02-031-460 Me. Code R. § 5

Current through 2025-03, January 15, 2025
Section 031-460-5 - Specific provisions
A. Employee's prior workers' compensation claim history shall include all workers' compensation claim known or accessible to the insurer or self-insurer, including claims on injuries occurring prior to January 1, 1987.
B. Attorney involvement shall mean the earliest date the attorney's representation is known by the insurer or self-insurer.
C. Information reported pursuant to § 2371(2)(B)(3) shall be limited to the date of maximum medical improvement.
D. If there is more than one hearing date for a single claim, the dates of each hearing shall be recorded, but the claim information may be based on the hearing which results in a decision.
E. Identification of offsets pursuant to § 2371(5) shall also include the following:
(1) Whether the insurer was eligible for recoveries from the Second Injury Fund;
(2) The dollar amount recovered from the Second Injury Fund; and
(3) Whether recovery was restricted by an inadequate balance in the Second Injury Fund.
F. Medical payment information reported pursuant to § 2371(2)(D) shall be provided for all claims unless the Superintendent approves an alternative collection procedure. Alternatives which the Superintendent may select include, but are not limited to, closed claim reporting only, sampling, specified categories of medical procedures, or information consistent with that collected by the Workers' Compensation Commission in establishing fee schedules.

02-031 C.M.R. ch. 460, § 5