Oleson v. International Paper
Sedgwick Claims Management Services
October 23, 2014
CategoriesDurational Limit Durational Limit Res Judicata
Total Incapacity Back Shoulder Multiple Injuries Partial Incapacity Durational Limit
Summary from the Troubh Heisler Attorneys
Oleson injured his back in 2000 and his shoulder in 2001. IP initially paid benefits on both dates of injury, and Oleson returned to work. He left work in October 2001 because of his low back condition, and IP voluntarily paid him total incapacity benefits for the 2000 back injury alone. In 2010, IP filed a Petition for Review and Petition to Determine PI regarding only the 2000 low back injury, and Hearing Officer Garry Greene granted both petitions in 2011, finding that Oleson had a partial work capacity and 10% PI. In 2012, IP filed another Petition for Review on the 2000 injury, seeking to discontinue Oleson’s partial incapacity benefits per the 520-week limitation. Oleson filed a Petition for Award and Petition to Determine PI on the 2001 shoulder injury, claiming only ongoing incapacity benefits.
HO Greene granted IP’s Review, finding that the 520-week limitation had expired on both the 2000 and the 2001 injuries, and that his 2011 decision had res judicata effect on both the 2000 and 2001 injuries, since Oleson could have filed his petition on the 2001 injury previously, but he chose not to do so. Oleson appealed and the Appellate Division granted his appeal, vacating HO Greene’s decision and remanding it back to him to determine the employee’s entitlement to ongoing incapacity benefits on the 2001 shoulder injury.
The Appellate Division panel stated that IP did not:
indicate on the WCB documents it filed that it was paying benefits on both injuries,
“code its payments to reflect all dates of injury contributing to the incapacity” for which it paid benefits, or
file a petition on 2001 shoulder injury together with its 2012 Petition for Review on the 2000 back injury.
Neither party filed a petition on the 2001 claim seeking a determination of retrospective benefits for that injury, and the Appellate Division held that it was improper for Hearing Officer Greene to make that determination in deciding the petition filed on the 2000 claim. The Appellate Division also reversed the hearing officer’s res judicata ruling as inconsistent with established Maine law.
We have long advised employers and insurers to allocate a portion of their incapacity benefits to each of the employee’s disabling injuries in appropriate cases, thus obtaining credit toward the 520-week limitation on all dates of injury. This decision validates that proactive approach, which requires a careful analysis of the full claims history and potential defenses, such as the statute of limitations, even where the employee is claiming under a single injury date.