10 language in Mcintyre, the Workers' Compensation Board has found that a new
work search alone is insufficient to demonstrate a change in circumstances. ~
v. Anthem BC/BS, W.C.B. 03-01-84-71, *2 (Me. 2007) ("I conclude that the
performance of a new work search, even a work search capable of carrying the
employee's burden of proof on the issue of unavailability of work, is insufficient
on its own, to demonstrate a change in circumstances where the Board has
recently decided the issue against the Employee.").
Defendant relies on several cases in which the Board increased partial
incapacity benefits after an employee performed a work search. In Bergeron v.
Keith Pelletier Logging, the Board originally found that the employee had a 50%
partial incapacity. Bergeron v. Keith Pelletier Logging, W.C.B. 98-00-63-06, *2
(Me. 2010). The employee filed a petition for review and the Board found that he
demonstrated a change in economic circumstances based on a work search. Id. at
*3-5. The Board's decision, however, also noted that the employee's injury had
worsened and that he no longer had a valid work visa to look for employment in
Maine. Id. *2-3. Thus, unlike in~ the Board's decision was not premised
solei y on a new work search.
Similarly, in Dallaire v. Intelligent Control, Inc. and Hilligoss v. Sisters of
Charity, the employee showed a change in circumstances beyond performing a
work search. In Dallaire, the employee entered into a consent decree with the
employer that required the employer. to pay 25% partial incapacity benefits.
Dallaire v. Intelligent Control, Inc., W.C.B. 04-030795, *1 (Me. 2010). Following
the consent decree, the employee lost his job, was laid off from two other jobs,
and remained unemployed for an extended period. Id. at *3. Because of these
new circumstances, the Board entertained the employee's request for 100%
11 partial incapacity benefits and found the failed work search sufficient to award
full benefits. Id. *4-6. Hilligoss also involved a consent decree, after which the
employee's doctors instructed her to stop working. Hilligoss v. Sisters of
Charity, W.C.B. 03-011415, *1 (Me. 2011). Both of these cases involved changed
circumstances that went beyond the employee's decision to do a work search.
The other cases defendant relies on involved a change in medical
circumstances. See Grant v. Schwan's Home Serv., Inc. W.C.B. 03-01-74-43, *2-3
(Me. 2012) (involving an employee whose work-related depression had
worsened); Shavirov v. Applicator's Sales & Serv., Inc., W.C.B. 05-031607, *4 (Me.
2010) (involving an employee who was diagnosed with depression and anxiety
since the initial award of benefits). Despite defendant's claims, a work search
alone does not constitute changed circumstances.
b. 100% Partial Incapacity vs. Total Incapacity
Plaintiff's expert states if plaintiff had performed a work search, "the
Worker's Compensation Board probably would have concluded that her work
search was adequate under the Act, entitling her to full benefits." (Add. S.M.F.
'11:'11: 19-20.) The crucial distinction between receiving total incapacity benefits and
100% partial incapacity benefits is the length of time the benefits can last. Total
incapacity benefits last as long as the disability lasts or, in the case of a
permanent disability, the employee's lifetime. 39-A M.R.S.A. § 212(1). Partial
benefits, on the other hand, are limited to a maximum of ten years. 6 See 39-A
M.R.S.A. § 213(1)(A) & (4) ("The 260-week limitation contained in subsection 1
may not be extended under this subsection to more than 520 weeks."). A critical
6 There is an exception to the 10-year rule if the employee's partial injury "is in excess of 15% of the body." 39-A M.R.S.A. § 213(1)(A). Plaintiff's injury does not fall under this exception. (Add. S.M.F. 1 31.)
12 issue in this case regarding damages is whether a work search likely would have
resulted in a finding of total incapacity or 100% partial incapacity.
As discussed above, there are two ways to receive total incapacity
benefits. The first method is by medically demonstrating "a lack of the physical
ability to earn." Monaghan, 2007 ME 100, 111, 928 A.2d 786. The independent
medical examiner, Dr. Bridgman, testified that plaintiff did not have a total
incapacity to earn. (Supp. S.M.F. 118.) Plaintiff would not have been able to
demonstrate a total incapacity under this method because the hearing officer
must credit the independent medical examiner's opinion absent clear and
convincing evidence to the contrary in the record. 39-A M.R.S.A. § 312(7).
The second method for demonstrating a total incapacity applies only in
"limited situations." Monaghan, 2007 ME 100, 112, 928 A.2d 786. The employee
with partial incapacity to earn may qualify for total incapacity benefits by
showing both (1) the unavailability of work in the local community and (2) "the
physical inability to perform full-time work in the statewide labor market,
regardless of availability." Id. 1 12. Although a work search is a necessary
element of proving total incapacity benefits under this method, plaintiff would
also have had to show that she was incapable of performing any full-time work
in the state at the time of the hearing. See Pratt v. Fraser Paper, Ltd., 2001 ME
102, 115, 774 A.2d 351.
Plaintiff has not raised a genuine issue of material fact regarding whether
she would have received total incapacity benefits under the second method if she
had performed a work search prior to the May 2006 hearing. Although plaintiff's
experts state that plaintiff likely would have received total incapacity benefits if
she had performed a work search, they do not explain how the hearing officer
13 would have found that she was not capable of performing any full-time work.
(Cohen Aff. 'li 10; MacAdam Aff. 'li 3.) Plaintiff argues that the hearing officer did
find that she was only capable of part-time, light-duty work. (Add. S.M.F. 'li 12.)
In the decision, the hearing officer states:
12. I find and conclude that the employee has been partially, as opposed to totally, incapacitated on account of her work injury since August 30, 2005, and continuing. Ms. Allen has not presented evidence of a work search and is therefore not eligible for 100% partial incapacity benefits.
13. The employee is probably capable at this time of part-time, light-duty work. Based upon an analysis of such factors as the employee's age, education, vocational history, presentation/ demeanor at hearing, pre-injury AWW and physical restrictions related to the injury, I find and conclude that Ms. Allen has been since August 2005 capable of earning about $200.00 I week in the local competitive labor market.
(Add. S.M.F. 'll'll 12, 14; Pl.'s Ex. N.) The hearing officer states only that plaintiff
was not eligible for 100% partial incapacity benefits and explicitly finds that she
was not totally incapacitated.
Plaintiff cites nineteen cases in which plaintiff alleges the same hearing
officer awarded "full benefits." (Plaintiff's Opp. Mem., 9 n.1.) The hearing
officer awarded total incapacity benefits, as opposed to 100% partial incapacity
benefits, based on a failed work search in only four of these cases. In the cases in
which total incapacity benefits were awarded, the hearing officer received
undisputed medical opinions that the employee should be restricted to part-time
work. See Hilligoss, W.C.B. 03-011415, *2 (Me. 2011) (relying on a section 207
doctor's opinion that the employee should be restricted to 10-20 hours per week
of work); Melanson v. Bath Iron Works Corp., W.C.B. 83-015213, *2 (Me. 2009)
(relying on the opinions of two doctors and the consistent report of the
independent medical examiner); Slocomb v. Me. Grown Poultry, Inc., W.C.B. 98-
14 011596, *3 (Me. 2008) (relying on a section 207 7 doctor's opinion that the
employee "would be able to tolerate just 4 hours per day upon entering the
workforce"); Duteau v. Lepage Bakeries, Inc., W.C.B. 00-003206, *2 (Me. 2006)
(relying on the independent medical examiner's opinion "that the employee has
only a part-time work capacity").
These cases make clear that plaintiff would have to show the independent
medical examiner, Dr. Bridgman, limited her to part-time work. Plaintiffs have
not identified any portions of Dr. Bridgman's opinion that would support her
claim for total incapacity benefits. Dr. Bridgman merely opined that plaintiff "is
capable of some limited work with her upper extremities." (Supp. S.M.F. '[ 18.)
Thus, plaintiff's expert's opinion that the hearing officer would have awarded
total incapacity benefits is speculation. As discussed above, "when the matter
remains one of pure speculation or conjecture, or even if the probabilities are
evenly balanced, a defendant is entitled to judgment." Niehoff, 2000 ME 214, <_[ 8,
763 A.2d 121. It is probable the hearing officer would not have awarded total
incapacity benefits to plaintiff in 2006. Accordingly, summary judgment on the
issue of total incapacity benefits is appropriate.
Plaintiff has raised a genuine issue of material fact regarding whether she
would have received 100% partial incapacity benefits if she had been advised to
conduct a work search. To receive 100% partial incapacity benefits, a plaintiff
must present evidence only of a failed work search or other comparable
evidence. From April 2009 to December 2010, plaintiff performed a thorough but
unsuccessful work search. (Add. S.M.F. '['[ 34-36.) Thus, plaintiff can argue that
7 39-A M.R.S.A. § 207 requires an employee to submit to a medical examination by a doctor of the employer's choosing.
15 if she had performed the same search before the 2006 hearing, she would have
been awarded 100% partial incapacity benefits.
c. SSDI Offset
Defendant argues even if plaintiff performed a work search and was
awarded 100% partial incapacity benefits, the additional benefits would have
been offset by a reduction in her SSDI benefits. 8 (Supp. S.M.F. <][ 43; Opp. S.M.F.
<][ 43 9 .) Under federal law, an SSDI beneficiary who also receives workers'
compensation benefits under state law cannot receive more than 80% of her
"average current earnings." 10 42 U.S.C. § 424a(a)(5) (2013); see also Davidson v.
Sullivan, 942 F.2d 90, 92 (1st Cir. 1991) ("Where an individual receives both
worker's compensation benefits and social security benefits, the total benefits
received may not exceed eighty percent of his predisability income.") 8 Plaintiff argues the collateral source rule prevents the court from considering the SSDI payments. Under the collateral source rule, "if a plaintiff is compensated in whole or in part for his damages by some source independent of the tortfeasor, he is still permitted to have full recovery against him." Werner v. Lane, 393 A.2d 1329, 1335 (Me. 1978). Plaintiff relies on St. Francis de Sales Federal Credit Union v. Sun Insurance Co. of New York,S in which the Law Court ruled "that evidence of other insurance covering the same losses was not admissible on issues of causation and punitive damages." St. Francis de Sales Fed. Credit Union v. Sun Ins. Co. of New York, 2002 ME 127, 'J[ 21, 818 A.2d 995. In this case, however, defendant also represented plaintiff in obtaining SSDI benefits. Defendant made a strategic decision to pursue a variety of benefits for plaintiff and those benefits were not collateral. The proper damages in the case should be the difference between the amount of benefits defendant obtained for plaintiff and the amount plaintiff alleges he should have obtained for her. See Hoitt v. Hall, 661 A.2d 669, 673 (Me. 1995) ("The measure of damages is the amount the client would have recovered but for the attorney's negligence."); see also 3 Ronald E. Mallen & Jeffrey M. Smith, Legal Malpractice§ 21.20 (2014 ed.) ("In a legal malpractice action, the objective is to determine what sum the client should have recovered had the lawyer not erred.") 9 Plaintiff relies on the deposition of Jeffrey Cohen, which has not been provided to the court. Paragraph 17 of the Allen affidavit appears to conflict with Exhibit D attached to the affidavit. In any event, paragraph 17 is not referred to in the plaintiff's statement of material facts and is not considered. 10 "Average current earnings" is defined in 42 U.S. C. § 424a(a) as: "the largest of (A) the average monthly wage (determined under section 415(b) of this title as in effect prior to January 1979) used for purposes of computing his benefits under section 423 of this title, (B) one-sixtieth of the total of his wages and self-employment income (computed without regard to the limitations specified in sections 409(a)(1) and 411(b)(1) of this title) for the five consecutive calendar years after 1950 for which such wages and self-employment income were highest, or (C) one-twelfth of the total of his wages and self-employment income (computed without regard to the limitations specified in sections 409(a)(1) and 411(b)(1) of this title) for the calendar year in which he had the highest such wages and income during the period consisting of the calendar year in which he became disabled (as defined in section 423(d) of this title) and the five years preceding that year."
16 Plaintiff was awarded weekly workers' compensation benefits for partial
incapacity at the rate of $308.48 beginning in May 2006. (Add. S.M.F. '1[ 13.) If
plaintiff had been awarded 100% partial incapacity benefits, she alleges she
would have received an additional $147.76 per week. (Add. S.M.F. '1[ 45.)
Defendant argues this additional $147.76 per week would have been subtracted
from plaintiff's SSDI benefits. Thus, defendant argues plaintiff sustained no
damages over the ten-year period that the partial incapacity benefits would have
lasted. (Supp. S.M.F. '1['1[ 43-4511 .)
It appears plaintiff's monthly SSDI reduced benefits of $857.10 were based
on plaintiff's worker's compensation benefits of $456.24 per week or $1,977.00
per month and based on her allowed maximum amount of workers'
compensation and SSDI benefits of $2,822.40. (Opp. S.M.F. '1[ 43; Allen Aff. '1[ 16;
Ex. D, 1-2.) ("We have to take into account your workers' compensation payment
of $1,977.00 when we figure your Social Security benefits. Because you receive
this payment, we are reducing the benefits you are due.") The Notice of Award
from the Social Security Administration, referred to by plaintiff as an explanation
of her benefits, shows the SSDI benefits would not have been reduced from the
initial total SSDI benefit amount if the plaintiff's workers' compensation benefits
were based on $1336.70 per month or $308.48 per week. (Opp. S.M.F. '1[ 43
("Your present workers' compensation payments of $1,336.70 do not affect your
Social Security benefits.")) Accordingly, if the defendant had succeeded in
obtaining the weekly amount of workers' compensation benefits plaintiff alleges
11 Plaintiff responds to the testimony of the defendant on this issue by referring to the Notice of Award from the Social Security Administration and by objecting to the testimony as a legal conclusion and as precluded by the collateral source rule. (Opp. S.M.F. 9[9[ 43-45.)
17 he should have obtained, her SSDI benefits would have been reduced as they
were in the Notice of Award. Plaintiff has not raised a genuine issue of material
fact regarding whether increased social security benefits would have offset her
reduced workers' compensation benefits.
d. Workers' Compensation Settlement
Plaintiff settled her workers' compensation case in 2010 for $300,000Y
(Supp. S.M.F. ~ 63.) Plaintiff alleges she lost $147.76 per week as the difference
between the benefits she received and 100% partial incapacity benefits. (Add.
S.M.F. ~ 45.) During ten years, or 520 weeks, the maximum defendant's
negligence could have harmed plaintiff was $76,835.20. 13 The settlement more
than fully compensated her for not receiving 100% partial incapacity benefits.
Because plaintiff cannot prove that she would have received total incapacity
benefits, which continue beyond the ten-year limit, the settlement compensated
plaintiff for any financial harm defendant may have caused her.
4. Emotional Distress
In her complaint, plaintiff also alleged that she suffered emotional distress
damages as a result of defendant's negligence. (Compl. ~ 12.) When an attorney's
conduct is not egregious and the only alleged injury is economic, damages for
emotional distress are not recoverable. Garland v. Roy, 2009 ME 86, ~ 26, 976
A.2d 940. Defendant's alleged negligence, essentially a tactical error, cannot be
described as egregious. Plaintiff is not entitled to damages for emotional distress.
Defendant's Motion for Summary Judgment is GRANTED. Judgment is granted in favor of the
12 $40,000 of this settlement went to plaintiff's attorney for costs and fees. (Supp. S.M.F. 64.) 13 520 weeks x $147.76 = $76,835.20.
18 Defendant and against the Plaintiff on the Plaintiff's Complaint. Defendant's Third-Party Complaint for Contribution and/ or Inde fication is Moot.
Date: March 18, 2014
CUMB CV-12-161
19 PHILIP MANCINI ESQ w DRUMMOND & DRUMMOND ONE MONUMENT WAY PORTLAND ME 04101
MARSHALL TINKLE ESQ f DAVID HIRSH ON ESQ 208 FOREST PORTLAND ME 04101