Hamilton v. Maine Department of Health and Human Services

Name

Insurance Company

Date Decided

February 1, 2018

Panel Members

Sue Jerome

Tom Pelletier

Mike Stovall

File Size

185 KB

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Summary from the Troubh Heisler Attorneys

Ms. Hamilton suffered a mental stress injury from her work as a DHHS a caseworker. DHHS paid her total incapacity benefits and medical bills, but it then obtained surveillance which it sent to Dr. Voss as part of a §207 exam. Dr. Voss opined that Ms. Hamilton's psychological condition was worse than before and that she had 17% PI. DHHS obtained additional surveillance and send it and Ms. Hamilton to Dr. Gallon, who opined that she could immediately return to work and had only 2.5% PI. DHHS discontinued Ms. Hamilton's benefits, and she filed a Petition for Review.

Ms. Hamilton was then evaluated by yet another psychologist, Dr. Werrbach, who opined that, although the litigation itself was playing a role in her condition, the effects of her work injury continued, and that she had no work capacity. Judge Hirtle granted Ms. Hamilton's petition and awarded her ongoing partial incapacity benefits subject to an imputed earning capacity of $150 per week. He acknowledged that non-occupational stressors were contributing to her overall psychological condition, but he also found that her work continued to contribute to her symptoms and that she had 17% PI.

DHHS appealed, arguing that Ms. Hamilton's non-occupational stressors played a role in her condition. The Appellate Division held that Judge Hirtle utilized the correct standard by finding that, despite other more recent non-work contributors, the effects of the work injury had not ended but continued to play a role in her condition and her incapacity. DHHS also argued that Judge Hirtle should not have adopted Dr. Voss's opinion because he did not review the most recent surveillance, but the panel held that this omission did not render his opinions incompetent.

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