Court Opinion

ID: 9770083
Source: CourtListenerOpinion
Date Created: 2023-08-29 15:38:22.828969+00
Date Added: 2024-06-11T07:31:13.033414
License: Public Domain

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 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 at 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.
[¶ 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 *110run until the subsequent aggravating injury has occurred. Doucette made a claim for incapacity based on the 2008 injury, which he alleged aggravated a preexisting 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 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.