Maine High Court Blocks Employer’s Attempt to Challenge Continued Existence of Disability

Highlighting the fine line that exists, on the one hand, between a party’s attempt to relitigate an issue already decided and, on the other hand, a party’s contention that a change of condition or circumstances warrants revisiting the issue of an injured worker’s continued level of disability, the Supreme Judicial Court of Maine affirmed a decree of the state’s Workers’ Compensation Board Appellate Division that concluded that a 2007 determination of permanent impairment as of the date of MMI was final and, therefore, res judicata princples barred relitigation of the issue [Bailey v. City of Lewiston, 2017 ME 160, 2017 Me. LEXIS 170 (July 20, 2017)].

2007 Decision as to MMI & Impairment

In that 2007 decision, which was not appealed by the employer, the hearing officer found, based upon the results of an independent medical exam, that the worker had reached MMI and that he had sustained an injury that resulted in a permanent impairment level of 32 percent. In 2013, the employer sought a review of the worker’s condition, contending that an updated medical examination showed the worker’s level of permanent impairment had decreased to zero percent.

Hearing Officer’s Findings

The hearing officer rejected the worker’s claims that the doctrine of res judicata precluded the employer’s petition to determine the extent of permanent impairment. The hearing officer also found that the new medical evaluation constituted a change of circumstances warranting a new permanent impairment rating. The Appellate Division vacated the hearing officer’s decree, concluding that there existed no change of circumstances to warrant the hearing officer revisiting the issue of the worker’s MMI.

High Court Agrees with Appellate Division

The Supreme Judicial Court stressed that the Appellate Division’s conclusion that relitigation of the worker’s permanent impairment level was barred by the doctrine of res judicata. The Court added that except for the very limited circumstances referenced in 39-A M.R.S. §§ 319 and 321, the workers’ compensation statute provided no opportunity for a redetermination of a hearing officer’s or ALJ’s findings regarding permanent impairment or MMI. The Court contrasted the current situation with that in which the statute allowed adjustment in benefit levels based upon a change in an injured employee’s ability to be gainfully employed. The Court observed that if a party were able to disturb a permanent impairment finding so as to either terminate an employee’s eligibility to receive ongoing benefits or award such eligibility after it had already been denied, the statute would be completely circumvented.

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