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FACTS ABOUT MAINE'S WORKERS' COMPENSATION LAWS
Prepared and distributed by the Maine Workers' Compensation Board
Printed under Appropriation Number 014 90C 0183
The Maine Workers' Compensation Board prepared this guide to help you understand Maine's workers' compensation system. This guide attempts to answer the questions most commonly asked by injured workers. Much of the information in this guide only applies to employees who were injured on or after January 1, 1993, although there is some information about earlier dates of injury. A glossary of commonly used terms is also provided.
If you would like additional information, please contact one of the regional offices of the Workers' Compensation Board listed below:
24 Stone Street
Augusta, Maine 04330-5220
207) 287-2308 or 800-400-6854 (Maine only)
106 Hogan Road
Bangor, Maine 04401-5640
(207) 941-4550 or 800-400-6856 (Maine only)
10 Washburn Ave, Suite 110
Caribou, Maine 04736-2347
(207) 498-6428 or 800-400-6855 (Maine only)
36 Mollison Way
Lewiston, Maine 04240-7761
(207) 753-7700 or 800-400-6857 (Maine only)
62 Elm Street
Portland, Maine 04101-0840
207) 822-0840 or 800-400-6858 (Maine only)
Workers' Compensation Board Mission Statement
The Board's mission is to serve the employees and employers of the state fairly and expeditiuosly by ensuring compliance with the workers' compensation laws, ensuring the prompt delivery of benefits legally due, promoting the preventing of disuptes, utilizing dispute resolution to reduce litigation and facilitating labor-management cooperation.
TABLE OF CONTENTS
Glossary of frequently used items
A summary of workers' compensation
What should I do if I'm injured at work?
When must I tell my employer that I have been injured at work?
What should my employer do when I report an injury?
Can I get medical help for my injury?
Can my employer ask me to see another doctor?
Will my employer pay for any other medical costs?
How long can I receive treatment for my injury?
If I need treatment while my claim is being disputed, will my health insurer pay my bills?
What if I have to miss time from work because of my injury?
Will my employer pay me my full salary while I am out?
When does my employer have to decide if it is going to pay me for my lost time?
What if my employer does not do anything for the first 14 days?
How will I know if my employer is going to pay my claim?
My Memorandum of Payment says that my claim has been "accepted." What does that mean?
My Memorandum of Payment says that my "claim is voluntary payment pending investigation." What does that mean?
What if I can go back to work, but I cannot earn as much as I used to earn?
Do I have to do anything when I return to work after an injury?
How long can I receive benefits for lost time?
Can my employer stop paying benefits without my agreement?
What is a 21-day certificate of discontinuance?
What can I do if I receive a 21-day certificate of discontinuance?
What if my injury bothers me in the future?
What is the statute of limitations?
What if my employer refuses to pay my claim?
What happens if my employer files a Notice of Controversy?
What if the Troubleshooter cannot resolve the dispute?
If my case is sent to mediation, will someone be available to help me?
What will the Worker Advocate do?
Can I get a lawyer to help me?
What if the Mediator cannot resolve the dispute?
Will the Worker Advocate be able to help me after mediation?
What is a formal hearing?
What if I disagree with the Hearing Officer?
What is an independent medical exam?
What is the difference between an independent medical exam under Section 312 and a medical exam under Section 207?
Does my employer have to give me my job back?
What if I cannot return to my old job, and there is no other work at my employer's business?
What if my employer will not pay for vocational rehabilitation?
Can my employer discriminate against me if I file a workers' compensation claim?
Are there penalties in the Workers' Compensation Act?
Where can I get more information?
What are the address and phone numbers of the Worker Advocate offices?
GLOSSARY OF FREQUENTLY USED TERMS
Average Weekly Wage: In most cases the average amount of money you earned each week for the 52 weeks prior to your injury. Special rules apply to employees who customarily work less than 26 weeks per year, or who work in certain kinds of jobs. Fringe benefits may also be included in your average weekly wage.
Compensation Rate: What injured workers are paid for time they have missed from work because of an injury. The compensation rate equals 80% of the injured workers's average weekly wage after taxes have been taken out. Currently, the maximum compensation rate is $441.00
Compensable: The word compensable can describe an injury that is related to work. It can also describe a medical bill or a claim for lost wages that your employer must pay.
First Report: A written report prepared by the employer for any work-related injury a worker reports. The report must be completed within seven days after you have notified your employer of an injury. Your employer must give you a copy.
Health Care Provider: Any doctor, nurse, chiropractor, physical therapist or other person who provides medical treatment.
Hearing Officer: An employee of the Workers' Compensation Board who holds hearings and writes decisions which resolve disputes between workers and employers.
Insurer: An insurance company that pays workers' compensation claims for employers. They also represent employers when disagreements occur between workers and employers.
Lost Time: A phrase used to refer to the fact than an employee has missed time from work because of an injury.
Lost Wages: A phrase used to refer to earnings that are lost because an employee has missed time from work because of an injury.
Mediator: An employee of the Workers' Compensation Board who holds conferences to help injured workers, insurers and employers voluntarily resolve disputes.
Memorandum of Payment: Often called a "MOP." A written notice sent from an employer to an injured worker and the Workers' Compensation Board to notify the worker that a payment for lost time has been made.
Notice: When you tell your employer (which can mean a supervisor, or someone from management) that you are injured and that your injury is related to your job, you give notice of your injury. You must give notice of your injury to your employer within 90 days of your injury.
Notice of Controversy: Often called a "NOC" (pronounced "knock"). A form sent from an employer to an injured worker and the Workers' Compensation Board to let an injured worker know that the employer is denying their request for benefits.
Payment without prejudice: Your employer may pay you benefits without being certain that your injury is related to work. These payments are made without prejudice. In other words, they are voluntary.
Petition: A written request by a party asking that a hearing officer hold a formal hearing. Common petitions include:
Petition for Award: Used to demand payment of lost wages.
Petition to Fix: Used to demand payment of medical bills and expenses.
Petition for Reinstatement: Used to demand that your employer give you a job.
Petition to Remedy Discrimination: Used to demand relief for discrimination related to a workers' compensation claim.
Petition for Review: Used by employees to request that a Hearing Officer review a suspension of benefits. Used by employers to end or reduce payments for lost time.
Statute of limitations: If you are injured at work, there is a time limit within which you must file a claim. This is called the statute of limitations. If you do not file a petition, or your employer does not pay benefits for a two-year period, you may lose your right to claim benefits in the future.
Troubleshooter: An employee of the Workers' Compensation Board whose job is to resolve disputes between workers and employers. The troubleshooter also provides assistance and information to parties who use the workers' compensation system.
Weekly compensation benefits: If you miss time from work because of an injury, you will receive benefits to replace some of your lost wages. These payments are called weekly compensation benefits.
Worker Advocate: An employee of the Workers' Compensation Board who helps injured workers prepare for mediation and formal hearing, and also attends mediation and formal hearing with injured workers.
Workers' Compensation Board: The state agency that oversees the workers' compensation system. The Workers' Compensation Board helps injured workers and employers resolve disputes about workers' compensation benefits.
A SUMMARY OF WORKERS' COMPENSATION
Workers' Compensation is a type of insurance provided by your employer. It provides benefits to employees who suffer injuries on the job. These benefits include:
- Weekly payments for lost time from work because of an injury.
- Payment of medical bills, prescriptions and related costs.
- Payment for the loss of a specific body part.
- Payment of the cost of vocational rehabilitation (such as job retraining and job placement).
- Payment of death benefits to the dependents of a worker whose death was work related.
There are certain steps you must take if you are injured at work:
- You must tell your employer (which can mean a supervisor, or someone from management) that you were injured within 90 days of the injury.
- If your employer has selected a health care provider, you must go to your employer's health care provider for the first ten days of treatment.
- If you want to change health care providers after the first ten days, you must tell your employer that you are going to do that, and tell them who the new health care provider is.
When you tell your employer you have been injured at work your employer must:
- Fill out a First Report of Injury and give you a copy.
- Pay your claim for lost time within fourteen days; or,
- Send a Notice of Controversy to you and to the Workers' Compensation Board if your employer does not want to pay your medical bills and/or lost time benefits.
If there is a dispute about whether your employer must pay your claim:
- A Troubleshooter will contact you and try to resolve the dispute.
- If the Troubleshooter cannot resolve the dispute, a mediation will be held.
- If mediation does not resolve the dispute, you may request a formal hearing.
Qualified injured workers are entitled to the services of a Worker Advocate. Worker Advocates help injured workers prepare for mediation and formal hearing.
QUESTIONS AND ANSWERS
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