An Act To Amend the Laws Governing Workers' Compensation
Maine Legislature, Session 125, LD 1571
Committee: Labor, Commerce, Research and Economic Development
Sponsors: CUSHING, COURTNEY, CURTIS, FITTS, PLOWMAN, THIBODEAU
Amends: 39-A MRSA §107, 39-A MRSA §151, 39-A MRSA §153, 39-A MRSA §153-A, 39-A MRSA §201, 39-A MRSA §205, 39-A MRSA §207, 39-A MRSA §209, 39-A MRSA §213, 39-A MRSA §223, 39-A MRSA §306, 39-A MRSA §324, 39-A MRSA §325, 39-A MRSA §355-A, 39-A MRSA §355-B, 39-A MRSA §355-C, 39-A MRSA §356, 39-A MRSA §358-A

Legislative Document 
No. 1571 
H.P. 1154 
House of Representatives, May 12, 2011 
An Act To Amend the Laws Governing Workers' Compensation 
(AFTER DEADLINE) 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
205. 
Reference to the Committee on Labor, Commerce, Research and Economic Development 
suggested and ordered printed. 
HEATHER J.R. PRIEST 
Clerk 
Presented by Representative CUSHING of Hampden. 
Cosponsored by Senator COURTNEY of York and 
Representatives: CURTIS of Madison, FITTS of Pittsfield, McKANE of Newcastle, Senators: 
PLOWMAN of Penobscot, THIBODEAU of Waldo. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  39-A MRSA §107, 3rd ¶, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by §§9 to 11, is amended to read: 
If the employee or the employee's beneficiary recovers damages from a 3rd person, 
the employee shall repay to the employer, out of the recovery against the 3rd person, the 
benefits paid by the employer under this Act, less the employer's proportionate share of 
cost of collection, including reasonable attorney's fees. 
Sec. 2.  39-A MRSA §107, last ¶, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by §§9 to 11, is amended to read: 
If the employer recovers from a 3rd person damages in excess of the compensation 
and benefits paid or for which the employer has become liable, then any excess must be 
paid to the injured employee, less a proportionate share of the expenses and cost of 
actions or collection, including reasonable attorney's fees. Settlement of any such 
subrogation claims and the distribution of the proceeds therefrom must have the approval 
of the court in which the subrogation action is pending or to which it is returnable; or if 
not in suit, of the board. When the court in which the subrogation action is pending or to 
which it is returnable is in vacation, the judge of the court, or, if the action is pending in 
or returnable to the Superior Court, any Justice of the Superior Court has the power to 
approve the settlement of the action and the distribution of the proceeds therefrom.  The 
beneficiary is entitled to reasonable notice and the opportunity to be present in person or 
by counsel at the approval proceeding. 
Sec. 3.  39-A MRSA §151, sub-§1, as amended by PL 2009, c. 640, §1, is further 
amended to read: 
1.  Board established.  Pursuant to Title 5, section 12004-G, subsection 35, the 
Workers' Compensation Board is established as an independent board composed of 7 
members.  The members of the board, including the executive director, must be appointed 
by the Governor within 30 days after a new board member is authorized or a vacancy 
occurs, subject to review by the joint standing committee of the Legislature having 
jurisdiction over labor matters and confirmation by the Legislature.  Notwithstanding the 
provisions of Title 3, section 157, the designated committee shall complete its review of 
the appointments of the Governor within 15 days of the Governor's written notice of 
appointment and the vote of the Legislature must be taken no later than 7 days after the 
vote of the designated committee. 
The board consists of 3 representatives of management, 3 representatives of labor and the 
executive director appointed pursuant to subsection 1-A.  All management representatives 
must be appointed from a list provided by the Maine Chamber of Commerce and Industry 
or other bona fide organization or association of employers.  All labor representatives 
must be from a list provided by the Executive Board of the Maine AFL-CIO or other 
bona fide labor organization or association of employees representing at least 10% of the 
Maine work force.  The Governor shall appoint one labor representative from a list 
provided by the executive board of the Maine AFL-CIO or other bona fide labor 
organization or association of employees.  The remaining 2 representatives of labor are 
appointed at the discretion of the Governor.  Any list submitted to the Governor must 
have at least 4 times the number of names as there are vacancies for the group represented 
by the vacancies. 
A member of the board is not liable in a civil action for any act performed in good faith in 
the execution of duties as a board member. 
A member of the board may not be a lobbyist required to be registered with the 
Commission on Governmental Ethics and Election Practices, a service provider to the 
workers' compensation system or a representative of a service provider to the workers' 
compensation system.  In addition to the conflict of interest provisions in section 152, 
subsection 8, a member of the board may not take part in reaching a decision or 
recommendation in any matter that directly affects an insurer, self-insurer, group self-
insurer or labor organization that the member represents. 
Members of the board representing management and labor hold office for staggered terms 
of 4 years, commencing and expiring on February 1st, except for initial appointees and 
members appointed to fill unexpired terms. 
Sec. 4.  39-A MRSA §153, sub-§2, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by §§9 to 11, is repealed. 
Sec. 5.  39-A MRSA §153, sub-§6, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by §§9 to 11, is amended to read: 
6.  Mediation.  The board shall establish a mediation program to provide mediation 
services to parties to when requested by both the employer and the employee in a 
workers' compensation cases case. 
Sec. 6.  39-A MRSA §153, sub-§8, ¶B, as enacted by PL 1991, c. 885, Pt. A, §8 
and affected by §§9 to 11, is amended to read: 
B.  The board shall collect and analyze data from Maine cases, studies from other 
states and generally accepted medical guidelines for occupational impairment to 
examine the feasibility and desirability of establishing an objectively ascertainable 
functional capacity standard to be used for determining eligibility for benefits under 
this Act consistent with section 213, subsection 2. 
Sec. 7.  39-A MRSA §153, sub-§9, as amended by PL 2005, c. 603, §3, is further 
amended to read: 
9.  Audit and enforcement.  The executive director shall establish an audit, 
enforcement and monitoring program by July 1, 1998, to ensure that all obligations under 
this Act are met, including the requirements of section 359.  The functions of the audit 
and enforcement program include, but are not limited to, auditing timeliness of payments 
and claims handling practices of insurers, self-insurers, the Maine Insurance Guaranty 
Association and 3rd-party administrators; determining whether insurers, self-insurers, the 
Maine Insurance Guaranty Association and 3rd-party administrators are unreasonably 
contesting claims; and ensuring that all reporting requirements to the board are met.  
When auditing the Maine Insurance Guaranty Association, the program shall consider 
when the Maine Insurance Guaranty Association obtained the records of an insolvent 
insurer.  The program must be coordinated with the abuse investigation unit established 
by section 153, subsection 5 as appropriate.  The program must monitor activity and 
conduct audits pursuant to a schedule developed by the deputy director of benefits 
administration.  Audit working papers are confidential and may not be disclosed to any 
person outside of the board except the audited entity.  For purposes of this subsection 
"audit working papers" means all documentary and other information acquired, prepared 
or maintained by the board during the conduct of an audit or investigation, including all 
intra-agency and interagency communications relating to an audit or investigation and 
draft reports or any portion of a draft report.  The final audit report, including the 
underlying reconciled information, is not confidential.  At the end of each calendar 
quarter, the executive director shall prepare a compliance report summarizing the results 
of the audits and reviews conducted pursuant to this subsection.  The executive director 
shall submit the quarterly compliance reports to the board, the Bureau of Insurance and 
the Director of the Bureau of Labor Standards within the Department of Labor.  An 
annual summary must be provided to the Governor and to the joint standing committees 
of the Legislature having jurisdiction over labor and banking and insurance matters by 
February 15th of each year.  The quarterly compliance reports and the annual summaries 
must be made available to the public following distribution. 
Sec. 8.  39-A MRSA §153-A, sub-§2, as enacted by PL 1997, c. 486, §4, is 
amended to read: 
2.  Qualified employee.  For purposes of this section, "qualified employee" means an 
employee who, with respect to an injury occurring on or after January 1, 1993, has 
participated in the troubleshooter program and has not informally resolved the dispute 
and has demonstrated to the board that legal counsel has not been retained. 
Sec. 9.  39-A MRSA §201, sub-§5, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by §§9 to 11, is amended to read: 
5.  Subsequent nonwork injuries.  If an employee suffers a nonwork-related injury 
or disease that is not causally connected to a previous compensable injury, the subsequent 
nonwork-related injury or disease is not compensable under this Act.  If an employee 
otherwise receiving workers' compensation benefits becomes totally disabled as a result 
of an unrelated and independent cause, the employee's rights and benefits cease for the 
duration of such total disability. 
Sec. 10.  39-A MRSA §205, sub-§9, ¶B, as amended by PL 2009, c. 280, §1 and 
affected by §2, is further amended to read: 
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 paragraph. 
(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 and to the 
board, together with any information on which the employer, insurer or group 
self-insurer relied to support the discontinuance or reduction.  The employer may 
discontinue or reduce benefits no earlier than 21 days from the date the certificate 
was mailed to the employee, except that benefits paid pursuant to section 212, 
subsection 1 or section 213, subsection 1 may be discontinued or reduced based 
on the amount of actual documented earnings paid to the employee during the 
21-day period if the employer files with the board the documentation or evidence 
that substantiates the earnings and the employer only reduces or discontinues 
benefits for any week for which it possesses evidence of such earning.  The 
certificate must advise the employee of the date when the employee's benefits 
will be discontinued or reduced, as well as other information as prescribed by the 
board, including the employee's appeal rights. 
(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 by a decree issued 
by a hearing officer.  The employer, insurer or group self-insurer may reduce or 
discontinue benefits pursuant to such a decree pending an appeal from that 
decree.  Upon the filing of a petition, the employer may discontinue or reduce the 
weekly benefits being paid pursuant to section 212, subsection 1 or section 213, 
subsection 1 based on the amount of actual documented earnings paid to the 
employee after filing the petition.   The employer shall file with the board the 
documentation or evidence that substantiates the earnings and the employer may 
discontinue or reduce weekly benefits only for weeks for which the employer 
possesses evidence of such earnings. 
Sec. 11.  39-A MRSA §207, first ¶, as amended by PL 2001, c. 278, §1, is further 
amended to read: 
An employee being treated by a health care provider of the employee's own choice 
shall, after an injury and at all reasonable times during the continuance of disability if so 
requested by the employer, submit to an examination by a physician, surgeon or 
chiropractor authorized to practice as such under the laws of this State, to be selected and 
paid by the employer.  The physician, surgeon or chiropractor must have an active 
practice of treating patients.  For purposes of this section, "active practice" may be 
demonstrated by having active clinical privileges at a hospital.  A physician or surgeon 
must be certified in the field of practice that treats the type of injury complained of by the 
employee.  Certification must be by a board recognized by the American Board of 
Medical Specialties or the American Osteopathic Association or their successor 
organizations.  A chiropractor licensed by the Board of Chiropractic Licensure, who has 
an active practice of treating patients may provide a 2nd opinion when the initial opinion 
was given by a chiropractor.  Once an employer selects a health care provider to examine 
an employee, the employer may not request that the employee be examined by more than 
one other health care provider, other than an independent medical examiner appointed 
pursuant to section 312, without prior approval from the employee or a hearing officer.  
This provision does not limit an employer's right to request that the employee be 
examined by a specialist upon referral by the health care provider.  Once the employee is 
examined by the specialist, the employer may not request that the employee be examined 
by a different specialist in the same specialty, other than an independent medical 
examiner appointed pursuant to section 312, without prior approval from the employee or 
the board.  The employee has the right to have a physician, surgeon or chiropractor of the 
employee's own selection present at such an examination, whose costs are paid by the 
employer employee.  The employer shall give the employee notice of this right at the time 
the employer requests an examination. 
Sec. 12.  39-A MRSA §209, sub-§1, ¶A, as enacted by PL 1991, c. 885, Pt. A, §8 
and affected by §§9 to 11, is amended to read: 
A.  Standards, schedules or scales of maximum charges for individual services, 
procedures or courses of treatment.  In establishing these standards, schedules or 
scales, the The board shall consider maximum establish standards, schedules or scales 
based upon reasonable and customarily negotiated charges paid by private 3rd-party 
payors for similar services provided by health care providers in the State and shall 
consult with organizations representing health care providers and other appropriate 
groups.  The standards must be adjusted annually to reflect any appropriate changes 
in such negotiated levels of reimbursement.  The standards apply to hospital costs and 
health care providers and must be in effect no later than January 1, 1993.  If standards 
are not established pursuant to this paragraph by October 1, 2011, charges 
customarily paid by MaineCare apply; and 
Sec. 13.  39-A MRSA §209, sub-§2, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by §§9 to 11, is amended to read: 
2.  Payment for services.  A health facility or health care provider must be paid 
either the amounts authorized pursuant to the standards established in subsection 1, 
paragraph A or its usual and customary charge for any health care services or the 
maximum charge established under the rules adopted pursuant to subsection 1, whichever 
is less. 
Sec. 14.  39-A MRSA §209, sub-§3, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by §§9 to 11, is amended to read: 
3.  Limitation on reimbursement.  In order to qualify for reimbursement for health 
care services provided to employees under this Title, health care providers providing 
individual health care services and courses of treatment may not must charge more for the 
services or courses of treatment for employees than is charged to private 3rd-party payors 
for similar services or courses of treatment in accordance with the standards established 
in subsection 1.  An employer is not responsible for charges that are determined to be 
excessive or treatment determined to be inappropriate by an independent medical 
examiner appointed pursuant to section 312 or by the insurance carrier, self-insurer or 
group self-insurer pursuant to section 210, subsection 7 or the board pursuant to section 
210, subsection 8. 
Sec. 15.  39-A MRSA §213, sub-§1, as amended by PL 2003, c. 52, §1, is 
repealed and the following enacted in its place: 
1.  Benefit and duration.  Compensation for partial incapacity is governed by this 
subsection. 
A.  While the incapacity for work is partial, the employer shall pay the injured 
employee a weekly compensation equal to 80% of the difference between the injured 
employee's after-tax average weekly wage before the personal injury and the after-tax 
average weekly wage that the injured employee is able to earn after the injury, but not 
more than the maximum benefit under section 211. 
B.  For injuries occurring from January 1, 2006 to September 30, 2011, compensation 
must be paid for the duration of the disability if the employee's permanent 
impairment, determined according to subsection 1-A and the impairment guidelines 
adopted by the board pursuant to section 153, subsection 8, resulting from the 
personal injury is in excess of 11% to the body. 
C.  For injuries occurring on or after October 1, 2011, an employee may not receive 
compensation under this subsection after the employee has received compensation 
under section 212, subsection 1, this section or both, for the following number of 
weeks: 
(1)  Fifty-two weeks, if there is no permanent impairment resulting from the 
injury or if the permanent impairment resulting from the injury is not in excess of 
3%; 
(2)  One hundred and four weeks, if the permanent impairment resulting from the 
injury is in excess of 3% but not in excess of 6%; 
(3)  One hundred and fifty-six weeks, if the permanent impairment resulting from 
the injury is in excess of 6% but not in excess of 9%; 
(4)  Two hundred and eight weeks, if the permanent impairment resulting from 
the injury is in excess of 9% but not in excess of 12%; 
(5)  Two hundred and sixty weeks, if the permanent impairment resulting from 
the injury is in excess of 12% but not in excess of 15%; 
(6)  Three hundred and twelve weeks, if the permanent impairment resulting from 
the injury is in excess of 15% but not in excess of 18%; 
(7)  Three hundred and sixty-four weeks, if the permanent impairment resulting 
from the injury is in excess of 18% but not in excess of 21%; 
(8)  Four hundred and sixteen weeks, if the permanent impairment resulting from 
the injury is in excess of 21% but not in excess of 24%; 
(9)  Four hundred and sixty-eight weeks, if the permanent impairment resulting 
from the injury is in excess of 24% but not in excess of 27%; and 
(10)  Five hundred and twenty weeks, if the permanent impairment resulting from 
the injury is in excess of 27%. 
For purposes of this paragraph, the permanent impairment resulting from the personal 
injury is determined according to subsection 1-A and the impairment guidelines 
adopted by the board pursuant to section 153, subsection 8. 
Sec. 16.  39-A MRSA §213, sub-§2, as amended by PL 2001, c. 712, §3 and 
affected by §6, is repealed. 
Sec. 17.  39-A MRSA §213, sub-§3, as amended by PL 2001, c. 448, §1, is 
repealed. 
Sec. 18.  39-A MRSA §213, sub-§4, as amended by PL 2001, c. 448, §2, is 
repealed. 
Sec. 19.  39-A MRSA §223, sub-§1, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by §§9 to 11, is amended to read: 
1.  Presumption.  An employee who terminates active employment and is receiving 
nondisability pension or retirement benefits under either a private or governmental 
pension or retirement program, including old-age benefits under the United States Social 
Security Act, 42 United States Code, Sections 301 to 1397f, that was paid by or on behalf 
of an employer from whom weekly benefits under this Act are sought is presumed not to 
have a loss of earnings or earning capacity as the result of compensable injury or disease 
under this Act.  This presumption may be rebutted only by a preponderance of evidence 
that the employee is unable, because of a work-related disability, to perform work 
suitable to the employee's qualifications, including training or experience.  This standard 
of disability supersedes other applicable standards used to determine disability under this 
Act. 
Sec. 20.  39-A MRSA §306, sub-§1, as enacted by PL 1999, c. 354, §6 and 
affected by §10, is amended to read: 
1.  Statute of limitations.  Except as provided in this section, a petition brought 
under this Act is barred unless filed within 2 years after the date of injury or the date the 
employee's employer files a required first report of injury as if required in section 303, 
whichever is later. 
Sec. 21.  39-A MRSA §324, sub-§1, as amended by PL 2009, c. 129, §9 and 
affected by §13, is further amended to read: 
1.  Order or decision.  The employer or insurance carrier shall make compensation 
payments within 10 days after the receipt of notice of an approved agreement for payment 
of compensation or within 10 days after any order or decision of the board awarding 
compensation.  If the board enters a decision awarding compensation and a motion for 
findings of fact and conclusions of law is filed with the hearing officer or an appeal is 
filed with the Law Court pursuant to section 322, payments may not be suspended while 
the motion for findings of fact and conclusions of law or appeal is pending.  The 
employer or insurer may recover from an employee payments made pending a motion for 
findings of fact and conclusions of law or appeal to the Law Court if and to the extent that 
the hearing officer or the Law Court has decided that the employee was not entitled to the 
compensation paid. The board has full jurisdiction to determine the amount of 
overpayment, if any, and the amount and schedule of repayment, if any. The board, in 
determining whether or not repayment should be made and the extent and schedule of 
repayment, shall consider the financial situation of the employee and the employee's 
family and may not order repayment that would work hardship or injustice.  The board 
shall notify the Commissioner of Health and Human Services within 10 days after the 
receipt of notice of an approved agreement for payment of compensation or within 10 
days after any order or decision of the board awarding compensation identifying the 
employee who is to receive the compensation.  For purposes of this subsection, 
"employer or insurance carrier" includes the Maine Insurance Guaranty Association 
under Title 24-A, chapter 57, subchapter 3. 
Sec. 22.  39-A MRSA §324, sub-§2, as amended by PL 2009, c. 129, §10 and 
affected by §13, is further amended to read: 
2.  Failure to pay within time limits.  An employer or insurance carrier who fails to 
pay compensation, as provided in this section, is penalized as follows.  For purposes of 
this subsection, "employer or insurance carrier" includes the Maine Insurance Guaranty 
Association under Title 24-A, chapter 57, subchapter 3. 
A.  Except as otherwise provided by section 205, if an employer or insurance carrier 
fails to pay compensation as provided in this section, the board may assess against the 
employer or insurance carrier a fine of up to $200 for each day of noncompliance.  
The board may not assess a fine in excess of $25,000 under this subsection unless a 
majority of the board finds by clear and convincing evidence that the employer or 
insurance carrier intentionally and fraudulently failed to pay compensation.  If the 
board finds that the employer or insurance carrier was prevented from complying 
with this section because of circumstances beyond its control, a fine may not be 
assessed. 
(1)  The fine for each day of noncompliance must be divided as follows:  Of each 
day's fine amount, the first $50 is paid to the employee to whom compensation is 
due and the remainder must be paid to the board and be credited to the Workers' 
Compensation Board Administrative Fund. 
(2)  If a fine is assessed against any employer or insurance carrier under this 
subsection on petition by an employee, the employer or insurance carrier shall 
pay reasonable costs and attorney's fees related to the fine, as determined by the 
board, to the employee. 
(3)  Fines assessed under this subsection may be enforced by the Superior Court 
in the same manner as provided in section 323. 
B.  Payment of a fine assessed under this subsection is not considered an element of 
loss for the purpose of establishing rates for workers' compensation insurance. 
Sec. 23.  39-A MRSA §325, sub-§4, as enacted by PL 1991, c. 885, Pt. A, §8 and 
affected by §§9 to 11, is amended to read: 
4.  Attorney's fees for lump-sum settlements.  Attorney's fees for lump-sum 
settlements pursuant to section 352 for injuries after January 1, 2005 must be determined 
as follows: 
A.  Before computing the fee, reasonable expenses incurred on the employee's behalf 
must be deducted from the total settlement, including: 
(1)  Medical examination fee and witness fee; 
(2)  Any other medical witness fee, including cost of subpoena; 
(3)  Cost of court reporter service; and 
(4)  Appeal costs; and 
B.  The computation of the fee, based on the amount resulting after deductions 
according to paragraph A, may not exceed: 
(1)  Ten percent of the first $50,000 of the indemnity benefits of the settlement; 
(2)  Nine percent of the first $10,000 over $50,000 of the indemnity benefits of 
the settlement; 
(3)  Eight percent of the next $10,000 over $50,000 of the indemnity benefits of 
the settlement; 
(4)  Seven percent of the next $10,000 over $50,000 of the indemnity benefits of 
the settlement; 
(5)  Six percent of the next $10,000 over $50,000 of the indemnity benefits of the 
settlement; and 
(6)  Five percent of any amount over $90,000 of the indemnity benefits of the 
settlement.; and 
C.  A fee may not be assessed for the amount of any settlement intended to pay for 
current or future medical costs. 
Sec. 24.  39-A MRSA §355-A, as enacted by PL 2001, c. 448, §5, is repealed. 
Sec. 25.  39-A MRSA §355-B, as enacted by PL 2001, c. 448, §5, is repealed. 
Sec. 26.  39-A MRSA §355-C, as enacted by PL 2001, c. 448, §5, is repealed. 
Sec. 27.  39-A MRSA §356, as amended by PL 2001, c. 448, §6, is repealed. 
Sec. 28.  39-A MRSA §358-A, sub-§1, as enacted by PL 1997, c. 486, §8, is 
amended to read: 
1.  Workers' compensation system annual report.  The board, in consultation with 
the Superintendent of Insurance and the Director of the Bureau of Labor Standards within 
the Department of Labor, shall submit an annual report to the Governor and the joint 
standing committees of the Legislature having jurisdiction over labor and banking and 
insurance matters by February 15th of each year regarding the status of the workers' 
compensation system.  At a minimum, the report must include an assessment of the 
board's implementation of the following provisions: 
A.  The number of individual cases monitored to ensure the provision of benefits in 
accordance with law, pursuant to section 152, subsection 10; 
B.  The number of cases monitored to ensure the payments are initiated within the 
time limits of sections 205 and 324 and the adequacy of compensation provided 
pursuant to section 153, subsection 1; 
C.  The number of investigations performed pursuant to section 153, subsection 7; 
D.  The number of lump-sum settlements cases monitored and a summary of 
postsettlement employment experience pursuant to section 352, subsection 6; 
E.  The number of audits performed and an assessment of compliance with this Act 
based on audit results pursuant to section 359, subsection 1; 
F.  The number of penalties assessed and the reasons for the assessments pursuant to 
section 205, subsection 3; section 313, subsection 4; section 324, subsections 2 and 3; 
section 359, subsection 2; and section 360; and 
G.  The results of the monitoring program giving side-by-side information 
compilations for the past 5 years pursuant to section 359, subsection 3. 
The report must contain specific data regarding compliance, including benchmarks 
measuring individual insurer's, self-insurer's, or 3rd-party administrator's compliance with 
the provisions of this Act and any penalties assessed.  Benchmarks must be developed by 
the board with input from insurers, self-insurers and 3rd-party administrators and other 
parties the board considers appropriate. The board shall also report on the utilization of 
troubleshooters, advocates and retained legal counsel, with correlating outcomes. 
SUMMARY 
This bill amends provisions of the Maine Workers' Compensation Act of 1992 and 
procedures of the Workers' Compensation Board. 
1.  It amends the law to provide for full reimbursement to an employer from proceeds 
paid by a 3rd party. 
2.  It amends the selection process for the Workers' Compensation Board.  Under 
current law, the 3 representatives of labor on the board must be appointed from a list 
provided by a bona fide labor organization or association of employees.  This bill instead 
requires that one of the 3 labor members be appointed from that list; the other 2 labor 
representatives must be appointed at the discretion of the Governor. 
3.  It repeals the troubleshooter program established under the Maine Revised 
Statutes, Title 39-A, section 153, subsection 2. 
4.  It amends the mediation provision to require that mediation be requested both by 
the employer and the employee. 
5.  It eliminates the board's audit and enforcement oversight of the Maine Insurance 
Guaranty Association. 
6.  It amends the law to address the decision in Roy v. Bath Iron Works, 2008 ME 94, 
to specifically provide that a subsequent nonwork injury, independent of any work-related 
injury, and unrelated to any work-related injury, that results in total disability results in a 
cessation of benefits for the duration of the disability. 
7.  It specifies that, if an award has been entered, the employer, insurer or group 
self-insurer may petition the board for a reduction and may not reduce or discontinue 
benefits until the issuance of a decree by a hearing officer, after which benefits may be 
reduced or discontinued pending an appeal from the hearing officer's decree. 
8.  It eliminates the requirement that a physician have an active practice in order to be 
qualified to conduct a medical examination. 
9.  It provides that if an employee chooses to have a physician present at an 
employer-required examination, the employee must pay the cost of that physician. 
10.  Under current law, in establishing standards, schedules or scales of maximum 
charges, the board is required to consider maximum charges paid by private 3rd-party 
payors.  This bill requires the board to base those standards, schedules or scales on 
reasonably and customarily negotiated charges between health care providers and 
3rd-party insurers and requires that if standards are not established by October 1, 2011, 
then charges customarily paid by MaineCare apply. 
11.  It amends the laws governing compensation for partial incapacity. 
A.  Under current law, the compensation must be paid for the duration of the 
disability if the employee's permanent impairment resulting from the personal injury 
is in excess of 15%; if the permanent impairment is equal to or less than 15%, the 
employee may not receive compensation for more than 260 weeks unless the board 
extends the duration of benefit entitlement beyond 260 weeks due to extreme 
financial hardship. 
B.  This bill instead provides that, for injuries occurring from January 1, 2006 to 
September 30, 2011, compensation must be paid for the duration of the disability if 
the employee’s permanent impairment is in excess of 11%; for injuries occurring on 
or after October 1, 2011, an employee may not receive compensation for more than 
weeks, if there is no permanent impairment resulting from the injury or if the 
permanent impairment resulting from the injury is not in excess of 3%; 104 weeks, if 
the permanent impairment resulting from the injury is in excess of 3% but not in 
excess of 6%; 156 weeks, if the permanent impairment resulting from the injury is in 
excess of 6% but not in excess of 9%; 208 weeks, if the permanent impairment 
resulting from the injury is in excess of 9% but not in excess of 12%; 260 weeks, if 
the permanent impairment resulting from the injury is in excess of 12% but not in 
excess of 15%; 312 weeks, if the permanent impairment resulting from the injury is 
in excess of 15% but not in excess of 18%; 364 weeks, if the permanent impairment 
resulting from the injury is in excess of 18% but not in excess of 21%; 416 weeks, if 
the permanent impairment resulting from the injury is in excess of 21% but not in 
excess of 24%; 468 weeks, if the permanent impairment resulting from the injury is 
in excess of 24% but not in excess of 27%; and 520 weeks, if the permanent 
impairment resulting from the injury is in excess of 27%.  This bill also eliminates 
the board’s ability to extend the duration of benefit entitlement in cases of extreme 
financial hardship. 
12.  It repeals provisions of the law requiring the board to adjust the 15% impairment 
threshold, dates of injury and extension of the period of benefit limitation. 
13.  It provides that an employee who is otherwise retired is not presumed to have a 
loss of earnings or earning capacity regardless of whether the employee terminates active 
employment. 
14.  It amends the statute of limitations periods when no first report of injury is 
required to be filed. 
15.  It amends the law to address the decision in Larochelle v. Crest Shoe, 655 A. 2d 
1245 (Me 1995) to specify that overpayments made during the pendancy of a motion for 
findings of fact and conclusions of law must be repaid. 
16.  It prohibits the board from assessing a fine against an employer or insurer in 
excess of $25,000 unless the employer or insurer intentionally and fraudulently failed to 
pay compensation. 
17.  It provides that, for injuries occurring after January 1, 2005, lump-sum attorney's 
fees are paid on the indemnity portion of a settlement. 
18.  It prohibits the assessment of an attorney's fee for the amount of any settlement 
intended to pay for current or future medical costs. 
19.  It repeals provisions regarding the Supplemental Benefits Fund, which was 
established to reimburse payments of compensation to employees under provisions 
governing extended benefits for partial incapacity that are repealed in this bill.