Nickerson v. Paul's Marina
Maine Employers' Mutual Insurance Company
May 18, 2016
Notice of Injury Mistake of Fact Timely Notice 14-Day Rule Payment of Benefits Head
Summary from the Troubh Heisler Attorneys
Nickerson was hired at the boat yard during the “busy spring season,” which apparently was “slated to end on May 28 or 29, 2010.” He injured his head at work on May 4, reported the injury, and got medical treatment, but he continued working. On May 24, Nickerson went home because he was “not feeling well,” and Judge Goodnough found that Paul's likely “associated … Nickerson's “illness with his work-related head injury.”
On June 1, at MEMIC’s request, Nickerson completed an injury statement form indicating that he lost only one day of work on May 10, but Nickerson never returned to work. In October 2010, Nickerson's mother contacted MEMIC claiming that her son was out of work due to the May 4 head injury. MEMIC then filed a Notice of Controversy contesting the lost time claim but not the related medical bills. Nickerson filed a Petition for Award and claimed a 14-day violation requiring immediate payment of total incapacity benefits.
In May 2014, Judge Goodnough granted the petition and awarded Nickerson incapacity benefits (apparently partial rather than total) from May 25, 2010 to the present and continuing, but he denied payment of additional benefits finding Paul's did not violate the 14-day rule. Judge Goodnough found that Paul’s did not have “the information necessary to conclude that a claim for incapacity benefits was being made on May 24,” and that as of June 1 “Nickerson did not consider himself to be out of work to the injury.” Nickerson appealed the 14 day issue.
Nickerson argued that Paul’s knowledge on May 24 that Nickerson was going home because of symptoms from his prior work injury was sufficient to trigger Paul’s obligation to file a Notice of Controversy within 14 days thereafter. The Appellate Division panel, however, affirmed Judge Goodnough’s decision, finding found that Nickerson “effectively withdrew his request for lost wage benefits before the 14 days had expired.”