Bridgeman v. SD Warren Co.

• Decision Date: 16 March 2005
• Citation: 2005 ME 38,872 A.2d 961
• Parties: Oreta BRIDGEMAN v. S.D. WARREN COMPANY et al. Kevin Mitchell v. United Parcel Service et al.
• Court: Maine Supreme Court

872 A.2d 961

2005 ME 38

Oreta BRIDGEMAN v. S.D. WARREN COMPANY et al.

Kevin Mitchell v. United Parcel Service et al.

Supreme Judicial Court of Maine.

Argued: September 20, 2004.

Decided: March 16, 2005.

James J. MacAdam (orally), Anna Priluk, MacAdam Law Offices, P.A., Portland, for Oreta Bridgeman.

Kevin M. Noonan (orally), McTeague, Higbee, Case, Cohen, Whitney & Toker, P.A., Topsham, for Kevin Mitchell.

Thomas R. Kelly (orally), Thomas Quartararo, Robinson Kriger & McCallum, Portland, Richard D. Tucker (orally), Tucker & Dostie, P.A., Bangor, for S.D. Warren Co.

John P. Flynn III (orally), Troubh Heisler Piampiano Hark Andrucki, Portland, for United Parcel Service.

Panel: SAUFLEY, C.J., and CLIFFORD, RUDMAN, DANA, ALEXANDER, CALKINS, and LEVY, JJ.

CLIFFORD, J.

[¶ 1] In this consolidated appeal, the employers, S.D. Warren Co. and United Parcel Service (UPS), appeal from decisions of hearing officers of the Workers' Compensation Board challenging the validity of Me. W.C.B. Rule, ch. 1, § 1, the fourteen-day rule, pursuant to which 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. The S.D. Warren employee, Oreta Bridgeman, also cross appeals, alleging, in part, that pursuant to the rule, he is entitled to past due benefits beginning on the date of the incapacity and not the date that the employer received notice of the claim. We affirm the decision in Mitchell v. UPS. In doing so, we conclude that the hearing officers correctly upheld the validity of the fourteen-day rule. We also agree, in part, with Bridgeman's challenge to the decision in his case and vacate part of that decision.

I. BACKGROUND

A. Bridgeman v. S.D. Warren Co., WCB-03-608

[¶ 2] Bridgeman filed petitions for award for several work-related injuries while employed by S.D. Warren. The hearing officer (McCurry, HO) granted some, but not all, of the petitions and concluded that Bridgeman is entitled to compensation for partial incapacity. The hearing officer further found that S.D. Warren and its insurer, Liberty Mutual, received notice of two of the compensable claims in May of 2001. The hearing officer concluded that Liberty Mutual violated Board Rule, ch. 1, § 1 by failing to file the required notice of controversy within fourteen days of the employee's notice of the claim. The notice of controversy was not filed until August of 2001. Moreover, the employer did not pay past due benefits at the time the notice of controversy was filed.

[¶ 3] As a result of this violation of the fourteen-day rule, and pursuant to its provisions, the hearing officer awarded continuing total incapacity compensation to Bridgeman beginning on the date that Bridgeman's petitions were filed and continuing until the employer files a notice of controversy "and pays the compensation that was due." We granted S.D. Warren's petition for appellate review and Bridgeman's cross-petition pursuant to 39-A M.R.S.A. § 322 (2001).

B. Mitchell v. UPS, WCB-03-564

[¶ 4] Kevin Mitchell suffered work-related injuries to his left knee in September and December of 2000 while employed by UPS. In November of 2001, UPS received notice of Mitchell's claim seeking workers' compensation incapacity benefits beginning May 15, 2001, but failed to file a notice of controversy until May of 2002. UPS also failed to pay past due benefits at that time.

[¶ 5] The hearing officer (Sprague, HO) granted Mitchell's petitions for award, but found that he is entitled only to protection of the Act because the injuries did not result in ongoing incapacity. The hearing officer concluded further, however, that UPS violated Board Rule, ch. 1, § 1 by failing to controvert the claim within fourteen days of receiving notice of the claim, and by failing to contemporaneously pay past due benefits when the notice of controversy was filed late. Applying the rule, Mitchell was awarded short-term total incapacity benefits beginning on the date of the incapacity, May 15, 2001. We granted the employer's petition for appellate review pursuant to 39-A M.R.S.A. § 322, and consolidated the case with Bridgeman for the purposes of oral argument.

II. DISCUSSION

A. Validity of the Rule

[¶ 6] The employers in this consolidated appeal challenge the validity of Board Rule, ch. 1, § 1, contending that the rule is in conflict with the statutory language and, therefore, ultra vires.

[¶ 7] Board Rule ch. 1, § 1 provides, in pertinent part:

§ 1. Claims for Incapacity and Death Benefits

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" in Box 18; or

B. Pay without prejudice and file a Memorandum of Payment checking "Voluntary Payment Pending Investigation" in Box 18; or

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

2. If the employer fails to comply with the provisions of Rule 1.1, the employee must be paid total benefits, with credit for earnings and other statutory offsets, from the date of incapacity in accordance with 39-A M.R.S.A. § 205(2) and in compliance with 39-A M.R.S.A. § 204.[¹] The requirement for payment of benefits under this subsection automatically ceases upon the filing of a Notice of Controversy and the payment of any accrued benefits.

3. Payment under Section 1.2 requires the filing of a Memorandum of Payment.

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

5. Failure to comply with the provisions of Rule 1.1 may also result in the imposition of penalties pursuant to 39-A M.R.S.A. §§ 205(3), 359, and 360.

Me. W.C.B. Rule, ch. 1, § 1 (emphasis added).

[¶ 8] Board Rule, ch. 1, § 1 was promulgated to implement section 205, which provides, in pertinent part:

1. Prompt and direct payment. Compensation under this Act must be paid promptly and directly to the person entitled to that compensation at the employee's mailing address, or where the employee designates, without an award, except in cases when there is an ongoing dispute.

2. Time for payment. The first payment of compensation for incapacity under section 212 or 213 is due and payable within 14 days after the employer has notice or knowledge of the injury or death, on which date all compensation then accrued must be paid. Subsequent incapacity payments must be made weekly and in a timely fashion. Every insurance carrier, self-insured and group self-insurer shall keep a record of all payments made under this Act and of the time and manner of making the payments and shall furnish reports, based upon these records, to the board as it may reasonably require.

3. Penalty for delay. When there is not an ongoing dispute, if weekly compensation benefits or accrued weekly benefits are not paid within 30 days after becoming due and payable, $50 per day must be added and paid to the worker for each day of 30 days in which benefits are not paid. Not more than $1,500 in total may be added pursuant to this subsection....

....

7. Memorandum of payment. Upon making the first payment of compensation for incapacity or upon making a payment of compensation for impairment, the employer shall immediately forward to the board a memorandum of payment on forms prescribed by the board....

39-A M.R.S.A. § 205 (2001).

[¶ 9] The Board's rulemaking authority derives from 39-A M.R.S.A. § 152, which provides:

Subject to any applicable requirements of the Maine Administrative Procedure Act, the board shall adopt rules to accomplish the purposes of this Act. Those rules may define terms, prescribe forms and make suitable orders of procedure to ensure the speedy, efficient, just and inexpensive disposition of all proceedings under this Act.

39-A M.R.S.A. § 152(2) (2001) (footnote omitted). Along with its duty to administer the Act, the Board is required to monitor cases to ensure that "[p]ayments are initiated within the time limits established in section 205." 39-A M.R.S.A. § 153(1)(A) (2001). Moreover, the mission of the Board is "to serve the employees and employers of the State fairly and expeditiously by ensuring compliance with the workers' compensation laws, ensuring the prompt delivery of benefits legally due...." 39-A M.R.S.A. § 151-A (2001) (emphasis added).

[¶ 10] The legislative history of the creation of the Board suggests that it was intended to exercise wide discretion in its administration of the Act. Unlike the former Workers' Compensation Commission,² the newly created eight-member Board was equally divided between representatives of labor and management, all serving as part-time members. 39-A M.R.S.A. § 151(1) (2001). The Legislature recognized that the necessarily informal, ad hoc, and inherently political nature of Board decision-making requires that the Board exercise broad authority to promulgate rules to serve the broader purposes of the Act, and to manage and govern the workers' compensation system.³

[¶ 11] We give great deference to Board rules interpreting the Act, and we have encouraged the Board to enact rules to fill in the "gray areas" that were intentionally left in the Act. See, e.g., Russell v. Russell's Appliance Serv., 2001 ME 32, ¶ 10 n. 3, 766 A.2d 67, 71

; Bureau v. Staffing Network, Inc., 678 A.2d 583, 588 n. 2 (Me.1996). "[T]he Act reflects not so much a legislative intent to comprehensively address every workers' compensation issue in a detailed and specific way, but to commit some issues to a process in which the participants in the system, labor and management, can work out flexible and realistic solutions." Russell, 2001 ME 32, ¶ 10 n. 3,

766 A.2d at 71 (quoting Bureau, 678 A.2d at 588 n. 2).

[¶ 12] Although we have struck down Board rules when they have been in direct conflict with express statutory language, see, e.g., ...