New Mexico’s established labor laws and newer legislation work together to protect workers from workplace negligence that leads to serious injuries or even death.

Employers must comply with NM worker’s compensation guidelines or risk fines from the U.S. and NM Departments of Labor and worker’s compensation lawsuits from injured workers seeking fair compensation.

Protecting yourself from workplace injuries isn’t always possible. That’s why you may need to hire a New Mexico personal injury attorney to represent your best interests.

In this blog, we’ll share some of the most common questions about NM worker’s compensation and how to seek help if you want to file a third-party negligence claim against your employer. You’ll learn:

• What is worker’s compensation?
• Who is covered by NM worker’s compensation laws?
• What injuries and illnesses does NM worker’s compensation cover?
• What benefits are available to injured workers?
• How do you file a NM worker’s compensation claim?
• What should you do if your claim is denied?

What is worker’s compensation?

The worker’s compensation system in New Mexico is designed to provide benefits to workers who suffer from work-related injuries or illnesses. Employers must buy adequate worker’s compensation insurance coverage to provide cash benefits and medical care to workers who get hurt on the job.

Worker’s compensation coverage also provides survivor benefits to family members of workers killed on the job. They must file a claim to receive coverage.

New Mexico’s Worker’s Compensation Administration (WCA) exists to ensure the efficient and timely delivery of benefits to workers or their surviving family members who qualify. However, that doesn’t mean that employers can’t object to worker’s compensation benefits once you file a claim. Sometimes they can deny your claim, forcing you to pursue legal action.

Who is covered by NM worker’s compensation laws?

According to New Mexico’s worker’s compensation laws, all employees are covered by benefits if they become injured or ill because of working conditions. The law defines employees as:

• Anyone who works for a business. This includes family members, part-time employees, full-time employees, and seasonal workers.
• Business owners. If you own a business and actively work there, you’re covered under NM worker’s compensation laws.
• Part-time and seasonal workers in the agricultural industry. Even if an employee only works for some of the time each year, they’re still covered under the law.
• Volunteers for charities, nonprofits, and religious organizations. If you run one of the organizations, in this category, talk to an employment attorney about whether worker’s compensation or general liability insurance is more appropriate.

The law also outlines who is not considered a covered worker in New Mexico. Some of the exceptions include:

• Executive employees and sole proprietors with a financial interest in the company.
• Federal employees covered by the Federal Employees Compensation Act.
• Independent contractors.

What injuries and illnesses does NM worker’s compensation cover?

Any injury or illness that happens on the job is covered by NM worker’s compensation benefits. You can get temporary benefits if you have injuries or an illness that prevents you from working during recovery.

Worker’s compensation benefits also include getting the care you need and the funds to pay for it. Generally, if you’re injured or become ill at work, your employer covers the cost of seeing a medical provider and receiving any medications or treatments prescribed for recovery.

Covered injuries and illnesses include:

• Back injuries
• Broken bones
• Cuts and lacerations
• Hearing loss
• Muscle sprains, strains, and tears
• Repetitive movement injuries
• Slips and falls

Workplace fatalities covered under worker’s compensation include what OSHA refers to as “the fatal four.” They are:

• Electrocution
• Falls
• Crushed between objects
• Struck by object or equipment

Employers can require you to use a medical provider of their choosing for illnesses and injuries. However, you have a right to seek a second opinion if you disagree with a diagnosis or recommended treatment protocol. Consult with NM worker’s compensation attorney if you believe your rights are being violated.

Circumstances not covered by worker’s compensation

Not all illnesses and injuries suffered at work qualify for coverage under the law. Here are some of the times you can expect your employer to challenge a claim:

• An illness or injury is self-inflicted (workplace fights fall into this category).
• Disregard for safety rules and company policies.
• Engagement in unlawful activities (like DUI while making deliveries for work).
• Intoxication or working under the influence of controlled substances.

What benefits are available to injured workers?

NM worker’s compensation provides comprehensive benefits for workers who are injured or become ill on the job. Among the benefits you’re eligible to receive include medical treatment, vocational rehabilitation, and wage replacement.

• Medical treatment includes all necessary medical care related to a work-related illness or injury. Doctor visits, hospitalizations, surgeries, physical therapy, and prescription medications all fall into this category. Assistive devices like wheelchairs are part of medical treatment. 
• Vocational rehabilitation becomes necessary if your illness or injury prevents you from returning to your regular work duties. Your employer must offer to train you for a new position or find a replacement that’s suitable for your abilities.
• Wage replacement kicks in when you miss work because of your illness or injury. The severity of your disability determines the amount of wage-replacement benefits you receive.

Sometimes benefit coverage isn’t adequate to meet your needs. For instance, wage replacement might not equal your full salary, which can cause financial hardship. In those situations, you may need to consult a NM worker’s compensation attorney who can pursue legal action to get you the compensation you deserve.

Benefits for fatal workplace accidents

Work-related fatalities fall under worker’s compensation laws. The amount you receive depends on the employer’s coverage. Some of the benefits you can receive for a loved one’s death on the job include:

• Burial and funeral costs. Most states provide between $5,000 and $10,000 for this benefit.
• Lost wages. When the death of a loved one causes financial hardship due to lost wages, indemnity benefits usually provide weekly installments equal to up to two-thirds of the deceased’s average weekly compensation.
• Medical expenses. If your loved one received medical care before they died from their work-related illness or injury, those bills must be covered by the employer.

Sometimes employers push back against survivor benefits. When that happens, request a free case evaluation with a third-party negligence attorney to review your rights and pursue legal action if necessary.

How do you file a NM worker’s compensation claim?

The key to avoiding complications with NM worker’s compensation claims is to notify your employer as soon as possible about your illness or injury.

Once you notify your employer, they should provide you with the necessary forms, called Notice of Accident (NOA), to complete to request your benefits. NOAs must be filed within 15 days of the date of your illness or injury.

Employers can’t refuse to sign or submit an NOA on your behalf. If they do, seek legal advice immediately. You also can contact the ombudsman program at the NM Worker’s Compensation Administration.

What should you do if your claim is denied?

You have the right to appeal the decision if your employer denies your worker’s compensation claim. The New Mexico Worker’s Compensation Administration handles all appeals. You must file it within 15 days of receiving the denial notification.

You may want to consult with an attorney who specializes in worker’s compensation or third-party negligence laws in New Mexico before filing your appeal.

An attorney can file the appeal on your behalf. Sometimes having legal representation on board improves the outcome of your appeal.

Should the administration deny your appeal, you already have an attorney familiar with your case who can immediately file a worker’s compensation lawsuit to seek fair compensation.

Help for on-the-job injuries

Not all worker’s compensation cases end up in a courtroom. A skilled attorney can push for a settlement that’s fair to you and avoids a lengthy trial.

Reach out to Bill Russell and Marcus Cameron for a free case evaluation. We’ll relentlessly seek out fair compensation for worker’s compensation injuries and fatalities.