DI 52120.170 New Mexico Workers’ Compensation (WC)
A. Types of WC Payments
1. Temporary Total (TT)
These benefits go into effect on the 8th day of non-work status. The first 7 days of non-work status are not payable unless claimant is off work up to 4 weeks. The first payment of benefits is mailed 21 days claimant is off work. Thereafter, benefits are mailed every 2 weeks. TT payments are made until the date maximum medical improvement (MMI) is reached. At MMI, a percentage of disability is established and permanent partial benefits are paid at a rate equal to the TT rate multiplied by the percentage of disability established.
2. Permanent Total (PT)
Benefits are payable for the life of the disabled worker.
3. Permanent Partial (PP)
Duration of the PP payments based on schedules provided in the law.
B. Cost-of-living adjustments (COLAs)
Since 01/1988, increases have been given effective January of each year.
C. Attorney fees
The maximum amount that can be paid for each claim to the lawyer for each side is set by law at $22,500.00.
D. Retirement insurance benefit (RIB) considerations
New Mexico does not offset its WC for SSA retirement benefits
E. Partial lump sum payments
After maximum medical improvement (MMI) and with the workers’ compensation judge’s approval, a worker may elect to receive a partial lump sum payment of workers’ compensation benefits for the sole purpose of paying debts that may have accumulated during the course of the worker’s disability. The number of weeks of additional PP payments due will then be reduced by the number of weeks of benefits that make up the partial LS.
Reference: New Mexico Statute Annotated 1978 (NMSA 1978) 52-5-12C http://nxt.ella.net/NXT/gateway.dll?f=templates$fn=default.htm$vid=nm:all
Simultaneously prorate the partial lump sum for offset purposes while offsetting the periodic WC payments. Prorate the partial lump sum beginning with the date the lump sum award was approved unless the award specifies otherwise.
Example: If the original order was for 500 weeks of permanent partial (PP) benefits, and the worker is awarded a partial LS equal to 133 weeks of those benefits, the periodic benefits are paid for 367 weeks instead of 500. Add the prorated lump sum to the ongoing PP periodic payments.
F. Uninsured Employers’ Fund
For injuries occurring on or after 06/20/2003, a New Mexico law created a special workers’ compensation fund, Uninsured Employers’ Fund, to pay injured workers whose employers failed to insure them for workers’ compensation but should have. Such payments are subject to WC offset.
G. Verifying WC
State law prohibits the New Mexico WC Commission from providing the Social Security Administration with WC information even with written authorization of the injured worker.
Make all requests for WC verification to the worker or insurance carrier.