Code of Maine Rules
90 - INDEPENDENT AGENCIES
351 - WORKERS' COMPENSATION BOARD
Chapter 1 - PAYMENT OF BENEFITS
Section 351-1-1 - Claims for Incapacity and Death Benefits

Universal Citation: 90 ME Code Rules ยง 351-1-1

Current through 2024-38, September 18, 2024

1. Within 14 days of notice or knowledge of a claim for incapacity or death benefits for a work-related injury, the employer or insurer will:

A. Accept the claim and file a Memorandum of Payment checking "Accepted"; or

B. Pay without prejudice and file a Memorandum of Payment checking "Voluntary Payment without Prejudice"; or

C. Deny the claim and file a Notice of Controversy.

2. Notice of the claim must be provided consistent with 39-A M.R.S.A. §301, or to the employer's insurance carrier at the address registered with the Bureau of Insurance.

3. If the employer fails to comply with subsection 1 of this section, the employee must be paid total benefits, with credit for earnings and other statutory offsets, from the date the claim is made in accordance with 39-A M.R.S.A. §205(2) and in compliance with 39-A M.R.S.A. §204. The employer may discontinue benefits under this subsection when both of the following requirements are met:

A. The employer files a Notice of Controversy; and

B. The employer pays benefits from the date the claim is made. If it is later determined that the average weekly wage/compensation rate used to compute the payment due was incorrect, and the amount paid was reasonable and based on the information gathered at the time, the violation of subsection 1 of this section is deemed to be cured.

4. Payment under subsection 3 of this section requires the filing of a Memorandum of Payment.

5. Benefits paid under this section are indemnity payments and are credited toward future benefits in the event that benefits are ordered or paid.

6. Failure to comply with the provisions of subsection 1 of this section may also result in the imposition of penalties pursuant to 39-A M.R.S.A. §§205(3), 359, and 360.

7. This rule applies to all dates of injury and all pending claims.

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