Source: http://www.courts.maine.gov/opinions_orders/opinions/2003_documents/03me10yo.htm
Timestamp: 2017-05-29 22:36:38
Document Index: 118402831

Matched Legal Cases: ['§ 55', '§ 213', '§ 55', '§ 213', '§ 322', '§ 55', '§ 205', '§ 54', '§ 152']

YOUNG v. CMP
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Decision: 2003 ME 10
Docket: WCB-02-180
Argued: October 10, 2002
Decided: January
MAINE POWER COMPANY
DANA, J. [¶1]
The employer, Central Maine Power Co. (CMP), appeals
from a decision of a hearing officer of the Workers' Compensation Board,
denying the employer's petition for review seeking a prospective order
permitting CMP to terminate benefits after the payment of 400 weeks of partial
incapacity benefits pursuant to 39 M.R.S.A. § 55-B (1989), repealed and
replaced by P.L. 1991, ch. 885, §§ A-7,
A-8 (codified at 39-A M.R.S.A. §§ 213, 214 (2001 & Supp. 2002)). The hearing officer denied the
petition, concluding that the issue of an employer's ability to terminate
benefits pursuant to the 400-week limitation is not ripe until the 400-week
termination date has been reached. We disagree and vacate the decision.
[¶2] The parties have stipulated to the
essential facts. The employee,
Michael L. Young, suffered a work-related injury on November 10, 1989 while
employed at CMP, and returned to work after the injury, earning less than his
pre-injury wage. CMP paid partial incapacity benefits pursuant to a 1991
decree. In a later decree, a
hearing officer found that Young's date of maximum medical improvement was
August 27, 1994. [¶3] CMP filed a
petition for review of incapacity in June 2001, seeking a determination that
Young's benefits will expire on May 6, 2002 pursuant to the 400-weeks
limitation for partial incapacity benefits for Young's date of injury. See 39 M.R.S.A. § 55-B (1989), repealed and replaced by P.L. 1991, ch. 885, §§ A-7, A-8 (codified at 39-A
M.R.S.A. §§ 213, 214 (2001 & Supp. 2002)). The parties agreed to forego a hearing on the factual
issues, stipulating that "[t]he sole issue to be decided by the Board concerns
whether the Employer is entitled to a finding, prospectively, that the
Employee's benefits will end on May 6, 2002 as the result of the running of the
400 weeks, pursuant to a Petition for Review prior to the actual date that the
benefits have run." In connection
with this proceeding, Young stipulated that: (1) on February 5, 2002 (the date
of the stipulation), he was partially incapacitated; (2) the date of maximum
medical improvement was August 24, 1994; and (3) "barring any change in
circumstances between now and May, 2002, the Employee will have received 400
weeks of partial incapacity benefits subsequent to maximum medical improvement,
on May 6, 2002." [¶4] On March 13, 2002 the hearing officer
denied the petition, concluding that it would be inappropriate to order
prospective relief, because the employee's situation may change prior to the
actual expiration of 400 weeks. The hearing officer stated, "the matter is not really ripe for a final
adjudication on the merits because all of the necessary predicates for benefit
termination have yet to occur."[1] [¶5] The hearing officer also stated that
"if the underlying facts remain stable, the employer can in the near future
file a . . . petition [to terminate benefits] along with a Request for an
Expedited Proceeding." The hearing
officer suggested further that, in the event that the employer filed a new
petition, "[i]t would appear that the requested relief could be granted
(assuming all of the underlying facts remain the same) in a fairly expeditious
manner, thereby limiting the employer's exposure beyond the 400-week period."
[¶6] Two days after the date of the decree,
CMP filed a second petition for review with the Board and requested an
expedited hearing. On May 13,
2002, the parties again stipulated to the essential facts, and this time, the
employee conceded that the 400 weeks had run. On May 15, 2002, the hearing officer signed a stipulated
decree permitting CMP to terminate benefits on that date pursuant to the
400-weeks limitation.[2]
[¶7] We granted CMP's petition for appellate
review pursuant to 39-A M.R.S.A. § 322 (2001). II. DISCUSSION
[¶8] Young
contends that the appeal is moot because, after CMP filed its petition for
appellate review, CMP filed for and obtained an order from the hearing officer
in a separate proceeding permitting it to terminate benefits pursuant to the
400-week rule. CMP urges us to
decide the appeal pursuant to the exceptions to the mootness doctrine. We have recognized an exception to the
mootness doctrine in three situations:
(1) Sufficient collateral consequences will result from the
determination of the questions presented so as to justify relief;
(2) the appeal contains questions of great public concern
that, in the interest of providing future guidance to the bar and the public we
may address; or
(3) the issues are capable of repetition but evade review
because of their fleeting or determinate nature.
Lewiston Daily Sun v. Sch. Admin. Dist. No. 43, 1999 ME 143, ¶ 17, 738 A.2d 1239, 1243 (quoting Halfway
House, Inc. v. City of Portland, 670 A.2d
1377, 1380 (Me. 1996)). [¶9] We agree with
CMP that the appeal raises issues of great public concern, particularly to the
workers' compensation bar. Moreover, the nature of the issue is such that it would be difficult for
a party ever to get this issue before us without running into mootness problems. An employer or insurer seeking to reduce liability that is
denied the opportunity to obtain a prospective order, is likely to obtain an
order to terminate benefits shortly after the expiration of the 400-week time
limitation, as CMP has done, but while its petition for appellate review from
the denial of its prospective order is still pending before us.
[¶10] Concluding
that CMP's appeal falls within several exceptions to the mootness doctrine, we
now address the merits. B. The
[¶11] At the time
of Young's injury, former section 55-B provided, in pertinent part:
the incapacity for work resulting from the injury is partial, the employer
shall pay the injured employee a weekly compensation equal to 2/3
the difference, due to the injury, between his average gross weekly wages,
earning or salary before the injury and the weekly wages, earnings or salary
which he is able to earn after the injury, but not more than the maximum
benefit under section 53-B. Payments
under this section shall not continue for longer than 400 weeks after maximum
39 M.R.S.A. § 55-B (1989), amended by P.L. 1991, ch. 615, § D-7, repealed by P.L. 1991, ch. 885, § A-7 (emphasis added). [¶12] Subsection
205(9) provides the procedure for the termination of benefits and provides, in
Discontinuance or reduction of payments. The employer, insurer or group
self-insurer may discontinue or reduce benefits according to this subsection.
A. If the employee
has returned to work with or has received an increase in pay from an employer
that is paying compensation under this Act, that employer or that employer's
insurer or group self-insurer may discontinue or reduce payments to the
B. In all circumstances other than the
return to work or increase in pay of the employee under paragraph A, if the
employer, insurer or group self-insurer determines that the employee is not
eligible for compensation under this Act, the employer, insurer or group
self-insurer may discontinue or reduce benefits only in accordance with this
(1) If no order or award of compensation or compensation
scheme has been entered, the employer, insurer or group self-insurer may
discontinue or reduce benefits by sending a certificate by certified mail to
the employee . . . . The employer
may discontinue or reduce benefits no earlier than 21 days from the date the
certificate was mailed to the employee. . . .
(2) If an order or award of compensation or compensation
scheme has been entered, the employer, insurer or group self-insurer shall
petition the board for an order to reduce or discontinue benefits and may not
reduce or discontinue benefits until the matter has been finally resolved
through the dispute resolution procedures of this Act, any appeal proceedings
have been completed and an order of reduction or discontinuance has been
entered by the board.
39-A M.R.S.A. § 205(9) (2001).
[¶13] We have held
that terminations of benefits pursuant to the 400-week limitation must be made
in accordance with section 205(9)(B)(2) in cases when there is an existing
payment scheme, e.g., an order requiring the payment of benefits. See Russell v. Russell's Appliance Serv., 2001 ME 32, ¶ 10, 766 A.2d 67, 70-71. Our decision in Russell is based on the statutory language, and also the practical
reality that, in some cases, there will be a dispute concerning whether the
400-week limitation is applicable. As we stated:
Although this case presents a situation without
disagreement as to the application of the 400-week limitation, other cases
involving the 400-week limitation are not so clear. For example, the date of maximum medical improvement, which
is the operative date from which the 400-week period runs, may be in
dispute. See, e.g., Williams v. E.S. Boulos Co., 2000 ME 40, ¶¶ 9-10, 747 A.2d 181, 185-86. Moreover, when an employee has received
400 weeks of full or "total" compensation, it is not always apparent whether
the employee has received 100% partial incapacity benefits under section 55-B,
or benefits for total incapacity under former 39 M.R.S.A. § 54-B (1989), repealed
and replaced by P.L. 1991, ch. 885, § A-7,
A-8, which may not be included in the 400-week calculation. See, e.g., Toothaker
v. Lauri, Inc., 631 A.2d 1241, 1243 (Me.
1993) (receipt of full benefits pursuant to memorandum of payment does not
conclusively establish total incapacity); see also Williams, 2000 ME
40, ¶¶ 5-8, 747 A.2d at 183-85 (weeks of total incapacity not included in
400-week limitation). We find no
evidence of a legislative intent to permit employers to determine unilaterally
whether maximum medical improvement has been reached or whether, and to what
extent, payments have been made for partial as opposed to total incapacity. There is also the situation that occurs
when a worker is receiving benefits for two workplace injuries, and only one
injury is subject to the 400-week limitation. In such a situation a question may arise as to the amount of
benefits the employee is entitled to receive once the 400-week limitation is
reached. See Cust v. Univ. of
Maine, 2001 ME 29, ¶¶ 3, 4, 766 A.2d 566
[, 567]. Because there are
differing situations relating to the calculation of the 400-week limitation,
the Legislature determined that some procedural protections are necessary for
Id. ¶ 7, 766 A.2d at 70.
[¶14] In an
attached footnote, however, we recognized the need for a procedure to prevent
overpayment of more than 400 weeks of benefits during the hearing and appeal
We recognize the possibility that subparagraph B(2), requiring that benefits continue until final resolution of the petition, may result in employers paying benefits in excess of 400 weeks. The statute is silent on the timing of the employer's petition to discontinue benefits. We suggest that the Board, with its broad rule-making authority, (see 39-A M.R.S.A. § 152(2) (Pamph.2000)), consider promulgating a fair, workable, and cost-effective procedure for discontinuing benefits pursuant to the 400-week rule, consistent with the general requirements of subparagraph B(2). As we have stated, "[t]he Act reflects not so much a legislative intent to comprehensively address every workers' compensation issue in a detailed and specific way, but to commit some issues to a process in which the participants in the system, labor and management, can work out flexible and realistic solutions." Bureau v. Staffing Network, Inc., 678 A.2d 583, 588 n.2 (Me. 1996). Id. ¶ 10 n.3, 766 A.2d at 71. At the time of this decision, the Board has not issued a rule to address this problem.
[¶15] The clear
purpose of former section 55-B was to limit an employer's liability for partial
incapacity benefits to 400 weeks of benefits after the date of maximum medical
improvement. The hearing officer's decision precluding a prospective
determination will inevitably result in an overpayment in many cases and thwart
the legislative intent. We see
nothing in the Act or in the Board rules to prevent an employer from seeking and
obtaining a prospective determination that benefits will cease pursuant to the
400-week rule on a specific date in the future. If a hearing officer makes such a determination based on a
stipulation of the parties or after an evidentiary hearing, the hearing officer
should issue a prospective order permitting a termination of benefits on that
date. If the circumstances should
change in the intervening period after such an order, but prior to the
expiration of 400-week date of termination, the employee can file a petition
with the Board to show that the date should be extended.
decision of the hearing officer of the Workers' Compensation Board is
vacated. Remanded to the Workers'
Compensation Board for further proceedings consistent with the opinion herein. Attorney for employee:
Jeffrey L. Cohen, Esq. (orally)
McTeague, Higbee, Case, Cohen, Whitney & Toker,
P O Box 5000
Topsham, ME 04086-5000
Attorney for employer:
William O. LaCasse, Esq,
Portland, ME 04112-46000
[1] The hearing officer stated:
The general desirability of
eliminating employer exposure in a case such as the one presented herein must
be balanced against the general undesirability from a decisional and administrative
standpoint of entering an order that is essentially contingent on anticipated
facts actually materializing. Such
an order is undesirable because it can lead to final judgment problems. [2] The record is unclear whether there was an overpayment of one week for the period from the expiration of 400 weeks on May 6, 2002 to the date that the decree was entered, May 15, 2002.