Stein v. Inland Hospital

Insurance Company

Eastern Maine Group

Date Decided

November 26, 2019

Panel Members

Timothy Collier

Evelyn Knopf

Mike Stovall


Coordination of Benefits Death Presumption Coordination of Benefits Death Presumption


§327 §221 Unable to Testify Workplace Stress Delayed Onset Notice

File Size

133 KB


Summary from the Troubh Heisler Attorneys

Dr. Stein worked at Inland for several years as an obstetrician gynecologist, until Anthem told her that, because she was not board-certified, they were terminating her participation in its network. She took and failed the board exam, so Inland suspended her from practice. Dr. Stein became distraught and stressed, raising her blood pressure. She got a severance package and a few months later suffered a stroke, limiting her ability to walk or talk.

Her doctor diagnosed “situational hypertension,” and she filed petitions alleging a workplace stress injury from her employment suspension. Judge Elwin found her “unable to testify,” and gave her the evidentiary presumption under §327 that her injury was compensable under the Act. Judge Elwin then found that Inland failed to rebut the presumption and granted her petitions. Judge Elwin initially allowed an offset for the severance payments, but on additional findings amended her decree denying the offset.

Inland appealed, but the Appellate Division affirmed Judge Elwin’s decision. The panel noted that, when an employee “is physically or mentally unable to testify,” the presumption applies, shifting the burden to the employer to prove that no injury occurred. Inland argued that the injury occurred after Dr. Stein’s employment was terminated, but the panel cited the “delayed action” theory Professor Larson noted in his treatise on workers’ compensation law. Inland argued that Dr. Stein had a pre-existing arteriosclerosis, but the panel found that her employment contributed to her disability in a significant manner per §201(4). Finally, the panel found that the severance package was not a “wage continuation plan” because it was not expressly intended to replace her lost wages during her disability.

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