Maine Workers Compensation

What is Workers Compensation?

Workers compensation is a state facilitated program that provides benefits for disease or occupational injuries suffered by employees. The delivery of workers compensation in Maine is fulfilled without fault. Benefits provided by ME workers compensation laws include lost wages and payment of medical services; the amount of payment is limited by ME workers compensation laws. In Maine, workers’ compensation is regarded as the exclusive remedy for the coverage of work related illnesses and injuries by the employer.

As a Maine Employer, Do I Need ME Workers’ Compensation Insurance Coverage?

ME workers’ compensation laws require almost every private and public employer to possess workers’ compensation coverage. ME workers’ compensation law defines an employer as “public employers private employers, water districts, municipal school committees, school union committees, design professionals and quasi-public corporations.

In Maine, the Workers’ Compensation Board may impose penalties for failing to provide coverage; failure to provide coverage does not relieve Maine employers of their responsibility for providing payments to injured or sick workers.

According to ME workers’ compensation laws, employers who fail to attain workers’ compensation insurance may be sued by employees for suffering work-related illnesses or injuries. These employers can be found guilty of class d felonies, subject to civil fines of up to $10,000 or an amount equal to 108% of the premium that would have been paid during the time the employer failed to attain coverage (whichever figure is greater).

How do I Purchase Workers Compensation Insurance Maine?

To purchase workers compensation insurance Maine, you must partake in one of the following two methods:

• You can purchase a workers compensation insurance Maine package yourself (self insurance)

• Or you can purchase a workers compensation insurance Maine package from a licensed producer who sells causality insurance and property and who specializes in or is familiar with workers compensation insurance.

Currently, the workers compensation insurance Maine market is competitive for employers who have had either very few losses or no losses. The market seeks employers who have a good attitude concerning the implementation and practice of safety programs.

First time business owners, with no records of claims experience, will face difficulty attaining workers compensation ME. That being said, Maine Employers’ Mutual Insurance Company permits these entities (high risk enterprises, smaller businesses and business owners with severe problems or high accident frequencies) to attain workers compensation insurance ME.

The Maine Employers’ Mutual Insurance Company specializes in risk management, loss control, returning employees to work and aiding employers with their workers compensation ME packages. This level of service helps employers become aware of the necessary steps they can take to reduce overall claims costs. The Maine Employers' Mutual Insurance Company, in addition to the aforementioned services, also insures in the regular market, as it competes with other insurers.

There are over 300 companies authorized to sell workers compensation insurance ME; costs and services will vary from company to company. The following tips will help you explore what is available in the marketplace to meet your company’s particular needs:

1. Secure proposals for insurance at least 90 days before your existing policy expires; it typically takes an insurance company at least one money to review and evaluate an application. Moreover, it takes time for the insurance provider to prepare applications and submit them to the company of interest.

2. Your producer should request proposals from several companies and present them to you. There are several companies that specialize in certain forms of risks and offer competitive pricing.

3. Request information from your producer concerning the rating, the reputation of the prospective insurer and the loss control services if you are thinking about switching workers compensation insurance ME.

4. To secure the best proposals, you will need the following:

a. A listing of current classifications and corresponding payrolls

b. Loss runs from your insurer showing losses over the past four years

c. A description of operations

d. A copy of recent premium audit summaries

Are All Employers Required to Attain ME Workers Compensation?

No, according to ME workers compensation laws, not all employers are required to possess ME workers compensation insurance. The following employees, by law, are not required to secure or offer ME workers compensation insurance:

• Any employer who has employees engaged in aquaculture or agriculture as seasonal or casual laborers, if the employer maintains at least $25,00 in employers’

What is the Office of Claims Administration?

The Office of Claims Administration is the foundation or starting point for the Department of Industrial Accidents. Workers Compensation Insurance Maine are established from filings received from filings received from insurance companies, employers, third party providers and attorneys. The Office of Claims Administrations has several roles of responsibility that are prominent within the DIA and the public sector.

Where to Start your Claim for Maine Workers Compensation Laws:

If you suffer a work-related illness or injury which forces you to miss work for at least five full or partial calendar days, your employer is required to file the Employer’s First Report of Injury or Fatality-Form 101 with the Department of Industrial Accidents and their worker’s compensation insurance company within seven days from the fifth full or partial day you have been incapacitated because of an illness or injury.

The responding insurance company has 14 calendar days from when they secure the aforementioned from your employer to formally investigate the claim and render a decision as to whether to pay the claim or not.

Filing Your Claim for Maine Workers Compensation Laws:

To file for a Workers Insurance Compensation Maine please observe the following steps:

The first step to filing for Workers Insurance Compensation Maine is to fill-an as many of the boxes on the Employee Claim—Form 110 as you can. The boxes or information listed below are particularly critical with regards to getting your request processed by the Department of Industrial Accidents.

Information you will need to Secure Maine Workers Compensation Laws:

Section #1: Print or type your full name (last name, first name and middle initial)

Section #2: Enter your nine digit social security number (voluntary) but is helpful to the Department of Industrial Accidents in maintaining your records separate from others with the same name.

Section #3: Print or type your home telephone number

Box #5: Print or type your number of dependents (this information is required according to Maine Compensation Laws)

Box #7: Enter your e-mail address and indicate your native language

Box #10: Print or type your employer’s business name and its address. If your employer maintains multiple addresses, use the address where you conduct most of your work.

Box #11: Print or type your employer’s workers’ compensation insurance provider (do not record the insurance agent’s information, but instead, the name of the carrier that will provide compensation). The Maine Labor and Workforce Development cannot schedule meetings without this information. If your employer does not provide you with the name of their insurance provider, please call the state’s office of insurance at 727-4900, extension 405.

Box #12: Print or type the date that you were originally hurt or became ill as a result of a work-related illness. You—according to Maine Workers Compensation Laws—should provide the department with the date you first received medical treatment or the last day you worked. You are also required to provide the department with the case claim number that your employer’s workers’ compensation insurance company assigned your claim.

Box #13: Provide the department with the first day that you were incapable of earning wages because of your illness or injury

Box #14: To secure workers compensation insurance Maine, you must type or print the fifth day that you were not capable of earning full wages because of your illness or injury.

Box #17: To secure workers compensation insurance Maine. Print or type the nature of your illness or injury and the part of your body that has been affected—to do this, please look at the codes on the back of the application.

Box #23: The application for Workers compensation insurance Maine requires that you check the benefits that you are claiming are due according to Maine workers compensation laws. Other sections of this law will include: willful misconduct of the employer, medical bills and interest or penalties for late payments.

When Should I File For Workers Compensation Insurance Maine (Form 110)

The Employee Claim Form 110 (official form for Workers Compensation Insurance Maine) should be finished whenever you think you are not receiving the workers’ compensation insurance Maine you are entitled to. For instance, your employer or its insurance providers contests your right to receive workers compensation insurance Maine or it has stopped payment of your compensation for reasons that you think are unfair. Remember—according to Workers Compensation Insurance Maine—if you are filing for workers compensation insurance Maine to offset medical costs, you must provide copies for all medical bills.

Workers Compensation Insurance Maine: Steps of the Dispute Process

There are four levels to settle your dispute within the Department of Industrial Accidents:

Level #1: The Conciliation Session

The conciliation is the opening step to securing workers compensation insurance Maine. The conciliation is an informal meeting between you and your employer’s insurance provider. Results of the conciliation will not be binding unless you agree to the provisions. That being said, even if you are satisfied with the payment, you may secure a notice to attend a conciliation that you did not want or request. This situation means that either the insurance provider thinks it is paying too much and wishes to reduce you benefits or halt your benefits entirely.

Level #2: The Conference

If your case is referred by a local administrative judge, a conference will be scheduled. The conference—like the conciliation—is informal with discussions between two parties. If the matter regarding your amount of workers compensation insurance Maine is not settled, a judge will issue temporary orders indicating whether or not the insurance provider must deliver compensation. If you are not happy with the judge’s ruling or order, you may appeal it within 14 days of the filing date of the decision. Insurance providers also possess the right to appeal.

Level #3: Hearing

If your case for workers compensation insurance Maine is appealed by the insurance company or yourself, if till move to the hearing stage, where the administrative judge is responsible for conducting a formal hearing where all of the evidence will be evaluated. These hearings take the form of regular trials; witnesses are brought to the stand and sworn and testimonies are taken by stenographers.

Level #4: Review Board

Either party—according to Maine compensation law, may appeal the administrative judge’s decision to the review board within 30 days. Maine compensation laws state that three administrative law judges will examine the transcripts. These judges may also ask for legal arguments. After reviewing the information, the Review Board will reverse the decision only if the decision was beyond the Administrative Judge’s power, was rendered without any justification or conflicted with Maine compensation laws.