Low v. Poland Springs

Insurance Company

Sedgwick Claims Management Services

Date Decided

September 8, 2017

Panel Members

Elizabeth Elwin

David Hirtle

Evelyn Knopf


Medical Evidence Res Judicata Reopening Evidence Medical Evidence Reopening Evidence Res Judicata


Pre-Existing Aggravation Face Medical Evidence

File Size

248 KB


Summary from the Troubh Heisler Attorneys

Ms. Low had previously established her work injury as a compensable “aggravation of an underlying myofascial pain condition” and had received fixed partial incapacity benefits. Nestlé got a §207 medical exam finding the effects of her injury had ended and that her ongoing symptoms were due to fibromyalgia, a non-work-related condition. Ms. Low’s doctors disagreed, but Judge Collier adopted the §207 exam findings and discontinued her medical and incapacity benefits. In addition to requesting further findings, Ms. Low asked to reopen the evidence, and she presented several more records from her treating physicians supporting her claim, but Judge Collier found that the new records did not change his opinion.

Ms. Low appealed, arguing that Nestlé had not produced comparative medical evidence showing the change in circumstances, but the Appellate Division disagreed. The panel cited prior Maine Supreme Court cases holding that "an employer can prove a change of medical circumstances with proof that the injured worker is no longer disabled because of the work injury.” The panel expressly held that a §207 examiner’s opinion is “competent and legally sufficient evidence to support the ALJs findings.”

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