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How New Mexico's workers' compensation system works

Overview

New Mexico workers' compensation laws provide money and medical benefits when workers are injured or suffer illness while working. Employers with 3 or more workers must have workers' compensation insurance. Construction employers must have workers' compensation insurance even if they employ less than 3 workers. This is no-fault insurance that pays for medical expenses and a portion of lost wages regardless of fault. However, being drunk or high when you were hurt or engaging in horseplay could negatively affect your workers' compensation benefits.

In most cases, New Mexico workers' compensation laws prohibit workers from filing a lawsuit against their employers outside of the workers' compensation injury, such as for personal injury because of the employer's negligence.

It is critical for workers to know their rights and responsibilities under New Mexico's workers' compensation laws.

What are the important deadlines?

Here are some important deadlines employees and employers should remember:

  • A worker must give notice of a work injury to the employer “within fifteen days after the worker knew, or should have known” of being injured. NMSA 1978 § 52-1-29.
  • A worker must file a complaint at the New Mexico Worker's Compensation Administration “not later than one year after the failure or refusal of the employer or insurer to pay compensation.” NMSA 1978 § 52-1-31. Case law has construed this deadline to mean “one year and a month”. This deadline applies only to the non-payment of money benefits. It does not apply to non-payment of medical benefits.

There are other important deadline but these two are the most important. Violation of these deadlines can cause you to lose all or part of your case.

If you have any doubts about deadlines, please call me at 505 292-8836 or email me at [email protected]. DO NOT WAIT.

What benefits are available to injured workers?

New Mexico's workers' compensation laws provide money and medical treatment benefits to injured workers.

New Mexico's workers' compensation laws provide money benefits to a workers' spouse and children if the worker is killed on the job or if the worker's injuries cause him or her to die.

New Mexico's workers' compensation laws provide in certain cases for the return to work of the injured worker.

New Mexico's workers' compensation laws do not provide for retraining or vocational rehabilitation.

New Mexico's workers' compensation laws do not provide for personal injury damages such as pain and suffering.

What are the employer's obligations?

New Mexico workers' compensation laws require employers to provide workers' compensation benefits to all employees. There are some very limited exceptions.

Employers should provide an accident report form to the worker to fill out on the day of the injury.

Employers and their workers' compensation insurers should authorize medical treatment once the worker is injured unless there is some demonstrable and legal reason why medical treatment should be denied.

Employers and their workers' compensation insurers should pay money benefits within 5 days of the worker stopping work because of a work injury.

If employers and their workers' compensation insurers deny any benefits they must explain the denial to the worker if requested to do so.

Employers are prohibited from retaliating against employees for reporting a work accident or filing a workers' compensation claim. Retaliation can come in several forms. A demotion, a pay cut, change in job responsibilities, unwarranted discipline and job termination are all examples of retaliation. Retaliation is litigated under a different set of laws. If you think your employer has retaliated against you, you should call me at 505 292-8836 or email me at [email protected]. DO NOT WAIT. Deadlines apply to retaliation cases.

The law guarantees workers certain rights entitling them to medical treatment and money benefits from the employer. Retaliating against workers employees for exercising their right to get workers' compensation is against the law.

What is the process?

In my opinion, the New Mexico workers' compensation system is a two-part process. Each part has subparts.

The first part is before the work accident or work injury. Before a work injury, a worker must do the following:

  • Determine if the employer has workers' compensation insurance. If they don't, then you probably should look for another job. It is very difficult to get any workers' compensation benefits from an employer with no workers' compensation insurance.
  • Ask the employer (human resources, your supervisor) what they should do if they are hurt at work. This includes the following:
  • Determine how to get an accident report and who to give it to when completed.
  • Ask what doctor or healthcare provider to see for treatment.

The second part is after the work accident or work injury. Once injured, workers should do the following:

  • If not an emergency, report the accident and injury to your supervisor or someone in management. You must notify somebody. If you are injured seriously, you should go to the nearest emergency room immediately. When you're no longer an emergency, you can give notice and do the other things listed below. Emergency or non-emergency, you must tell the healthcare provider that your injuries were caused at work.
  • As soon as possible fill out an accident report form. This should be done, if possible, a day or two after the work injury. It's always good to fill out an accident report form and give it to the employer, but don't worry if you can't do it. Verbal notice of a work injury often satisfies the notice requirement. Once again if you have questions about notice or any part of your workers' compensation case contact me at 505 292-8836 or email me at [email protected]. DO NOT WAIT. As stated above giving proper notice of a work injury is critical.
  • If medical treatment is not authorized or denied, you can use your own medical insurance. Once the treatment is authorized, the workers' compensation insurer should reimburse your medical insurer.
  • Ask what you should do and/or who you should talk to after you've gotten the initial treatment and would like to return to work. You will probably have work restrictions, and a return to work may not be possible. In that case, you should be paid money benefits.

If any part of your workers' compensation claim is denied, you should contact me at 505 292-8836 or email me at [email protected]. DO NOT WAIT.

Often getting a lawyer can resolve the issues in a workers' compensation claim. If it doesn't, I will file a complaint for workers' compensation benefit. There will be a mediation within two months or so of filing the complaint. If the parties cannot resolve all of the issues at the mediation, a workers' compensation judge will be assigned to the case. A trial will be scheduled 6 to 12 months later. I have been able to resolve many cases before trial. However, sometimes a judge must resolve the case disputes. Judges file their rulings after trial anywhere from a month to 6 months after the trial.

If you feel that filing a complaint is necessary, you should be represented by a lawyer and you should contact me.

This is a simplified summary of the workers' compensation process in New Mexico. It is a bit more complicated especially if you have to file a complaint to get benefits.

Why an injured worker needs an experienced workers' compensation lawyer

Employers and their workers' compensation insurers, up to a point, usually want to assist injured workers in getting medical treatment and money benefits so that they can return to work as soon as possible.

However, disputes often arise and benefits are denied. When this happens injured workers are at a disadvantage because they usually have no experience with New Mexico's worker's compensation system. Employers and their workers' compensation insurers, however lots of experience, and they often use that experience against the injured worker to limit or completely deny workers' compensation benefits.

I have been representing injured workers in New Mexico for almost 30 years. I have the experience and knowledge to successfully assist injured workers in not only getting workers' compensation benefits, but maximizing their benefits. I can also identify other possible cases related to the work accident and work injuries. These other possible cases can include possible personal injury cases against negligent third parties and possible employment cases such as disability discrimination cases.

It is in your best interest to call me as soon as possible after a work accident even if you don't think there are any disputes or denied workers' compensation benefits. Getting an evaluation from a worker' compensation lawyer soon after a work accident can prevent disputes from arising and can help you get back to work sooner. If I don't think you need a lawyer, I will tell you so. If I do think you need representation, I will tell you why.

Thanks for reading this.

Contact me Today

Attorney Robert Scott is committed to answering your questions about workers' compensation, employment law, wage theft, personal injury, and wrongful death law issues in Albuquerque.

I offer a free consultation and I'll gladly discuss your case with you at your convenience. Contact me today to schedule an appointment.

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