New Mexico Administrative Code

September 30, 2016, unless a later date is cited at the end of a section.

The objective of 11.4.2 NMAC is to establish reporting and safety requirements for employers. This rule creates a standardized method for reporting data on work accidents, notifying workers about legal requirements for making a claim, and complying with mandatory safety provision…

A. "American standard code for information interchange (ASCII)" means a code that follows the proposed standard for defining codes for information exchange between equipment produced by different manufacturers. B. "Claims administrator" means the insurance carrier, third party ad…

A. General provisions: (1) Paper copies of FROI and SROI will not be accepted by the WCA as of January 1, 2017. Beginning January 1, 2017, FROI and SROI data shall only be submitted through EDI or the WCA website. (2) It is the claims administrator's or an uninsured employer's re…

A. Annual inspections: (1) All employers, as identified in Section 52-1 -6.2 NMSA 1978, are required to have an annual safety inspection. All other employers are encouraged to do so. (2) Any employer who purchases or renews a policy of workers' compensation insurance with a premi…

Workers' Compensation Administration.

A. Upon written request of an employer, the insurer carrying the employer's workers' compensation insurance shall provide a list of workers' compensation claims made against that employer, which shall contain the information specified in Section 52-5-20 NMSA 1978 (Repl. Pamp. 199…

A. Employer shall pay worker's mileage, transportation, meal and commercial lodging expenses for travel to HCPs pursuant to this rule. Payment shall be made only to the injured worker and within 30 days of the employer's receipt of an original itemized receipt that complies with …

A. GENERAL PROVISIONS (1) This section establishes regulations for post-accident drug and alcohol testing pursuant to Section 52-1-12.1 NMSA 1978. (2) These rules are not intended to supersede other laws and are only intended to establish post-accident testing protocols and cut o…

A. Worker's duties: (1) Worker shall answer reasonable requests from the employer regarding work status. (2) When a worker is receiving disability benefits, worker shall report to employer, within 15 days, any return to work, any written medical release to return to work provided…

A. An attorney or other representative of a party may not engage in or advocate meritless claims or defenses when appearing before the WCA. B. An attorney or other representative of a party shall be courteous and professional and shall be punctual for mediations and hearings. C. …

Any violation of these rules may be investigated and penalized pursuant to the procedures in 11.4.5 NMAC.

This part governs all employers and workers subject to the act.

Section 52-5-4 NMSA 1978 (Repl. Pamp. 1991), as amended, authorizes the director of the WCA to adopt reasonable rules and regulations for effecting the purposes of the act. Sections 52-5-20 to 52-5-22 NMSA 1978 (Repl. Pamp. 1991), as amended, contain certain payment deadlines and…

Permanent.

June 1, 1996 unless a later date is cited at the end of a section.

This rule is intended to regulate the manner of payment of workers' compensation claims, to provide for post-accident drug and alcohol testing, and to clarify the parties' mutual obligations of prompt payment, cooperation and information reporting.

See 11.4.1.7 NMAC.

A. If an accidental injury or occupational disease occurs to a worker during the course of employment and results in lost time to the worker of more than seven cumulative days, the employer shall file an E1.2 report with the WCA, and shall concurrently provide a copy to the worke…

A. The WCA shall determine the timeliness of initial payments to workers. B. Upon request of the WCA, an employer shall provide documentation to verify the timeliness of initial payments. C. If an employer is identified by the WCA as having made initial payments on an untimely ba…

Workers' Compensation Administration ("the WCA").

A. Mediation of complaints:(1) The director's designee, a mediator, shall evaluate all initial complaints in new cases. (2) The mediator shall evaluate and mediate the merits of the complaint for jurisdiction, proper parties, compensability, the nature and extent of any benefits …

A. The following matters shall be pleaded on the mandatory application to director form: (1) judge assignment disputes; (2) request for relief from an untimely rejection of a recommended resolution; (3) request to withdraw an acceptance of a recommended resolution; (4) appointmen…

A. HCP general provisions:(1) These rules apply to claims governed by the 1990 amendments to the act. (2) The assigned judge shall decide HCP choice disputes. If no judge has been assigned, a judge shall be appointed by the clerk solely to resolve the HCP dispute. (3) The HCP jud…

A. Assignment of judge:(1) Upon receipt of a timely rejection of a recommended resolution, an application to judge or petition for lump sum payment, the clerk shall assign a judge to the case and shall serve notice on all parties. Pro se parties shall be served by certified mail …

A. The entry of appearance of an attorney or a firm for a party in a pending case shall not be withdrawn without permission of the judge or by the director if no judge has been assigned to the case. A motion to the judge or application to director requesting withdrawal shall be f…

A. Parties may request the award of attorney fees by application to a judge. The application must contain sufficient information to determine if the fee requested is appropriate. The contested application should indicate the date and terms of any offers of settlement made; the pr…

A. The judge may sanction any party, attorney, or personal representative for conduct that interferes with the orderly administration of the court or a hearing, including, but not limited to:(1) rejecting a recommended resolution without reasonable basis, or without reasonable ex…

A. Public court records filed with the clerk of court or offered as evidence in an administrative or adjudicative hearing shall not be sealed based solely on the agreement or stipulation of the parties. B. The party requesting to seal court records subject to public inspection sh…

A. In any case where a party believes that a potentially violent or dangerous situation might arise during a court hearing or appearance, that party, through counsel or pro se, should notify the assigned judge or clerk of the court sufficiently in advance so that appropriate secu…

These rules apply to parties involved in claims arising under the Workers' Compensation Administration Act and Occupational Disease and Disablement Law (collectively "the act").

Section 52-5-4 NMSA 1978 authorizes the director to adopt reasonable rules and regulations for effecting the purposes of the act.

Permanent.

January 1, 2023, unless a later date is cited at the end of a section.

The objective of 11.4.4 NMAC is to establish rules governing the resolution of claim disputes under the act, including but not limited to the process for filing and service of pleadings and the conduct of mediation conferences, discovery, and formal hearings.

See 11.4.1.7 NMAC. A. "Initial pleading" means a workers' compensation complaint, application to workers' compensation judge, application to director, petition for lump sum payment, or notice of change of HCP that opens or reopens an action or case before the WCA. B. "Insurer" me…

A. An ombudsman shall provide information and facilitate communication regarding the act. An ombudsman is required to maintain a neutral position when providing information or facilitating communication. When responding to inquiries, an ombudsman shall:(1) confer with workers, em…

A. General provisions:(1) WCA employees shall be addressed in a courteous and respectful manner at all times. (2) Unless otherwise stated or necessarily implied in these rules, the rules of civil procedure for the district courts of New Mexico shall apply to and govern all procee…

Workers' Compensation Administration.

A. These rules establish a procedure for the administrative enforcement of the act by the director. These rules do not govern procedure for criminal prosecution by the WCA's enforcement bureau. B. Administrative enforcement proceedings shall be presided over by the director or de…

A. Commencement of action: (1) An action may be commenced by the issuance of a notice of administrative enforcement proceeding by the enforcement bureau chief. The notice shall be delivered immediately to the director. (2) The notice of administrative enforcement proceeding shall…

For every case not referred to a workers' compensation judge and upon the filing of the notice of administrative enforcement proceedings and finding of probable cause: A. Summons: A summons shall be issued by the clerk, directed to the alleged violator and must contain:(1) The na…

A. Unless otherwise stated in Part 5 or approved by the director, motion practice shall not be allowed in administrative enforcement proceedings. B. The use of discovery is discouraged. Discovery may be approved only by the director or the director's designee, in exceptional circ…

A. The issuance of subpoenas to compel attendance at the hearing shall be issued pursuant to the Supreme Court Rules Annotated 1986, 1-045. The clerk of the WCA may issue a subpoena, signed but otherwise in blank, to a party requesting it, who shall complete it before service. An…

A. The hearing shall be conducted expeditiously, but each party shall be permitted to present their position amply and fairly. The director may admit any documentary evidence, including hearsay evidence, provided that the evidence is relevant, has sufficient indicia of reliabilit…

A. If the director finds a violation of the act or these rules, a notice of penalty shall be filed. A notice of penalty shall contain sufficient facts to support the penalty, and the dollar amount of the penalty. B. A party may request reconsideration of a notice of penalty by fi…

Rules apply to any party to a claim arising under the act and any person receiving medical payments from an employer under the act.

Section 52-5-4 NMSA 1978 (Repl. Pamp. 1991), authorizes the WCA to adopt reasonable rules and regulations for effecting the purposes of the act. Section 52-1-28.1 NMSA 1978 (Repl. Pamp. 1991), authorizes the director to promulgate rules and regulations regarding the prohibition a…

Permanent.

October 1, 2014, unless a later date is cited at the end of a section.