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What New Mexico's Lifetime Workers' Compensation Medical Benefits Really Mean

The New Mexico Workers' Compensation Act provides for "lifetime" medical benefits for injured workers. This often causes confusion.

I explain it this way to my clients: "Lifetime" medical benefits means that an injured worker can pursue medical treatment for work injuries for the rest of the injured worker's life. The medical treatment must satisfy the requirements in the Workers' Compensation Act (e.g. the treatment must be requested by an authorized healthcare provider, the treatment must be reasonable and necessary, etc.).

However, even if the medical treatment meets all of the Workers' Compensation Act, the employer/insurer can (and do) refuse to authorize the treatment. The employer/insurer's refusal to authorize treatment must be based on good faith reasons.

If the employer/insurer deny medical treatment, the worker's remedy is to file a complaint and have a workers' compensation judge decide if the employer/insurer must pay for the denied medical treatment. In many cases the worker's medical records and the workers' doctors' testimony will determine if the employer/insurer have to pay for the medical treatment.

Unfortunately, it can take months and sometimes a year or two to litigate a medical benefits dispute.

So, "lifetime" medical benefits does not mean guaranteed lifetime medical benefits.

"Lifetime" medical benefits means that an injured worker has the right to pursue medical treatment for the rest of his or her life.

I hope this reduces confusion in the future.

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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.

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