Code of Maine Rules › 90 - INDEPENDENT AGENCIES › 351 - WORKERS' COMPENSATION BOARD › Chapter 15 - PENALTIES › Section 351-15-10 - Assessment of Penalties under 39-A M.R.S.A. section 360(2)

Current through 2024-29, July 17, 2024
1. Pursuant to
				39-A M.R.S.A.
				§152(7), the Maine
				Workers' Compensation Board delegates to the Workers' Compensation Board Abuse
				Investigation Unit the authority to recommend the imposition of penalties
				pursuant to §360(2) and delegates to the Executive Director, or the
				Executive Director's designee, the authority to be the Presiding Officer for
				hearings conducted pursuant to this rule. The Presiding Officer shall have the
				authority to assess civil penalties, after hearing, pursuant to
				§360(2).
2. Any party in
				interest, including any deputy director or assistant director of the Workers'
				Compensation Board, may file a §360(2) complaint with the Abuse
				Investigation Unit. The Abuse Investigation Unit will investigate all
				complaints and, as part of the investigation, may require parties to submit
				written evidence concerning the complaint, including position papers.
3. Upon completion of the investigation, the
				Abuse Investigation Unit will determine whether the allegations, if true, rise
				to the level of willful violation, fraud, or intentional misrepresentation. If
				so, the subject of the investigation will be notified that the matter is being
				referred for hearing and possible imposition of civil penalties. If not,
				further investigation under §360(2) will be denied.
4. The Presiding Officer will schedule and
				hold a hearing in referred cases. The Presiding Officer will issue a hearing
				order to the parties concerning the procedure to be followed before and during
				the hearing, including the submission of additional evidence and the filing of
				motions. In cases where there are opposing parties, the burden will be upon the
				complaining party to prove its contentions; however, the Presiding Officer will
				actively participate to ensure that all relevant information is considered
				prior to issuing findings. In cases where there is no specific complaining
				party, the Abuse Investigation Unit will present evidence acquired during, or
				as a result of the investigation. If necessary, the Presiding Officer may
				request further investigation by the Abuse Investigation Unit in a case of
				circumstances warrant it.
5. The
				standard for determining whether a willful violation of the Act or intentional
				misrepresentation has occurred is by preponderance of the evidence. In the case
				of fraud, the standard is one of clear and convincing evidence.
6. In determining whether to assess a penalty
				or the amount to be assessed, the Presiding Officer will consider the severity
				of the offense, whether it is a repeated offense, and the amount of money at
				issue. The lack of a prior offense will not be a mitigating factor in
				determining the amount of the penalty assessed. Penalty amounts are limited to
				50% of the monies at issue up to the statutory cap.
7. In considering whether to order the
				repayment of benefits wrongfully received, the Presiding Officer will consider
				the severity of the offense and will accept and consider evidence of financial
				ability to repay.
8. All findings
				and conclusions will issue in a written order. This order will constitute final
				agency action which is appealable in Superior Court.