries and provides that the evaluator should use the “Injury” or “DRE” model if the patient’s condition fits within one of eight listed categories. It goes on to provide that if the condition does not fit into one of the eight categories, the physician should use the range of motion model as a differentiator to decide placement within one of the DRE categories.

In this case, Sprague’s own physician used the DRE model and assigned 10% permanent impairment. A 312 exam was conducted and the examiner used the range of motion model, reasoning that because Sprague had multiple surgeries he did not fit neatly within any of the DRE categories. Using the range of motion model, he assigned 12% permanent impairment.

The Hearing Officer adopted the 312 examiner’s opinion. Lucas appealed, contending that the 312 examiner should have used the range of motion model merely to place the employee in the proper DRE category, not as an assessment tool in and of itself.

Court ruling:

The Court found no error in the 312 examiner’s use of the range of motion model in assessing permanent impairment. The Court found enough support in the language of the Guides to use the range of motion model in and of itself to assess permanent impairment in some circumstances, and not just as a tool to differentiate between categories in the DRE model. In this case, the independent medical examiner concluded that Sprague’s condition did not fit neatly within any of the DRE categories so that the range of motion model provided the best estimate of his permanent impairment. This gives the examiner a good deal of flexibility in rating permanent impairment, providing the examiner can support that the condition doesn’t fit squarely within one of the DRE categories. That appears to be a fairly low threshold and could result in a wide range of ratings regarding the same condition.

View complete text of David J. Sprague v. Lucas Tree Experts, et al.