Workers’ Compensation Claims: What to Expect

According to the New Mexico Coverage, you need to apply for compensation insurance if your business includes more than three employees.

In New Mexico, workers’ compensation laws encompass the following:

  • Anyone who works for your business, including temporary workers, family members, seasonal workers, and part-time employees
  • Volunteers at non-profit and religious organizations 
  • Owners who actively work
  • Part-time, seasonal, and temporary workers at an agricultural business

If your employee suffers a work-related injury, you’ll have to file for a workers’ compensation claim. Read on to learn how you can file for one.

A Step-by-Step Guide to Filing a Workers’ Compensation Claim 

Here’s a comprehensive guide to filing for a workers’ compensation claim

The Employee Reports to the Employer 

As an employer, you should educate employees on workers’ compensation coverage. In addition, both you and your team should know when to report an on-job injury or illness. 

Look into the workers’ compensation insurance to determine what qualifies as an on-job injury. It may include injuries that require immediate treatment and those that warrant a doctor’s visit for diagnosis or medical care.

Remember that injured employees need to write a notice before the deadline notified by the law. New Mexico allows employees up to three years to report an injury.

The Employee Fills the Necessary Paperwork and Documents 

Once an employee notifies you about an injury or illness, you’ll have to give them a quick rundown of their rights and benefits. 

In most states, including New Mexico, employees have to complete a compensation claim form. The form includes the nature of their injury, where it occurred, and how it happened. 

In addition, injured employees have to fill a first report that you’ll submit to New Mexico’s workers’ compensation board. The type of forms required and the person responsible for filling them depends on the type of injury/illness and the insurer.

The Employer Files the Claim Form 

The employer is responsible for collecting the claim form, a medical report from the employee’s doctor, and supporting documents. Next, the employer has to submit all documents to the workers’ comp insurance.

You’ll also have to report the injury to your state’s division of workers’ compensation. Remember that this applies to all workplace injuries.

The Insurer Looks at the Claim 

Once you file the claim, the insurer will go through it to either approve or deny it.

If They Approve Your Claim

If your claim gets approved, the insurer will provide you with payment details. In addition, the employee and their workers’ compensation lawyer may:

  • Accept the insurance company’s payment offer
  • Negotiate for a lump-sum settlement 

If They Deny Your Claim

In case the workers’ compensation insurer denies benefits, employees may:

  • Request a reconsideration 
  • File for a formal appeal through the state workers’ compensation board

The Aftermath 

Once the employee gets well enough to return to work, they have to write a notice to their insurer and employer. If the injury is too severe, the insurance company has to pay permanent disability benefits.

New Mexico Workers’ Comp Insurance Coverage 

Before applying for New Mexico workers’ compensation coverage, you must meet the requirements mentioned in the NM Worker’s Compensation Act. Thus, you need to:

  • Display the Workers’ Compensation Act Poster where it is prominent 
  • Hang the Notice of Accident Form in a central place
  • Determine who qualifies as an Employee under Workers’ Compensation from your business
  • Follow the Workers’ Compensation Safety Inspection guidelines 
  • Pay the Workers’ Compensation Assessment Fee to the New Mexico Taxation and Revenue Department in a timely fashion

How Much Does Workers’ Compensation Cost in New Mexico?

The average workers’ compensation cost in New Mexico is $1.35 per $100 payroll. The cost of your workers’ compensation insurance depends on the following factors:

  • Payroll
  • Location 
  • Number of employees
  • Industry 
  • Risk factors
  • Coverage limits
  • Claims history 

The Bottom Line 

Ensure you provide employees with accurate information regarding their rights, benefits, and qualifying injuries/illnesses. In addition, they must report per New Mexico’s state deadlines. 

Make sure your justified claim doesn’t get denied by choosing the Law Office of Javier Martinez as your workers’ compensation law firm. Our expert probation violation lawyers help put you in the best position to ensure you win your case. Contact us today.