Case Title: Doucette v. Hallsmith/Sysco Food Services, et al.

Citation: 

Docket Number: WCB-10-669

State: maine

Court: Maine Supreme Court

Date: 2011-06-09T00:00:00Z

Document:
MAINE SUPREME JUDICIAL COURT 
 
 
 
     
    Reporter of Decisions 
Decision: 
2011 ME 68 
Docket: 
WCB-10-669 
Argued: 
February 9, 2011  
Decided: 
June 9, 2011 
 
Panel: 
SAUFLEY, C.J., and ALEXANDER, LEVY, SILVER, MEAD, GORMAN, and JABAR, 
JJ. 
Majority: 
SAUFLEY, C.J., and LEVY, SILVER, MEAD, GORMAN, and JABAR, JJ. 
Concurring: SAUFLEY, C.J., and LEVY, and GORMAN, JJ. 
Concurring/ 
Dissenting: 
ALEXANDER, J. 
 
MATTHEW DOUCETTE 
 
v. 
 
HALLSMITH/SYSCO FOOD SERVICES, INC., et al. 
 
SILVER, J. 
[¶1]  Hallsmith/Sysco Food Services, Inc. (Sysco), appeals from a decision 
of a Workers’ Compensation Board hearing officer (Collier, HO) awarding 
Matthew Doucette the protection of the Act for a 2004 work injury and total 
incapacity benefits for a violation of the “fourteen-day rule.”  See Me. W.C.B. 
Rule, ch. 1, § 1.  Sysco contends that the award for the fourteen-day rule violation 
should be vacated because (1) the third-party administrator attempted to file its 
notice of controversy electronically on the fourteenth day although it was not 
transmitted to the Board until the fifteenth day; (2) Doucette suffered no incapacity 
as a result of the injury; and (3) the award is unfair and imposes excessive costs on 
the workers’ compensation system.  We affirm the judgment.   
 
2 
I.  BACKGROUND AND PROCEDURE 
 
 
[¶2]  Matthew Doucette, now age twenty-nine, injured his back on 
April 1, 2004, while working as a selector in the warehouse for Sysco.  He felt pain 
in his lower back after lifting a bag of onions onto a pallet.  Doucette timely 
reported the injury to his supervisor, and was sent for treatment.  Diagnosed with 
lumbar strain, he was restricted from lifting more than twenty pounds.  Doucette 
was put on light duty for approximately two weeks, at which time he was released 
to full duty.  He did not lose any earnings as a result of this injury.  Sysco 
terminated Doucette’s employment in May 2004 for reasons unrelated to his back 
injury.  He had no further problems with his back until 2008, when he reinjured it 
while working for a different employer.   
[¶3]  On January 15, 2009, Doucette filed a petition for award against Sysco 
for the 2004 injury, alleging entitlement to “total/partial compensation from 
April 1, 2004 to the present and continuing.”  The hearing officer concluded that 
Doucette is entitled to the protection of the Act even though he suffered no loss of 
earnings as a result of the injury, and is not entitled to wage loss benefits.  
Doucette also asserted a fourteen-day rule violation against Sysco for failing to file 
a notice of controversy (NOC) within fourteen days of receiving the petition for 
 
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award.1  The rule requires that an employer “[w]ithin 14 days of notice or 
knowledge of a claim,” accept a claim, pay without prejudice, or deny the claim 
and file a NOC.  
[¶4]  Gallagher Bassett Services, Inc. (Gallagher Bassett), served as a 
third-party administrator for Sysco for the 2004 date of injury.  On January 16, 
2009, a claims representative for Gallagher Bassett learned that Doucette’s petition 
for award alleging the April 1, 2004, date of injury had been filed.  Gallagher 
Bassett’s file for Doucette’s 2004 injury showed that Doucette had received 
treatment on three dates and was released to full duty work on April 21, 2004.  It 
was the claims representative’s intention to file a “partial denial,” which required 
the filing of a NOC with the Board and also required specific coding to be entered 
into Gallagher Bassett’s computer system. 
[¶5]  The claims representative started the process of filing a NOC on 
January 26, 2009, by entering the coding and the date of injury.  The information 
went to another department within Gallagher Bassett, the Electronic State 
Reporting (ESR) Unit, which she anticipated would “kick” the report forward to 
the Maine Workers’ Compensation Board.  On January 27, 2009, the claims 
representative received a rejection notice from the ESR department because the 
                                         
  1  Doucette also filed petitions for award and to remedy discrimination with the Workers’ Compensation 
Board against a different employer regarding the 2008 date of injury, but those petitions are not at issue in 
this appeal. 
 
 
4 
claim required additional information, including a jurisdictional claim number 
(JCN).  The claims representative then learned that because the claim had not been 
electronically reported back in 2004, she needed to generate a first report of injury 
in order to obtain a JCN.  After initially rejecting the first report of injury due to a 
coding error, the Board accepted it on January 29, 2009.  A JCN was generated and 
the claims representative believed she had transmitted the partial denial/NOC to 
the Board on January 29, 2009, the fourteenth day.  On that same date, she sent a 
hard copy of the NOC by certified mail to Doucette and his attorney.  The NOC in 
the Board’s file, however, indicates a date of filing of January 30, 2009.  Because 
Gallagher Bassett’s electronic communication system did not transmit the NOC to 
the Board until after midnight, the NOC was filed on the fifteenth day.   
[¶6]  The claims representative did not learn that there had been a late filing 
until March 19, 2009.  Upon learning of Doucette’s claim that he was entitled to 
payment for total benefits from the date of incapacity due to the late-filed NOC, 
Gallagher Bassett attempted to determine the extent of Doucette’s claim of 
incapacity.  On April 13, 2009, having received no response from Doucette, 
Gallagher Bassett paid Doucette a sum equal to one dollar for each working day 
after April 1, 2004.  
 
5 
 
[¶7]  Because the Board did not receive the NOC until after midnight on the 
fifteenth day, the hearing officer determined that Sysco was in violation of the 
fourteen-day rule.  The hearing officer found: 
[T]he insurer diligently attempted to file the NOC in a timely fashion 
but . . . a series of internal problems, culminating in the insurer’s own 
automated system bundling electronic claims for filing after midnight 
on the night of January [29], resulted in the NOC being transmitted to 
and received at the Board (and therefore “filed” under the Rule) in the 
early morning hours of January 30, 2009, which was the 15th day 
after the employer received notice of the claim for incapacity benefits. 
 
See Me. W.C.B. Rule, ch. 3, § 2(2)(A)2 (providing that a document is filed with the 
Board when the Board receives it).  Thus, the hearing officer ordered Sysco to pay 
Doucette total incapacity benefits from April 1, 2004, to April 13, 2009, the date 
the violation was cured, with credit for earnings and statutory offsets.3   
[¶8]  Sysco filed a motion for additional findings of fact and conclusions of 
law, and a motion requesting that the hearing officer stay the enforcement of the 
fourteen-day rule violation pending a ruling on that motion.  The hearing officer 
                                         
  2  Me. W.C.B. Rule, ch. 3, § 2(2)(A) provides: 
Except as specifically provided in 39-A M.R.S.A. § 101 et seq. or in these rules, forms 
and correspondence required to be filed in the Central Office of the Workers’ 
Compensation Board are filed when the Board receives the form by mail, in-hand 
delivery, fax, or other form of electronic transfer. 
 
(Emphasis added).  
 
  3  The hearing officer further found that Sysco had made a good faith attempt to cure the violation as of 
April 13, 2009, which “served to end the ongoing violation.” 
  
 
6 
granted the stay, but ultimately denied Sysco’s motion for additional findings of 
fact and conclusions of law, and lifted the stay.  In denying the motion, the hearing 
officer stated: 
On the issue of the fourteen day violation, the enforcement of any 
deadline can seem arbitrary and harsh as applied to a given set of 
facts.  If an employee misses a notice date or exceeds a limitations 
period his or her claim may be unenforceable.  But a deadline does 
provide the advantage of clarity.  In this case, the NOC was filed on 
the fifteenth day, January 30, 2009.  Therefore the Board’s Rule was 
violated and the penalty must stand. 
 
[¶9]  Sysco then filed a notice of appeal and a motion to stay enforcement of 
the hearing officer’s decision on the fourteen-day rule violation.  We issued a per 
curiam opinion on December 23, 2010, in which we denied Sysco’s motion for a 
stay.  Doucette v. Hallsmith/Sysco Food Servs., Inc., 2010 ME 138, ¶¶ 5-6, 
10 A.3d 692, 694.  “Recognizing the urgency of the issue presented for appeal,” 
we treated the motion for a stay and Doucette’s response as the petition for 
appellate review and response pursuant to M.R. App. P. 23(b)(1), granted the 
petition, and set an expedited briefing schedule.  Id. ¶¶ 7-8, 10 A.3d at 694-95.    
II.  DISCUSSION 
[¶10]  In this appeal, we are asked to decide whether the hearing officer 
erred in determining that a fourteen-day rule violation occurred.  We must also 
decide whether it was error to award total benefits from the date of injury when the 
 
7 
employee suffered no loss of earnings as a result of that injury, and whether that 
award is excessive and unfair.   
A. 
Standard of Review and Authority of the Workers’ Compensation Board   
[¶11]  Our focus here is on Me. W.C.B. Rule, ch.1, § 1.  We have recognized 
“a legislative intent to delegate broad authority to the Board to interpret the Act 
when the statutory language is ambiguous either by rule or through its 
decision-making authority.”  Baker v. S.D. Warren Co., 2010 ME 87, ¶ 10, 3 A.3d 
380, 383; see also Bridgeman v. S.D. Warren Co., 2005 ME 38, ¶ 10, 872 A.2d 
961, 964; Russell v. Russell’s Appliance Serv., 2001 ME 32, ¶ 10 n.3, 766 A.2d 67, 
71.  “[W]e give deference to Board rules interpreting the Act and have encouraged 
the Board to enact rules to fill in the ‘gray areas’ that were intentionally left in the 
Act.”  Baker, 2010 ME 87, ¶ 10, 3 A.3d at 383; see also Bridgeman, 2005 ME 38, 
¶ 11, 872 A.2d at 964-65; Russell, 2001 ME 32, ¶ 10 n.3, 766 A.2d at 71; Bureau 
v. Staffing Network, Inc., 678 A.2d 583, 588 (Me. 1996).  
[¶12]  The Board derives its rulemaking authority from 39-A M.R.S. 
§ 152(2) (2010), which provides: 
2.  Rules.  Subject to any applicable requirements of the Maine 
Administrative Procedure Act, the board shall adopt rules to 
accomplish the purposes of this Act. Those rules may define terms, 
prescribe forms and make suitable orders of procedure to ensure the 
speedy, efficient, just and inexpensive disposition of all proceedings 
under this Act. 
 
 
8 
(Footnote omitted.) 
 
[¶13]  Along with its duty to administer the Act, the Board is required to 
monitor cases to ensure that “[p]ayments are initiated within the time limits 
established in section 205.”  39-A M.R.S. §§ 152(1), 153(1)(A) (2010).  Moreover, 
the mission of the Board is “to serve the employees and employers of the State 
fairly and expeditiously by ensuring compliance with the workers’ compensation 
laws, [and] ensuring the prompt delivery of benefits legally due . . . .”  
39-A M.R.S. § 151-A (2010). 
B. 
The “Fourteen-Day Rule” and Its Precursors 
[¶14]  Maine W.C.B. Rule, ch. 1, § 1 provides, in relevant part: 
 
1.  
Within 14 days of notice or knowledge of a claim for incapacity 
or death benefits for a work-related injury, the employer or insurer 
will: 
  
 
 
A. 
Accept the claim and file a Memorandum of Payment 
checking “Accepted” in Box 18; or 
  
 
 
B. 
Pay without prejudice and file a Memorandum of 
Payment checking “Voluntary Payment Pending Investigation” in Box 
18; or 
  
C. 
Deny the claim and file a Notice of Controversy. 
  
 
2. 
If the employer fails to comply with the provisions of Rule 1.1, 
the employee must be paid total benefits, with credit for earnings and 
other statutory offsets, from the date of incapacity in accordance with 
39-A M.R.S.A. Sec. 205(2) and in compliance with 39-A M.R.S.A. 
Sec. 204.  The requirement for payment of benefits under this 
 
9 
subsection automatically ceases upon the filing of a Notice of 
Controversy and the payment of any accrued benefits. 
 
[¶15]  This rule was promulgated to implement 39-A M.R.S. § 205 (2010),4 
which requires that employers and insurers pay incapacity benefits “within 14 days 
                                         
  4  Title 39-A M.R.S. § 205 (2010) provides in relevant part: 
 
§ 205 Benefit payment. 
 
    1. Prompt and direct payment.  Compensation under this Act must be paid promptly 
and directly to the person entitled to that compensation at the employee’s mailing 
address, or where the employee designates, without an award, except in cases when there 
is an ongoing dispute. 
 
    2. Time for payment. The first payment of compensation for incapacity under section 
212 or 213 is due and payable within 14 days after the employer has notice or knowledge 
of the injury or death, on which date all compensation then accrued must be paid. 
Subsequent incapacity payments must be made weekly and in a timely fashion.  Every 
insurance carrier, self-insured and group self-insurer shall keep a record of all payments 
made under this Act and of the time and manner of making the payments and shall 
furnish reports, based upon these records, to the board as it may reasonably require. 
    
    3. Penalty for delay. When there is not an ongoing dispute, if weekly compensation 
benefits or accrued weekly benefits are not paid by the employer or insurance carrier 
within 30 days after becoming due and payable, $50 per day must be added and paid to 
the worker for each day over 30 days in which the benefits are not paid.  Not more than    
$1,500 in total may be added pursuant to this subsection.  For purposes of ratemaking, 
daily charges paid under this subsection do not constitute elements of loss.  For purposes 
of this subsection, “employer or insurance carrier” includes the Maine Insurance 
Guaranty Association under Title 24-A, chapter 57, subchapter 3. 
   
    4. Payment of bills for medical or health care services. When there is no ongoing 
dispute, if bills for medical or health care services are not paid within 30 days after the 
carrier has received notice of nonpayment by certified mail from the provider of the 
medical or health care services or, if the bill was paid by the employee, from the 
employee who paid for the medical or health care services, $50 or the amount of the bill 
due, whichever is less, must be added and paid to the provider of the medical or health 
care services or, if the bill was paid by the employee, to the employee who paid for the 
medical or health care services for each day over 30 days in which the bills for medical or 
health care services are not paid.  Not more than $1,500 in total may be added pursuant to 
this subsection.  For purposes of this subsection, “carrier” includes the Maine Insurance 
Guaranty Association under Title 24-A, chapter 57, subchapter 3. 
    
    5. Employer failure to provide notice.  An employer who has notice or knowledge of 
the disability or death and fails to give notice to the carrier shall pay the penalty provided 
for in subsection 3 for the period during which the employer failed to notify the carrier. 
 
10 
after the employer has notice or knowledge of the injury,” and weekly thereafter.  
39-A M.R.S. § 205(2); Bridgeman, 2005 ME 38, ¶ 8, 872 A.2d at 963.  The statute 
also imposes penalties for failure to make timely payments when there is no 
ongoing dispute, not to exceed $1500.  39-A M.R.S. § 205(3).   
[¶16]  Section 205 was adopted in 1992 with the wholesale reformation of 
the Workers’ Compensation Act, P.L. 1991, ch. 885, § A-8, (effective Jan. 1, 
1993),5 and replaced the controversial “early pay system” adopted in the 1980s.  
                                                                                                                                   
   
    6. Interest. When weekly compensation is paid pursuant to an award, interest on the 
compensation must be paid at the rate of 10% per annum from the date each payment was 
due, until paid. 
    
    7. Memorandum of payment. Upon making the first payment of compensation for 
incapacity or upon making a payment of compensation for impairment, the employer 
shall immediately forward to the board a memorandum of payment on forms prescribed 
by the board.  This information must include, at a minimum, the following: 
      
 
A. The names of the employee, employer and insurance carrier; 
      
 
B. The date of the injury; 
      
C. The names of the employee’s other employers, if any, or a statement that there 
is no multiple employment, if that is the case; and 
      
 
D. The initial weekly compensation rate. 
    
    8. Information. Information regarding wages must be reported as provided in section 
303. 
    
    9. Discontinuance or reduction of payments.  The employer, insurer or group 
self-insurer may discontinue or reduce benefits according to this subsection.  
(Footnote omitted). 
 
  5  The 1992 reform of the Workers’ Compensation Act was intended to reduce workers’ compensation 
costs to employers and attract employers to the state, as well as cut costs to the system as a whole.  See 
7 Legis. Rec. S-37-42 (3d Spec. Sess. 1992); 7 Legis. Rec. H-76-81, 91-100 (3d Spec. Sess. 1992); Blue 
Ribbon Commission, Report of the Blue Ribbon Commission to Examine Alternatives to the Workers’ 
Compensation System and to Make Recommendations Concerning Replacement of the Present System 
(Aug. 31, 1992); see also P.L. 1991, ch. 885, Emergency Preamble (referring to recommendations of the 
Blue Ribbon Commission) (effective Oct. 7, 1992);  Temm v. S.D. Warren Co., 2005 ME 118, ¶ 13, 887 
 
11 
P.L. 1979, ch. 142 § 1 (effective Sept. 14, 1979), P.L. 1983, ch. 479 § 7 (effective 
June 24, 1983).  Under the early pay system, the failure of an employer to file a 
NOC within statutory time frames created a “compensation payment scheme” in 
which the employer was deemed to have accepted the employee’s claim of injury 
in certain instances.  See 39 M.R.S.A. § 51-B(1), (7) (1989), repealed by P.L. 
1991, ch. 885, § A-7 (effective Jan. 1, 1993).  The purpose of the early pay system 
was to encourage informal acceptance of claims and reduce attorney involvement.  
L.D. 1322, Statement of Fact (111th Legis. 1983).  We have interpreted section 
51-B to preclude a late-filing employer from disputing that an injury was 
work-related and to require the employer to accept the claim at the level alleged by 
the employee.  See Wentworth v. Manpower Temp. Servs., 589 A.2d 934, 937-38 
(Me. 1991); Stickles v. United Parcel Serv., 554 A.2d 1176, 1178-79 (Me. 1989).   
[¶17]  Although section 205 imposes a penalty for late payment, it does not 
preclude employers from disputing any aspect of the claim.  The fourteen-day rule, 
initially promulgated in 1993, fills this gap.  Me. W.C.B. Rule, ch 1, § 1.  
C. 
Validity of the Fourteen-Day Rule 
[¶18]  In the face of a challenge to its validity, we upheld the fourteen-day 
rule in Bridgeman, 2005 ME 38, ¶¶ 1, 14-15, 872 A.2d at 962, 965.  We 
                                                                                                                                   
A.2d 39, 43 (stating that the overall purpose of the workers’ compensation reform of 1992 was “to reduce 
costs in the workers’ compensation system”). 
 
 
12 
determined in that case that the Board did not exceed its authority in promulgating 
the rule because it was not in direct conflict with the Act.  Id. ¶¶ 12-15, 872 A.2d at 
965.  We reasoned: 
Pursuant to section 205, an employer receiving notice of a 
claim of workers’ compensation benefits has the option, initially, to 
pay benefits voluntarily without accepting liability and without a 
formal Board proceeding.  39-A M.R.S.A. § 205.  The Act, in concert 
with the Board rules, establishes a three-step system that applies when 
an employer does not pay benefits voluntarily.  First, the case is 
referred to a troubleshooter.  39-A M.R.S.A. § 153(2) (2001); Me. 
W.C.B. Rule, ch. 1, § 6(1).  Next, if the troubleshooter is unable to 
resolve the issue informally, the case will then go to mediation.  39-A 
M.R.S.A. §§ 307(5), 313(2) (2001); Me. W.C.B. Rule, ch. 1, § 6(1); 
ch. 11, § 1.  If the mediation is unsuccessful, the case may either be 
referred to arbitration, 39-A M.R.S.A. § 314 (2001), or assigned for a 
formal hearing before a hearing officer, 39-A M.R.S.A. § 315 (2001). 
 
 An employer’s failure to voluntarily pay benefits is therefore 
the triggering event for all subsequent proceedings to determine the 
compensability of an injury and to award benefits if benefits are due.  
The filing of a notice of controversy gives notice to the employee and 
to the Board of an employer’s intent to contest a claim.  By 
promulgating Board Rule, ch. 1, § 1, the Board reasonably sought to 
encourage the timely filing of a notice of controversy to facilitate the 
administrative process and to ensure “the speedy, efficient, just and 
inexpensive disposition of all proceedings under this Act,”  39-A 
M.R.S.A. § 152(2), and “the prompt delivery of benefits legally due,” 
39-A M.R.S.A. § 151-A. 
 
Id. ¶¶ 13-14, 872 A.2d at 965.   
 
[¶19]  We also examined in Bridgeman whether the fourteen-day rule 
requires payment of total incapacity benefits from the date the petition was filed or 
from the earlier “date of incapacity.”  Id. ¶¶ 16-17, 872 A.2d at 965-66.  The 
 
13 
employer had argued that “the hearing officer reasonably interpreted the rule to 
require payment from the date the petitions were filed rather than the date of 
incapacity” because the Board “did not intend its rule to encompass default 
payments for years of benefits prior to the date the claim was actually made.”  Id. 
¶ 17, 872 A.2d at 965-66  (quotation marks omitted).  We disagreed, and held 
pursuant to the plain language of the rule that the employee must be paid total 
benefits from the date of incapacity.  Id.   
D. 
Violation of the Fourteen-Day Rule 
 
1. 
Timeliness of Filing 
[¶20]  Sysco contends that the facts of record compel a finding that the 
employer filed the NOC in compliance with the fourteen-day rule.  It argues that 
we should vacate the decision and deem the NOC filed on the fourteenth day 
because (1) the third-party administrator transmitted the NOC, intending to file it 
on the fourteenth day; (2) the NOC was filed prior to the opening of business on 
the fifteenth day and therefore there was no resulting delay; (3) the Board’s 
decision penalizes an insurer for having a computer system designed to minimize 
erroneous filings to the Board; (4) if the NOC that lacked the JCN had been 
transmitted, the filing would have been timely; and (5) the third-party 
administrator acted with due diligence in attempting to timely file the NOC. 
 
14 
[¶21]  The hearing officer here made a factual finding that the NOC was 
filed on the fifteenth day.  We do not disturb that finding.  See Leighton v. S.D. 
Warren Co., 2005 ME 111, ¶ 22, 883 A.2d 906, 911 (declining to review a hearing 
officer’s factual findings as directed by statute); see also 39-A M.R.S. § 318 
(2010) (“The hearing officer’s decision, in the absence of fraud, on all questions of 
fact is final . . . .”); 39-A M.R.S. § 322(3) (2010); M.R. App. P. 23(b)(3).  A NOC 
filed on the fifteenth day after notice or knowledge of a claim is in violation of the 
rule and the rule calls for an award of total benefits from the date of incapacity 
until the violation is cured.  See Bridgeman, 2005 ME 38, ¶ 17, 872 A.2d at 
965-66.  Although the equities of this case arguably weigh in favor of a lesser 
penalty, there were no equitable remedies available to the Board.  See Hird v. Bath 
Iron Works Corp., 512 A.2d 1035, 1037-38 (Me. 1986) (“Without express or 
implied legislative authority to employ equitable estoppel to bar an employer’s 
statute of limitation defense[,] . . . the commission in this case exceeded its 
authority by applying the doctrine.”).  Likewise, because employees’ rights under 
the Act are purely statutory, Guar. Fund Mgmt. Servs. v. Workers’ Comp. Bd., 678 
A.2d 578, 583 (Me. 1996), and our appellate review of workers’ compensation 
cases is limited to errors of law, see 39-A M.R.S. §§ 318, 322(3); see also Kuvaja 
v. Bethel Sav. Bank, 495 A.2d 804, 806 (Me. 1985), we are constrained to apply 
rules promulgated within the Board’s statutory authority.     
 
15 
2. 
The Plain Language of the Rule  
[¶22]  Sysco next contends that, pursuant to the plain language of the rule, 
which requires that benefits be paid “from the date of incapacity,” it was error to 
award total benefits when the hearing officer expressly found that the employee 
suffered no entitlement to payment of any incapacity benefits for the 2004 injury 
“based on the merits of [that] claim.” 
[¶23]  We have previously addressed whether a penalty for a fourteen-day 
rule violation is appropriate when there is a finding that the employee suffered no 
incapacity.  In Bridgeman, we also decided a companion case in which the 
employee, Mitchell, had filed a petition for award for work injuries suffered in 
2000, and seeking incapacity benefits beginning May 15, 2001.  2005 ME 38 ¶ 4, 
872 A.2d at 962.  The hearing officer determined that Mitchell was entitled only to 
the protection of the Act because his injuries did not result in any ongoing 
incapacity.  Id. ¶ 5, 872 A.2d at 962-63.  The hearing officer also found a 
fourteen-day rule violation because the employer did not timely file a NOC and did 
not contemporaneously pay past due benefits when the NOC was later filed, and 
awarded Mitchell “short-term total incapacity benefits beginning on the date of 
incapacity, May 15, 2001.”  Id.  We affirmed the hearing officer’s decision.  Id.  
¶ 17, 872 A.2d at 966.   
 
16 
[¶24]  Although what constitutes the “date of incapacity” was not squarely 
addressed in Bridgeman, we nevertheless treated the phrase to mean the date of the 
alleged incapacity.  Id. ¶¶ 5, 17, 872 A.2d at 962-63, 966.  We approved the 
approach taken by the hearing officer in this case in Bridgeman when we 
considered and rejected the argument that it is inappropriate to award a penalty 
when no benefits would otherwise be due.  Cf. id. ¶ 23, 872 A.2d at 968 (Dana, J., 
dissenting) (“I see no authority in the Act for the Board to order employers to pay 
total incapacity benefits in cases when benefits are otherwise not legally due 
. . . .”).  Disallowing the award when the employee suffers no actual loss of 
earnings as a result of the injury could thwart an essential purpose of the rule—to 
encourage timely filings by employers/insurers thereby facilitating the 
administrative process—in all cases, not just cases in which wage loss benefits 
must be paid.6 
3. 
Legislative Intent 
[¶25]  Sysco asserts that allowing the award in this case, when the employee 
did not meet his burden of proving any loss of earnings stemming from the work 
                                         
  6  The dissent concludes that because Sysco paid medical benefits and accommodated Doucette at the 
time he initially reported the 2004 injury, Sysco’s duty to pay total incapacity benefits pursuant to the 
fourteen-day rule would not arise until the time Doucette reinjured his back and suffered additional 
incapacity in 2008.  However, the petition for award filed by Doucette relating to the 2004 injury is 
separate from the 2008 injury.  It is the first petition filed for that date of injury, and in it Doucette alleges 
he is entitled to “total/partial” wage loss benefits due to the 2004 injury during the time he worked for 
Sysco and “to the present and continuing.”  That some benefits had been paid on the 2004 date of injury 
does not obviate the employer’s obligation to pay benefits timely, file a notice of controversy in response 
to a claim for additional benefits, or pay total benefits from the alleged “date of incapacity.”         
 
17 
injury, is excessive, unfair to employers and insurers, and inconsistent with the 
goals of the Legislature and the mission of the Board to save costs, promote 
fairness, and ensure payment of benefits legally due.  See 39-A M.R.S.  § 151-A.  
Although the award may seem harsh in these particular circumstances, it has the 
benefit of clarity and promotes numerous goals including, as we identified in 
Bridgeman, “encourag[ing] the timely filing of a notice of controversy to facilitate 
the administrative process and to ensure the speedy, efficient, just and inexpensive 
disposition of all proceedings under this Act.”  2005 ME 38, ¶ 14, 872 A.2d at 965 
(quotation marks omitted).   
[¶26]  Since we decided Bridgeman in 2005, the Legislature has amended 
39-A M.R.S. § 205 on three occasions.  See P.L. 2007, ch. 218, § 1 (effective 
Sept. 20, 2007) (codified at 39-A M.R.S. § 205(4)); P.L. 2009, ch. 129, §§ 5-6 
(effective Sept. 12, 2009) (codified at 39-A M.R.S. § 205(3), (4)); P.L. 2009, ch. 
280, §§ 1-2 (effective Sept. 12, 2009) (codified at 39-A M.R.S. § 205(9)(B)).  
Despite this considerable legislative attention, the recent amendments to section 
205 do not abrogate our holding in Bridgeman or supersede our interpretation of 
Me. W.C.B. Rule, ch 1, § 1.  The Legislature’s silence in response to Bridgeman, 
particularly at a time when section 205 has otherwise undergone significant 
amendments, speaks volumes.  The Legislature is presumed to have knowledge of 
our decisions, Stockly v. Doil, 2005 ME 47, ¶ 14, 870 A.2d 1208, 1213; 
 
18 
Musk v. Nelson, 647 A.2d 1198, 1202 (Me. 1994), and in the absence of evidence 
that it intended to modify our decision, we will not interpret a rule or statute to 
effect such a modification, see Caron v. Me. Sch. Admin. Dist. No. 27, 594 A.2d 
560, 563 (Me. 1991).   
 
The entry is: 
Decision of the Workers’ Compensation Board 
hearing officer affirmed. 
 
 
 
 
 
 
 
 
LEVY, J., with whom SAUFLEY, C.J., and GORMAN, J., join, concurring. 
[¶27]  I concur in the majority opinion and its conclusion that the hearing 
officer correctly ruled that the insurer’s violation of the “fourteen-day rule,” 
Me. W.C.B. Rule, ch. 1, § 1, requires it to pay total benefits to the employee from 
the date of incapacity alleged in the employee’s petition.  I am moved to write 
separately, however, because of the hearing officer’s findings that not only had the 
insurer acted “diligently” and in “good faith” in seeking to contest the petition and 
preserve its rights, but also that Doucette had suffered no incapacity.   
[¶28]  Viewed through the lens of these findings, the penalty imposed in this 
case, in excess of $140,000, appears to be unfair, possibly punitive, and contrary to 
some of the policy objectives of the Workers’ Compensation Act.  It is beyond the 
 
19 
authority of this Court, however, to remedy this unfairness.  See, Cf. Wentzell v. 
Timberlands, Inc., 412 A.2d 1213, 1214-15 (Me. 1980) (declining to construe a 
provision of the Workers’ Compensation Act in a manner inconsistent with its 
plain language in order to achieve fairness).  Our review of the Board’s decisions is 
circumscribed by the Act itself.  See 39-A M.R.S. §§ 318, 322 (2010), see also 
Guar. Fund Mgmt. Servs. v. Workers’ Comp. Bd., 678 A.2d 578, 582-83 
(Me. 1996); Jordan v. Sears, Roebuck & Co., 651 A.2d 358, 362 (Me. 1994).  We 
have already determined that the Board did not exceed its authority in 
promulgating Board Rule, ch. 1, § 1.  Bridgeman v. S.D. Warren Co., 2005 ME 38, 
¶¶ 12-15, 872 A.2d 961, 965.   
[¶29]  Having promulgated the rule, the Board, as represented by its hearing 
officer, was not authorized to invoke equitable principles to achieve a more just 
outcome.  See Hird v. Bath Iron Works Corp., 512 A.2d 1035, 1037-38 (Me. 
1986).  Nonetheless, it is hard not to be left with the sense that the end result in this 
case is not just.  The only apparent path that might lead to greater justice, at least 
for purposes of future cases, is for the Board to examine the circumstances and 
outcome in this case to determine whether further development of the fourteen-day 
rule is needed. 
 
 
 
 
 
 
 
 
20 
 
ALEXANDER, J., concurring in part, dissenting in part. 
 
[¶30]  I concur with the Court’s analysis of the history and applicability of 
the “fourteen-day rule,” Me. W.C.B. Rule, ch. 1, § 1.  I also concur with the 
Court’s holding that the hearing officer’s finding of no incapacity as a result of the 
2004 injury must be of no significance in determining the applicability of the 
fourteen-day rule.  Were the law otherwise, there would be little incentive to 
respect the fourteen-day rule in close cases because there would be no effective 
sanction for those employers who violate the rule, but prevail on the substantive 
issue and secure a finding of no incapacity.   
 
[¶31]  I respectfully dissent from that portion of the Court’s opinion that 
awards retroactive benefits not authorized by law and turns the benefit payments 
clock back to 2004, rather than beginning that benefit payments clock at the 2008 
injury that preceded Doucette’s petition for award.  It is the 2008 injury that 
allegedly aggravated the prior injury and caused the incapacity, wage loss, and any 
medical payments at issue in this proceeding. 
 
[¶32]  In Bridgeman v. S.D. Warren Co., 2005 ME 38, ¶ 1, 872 A.2d 961, 
962, we recognized that, pursuant to the fourteen-day rule, “employers can become 
liable for the payment of short-term total incapacity benefits for failing to 
controvert a workers’ compensation claim within fourteen days of the receipt of 
 
21 
that claim” (emphasis added).  As Bridgeman also held, the date the default 
payments for violation of the fourteen-day rule is to begin is the date of the 
claimed injury and incapacity giving rise to the proceeding.  Id. ¶ 17, 
872 A.2d 965-66.  The default incapacity benefits awarded by the hearing officer 
here were neither “short-term,” nor did they begin running from the date of the 
claimed injury that gave rise to this proceeding.  
 
[¶33]  Matthew Doucette was injured while working for Sysco in 2004.  He 
properly reported that injury.  Sysco, the responsible employer, appropriately 
responded, covering any medical payments and placing him on light-duty work, at 
the same wage, until Doucette was released to full duty.  Doucette subsequently 
left employment with Sysco for reasons unrelated to the 2004 injury.  Over the 
next four years, Doucette made no claim for lost wages or medical payments 
arising from either incapacity or medical need generated by the 2004 injury.  
Accordingly, this case is very different from a case, such as Bridgeman, where an 
employer does not timely respond to an initial claim of injury and incapacity.   
 
[¶34]  In 2008, Doucette received another injury that, he alleges, resulted in 
an aggravation of the 2004 injury.  The aggravation claim would cause Sysco to 
share some responsibility for any incapacity and lost earnings resulting from the 
2008 injury.  The 2008 injury did not, and could not have, in any way cause lost 
earnings or medical payments for the four years before the 2008 injury occurred.  
 
22 
[¶35]  While there is an obligation to compensate for wages lost as a result 
of an earlier injury that is later aggravated by another injury, causing incapacity, 
the previous employer’s responsibility to pay wage replacement benefits cannot 
begin to run until the subsequent aggravating injury has occurred.  Doucette made 
a claim for incapacity based on the 2008 injury, which he alleged aggravated a pre-
existing injury.  The employer failed to timely respond.  Pursuant to the fourteen-
day rule, the obligation to pay benefits for wage replacement began to run on the 
date of the aggravating injury, Bridgeman, 2005 ME 38, ¶ 17, 872 A.2d at 965-66, 
and continued until Sysco made the good faith effort to cure its violation of the 
fourteen-day rule, Me. W.C.B. Rule, ch. 1, § 1(2).   
[¶36]  Because, by law, the previous employer was not liable to pay wage 
replacement benefits resulting from aggravation of a pre-existing injury causing an 
incapacity until the aggravating injury and the incapacity occurred, the Workers’ 
Compensation Board erred in awarding incapacity benefits for the period between 
2004 and the date of the aggravating injury in 2008.  Payments counted from the 
date of the 2008 injury would be the period of “short-term” total incapacity 
benefits for defaults in compliance with the fourteen-day rule.   
 
[¶37]  The Workers’ Compensation Board should have awarded incapacity 
benefits only for the period after the date of the 2008 injury and until the 
employer’s good faith cure of the violation of the fourteen-day rule.  Thus, the 
 
23 
order of the Workers’ Compensation Board should be vacated and remanded with 
direction to limit incapacity payments defaulted as a result of the fourteen-day-rule 
violation to the period after the 2008 injury.   
 
 
 
 
 
 
 
 
Attorneys for Hallsmith/Sysco Food Services: 
 
Elizabeth J. Ernst, Esq. 
Douglas, Denham, Buccina & Ernst 
PO Box 7108 
Portland, Maine  04112-7108 
 
Cara L. Biddings, Esq.   (orally) 
Robinson Kriger & McCallum 
PO Box 568 
Portland, Maine  04112-0568 
 
Attorneys for Matthew Doucette: 
 
James J. MacAdam, Esq.   (orally) 
Nathan A. Jury, Esq. 
David E. Hirtle, Esq. 
MacAdam Law Offices, P.A. 
208 Fore Street 
Portland, Maine  04101 
 
Attorneys for amicus curiae Maine AFL/CIO: 
 
Jeffrey L. Cohen, Esq. 
Benjamin K. Grant, Esq. 
McTeague, Higbee 
4 Union Park 
PO Box 5000 
Topsham, Maine  04086-5000 
 
Workers’ Compensation Board file numbers 04-007631 and 08-026570 
FOR CLERK REFERENCE ONLY