The Maine Workers' Compensation Appellate Division recently addressed cases dealing with refusal of suitable work and notice. Both decisions rely heavily on the specific facts of each case. In the context of a refusal of suitable work, a refusal may be deemed reasonable when an employee is medically not capable to perform the work offered, from a physical or psychological perspective. In terms of notice, where an individual is the sole owner and employee of a closely held business, the Appellate Division recently found that employee need not comply with notice requirements applicable to self-employed individuals.

Refusal of Suitable Work

St. Louis v. Acadia Hospital Corporation, WCB App. Div. No. 19-29 (August 19, 2019)

Section 214(1)(A) of the Maine Workers’ Compensation Act provides:

If an employee receives a bona fide offer of reasonable employment from the previous employer or another employer or through the Bureau of Employment Services, and the employee refuses that employment without good and reasonable cause, the employee is considered to have voluntarily withdrawn from the work force and is no longer entitled to any wage loss benefits under this Act during the period of the refusal.

Acadia Hospital appealed a decision (Hirtle, ALJ) granting St. Louis’s Petitions for Award, finding Acadia did not demonstrate that St. Louis refused a job offer without good and reasonable cause under § 214(1)(A). Acadia argued that Ms. St. Louis did not have sufficient cause to refuse the offer. The Appellate Division affirmed. When asked whether the job offered was suitable, Dr. Voss wrote: “Ms. St. Louis has a high degree of anxiety if she considers return to work in a setting where there is increased risk for being assaulted, such as in Acadia Hospital. . . .” The Appellate Division found, “[Dr. Voss] concluded that return to work there ‘is medically contraindicated,’ citing anxiety and panic attacks. This evidence and other evidence provides a reasonable basis for the ALJ’s conclusion that Ms. St. Louis’s refusal of the job offer was done with good and reasonable cause.”

Notice

Ouellette v. Ouellette Funeral & Memorial Services, Inc., WCB App. Div. No. 19-28 (August 14, 2019)

Section 301 of the Maine Workers' Compensation Act provides:

For claims for which the date of injury is prior to January 1, 2013, proceedings for compensation under this Act, except as provided, may not be maintained unless a notice of the injury is given within 90 days after the date of injury. . . .

The notice must be given to the employer, or to one employer if there are more employers than one; or, if the employer is a corporation, to any official of the corporation; or to any employee designated by the employer as one to whom reports of accidents to employees should be made. . . . If the employee is self-employed, notice must be given to the insurance carrier or to the insurance carrier's agent or agency with which the employer normally does business.

Section 302 of the Maine Workers' Compensation Act provides:

A notice given under section 301 may not be held invalid or insufficient by reason of any inaccuracy in stating any of the facts required for proper notice, unless it is shown that it was the intention to mislead and that the employer was in fact misled by the notice. Want of notice is not a bar to proceedings under this Act if it is shown that the employer or the employer's agent had knowledge of the injury.

Ouellette appealed a decision (Pelletier, ALJ) denying his Petitions based on his alleged failure to provide timely notice to his workers’ compensation insurer, MEMIC, pursuant § 301. Ouellette argued he was not required to provide notice to MEMIC under § 301 because he was not self-employed at the time of injury but was an employee of a corporation. He argued that the corporate employer’s knowledge of his work-related condition satisfied the notice requirement pursuant to § 302. The decision was vacated.

At issue is whether 39-A M.R.S.A. § 301 can be construed to require the sole owner of a closely held corporation who is also an employee of the corporation to comply with the notice requirements applicable to self-employed individuals.

The ALJ found that, because Ouellette was the sole owner and employee of a closely held business, he was essentially self-employed, and required to provide notice to MEMIC within 90 days (the applicable timeframe for his pre-1/1/13 date of injury). Because he failed to do so, the claim was barred. The Appellate Division found that because the employer was a corporation, Ouellette was not required to provide notice of his work- injury to his employer’s insurer within the statutory time frame. It was legal error to bar his claim for failure to provide notice on the basis that he was self-employed. Also, Ouellette was an employee and the employer. Thus, his receipt of the doctor’s report establishing causation established the employer’s actual knowledge of the work-related injury, satisfying the notice requirement under sections 301 and 302.