Name

Dennis Crosen v. Blouin Motors, Inc.

Insurance Company

MADA Workers' Compensation Trust

Date Decided

May 16, 2024

Panel Members

Categories

Tags

File Size

542 KB

Summary from the Troubh Heisler Attorneys

Dennis Crosen v. Blouin Motors, Inc.- 2024 ME 38- The Law Court grants Blouin’s appeal and vacates the Appellate Division decision (Dec. No. 23-08) which had affirmed the ALJ decision that Blouin Motors was not entitled to coordinate the full amount of the social security old age retirement benefit offset available under 39-A M.R.S.A. sec. 221(3)(A)(1). The Law Court holds that in multiple injury cases where one or more date of injury precedes the June 30 1985 effective date for coordination of social security retirement benefits, the injuries after June 30, 1985 are entitled to the full amount of the available coordination amount.

In Crosen, the employee had a 1984 neck injury with Rockingham and a 2002 back injury with Blouin Motors, which combined to produce the earning incapacity. Applying the apportionment statute sec. 354(3), a 2012 decree apportioned responsibility 40% to the 1984 Rockingham injury and 60% to the 2002 injury with Blouin Motors. As the most recent injury, Blouin Motors was responsible for paying Crosen $597.66 per week, with Rockingham reimbursing Blouin Motors $227.66 per week. Thus, Blouin Motors net benefit obligation was $370.00 per week. In 2014 Crosen began to collect social security old age retirement benefits. Under sec. 221(3)(A)(1) the employee’s incapacity benefits “must” be reduced by half of the weekly amount. Here, the weekly coordination reduction amount was $233.76. There was an informal agreement that Blouin Motors would only exercise coordination of 60% of the $233.76, or $140.26.

Thereafter Rockingham’s insurer became insolvent and ceased reimbursement to Blouin Motors. In 2021 Blouin Motors petitioned the board seeking to increase its social security offset to the full amount of $233.76. The ALJ denied the petition concluding the result was precluded by sec. 354(3), which provided that the apportionment statute may not effect the employee’s rights or benefits under the Act. The Appellate Division affirmed, see Dec. No. 23-08. The Law Court granted Blouin Motors request for appellate review.

The Law Court rejected the ALJ’s and Appellate Panel’s reliance on sec. 354. The Court reviewed the statutory purpose of sec. 221 coordination of benefits and reaffirmed that an employer’s obligation to pay weekly benefits must be reduced. The Court reasoned that sec. 221 did not apply to the 1984 injury at all, but was applicable to the obligation of Blouin Motors under the 2002 injury. Sec. 221 contained no reference or authority for apportionment of the offset based on an insurers share of apportionment responsibility. The statute did not contemplate any basis for the informal agreement entered into. Finally, the Court distinguished its decision in Juliano v. Ameri-Cana Transport, 912 A.2d1244 (Me. 2007) as inapplicable to the facts, and agreed with Blouin Motors that its decision in Berry v. H.R. Beal & Son, 649 A.2d 1101 (Me. 1994) supports taking the full offset. Because Blouin Motors apportioned responsibility of $370 per week exceeded the full offset of $233.76, the Court expressly left undecided whether in a case where the weekly sec. 221 coordination amount exceeds the apportioned share of the paying employer, that employer is entitled to the amount of offset which exceeds its apportioned share.