Workers' Compensation Law Summaries

Workers' Compensation Law Summaries

Maine, Workers' Compensation Law Summaries

Maine's workers' compensation law is located in the Maine Revised Statutes at Title 39-A, Part 1, Chapters 1, 3, 5, 7, 9, 15 and 19.

COVERAGE

Workers' compensation coverage in Maine is compulsory for all employments, including corporate executive officers. Corporate officers who are 20% shareholders may reject coverage. Coverage is elective as to self-employed persons or partners. Coverage is compulsory for employees of the state, its counties, cities and quasipublic corporations. Coverage includes fire fighters, police, volunteer fire fighters and emergency medical services personnel. Nonresident employers with employees in Maine must carry workers' compensation coverage, unless they have a special exemption (Sec. 102).

EXCEPTIONS

Employers of six or fewer regular agricultural or aquacultural employees are exempt if the employer maintains a liability insurance policy with limits of not less than $100,000 per employee and medical coverage of not less than $5,000 per employee (Sec. 401). Also excepted are maritime employees in interstate or foreign commerce, commission-paid real estate salespersons and brokers, provided that the broker or salesperson is an independent contractor and signs a contract with the agency indicating their status as an independent contractor.

In addition, independent contractors are excepted, as are employees who harvest 150 cords of wood from farm wood lots, voluntary participants in employer-sponsored athletic events, elected or appointed executive officers of a charitable, religious, educational or other nonprofit corporation (Sec. 102). Prisoners are not entitled to benefits unless employed by a private employer while in prison or participating in a work-release program (Sec. 203).

Coverage is voluntary for excluded employments. Parents, spouses and children of a sole proprietor, partner, corporate officer who is a 20% shareholder, or a shareholder of a professional corporation may reject coverage.

If an out of state employee is doing temporary work in Maine, the employee and employer are exempt from coverage during the period of temporary employment if (Sec. 102):

1. the employee is not a resident of Maine and was not hired in Maine;

2. the employer does not have a permanent place of business in Maine;

3. the period of temporary employment in Maine does not exceed five consecutive days, or 10 days in any 30-day period or 30 days in any 360-day period;

4. the employer and employee are covered by the workers' compensation law of another state that applies to the employer and employee while the employee is working in Maine;

5. the employer has obtained workers' compensation coverage in another state that covers the employee and employer while the employee is working in Maine;

6. the extraterritorial provisions of Maine's workers' compensation law that cover employee working temporarily in Maine are recognized in the other state; and

7. employers and employees covered in Maine are exempt from the application of workers' compensation laws of the other state under legislation that is comparable to this provision. If the above requirements do not apply to an out-of-state employee and employer temporarily working in Maine, the employer must obtain coverage from an authorized Maine insurer or self-insurer (Sec. 113).

The law does not cover domestics, seasonal (less than 26 weeks in a year of full-or part-time work) or casual agricultural or aquacultural employees.

WHAT THE EMPLOYER MUST DO

Insurance choices.- Covered employers must either self-insure, including group self-insurance or purchase insurance coverage from a private insurance carrier (Sec. 401). All self-insured employers must be members of the Maine Self-Insurance Guaranty Association (Sec. 404).

All policies issued to employers for workers' compensation insurance must disclose clearly to the employer as separate figures the base rate and the employer's experience modification factor. Upon request from an employer, when the policy is issued, it must be accompanied by a statement disclosing the percentages of premium expended during the previous year by the insurer for claims paid, loss control and other administrative costs, medical provider expenses, insurer and employee attorney's fees and private investigation costs (Sec. 2385-B).

Waiting period.- Compensation for incapacity to work is not payable for the first seven days of incapacity, except that fire fighters must receive compensation from the date of incapacity. Other than in the case of a fire fighter, when the incapacity continues for more than 14 days, compensation is allowed from the date of incapacity (Sec. 204).

Reports and records.- The employer must report to the board any work-related injury that caused the employee to lose a day's work or when the employer has knowledge of any such injury, within seven days of gaining knowledge. A wage statement must be sent to the board within 30 days of notice or knowledge of the injury (Sec. 303).

The person in charge of a workplace provided by the state, a state agency, a county, a municipal corporation, a school district or other public corporation or political subdivision must, within eight hours after the occurrence, report in writing or by telephone to the Director of the Bureau of Labor Standards the death of any person in the workplace or on the premises, stating as fully as possible the cause of the death and the place where the deceased person has been sent and supplying other information relative to the death that may be required by the director, who may investigate the causes of the death and require such precautions to be taken as will prevent the recurrence of similar events. In the event of a serious physical injury, the reporting requirement is within 24 hours after the occurrence of the injury (Title 26, Sec. 2).

Choice of physician.- The employer initially has the right to select a health care provider for the employee. After 10 days (from the time health care is provided by the employer), the employee may select a different health care provider by giving the employer the name of the provider and a statement indicating the employee's intention to be treated by that provider. The employee may not change health care providers more than once without approval from the employer or the workers' compensation board (Sec. 206).

Payment of benefits.- The provision of medical care for an injury or illness by or under the supervision of a health care provider employed by, or under contract with, the employer is a payment of benefits with respect to that injury or illness if:

1. care was provided for the injury or illness on six or more occasions in the 12-month period after the initial treatment; and

2. the employer or the health care provider knew or should have known that the injury or illness was work-related.

This law applies to all injuries and illnesses, regardless of when they occurred (Sec. 306(2)).

Health care facility mistakes.- A health care facility is prohibited from knowingly charging a patient or the patient's insurer or the patient's employer as defined in the state's workers' compensation law for health care services it provided as a result of or to correct a mistake or preventable adverse event caused by that health care facility (22 MRSA Sec. 1721(2), as amended by Ch. 31 (H. 258), L. 2009, enacted April 16, 2009).

Offset provisions.- Maine offsets benefits for personal injury or disease under an insured disability or medical payment plan against payments for workers' compensation.

Workers' compensation benefits are reduced by the amount of any concurrent unemployment compensation benefits (Sec. 220), excluding lump sum settlements and scheduled permanent partial disabilities. Total and partial disability benefits are reduced by:

1. 50% of the amount of “old age” insurance benefits received under the federal Social Security Act;

2. the after tax amount of the payments received under an employee benefit plan provided by the same employer, if the employee did not contribute directly to the plan; and

3. the proportional amount, based on the ratio of the employer's contributions to the total contributions, if the employee did contribute directly to the plan (Sec. 221).

Drug and alcohol use.- Injuries resulting from the injured employee's intoxication while on the job are not compensable, unless the employer knew at the time of the injury that the employee was intoxicated or that the employee had a habit of being intoxicated on the job and did nothing to stop the employee from working while intoxicated (Sec. 202).

NOTICE

Notice of an injury must be given to the employer within 90 days and notice of death must be given within three months; failure of notice is excusable (Sec. 301).

POSTING

Notice stating that the employer has conformed to the workers' compensation law must be posted and kept posted in each of an employer's workplaces. The notice must be conspicuous and posted in a place accessible to employees.

PENALTIES

If the employer or insurer fails to pay compensation, the board may assess up to $200 per day of noncompliance (Sec. 324(2), as amended by Ch. 265 (S. 359), L. 2007).

If an employer fails to secure payment of compensation, the employer is liable for a civil penalty of up to $10,000 or 108 percent of the premium, whichever is larger. A corporate employer is subject to administrative dissolution or revocation of its authority to do business in the state. Any licensed, registered or certified employer can lose its license, registration or certification (Sec. 324).

Reporting penalties may not exceed $100 per violation per person. The board may assess a fine against an individual of $1,000 or $10,000 against a corporation for a willful violation or fraud. The board can order the repayment of any compensation received through a violation, with 10 percent interest (Sec. 360).

Penalties can be assessed when an undisputed medical bill is not paid within 30 days after the carrier receives notice of nonpayment by certified mail or if the bill is paid by the employee. The penalty is the lesser of $50 or the amount of the bill to be added to the bill and paid to the billing provider or, if paid by the employee, to the employee, for each day over 30 days in which the bills are not paid, subject to a maximum of $1,500 (Sec. 205(4), as amended by H. 1297, L. 2007).

CONTACTS

Workers' Compensation Board, 27 State House Station, Augusta, ME 04333-0027, 207-287-3751.

See also ¶20-9900 .