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New Mexico Workers Compensation

New Mexico Workers Compensation

New Mexico Workers Compensation: Protecting Workers on the Job

Working is an essential part of almost everyone’s life, providing them with the means to provide for themselves and their families. However, no matter how careful they are, both employers and employees are susceptible to workplace accidents that can lead to injuries and disabilities.

New Mexico is one of the many states that have implemented a workers’ compensation program to protect employees that suffer work-related injuries or illnesses. This program provides employees with benefits such as medical treatment, reimbursement for lost wages, and compensation for permanent disabilities.

In this article, we will explore the various aspects of the New Mexico Workers Compensation program and what it means for employees in the state.

What is Workers Compensation?

Workers’ compensation is a state-mandated insurance program, which provides benefits to employees who sustain work-related injuries or illnesses. The program covers most employees, including those who are part-time, full-time, permanent, or temporary. Employers offer workers compensation coverage to their employees through insurance companies, with the premiums paid by the employer.

In the event of an injury or illness on the job, workers compensation provides employees with:

– Medical treatment: the program covers medical treatment required because of a work-related injury or illness.
– Reimbursement for lost wages: Employees eligible for workers compensation can claim a portion of their lost wages while recovering from the injury or illness.
– Compensation for permanent disabilities: If the employee is unable to perform the same work they did before the accident, a permanent disability may be compensable under workers compensation.

Employers are required to provide workers’ compensation coverage to their employees in New Mexico. If an employer does not provide workers’ compensation coverage, the employee may seek compensation from the Uninsured Employers’ Fund.

Workers’ compensation is a no-fault system, which means that employees do not have to prove that their employer was negligent or at fault for their injuries. As long as the injury or illness occurred during the course of employment, employees may be eligible for benefits.

Employees are covered by workers’ compensation in almost all cases except when the injury resulted from:

– Being under the influence of drugs or alcohol at the time of injury
– Willful misconduct or self-inflicted injury
– Violation of company policy

What are the Benefits of Workers Compensation?

The benefits of workers compensation include:

Medical benefits: Workers’ compensation provides coverage for all medical expenses related to the injury or illness. This includes hospitalization, emergency care, doctor visits, medications, and rehabilitation.

Lost wage replacement: When an employee is unable to work because of a work-related injury or illness, workers’ compensation provides a portion of their lost wages. The amount of lost wages paid by the program will depend on the severity of the injury or illness and the employee’s salary.

Permanent disability compensation: If an employee suffers a permanent disability that prevents them from performing the same work as before the injury or illness, workers’ compensation may provide compensation for the disability. The amount of compensation will depend on the severity of the disability, the employee’s salary, and their ability to work.

Death benefits: In case of a work-related death, workers’ compensation may provide benefits to the employee’s dependents. This includes a lump sum payment, ongoing financial support, and burial expenses.

How to make a Workers Compensation Claim in New Mexico?

If an employee suffers a work-related injury or illness, they must report the incident to their employer within 15 days of the injury. Failure to report the injury or illness within the specified time may result in denial of benefits.

The employer is then responsible for filing a claim with their insurance provider, who will file it with the New Mexico Workers’ Compensation Administration (WCA). The WCA will review the claim and determine the eligibility for benefits.

Employees do not have to pay for the costs related to filing a workers’ compensation claim. The insurance company or the employer bears all expenses.

What if a Workers’ Compensation Claim is denied?

If an employee’s workers compensation claim is denied, they have the right to appeal the decision. The appeal process includes filing a notice of appeal with the WCA within 30 days of the decision.

An appeal hearing will then take place before an administrative judge. During the hearing, the judge will review the evidence presented and determine the eligibility for benefits.

If the employee disagrees with the administrative judge’s decision, they may appeal to the WCA’s Appeals Board. The Appeals Board’s decision is considered final.

What else do employees need to know about Workers Compensation in New Mexico?

Several other things that employees should be aware of regarding workers compensation in New Mexico are discussed below.

Statute of Limitations

Employees who sustain work-related injury or illness have one year from the date of injury or illness to file their workers compensation claim. If the employer has already received notice of the injury or illness, the employee may file a claim within two years from the date of injury.

Independent Medical Examination

The insurance company or employer may require the employee to undergo an independent medical examination. In this examination, a doctor chosen by the employer or insurance company will review the employee’s medical records and conduct a physical examination.

The employee must participate in the IME if required. Failure to do so may affect the employee’s eligibility for benefits.

Maximum Benefits

New Mexico law has established maximum benefits that an employee may receive. The maximum benefits for temporary disability are two-thirds of the employee’s average weekly wage before the injury, up to a specified maximum. For permanent disability, the maximum benefit may depend on the type of disability.

Attorney’s Fees

Workers’ compensation claims may be complicated. It is important to seek the help of an experienced attorney if the claim is denied or the employee disagrees with the amount of benefits received. The attorney’s fee will be paid out of the employee’s compensation settlement.

Conclusion

Workers’ compensation in New Mexico helps protect employees who sustain work-related injuries or illnesses by providing them with medical treatment, reimbursement for lost wages, and compensation for permanent disabilities. Employers are mandated by law to provide coverage to their employees. The program is a no-fault system that provides benefits regardless of who caused the accident.

Employees should report any work-related injuries or illnesses to their employers within 15 days. They must file a workers’ compensation claim within one year of the injury or illness. The employee may appeal the insurance company’s denial of benefits if necessary.

The program has several other rules and regulations that require the attention of an experienced attorney. Employees should be aware of their rights and responsibilities under workers’ compensation law to avoid loss of benefits if an unfortunate incident occurs.


Quick Guide to Workers’ Compensation Insurance in New Mexico

New Mexico Workers’ Compensation Laws

Multiple New Mexico workers’ compensation laws are located under the state’s revised statutes.  The laws on New Mexico workers compensation Chapter 52 specifically, but the majority of information within this article about workers’ compensation insurance in New Mexico is referenced from the following website under the New Mexico workers compensation Administration.

Workers’ Compensation Insurance in New Mexico and Exemptions

The following report under the New Mexico workers compensation Administration refers to certain employees who are not covered by workers’ compensation insurance in New Mexico:

Normally, any employer with one or more employees must provide insurance under New Mexico workers’ compensation laws, but the report under the NM Workers’ Compensation Administration states the following employees are exempt from coverage NM workers’ compensation:

• self employed business owners but may be covered by a certain policies under New Mexico workers’ compensation laws

• employment covered by private insurance plans which provide equal or greater amounts of coverage than workers’ compensation insurance in New Mexico

• an employee who owns 10 percent or more of the stock of a corporation, or an executive of a limited liability company according to New Mexico workers’ compensation laws

• farms and ranchers who spend the majority of their time harvesting, but some farmers may still be covered by New Mexico workers compensation

How do I file a report for my injury under New Mexico Workers’ Compensation Laws?

You need to report the accident to your employee right away for NM workers’ compensation.  There are also certain forms you’ll have to submit for NM workers’ compensation which are located at the following link.

If you have any questions about workers’ compensation insurance in New Mexico, you can contact the Ombusman with the information about NM workers’ compensation at the following link.

Where can I find more information on New Mexico Workers’ Compensation Laws for Employers?

The following link under the New Mexico workers compensation Administration will provide you with valuable information about claims under New Mexico workers’ compensation laws:

What Benefits are available in Workers’ Compensation Insurance: New Mexico

An injured worker is entitled to several different kinds of benefits under workers’ compensation insurance in New Mexico: mainly medical benefits and wage loss benefits, but other NM workers’ compensation benefits may apply as well.  These types of benefits under New Mexico workers compensation are explained below:

1. Medical Benefits – the worker is fully covered for ALL medical expenses related to the work injury under workers’ compensation insurance in New Mexico.  These benefits under NM workers’ compensation are not limited to the compensation for services listed below:

• doctor and hospital services

• nursing services

• medication

• physical therapy

• medical equipment

• travel mileage to and from medical facilities

If the accident was severe, workers’ compensation insurance in New Mexico will also cover burial costs.

2. Wage Benefits – According to New Mexico workers’ compensation laws, a worker is entitled up to two thirds of their weekly wages for the amount of time they are covered.  If a doctor determines the worker has a permanent disability that will impact their level of work in the future, the degree or the permanent disability under NM workers’ compensation will compensate for the difference in wages.