New Mexico Workers’ Compensation Benefits Process

New Mexico workers' compensation benefits process

Every workers’ compensation claim is processed at the state level. For injured employees in New Mexico, a good understanding of the workers’ compensation process can help save you time as well as confusion when you’re ready to file. Below, you’ll find a brief overview explaining what steps you need to take when applying for New Mexico workers’ compensation benefits, plus a chart showing the program’s five-year statistical history.



Do You Have New Mexico Workers’ Compensation Insurance?

State law requires New Mexico workers’ compensation coverage for all employers with three or more employees. In fact, this rule applies even if your company only employs one New Mexico worker, but has 3+ total employees. Your coverage starts on your first day at work, even if you’re a temporary, part-time, or seasonal worker. However, state law specifically exempts these workers from automatic coverage:

  • Domestic servants
  • Real estate salespersons
  • Federal employees
  • Independent contractors

Important: Businesses operating on Native American reservations, pueblos or tribal lands fall under the sovereign tribe’s legal purview.

Does Covid-19 Qualify for Workers’ Comp?

In March 2021, the New Mexico House of Representatives passed House bill 268. However, it must still pass the Senate before Governor Michelle Lujan Grisham can sign it into law. Until then, no one diagnosed with Covid-19 can presume he or she qualifies for New Mexico workers’ compensation benefits.

How to File Your Application for New Mexico Workers’ Comp Benefits

Follow these steps to apply for New Mexico workers’ compensation:

  1. Notify your employer in writing within 15 days of your workplace accident date. (Only skip this step if your supervisor witnessed the accident that injured you.) If your injury is especially severe, the Workers’ Compensation Administration may grant you an extension to notify within 60 days.
  2. Your employer’s insurer determines who chooses your treating physician. Need urgent care? Go to an emergency room! Otherwise, ask your employer who to see or if you can pick your own doctor. You must see an approved provider for ongoing medical care or pay for it yourself.
  3. Your employer must then notify the WCA within 72 hours. This ensures your employer’s insurer pays your relevant medical bills.
  4. Not happy with your employer’s doctor? You can switch to your own after 60 days. If you choose your doctor for initial treatment, your employer can send you to see theirs after 60 days.
  5. . You must miss seven workdays to qualify for lost-wage benefits. Your first week off work remains unpaid until after a physician orders you to miss 28 days total.
  6. Your employer’s insurer must approve or deny your claim within 10 business days.
  7. Claim denied? Contact your employer’s insurer or file a complaint with the WCA within 30 days. You have one year from your incident date to resolve a disputed claim through mediation or request a formal hearing.

Every New Mexico workers’ compensation claim is different, so your experience may vary. Read New Mexico’s Injured Workers Guidebook for more information.

New Mexico Workers’ Compensation Statistics, 2015-2019

An annual report from the Bureau of Labor Statistics (BLS) includes workers’ comp program data from most U.S. states. You’ll find total claims, how many employees missed work or had job restrictions, and job sector-specific program data. Learn how the New Mexico workers’ compensation program changed from 2015-2019 in our interactive chart below:

As you can see, workers filed the most total claims in 2015. However, that number only represents about 1% of the state’s total population. Total claims fell 15% during the four-year period from 2015 to 2019. However, you’ll note that service-industry claims fell 19% from 2016 to 2017. This is important because service-industry employees file, on average, 3 in every 5 New Mexico workers’ compensation claims. Most of these workplace injuries aren’t serious enough to need time off work to recover, however.

Unless your injury forces you to miss at least seven consecutive workdays, you won’t receive lost-wage benefits. Less than half of the state’s claimants in any given year qualify for lost-wage payments (about 44%, on average).

You May Qualify for Legal Assistance

Your employer has the right to test you for drugs or alcohol after your workplace accident. It’s illegal to fire you for filing a claim or failing a drug or alcohol test. However, your employer can legally reduce your workers’ comp benefits by 90% afterwards. Our network of workers’ compensation attorneys can help you collect required documentation, negotiate with your employers’ insurance company, and represent your claim in court if needed. Best of all, these attorneys always work on contingency. That means you pay $0 for legal assistance if you don’t win a cash settlement. And if you do win, then you’ll only pay a small, one-time fee.

Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!

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