New Mexico Workers’ Compensation FAQ
Questions? Ask Our Albuquerque Workers’ Comp Attorney Today
Workers’ compensation law in New Mexico can be confusing to say the least. When faced with the myriad of different applicable laws, deadlines, and loopholes of coverage, it can be difficult to make sense of it all. Our firm has compiled a brief list of some of the most frequently asked questions to help answer some of your concerns.
If you have any further questions that are not listed here, we encourage you to contact our office and we will be happy to provide assistance.
What Is Workers’ Compensation?
In simple terms, workers’ compensation is an insurance program financed by businesses that provides monetary benefits to workers who are injured on the job or who develop work-related illnesses as a result of their occupation. Workers’ compensation pays for injured employees’ medical bills and up to two-thirds of their lost wages. In the event that a worker should pass away due to a work-related illness or injury, workers’ compensation pays death benefits to the deceased worker’s dependents.
What Injuries Are Covered Under Workers’ Comp?
Workers’ compensation covers injuries and illnesses that are directly caused by a person’s work. A doctor must verify this direct connection in order for the injury to be covered. Covered injuries oftentimes include repetitive motion injuries such as carpal tunnel syndrome, workplace slip-and-falls, on-the-job car accidents, and illnesses from exposure to dangerous chemicals. Injuries that occur outside of work that affect a person’s ability to do their work or injuries caused by horseplay are not covered. Injuries that are caused by a worker’s intoxication from drugs or alcohol are unlikely to be covered, though if they are, they will probably be covered with penalties.
Am I Eligible for Workers’ Comp Benefits?
All employers in New Mexico with three or more employees must have workers’ comp insurance, with a few exceptions. Domestic workers such as housekeepers and nannies, farmhands and agricultural workers, temporary employees acquired through temp agencies, and seasonal employees working minimal hours are usually exempt from workers’ comp benefits. Similarly, independent contractors are not eligible for workers’ comp.
How Can I Prove My Injury Is Work Related?
To minimize the chances of your employer or their insurance contesting the cause of your injury, you can strengthen your claim by providing witness testimonies, doctor’s notes, and prescriptions relevant to your accident. If this information still does not satisfy their requirement of proof, an attorney can advocate on your behalf and handle their objections in court.
What Should I Not Say to a Workers’ Comp Doctor?
Your employer can require you to see an approved doctor as a part of your workers’ compensation claim. Their diagnosis and treatment recommendations may be used to calculate your settlement.
These doctors aren’t always on your side; anything you say during the appointment could get back to the insurer—and be used to deny your claim. While you may be tempted to stretch the truth to strengthen your report, doctors are likely to notice any “white lies” and take note of them in their records. Follow these rules to avoid giving the insurer anything they could use against you:
- Don’t exaggerate. If the insurer challenges your claim, you may have to go through a long discovery process. Any inconsistencies in your story will likely be uncovered. Even if you have a valid claim, you could be denied coverage because of a perceived lack of credibility.
- Don’t gloss over previous injuries. Because an injury must be caused by work to qualify for workers’ comp coverage, some victims think they should avoid sharing information about previous injuries and conditions. Be mindful that your previous treatment records are in your medical file and could be used to challenge your truthfulness in a lawsuit.
- Don’t be rude to the doctor or your employer. Like in police dramas, anything you say can be used against you. Though they have nothing to do with your injuries, disparaging statements can tarnish your reputation if introduced as evidence.
Can I Collect Workers’ Comp Benefits and Sue My Employer?
Under most circumstances, no. In exchange for being covered under workers’ compensation, you waive your right to sue your employer. You may only sue your employer for damages if it can be proven that your employer intentionally tried to harm you. If your injuries were caused by a third party other than your employer, such as an equipment manufacturer or supplier, you may collect workers’ compensation benefits and file a claim against that party.
How Soon After My Injury Should I Notify My Employer?
If you have been injured at work, you must notify your employer within 15 days of your accident. Failure to adhere to this deadline could result in a denial of your claim.
What Should I Do if My Claim Is Denied?
If your workers’ compensation claim is denied, you may be able to appeal the denial with the assistance of a trained attorney. While some claim denials can be reversed relatively quickly if they result from a clerical error or mistake in paperwork, other appeals may require you to plead your case before an administrative law judge. An attorney can advocate on your behalf and greatly improve your chances of a successful appeal.
When Should I Hire a Workers’ Comp Lawyer?
When your workers’ comp case faces pushback, an experienced attorney can help you continue your case.
Reporting an injury, seeking a doctor’s opinion, and the other steps in a workers’ comp claim are designed to be straightforward and accessible to employees. If you follow appropriate procedure and submit a strong claim, you might receive a settlement soon thereafter. However, recovering compensation after a work injury isn’t this easy
Insurers look for reasons to deny claims because each settlement affects their bottom line. A lawyer can help you create a strong case to challenge their decision. Especially if a case goes to trial, having an attorney to advocate for you can make a huge difference.
Workers’ Compensation Attorney in Albuquerque, NM
If you have suffered a work-related injury, the highly-trained Albuquerque workers’ comp lawyers at Michael J. Doyle, Attorney at Law can walk you through the process of filing a claim and handle any disputes that should arise on your behalf. With more than a decade’s worth of trial-tested legal experience, we can ensure your rights are protected and maximize your chances of receiving every penny of your entitled benefits.
Call (505) 219-2176 or discuss your case for free during a confidential consultation today.