52-5-5. Claims; informal conferences.
420 words·~2 min read·
/nm/chapter-52-workers-compensation/article-5-workers-compensation-division/52-5-5·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
A. When a dispute arises under the Workers' Compensation Act [Chapter 52, Article 1 NMSA 1978] or the New Mexico Occupational Disease Disablement Law [52-3-1 NMSA 1978], any party may file a claim with the director no sooner than thirty-one days from the date of injury or the occurrence of the disabling disease. The director shall assist workers and employees not represented by counsel in the preparation of the claim document.
B. The director shall prepare a form of claim, which shall be available to all parties. The claim shall state concisely in numbered paragraphs the questions at issue or in dispute that the claimant expects to be determined with sufficient particularity that the responding or opposing party may be notified adequately of the claim and its basis, including, if applicable, the specific benefit that is due and not paid.
C. Upon receipt, every claim shall be evaluated by the director or the director's designee, who shall then contact all parties and attempt to informally resolve the dispute. Within sixty days after receipt of the claim, the director shall issue recommendations for resolution and serve the parties with a copy. Within thirty days of receipt of the recommendation of the director, each party shall notify the director on a form provided by the director of the acceptance or rejection of the recommendation.
A party failing to notify the director waives any right to reject the recommendation and is bound conclusively by the director's recommendation unless, upon application made to the director within thirty days after the foregoing deadline, the director finds that the party's failure to notify was the result of excusable neglect. If either party makes a timely rejection of the director's recommendation, the claim shall be assigned to a workers' compensation judge for hearing.
D. Each party to a dispute shall have a peremptory right to disqualify one workers' compensation judge; provided that:
(1)the employer and the employer's insurer shall constitute a single party for purposes of this subsection;
(2)this peremptory right to disqualify one worker's compensation judge shall not apply to the judge appointed pursuant to Section 52-1-49 NMSA 1978 to render a decision within seven days on a request for a different health care provider; and
(3)no party shall be required to disqualify a workers' compensation judge until a judge has been assigned to a case.
History: Laws 1986, ch. 22, § 31; 1987, ch. 235, § 47; 1989, ch. 263, § 74; 1993, ch. 193, § 10; 2013, ch. 134, § 7.