Maine Workers' Compensation: Deadlines, Benefits and How to File

Every private employer, including an independent contractor who hires and pays employees, must carry workers' compensation insurance or be approved to self-insure for all employees; the State and every county, city and town must also be covered. There is no minimum number of employees. Exemptions: employers of domestic-service workers; employers of seasonal or casual agricultural or aquacultural laborers who keep employer's liability coverage of at least $25,000 plus $5,000 medical-payment coverage; and certain small agricultural or aquacultural employers (6 or fewer laborers at once, or no more than 240 total labor hours a week) that keep the employer's liability and medical-payment coverage the law requires. The employer must prove it qualifies for an exemption.

For injuries on or after January 1, 2020, the worker (or someone on the worker's behalf) must give the employer notice of the injury within 60 days. The notice should include the time, place, cause and nature of the injury and the worker's name and address. It can be given to the employer, a corporate official, a supervisor in charge of the work, an employee the employer has designated to receive accident reports, or on-site medical staff employed by the employer. Earlier injuries had different deadlines (30 days for injuries from 2013 through 2019; 90 days before 2013).

A petition to the Workers' Compensation Board is generally barred unless filed within 2 years after the date of injury, or the date the employer files a required First Report of Injury, whichever is later. If the employer or insurer has paid benefits within that period, the deadline becomes 6 years from the most recent payment. Time when the worker was physically or mentally unable to file does not count. If the worker dies from the injury, a petition must be filed within 1 year after death or 2 years from the injury, whichever is later, but no later than 6 years after the last payment.

Wage-loss benefits are not paid for the first 7 days of incapacity (firefighters are paid from the first day). If the incapacity lasts more than 14 days, benefits are paid back to the date the incapacity began.

For injuries on or after January 1, 2013, total incapacity benefits are 2/3 of the worker's gross average weekly wage, up to the state maximum, and are paid for as long as the total incapacity lasts. (For injuries before 2013, the rate was 80% of after-tax average weekly wage.) A worker who can do full-time work in the ordinary labor market is not eligible for total benefits but may receive partial benefits.

For injuries on or after January 1, 2020, the maximum is 125% of the state average weekly wage (or $441, if higher). The Board's notice lists a maximum weekly rate of $1,561.40 for the payment period July 1, 2026 – June 30, 2027, based on a state average weekly wage of $1,249.12. For injuries from 2013 through 2019 the maximum is 100% of the state average weekly wage, listed as $1,249.12 for the same period. No general minimum weekly benefit was found in the sections reviewed.

The employer has the initial right to choose the health care provider. After 10 days from the start of that care, the worker may switch to a provider of the worker's choice by giving the employer the new provider's name and a statement that the worker intends to treat there. The employer may object by petition, which goes to mediation and, if unresolved, a hearing. After that switch, the worker may not change providers more than once without the employer's or the Board's approval. Referrals to specialists by the treating provider are allowed, and the worker may choose the pharmacy.

For injuries on or after January 1, 2020, partial incapacity benefits are 2/3 of the difference between the worker's pre-injury gross average weekly wage and what the worker can earn after the injury, up to the maximum, for no more than 624 weeks (counting total and partial benefits together); the Board can extend that limit in cases of extreme financial hardship. Total incapacity benefits are paid as long as the total incapacity lasts, and certain severe losses (such as loss of sight in both eyes, or loss of both legs or both arms) are presumed to be permanent total incapacity for 800 weeks. Actual loss of body parts is paid for a set number of weeks (for example, thumb 65 weeks, hand 215 weeks, leg 215 weeks, arm 269 weeks, eye 162 weeks). For injuries on or after January 1, 2020, total benefits are adjusted annually for wage changes (up to 5%) after 260 weeks.

If a work injury causes death (injury on or after January 1, 2013), wholly dependent survivors receive 2/3 of the worker's gross average weekly wage, up to the maximum, for 500 weeks from the date of death; partial dependents receive a proportional amount. Payments continue past 500 weeks for a dependent child until age 18 (longer if the child cannot earn a living because of incapacity). Payments to a dependent spouse end if the spouse dies or becomes dependent on another person, with a final payment of no more than $500. For injuries on or after January 1, 2020, if there are no dependents, the worker's parents receive the weekly benefit for up to 500 weeks. The employer also pays reasonable burial expenses up to $4,000 plus $3,000 in incidental compensation to the estate.

Tell your employer about the injury. The employer must complete a First Report of Injury and give you a copy, and must either pay your lost-time claim within 14 days or send you and the Board a Notice of Controversy. If there is a dispute, a Board troubleshooter will contact you to try to resolve it; if not resolved, the case goes to mediation; if mediation fails, you may request a formal hearing. Any interested party may file a petition with the Board, served on the other parties by certified mail. Qualified injured workers can get free legal representation from the Board's Worker Advocate Program.

A disputed claim is decided by an administrative law judge after a formal hearing; the judge's findings of fact are final. A party may appeal a legal question to the Board's Appellate Division by filing a notice of intent to appeal within 20 days after receiving notice of the decision. A party may then seek review by the Maine Supreme Judicial Court (Law Court) by filing a copy of the Appellate Division's decision with the Law Court clerk within 20 days after notice of it, followed within 20 days by a petition for appellate review; the Law Court decides whether to take the case.

An employer may not discriminate against an employee in any way for testifying or asserting a claim under the workers' compensation law. The employee may file a petition, which is heard by an administrative law judge; if the employee wins, the judge may order reinstatement, back wages, restored benefits and reasonable attorney's fees. Discrimination by a different employer is handled under the Maine Human Rights Act (5 M.R.S. § 4572).

Total incapacity benefits are paid for as long as the total incapacity lasts, with no fixed week limit. Partial incapacity benefits are capped by date of injury: 260 weeks for injuries before January 1, 2013; 520 weeks for injuries from January 1, 2013 through December 31, 2019; and 624 weeks for injuries on or after January 1, 2020. A worker whose permanent impairment is above the threshold set by law is not subject to the cap, and the Workers' Compensation Board may extend partial benefits past the cap in cases of extreme financial hardship due to inability to return to work. Separate fixed periods apply to certain specific losses (for example, 215 weeks for loss of a hand).

Yes. Future benefits can be commuted to a lump sum, but only on a petition to the Workers' Compensation Board, at least six months after the injury, and with the Board's approval. Before approving, the Board reviews with the worker their rights, the effect the settlement would have on those rights, and the prudence of consulting a financial or other expert. The Board may not approve the settlement unless the worker has fully participated in the review (absent good cause) and the Board finds it is in the worker's best interest. A settlement may also release future medical liability only under conditions the Board must find.

Fees for attorneys representing injured employees are subject to approval by the Workers' Compensation Board. In a case tried to completion, the fee may not exceed 30% of the benefits accrued. For lump-sum settlements of injuries on or after January 1, 2020, the fee may not exceed 10% of the amount left after allowable expenses; older injuries use a sliding scale starting at 10% of the first $50,000. An attorney who charges more than allowed forfeits the fee and is liable for twice the fee charged.

An employer that has secured workers' compensation is exempt from civil suits by an employee for work injuries or death, including wrongful-death and Tort Claims Act suits, and the exemption extends to its employees, supervisors, officers and directors; an employer using a temporary help agency that has coverage gets the same protection. A 2023 law makes an individual employee, supervisor, officer or director (but not the employer) liable for sexual harassment, sexual assault or a related intentional tort.

When someone other than the employer is legally liable for the injury, the worker may claim workers' compensation or proceed against that person. If the worker takes compensation, the employer has a lien on any later recovery from the third party for compensation paid, and if the worker does not pursue the third party within 30 days after the employer's written demand, the employer may sue in its own or the worker's name. A worker who recovers must repay the employer's benefits, less the employer's share of collection costs and attorney's fees; settlement of such claims needs approval of the court or the Workers' Compensation Board.

The civil-suit immunity applies only to employers that have secured workers' compensation, and in a damages suit by an employee the employer cannot defend on the ground that the employee was negligent, a co-worker was negligent, or the employee assumed the risk. An employer that fails to secure coverage faces a civil penalty of up to $10,000 or 108% of the premium that should have been paid, whichever is larger (paid to the Employment Rehabilitation Fund), a Class D crime for a knowing violation, and possible dissolution of the business or loss of licenses.

A petition to the Workers' Compensation Board must generally be filed within 2 years after the injury (or after the employer files a required first report of injury, if later); if the employer or insurer paid benefits, the period is 6 years from the most recent payment. A party may appeal an administrative law judge's decision to the Board's Appellate Division by filing a notice of intent to appeal within 20 days after receiving notice of the decision. The Appellate Division reviews legal issues only; findings of fact cannot be appealed to it.