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WCB Appellate Division Upholds Decree

On May 18, 2016, the Maine Worker's Compensation Board’s Appellate Division issued a decision which discusses the WCB’s 14-day rule.

In Nickerson v. Paul's Marina, Nickerson was hired at the boat yard during the "busy spring season," which apparently was "slated to end on May 28 or 29, 2010.” He injured his head at work on May 4, reported the injury, and got medical treatment, but he continued working. On May 24, Nickerson went home because he was "not feeling well," and Judge Goodnough found that Paul's likely "associated … Nickerson's "illness with his work-related head injury."

On June 1, at MEMIC’s request, Nickerson completed an injury statement form indicating that he lost only one day of work on May 10, but Nickerson never returned to work. In October 2010, Nickerson's mother contacted MEMIC claiming that her son was out of work due to the May 4 head injury. MEMIC then filed a Notice of Controversy contesting the lost time claim but not the related medical bills. Nickerson filed a Petition for Award and claimed a 14-day violation requiring immediate payment of total incapacity benefits.

In May 2014, Judge Goodnough granted the petition and awarded Nickerson incapacity benefits (apparently partial rather than total) from May 25, 2010 to the present and continuing, but he denied payment of additional benefits finding Paul's did not violate the 14 day rule. Judge Goodnough found that Paul's did not have "the information necessary to conclude that a claim for incapacity benefits was being made on May 24,” and that as of June 1 "Nickerson did not consider himself to be out of work to the injury." Nickerson appealed the 14 day issue.

Nickerson argued that Paul's knowledge on May 24 that Nickerson was going home because of symptoms from his prior work injury was sufficient to trigger Paul's obligation to file a Notice of Controversy within 14 days thereafter. The Appellate Division panel, however, affirmed Judge Goodnough’s decision, finding found that Nickerson "effectively withdrew his request for lost wage benefits before the 14 days had expired."

This decision is instructive on 2 points: (1) despite its amendment, the WCB's 14 day rule continues to be a potentially expensive problem for Maine employers; and (2) employers and insurers should have employees complete written incident reports following any claimed work injury. Had MEMIC not done so in this case, the result would likely have been different. The WCB still has not produced a form indicating "claim for incapacity benefits," so unless employers ask the question themselves, they are left to guess whether benefits are being claimed, perhaps to their financial detriment.

If you have any questions about this or any other case, please let us know.

Tom Getchell
Mike Richards
Dan Gilligan
Attorneys at Law