Lamonica v. Holmes

718 A.2d 182, 1998 Me. 190, 1998 Me. LEXIS 187
CourtSupreme Judicial Court of Maine
DecidedJuly 28, 1998
StatusPublished
Cited by6 cases

This text of 718 A.2d 182 (Lamonica v. Holmes) is published on Counsel Stack Legal Research, covering Supreme Judicial Court of Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lamonica v. Holmes, 718 A.2d 182, 1998 Me. 190, 1998 Me. LEXIS 187 (Me. 1998).

Opinions

WATHEN, Chief Justice.

[¶ 1] The employer, Ladd Holmes, appeals from a decision of the Workers’ Compensation Board granting the employee’s petition for restoration related to a 1977 injury. Although the employee suffered a subsequent injury in 1995 while employed by a second employer, the Board concluded that the subsequent injury was nonwork-related because the employee failed to give timely notice of that injury to preserve his workers’ compensation claim against his second employer, 39-A M.R.S.A. § 301 (Supp.1997). Ladd Holmes contends that the employee’s 1995 injury should have been treated as a subsequent work-related injury and that its liability should be reduced by the contribution of the second injury to the employee’s resulting incapacity. We affirm.

[¶ 2] The employee, Paul R. Lamonica, suffered a work-related injury on June 9, 1977, while employed by Ladd Holmes, and a subsequent injury on March 3, 1995, while employed by the Town of Skowhegan. Lamonica filed petitions with the Board for benefits related to both injuries. The Board granted Lamonica’s petitions for the 1977 injury, but denied his petition for award related to the 1995 injury because he failed to provide timely notice of his injury to the Town of Skowhegan. 39-A M.R.S.A. § 301 (“Proceedings for compensation under this Act, except as provided, may not be maintained unless a notice of the injury is given within 90 days after the date of injury.”). The Board concluded further that, because [183]*183the 1995 injury is not compensable, it must be treated as a nonwork-injury for purposes of determining the liability of Ladd Holmes. Applying 39-A M.R.S.A. § 201(5),1 the applicable provision when a work-injury combines with a subsequent nonwork-injury, the Board concluded that the 1995 injury was “causally connected” to the 1977 injury and, therefore, Ladd Holmes is fully liable for Lamonica’s subsequent disability. See Mushero v. Lincoln Pulp & Paper Co., 683 A.2d 504, 506 (Me.1996). We granted the employer’s petition for appellate review pursuant to 39-A M.R.S.A § 322 (Supp.1997).

[¶ 3] Ladd Holmes contends that, as a matter of common usage, the 1995 injury was a work-related injury because it arose out of and in the course of his employment with the Town of Skowhegan. Furthermore, because the 1995 injury was a subsequent work-injury, Ladd Holmes contends that it is entitled to an apportionment. As we have stated, however, “ ‘the law of workers’ compensation is uniquely statutory.’ ” Beaulieu v. Maine Med. Ctr., 675 A.2d 110, 111-12 (Me.1996) (quoting Wentzell v. Timberlands, Inc., 412 A.2d 1213, 1215 (Me.1980)). The basic entitlement to workers’ compensation benefits under the Act, 39-A M.R.S.A. § 201(1) (Supp.1997), expressly defines a compensable injury with reference to the notice-of-injury provision set forth in 39-A M.R.S.A. § 301. For purposes of the Act, an injury is not “work-related” if the employee does not provide notice of the injury. Because this appeal involves a work-injury and a subsequent nonwork-injury, the controlling statutory provision is 39-A M.R.S.A. § 201(5).

[¶ 4] Even if we considered the 1995 injury as work-related, that would not alter our decision concerning an apportionment. The applicable statute when an employee suffers more than one work-injury is section 354, providing, in pertinent part:

1.Applicability. When 2 or more occupational injuries occur, during either a single employment or successive employments, that combine to produce a single incapacitating condition and more than one insurer is responsible for that condition, liability is governed by this section.
2. Liability to employee. If an employee has sustained more than one injury while employed by different employers, or if an employee has sustained more than one injury while employed by the same employer and that employer was insured by one insurer when the first injury occurred and insured by another insurer when the subsequent injury or injuries occurred, the insurer providing coverage at the time of the last injury shall initially be responsible to the employee for all benefits payable under this Act.
3. Subrogation. Any insurer determined to be liable for benefits under subsection 2 must be subrogated to the employee’s rights under this Act for all benefits the insurer has paid and for which another insurer may be liable. Any such insurer may, in accordance with the rules adopted by the Superintendent of Insurance, file a request for appointment of an arbitrator to determine apportionment of liability among responsible insurers. ... Arbitration pursuant to this subsection is the exclusive means for resolving apportionment disputes among insurers and the decision of the arbitrator is conclusive and binding among all parties involved.

39-A M.R.S.A. § 354 (Supp.1997) (emphasis added).

[¶5] Subparagraph 1 states that section 354 applies when “more than one insurer is responsible for that condition.” 39-A M.R.S.A. § 354(1) (emphasis added). As we have stated, the right to an apportionment in workers’ compensation eases is limited to a right of subrogation. See Kennedy v. Brunswick Convalescent Ctr., 584 A.2d 678, 681 (Me.1991) (subsequent employer not entitled to apportionment after employee settled [184]*184claim against previous employer).2 The subrogation principle has been carried forward into the new Act by subsection 2. Because there is only one insurer responsible for compensation in this case, there is no statutory basis for an apportionment.3

[¶ 6] The employer’s remaining arguments are based more on policy than language of the Act. Ladd Holmes contends that, as a matter of fairness, employers should not be made fully liable for benefits resulting from multiple injuries merely because the employee, by his or her own inaction, failed to notify a subsequent employer. Ladd Holmes contends that “[t]here is no indication that the Legislature ever intended for such exceptional penalties to be borne by employers upon the fortuities of the employee’s own compliance with the statutory notice provisions.”

[¶ 7] We rejected a similar policy argument made by the employer in Harding, 647 A.2d at 1194. In that case, the employer sought an apportionment against an employee who suffered a subsequent injury while self-employed and not covered by the Act. Id. at 1193. The employer made the policy argument that “the self-employed employee who receives a subsequent injury arising from self-employment should not be entitled to look to a previous employer for full eom-pensation merely because that employee has failed to elect coverage under the Act.” Id. at 1194. We rejected the employer’s policy argument because it lacked support in the statutory language. Id. (“While the employer makes an interesting policy argument, such policy issues are more appropriately addressed to the Legislature.”).

[¶ 8] Ladd suggests further that the Board’s result will encourage employees to collude with subsequent employers in order to shift full liability to a prior employer. Such action, however, would not be without risk to the employee.

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Cite This Page — Counsel Stack

Bluebook (online)
718 A.2d 182, 1998 Me. 190, 1998 Me. LEXIS 187, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lamonica-v-holmes-me-1998.