In New Mexico it is also the employer who gets to pick which doctors an employee goes to for workers’ comp related medical care. But unlike other states that we have looked at, in New Mexico the employer can also reserve the right to allow their employees to go to a doctor of their choosing as well.
If you pick the doctor for your employees, though, an employee still has the right to switch if they feel it necessary or they just really have another doctor that they prefer to go to. In that case, employees can do so, but only after being treated by the doctor selected by the employer for 60 days of medical treatment.
If on the other hand you allow the employee to start out at the doctor of their choosing, then you can also make your employees switch to your doctor after 60 days o treatment. In both cases, whenever there is a doctor swap, whether it be the employer forcing the change on the employee or vice versa, a form must be filled out. It’s called the Notice of Change of Healthcare Provider form.
When the employee selects to visit another doctor after 60 days, then they have to fill out the Notice of Change of Healthcare Provider form and send it to their employer. Or if you are making the switch from an employee chosen doctor to one of your choosing, then you must fill out the Notice of Change of Healthcare Provider form and send the Notice of Change of Healthcare Provider form to your employee.
In either case, we have gotten ahead of ourselves. What must happen before an employee visits a doctor in the first place? They must report their injury, which in New Mexico they must do in writing at least within 15 days after the injury.
For the state of New Mexico, to show how its workers’ comp system is different, we should take a look at the varying types of benefits that the state system offers to injured workers. And you can imagine from all of the different states that we’ve looked at so far, the benefits and rules surrounding these benefits that each state varies widely between states, though the general principle is the same.
And what is that? Oh, loyal readers, I know you’re not asking these questions. That question must be coming from a new reader, whom we can excuse from asking such a basic question because they are just joining are in depth discussion on the topic. So for those beginner readers, I will share once more that workers’ comp systems are set up in each state to protect workers who are injured on the job, and to make their employers pick up the tab for these costs of such protection.
In New Mexico part of this protection involves receiving lost wages. When a worker is severely injured on the job, they may not be able to return to work temporarily, or permanently in some cases. Workers’ comp coverage picks this up, but in New Mexico, public employees are not entitled to more than their base monthly salary from the combination of monthly salary and leave time.
The exact amount a worker gets from leave time is calculated at 66.66 percent of their gross weekly earnings. But the way the New Mexico workers’ comp system works is that they do not get anything for the first 5 days that they miss from work, until they have been off from work for 28 consecutive days. Then they compensated for those first 5 days. And this is just one of the forms of benefits entitled to New Mexico injured workers.
New Mexico is one state that has worked hard to restructure their Department of Labor in order to serve the public better. I noticed that the New Mexico Worker’s Compensation Administration was separated from the New Mexico Department of Labor back in 1990, so that the director of worker’s compensation reports directly to the governor. Their structure is a little different from the federal Department of Labor, and different from most states.
The state of New Mexico has attempted to keep injured workers from possibly spending funds they need to set aside to make medical payments. This has been accomplished by creating a system to make periodic benefit payments instead of lump sum settlements. The medical payments are now often paid directly to the medical care provider instead of to the individual, which prevents both hassle and possible misuse. Lump sum or partial lump sum settlements are allowed in a few specific cases.
I believe the state is taking many steps to prevent frivolous claims. The limit on lump sums would keep some people from filing a suit, and some types of claims are not allowed. For example, New Mexico law does not recognize claims that are filed for stress on the job, and mental impairment must be clearly tied to severe trauma in the workplace.
The costs of worker’s compensation cases are held down in part by the ombudsman’s program. There is also mandatory mediation prior to court, and there is a cap on allowable attorney’s fees.
The Worker’s Compensation Administration also works hard to ensure that medical providers do not overcharge for services or charge the patient directly for costs that may be covered under their worker’s compensation policy. By keeping physicians from charging patients, the system is actually protecting the worker from being overcharged.
I noticed that New Mexico overhauled their Worker’s Compensation Administration Program, and created a new program to assist workers with claims. The Ombudsman program was developed so that employees who file claims can have help understanding their rights and responsibilities. Ombudsman is another phrase for an advisory person or group. It seems to me that this will enable them to come to resolutions without going to the trouble and expense of hiring an attorney.
The Administration not only has the Ombudsman program, it also has a staff of professional mediators. Every injured worker who files a complaint is required to attend a mediation session before the case goes to court. Benefits are created according to a specific formula, eliminating the need for legal negotiations.
I noticed that steps have been taken to prevent the distribution of injured workers’ names and addresses, which has helped with confidentiality issues in many ways. For one thing, they can’t be solicited by health care providers or attorneys. Also they won’t be blacklisted from work due to their injuries.
One important part of the Ombudsman program is that the Worker’s Compensation Administration worked closely with the Association of Latino Businesses of New Mexico to develop a Spanish language presentation on workplace safety. The presentation is targeted toward industries with significant accident records. As a reaction to the especially high rate of on-the-job injuries among Hispanic immigrants, they have tried to address the cultural and language differences as well as provide education about American Worker’s Compensation laws. This will give the Spanish speaking employees the tools and information necessary to prevent accidents and understand how the Worker’s Compensation system works, and to know where to go for help. The program began in Albuquerque but is expected to expand across the state.