These benefits continue for the duration of the disability. For certain severe injuries (such as paralysis or blindness) total incapacity is presumed for 800 weeks from the date of injury. After 800 weeks, and for less severe injuries, a determination of total incapacity must be made.

These benefits are based on 80 percent of the difference between worker’s after-tax earnings before and after an injury, subject to a weekly maximum payment amount. Depending upon the extent of the disability, these payments will either be capped at 364 weeks or will continue for the duration of the disability. The limit was increased from 260 weeks to 364 weeks as of 01/01/2000.

These payments commence at the time of the accident, and ARE reduced because of receipt of TT benefits. Some injured workers receive their compensation for a specific loss in a lump sum payment rather than over the prescribed weekly period; this does not change the fact that the payment is WC for offset purposes.

Maine lump sum settlement agreements that are arranged out of court between the parties and submitted to the WC Board for approval are effective upon execution. Unless either party can prove there was fraud or mistake of fact, the agreement can only be reopened to correct a clerical error.

Many of the lump sum settlements involve a structured settlement. For more information on structured settlements, see DI 52150.065D. Also, pay close attention to the wording in lump sum awards, as a life expectancy rate expressed in the award might have been calculated based on the net lump sum instead of the gross lump sum.

These additional WC payments (a type of scheduled award also known as Section 56a payments) were paid for cases where the DOI was before 01/01/1993. After several changes in the methods of determining the amount of these benefits, they were finally eliminated effective 01/01/1993. These benefits had been paid in addition to any other weekly compensation awarded.

There is no provision in the WC Act for cost of living adjustments.

COLAs are given for these cases, but the rules are complex. See the charts and instructions provided by the WC Board: http://www.maine.gov/wcb/departments/Claims/cola.rtf

This form is sent from an insurer to an injured worker and the WC Board to advise that a payment for lost time was made. It must include, at a minimum, the names of the employee, employer and insurance carrier, the date of injury, and the initial weekly WC rate.

When the employee's benefits are discontinued or modified in accordance with a decree or agreement between the parties this form must be sent to the WC Board.

The employer or insurer must file this form with the WC Board when compensation is initiated, reduced, modified or discontinued based on an agreement of the parties outside the litigation process.

When the employer is paying the worker ‘without prejudice’ (without admitting liability), it can discontinue WC benefits by mailing a 21-day certificate of discontinuance to provide advance notice to the worker. WC cannot be stopped earlier than 21 days from the date the certificate is mailed, and it must state the reasons for stopping payment. Sections 19-21 of the form (under ‘Discontinuance’) give information about the WC paid. Sections 24-26 (under ‘Modification’) provide information regarding the change in WC payments.

This form is sent from an employer to the injured worker and the WC Board to let them know the employer is denying the request for WC benefits.

Sections 24-26 (under ‘Modification’) provide information regarding the change in WC payments.

The employer, insurer, third-party administrator, employee, and/or attorney files the Lump Sum Settlement form to request approval of a lump sum settlement.

This form is filed by the carrier within 6 months from the date of injury when WC benefits are paid, and on the injury date anniversary subsequent to that. A final report is filed when no further benefits are anticipated.

This form is still used on cases with injury dates before 01/01/1993, although its use is not required (effective 01/01/1993 specific loss WC is paid as scheduled awards; see DI 52120.110A. 3. above for information on scheduled awards).