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Maine WC Alert: New Legislation Brings Procedural Changes, Benefit Modifications

Maine Workers' Comp Alert

LD 756 (“An Act To Improve the Maine Workers’ Compensation Act of 1992”), was signed into law by Governor Mills on June 17, 2019. LD 756 has an effective date of September 17, 2019. Most provisions apply to injuries on or after January 1, 2020. The following are key provisions of the new legislation.

Benefit Modifications

Maximum Benefit Rate (§ 211)
For dates of injury on or after 1/1/20, the maximum benefit rate increases to 125% of the state average weekly wage (SAWW).

Under current law, for injuries on or after 1/1/13, the maximum benefit rate is 100% of the SAWW.

Fringe Benefits (§ 102(4)(H))
For dates of injury on or after 1/1/20, employer-paid fringe benefits that do not continue must be included to calculate the compensation rate to a maximum of 2/3 of 125% of the SAWW.

Current law limits compensation rate adjustments for discontinued fringe benefits to a maximum of 2/3 of 100% of the SAWW.

Cost of Living Adjustment for Total Incapacity Benefits (§ 212(4))
For dates of injury on or after 1/1/20, in which § 212 total incapacity benefits are paid, after 260 weeks the total compensation rate is subject to an annual cost of living adjustment which may not exceed the maximum compensation rate.

Current law does not provide for cost of living adjustments other than to the maximum rate when payable.

Durational Limit on Partial Incapacity Benefits (§ 213)
For dates of injury on or after 1/1/20, an employee is not eligible to receive partial compensation after receiving 624 weeks (12 years) of benefits under §212, §213, or both. There may be an extension of benefits only for extreme financial hardship. 

Death Benefits (§ 215)
If death results from an injury on or after 1/1/20 and the employee has no dependents, death benefits must be paid to the employee’s parents during their lifetime, up to 500 weeks. “Parents” may be natural or adoptive, so long as parental rights were not terminated. For work-related deaths without dependents from 1/1/19 to 1/1/20, death benefits otherwise payable to the State are to be paid to the parents.

Procedural Changes

Time for Payment of Benefits (§ 205(2))
Effective 9/17/19 the requirement to pay benefits within 14 days of notice or knowledge of the injury is tolled if the first payment cannot be made due to an act of God, mistake of fact or unavoidable circumstances.

Penalties relating to timeliness of benefit payments (§ 205(2))
Effective 9/17/19, in the absence of filing a timely Notice of Controversy, the penalty for failure to pay within 14 days is limited to $50.00 per day for each day late over 30 days, capped at $1,500.00. The amendment to § 205 provides: “Further consequences” of a failure to make timely payment are specifically not a subject for rulemaking.

Investigation period (§ 205(2))
Effective 9/17/19, if payment of incapacity benefits without prejudice is initiated, by filing a Notice of Controversy within 45 days of first knowledge or notice, payment of incapacity benefits may be discontinued. After 45 days, benefits may be discontinued or reduced only with 21 day notice and the filing of a WCB-8.

Paid Time Off (§ 221)
Effective 9/17/19, the after-tax value of paid time off may be offset against the compensation otherwise due.

Notice (§ 301)
For dates of injury on or after 1/1/20, notice of the injury must be given within 60 days.