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August 21, 2009

Court rules against BIW in workers' comp case

The Maine Supreme Court has ruled against Bath Iron Works in a workers' compensation case that underscores frustration in Maine's business community with the absence of set reimbursement fees under the state's workers' comp law.

BIW had appealed to the supreme court a ruling by the Maine Workers' Compensation Board that said the shipyard must pay higher medical provider fees available under Maine workers' comp law than available under the federal Longshore and Harbor Workers' Compensation Act, even though the company's employees received benefits under the federal law. The case originated from two workplace injuries at BIW in 2001 and 2003. Both employees received treatment at St. Mary's Medical Center in Lewiston. The Maine Workers' Compensation Board has not established a fee schedule under the state workers comp law, so the hospital charged BIW $31,417 for treating a neck injury and $75,179 for a back injury. But BIW paid St. Mary's according to a federal Longshore Act fee schedule that allows only $13,566 for the neck injury and $24,633 for the back injury. BIW argued that "St. Mary's is not entitled to reimbursement under the Maine Act because the employees chose to proceed under the Longshore Act and therefore BIW's liability to St. Mary's should be determined according to that choice," according to the court's decision. However, the Maine Workers' Compensation Board did not agree with BIW and concluded that "federal and state jurisdiction is concurrent in this area" and that there is no authority "that would bar a health care provider from seeking medical payments under state law when the employees chose to proceed under the Federal Act." The Maine Supreme Court affirmed the board's decision.

The decision was not a surprise in the workers' comp arena, according to Michael Bourque, director of communications at MEMIC. But the more important outcome is that the Maine Workers' Compensation Board has moved closer to setting up a fee schedule that enumerates health care costs under the Maine law.

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