Code of Maine Rules
90 - INDEPENDENT AGENCIES
351 - WORKERS' COMPENSATION BOARD
Chapter 9 - PROCEDURES FOR COORDINATION OF BENEFITS
Section 351-9-2 - Coordination of Benefits Pursuant to section 221(3)

Current through 2024-38, September 18, 2024

1. Calculation of reduction to employee's weekly benefits

A. Except as provided in paragraph (B) of this section, when an employee receives payments pursuant to a plan or policy subject to §221(1)(B) or (C), the amount of the reduction to the employee's weekly benefits is calculated by converting the weekly payment into an after-tax amount using the tables of average weekly wage and 80% of the after tax average weekly wage published by the Board pursuant to 39-A M.R.S. §102(1) and then multiplying the applicable 80% of the after-tax amount by 1.25.

B. When an employee receives a benefit that is intended to be paid over the employee's lifetime in a lump sum or a periodic payment for a permanent or lifetime condition paid over a period less than the employee's life expectancy pursuant to a plan or policy subject to §221(1)(B) or (C), the amount of the reduction to the employee's weekly benefits is calculated by:
(1) Determining the employee's life expectancy based on standard actuarial tables in weeks;

(2) Determining a weekly benefit amount by dividing the lump sum amount by the number of weeks of life expectancy determined pursuant to sub-section B paragraph (1) of this section;

(3) Converting the weekly benefit amount determined pursuant to sub-section B paragraph (2) of this section into an after-tax amount using the tables of average weekly wage and 80% of the after tax average weekly wage published by the Board pursuant to 39-A M.R.S. §102(1); and,

(4) Multiplying the applicable 80% of the after-tax amount by 1.25.

C. This regulation applies retroactively to all pending cases including those on appeal.

2. Coordination of benefits paid pursuant to "paid time off" or equivalent plans

A. Paid time off or equivalent plan means an employer-paid benefit that covers both sick leave and vacation leave.

B. If a paid time off or equivalent plan designates a specific portion of the benefit as sick leave, an employer/insurer may reduce benefits, as set forth in 39-A M.R.S.A. §221(3)(A)(2).

C. If a paid time off or equivalent plan does not designate a specific portion of the benefit as sick leave, an employer/insurer may reduce benefits, as set forth in 39-A M.R.S.A. §221(3)(A)(2), when the benefit taken is used for the equivalent of sick leave rather than vacation leave.

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