reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 400 - TAX ADMINISTRATION › Section 11.3.400.419 - CHARGING OF BENEFITS

Current through Register Vol. 35, No. 13, July 16, 2024
Whenever a claimant files a new claim for benefits and is
				  found by the department to have sufficient base period wages to entitle the
				  claimant to benefits if otherwise eligible, the department shall issue a
				  "notice to employer of claim determination" on a form prescribed by the
				  department, to each base period employer unless that employer was also the
				  claimant's last employer and has been sent notice pursuant to
				  11.3.300.308
				  NMAC. The notice to each employer will give the name and social security
				  account number of the claimant, the claim date and the amount of wages paid by
				  that employer in each quarter of the base period.
A. NOTICE TO LAST EMPLOYER OF CLAIM
				DETERMINATION -- RESPONSE REQUIRED: Whenever a claimant files an initial claim
				for benefits or an additional claim, the department shall immediately transmit
				to the claimant's last known employer, at the employer's address of record, if
				the employer is registered, and, , to the address provided by the claimant if
				the employer is not registered with the department, a dated notice of the
				filing of the claim and a fact-finding questionnaire.
(1) The employer shall provide the department
				with full and complete information in response to the inquiry. The employer
				shall transmit a response directly to the department electronically through the
				employer's online account within 10 calendar days from the date of the
				transmittal of the notice of claim.
(2) If the employer fails to respond by the
				deadline, or if the submitted response is untimely or inadequate, and the
				initial claim determination is later reversed at the appeal level, the employer
				may be liable for any benefit charges incurred to the date of disqualification
				if the employer or the employer's agent has demonstrated an established pattern
				of failing to respond timely or adequately.
(a) A pattern is defined as failure to
				respond timely or adequately to five claims, or more at the secretary's
				discretion, within a calendar year.
(b) An inadequate response is defined as the
				employer's failure to provide relevant information or documentation that was
				reasonably available at the time a response was requested by the
				department.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 400 - TAX ADMINISTRATION › Section 11.3.400.420 - EMPLOYER ELECTIONS TO COVER MULTI-STATE WORKERS

Current through Register Vol. 35, No. 13, July 16, 2024
A. This rule shall govern the department in
				its administrative cooperation with other states subscribing to the interstate
				reciprocal coverage arrangement, hereinafter referred to as "the
				arrangement".
B. Submission and
				approval of coverage elections under the arrangement.
(1) Any employing unit may file an election,
				on a form provided by the division, to cover under the law of a single
				participating jurisdiction all of the services performed for the employer by
				any individual who customarily works for the employer in more than one
				participating jurisdiction.
(2)
				Such an election may be filed, with respect to an individual, with any
				participating jurisdiction in which:
(a) any
				part of the individual's services is performed;
(b) the individual resides; or
(c) the employing unit maintains a place of
				business to which the individual's services bear a reasonable
				relation.
(3) The agency
				of the elected jurisdiction shall initially approve or disapprove the
				election.
(4) If such agency
				approves the election, it shall forward a copy thereof to the agency of each
				other participating jurisdiction specified thereon, under whose unemployment
				compensation law the individual or individuals in question might, in the
				absence of such election, be covered. Each such interested agency shall approve
				or disapprove the election, as promptly as practicable; and shall notify the
				agency of the elected jurisdiction accordingly.
(5) In case its law so requires, any such
				interested agency may, before taking such action, require from the electing
				employing unit satisfactory evidence that the affected employees have been
				notified of, and have acquiesced in, the election.
(6) If the agency of the elected
				jurisdiction, or the agency of any interested jurisdiction, disapproves the
				election, the disapproving agency shall notify the elected jurisdiction and the
				electing employing unit of its action and of its reason therefore.
(7) Such an election shall take effect as to
				the elected jurisdiction only if approved by its agency and by one or more
				interested agencies.
(8) An
				election thus approved shall take effect, as to any interested agency, only if
				it is approved by such agency.
(9)
				In case any such election is approved only in part, or is disapproved by some
				of such agencies, the electing employing unit may withdraw its election within
				10 days after being notified of such action.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 400 - TAX ADMINISTRATION › Section 11.3.400.422 - INDIAN TRIBES

Current through Register Vol. 35, No. 13, July 16, 2024
A. ELECTION OF
				TREATMENT:
(1) An Indian tribe, tribal unit
				or a subdivision, subsidiary or business enterprise wholly owned by a tribe
				("electing entity") shall make its election to be a contributing employer or
				reimbursable employer on or before December 1, for previously registered Indian
				tribes, and 30 days after subjectivity is determined for newly subject Indian
				tribes, except for the year 2001, Indian tribes may make the election any time
				between July 1, 2001, and December 1, 2001. If the electing entity fails to
				make an affirmative election in writing in the manner provided in 11.3.400.422
				NMAC, the electing entity shall be deemed to have elected status as a
				contributing employer.
(2) If the
				Indian tribe, tribal unit or a subdivision, subsidiary or business enterprise
				wholly owned by a tribe is currently registered with the department and desires
				to change its manner of treatment, the electing entity may change its election
				on or before the due date of the wage and contribution report for the fourth
				quarter of 2001, which report is due January 31, 2002. Such change in election
				shall be in writing in the manner provided in 11.3.400.422 NMAC
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 400 - TAX ADMINISTRATION › Section 11.3.400.423 - PARTNERSHIPS

Current through Register Vol. 35, No. 13, July 16, 2024
A separate employer account number and experience rating
				  shall be assigned to each partnership of a group of two or more partnerships
				  composed of identical partners with identical interests, if all of the
				  following conditions are met:
A. each
				separate partnership joins in a request that individual reporting is
				appropriate;
B. a separate written
				partnership agreement exists for each partnership;
C. the accounting records for each
				partnership are separately maintained; and
D. there is no commingling of the employment
				of the two or more partnerships.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 400 - TAX ADMINISTRATION › Section 11.3.400.424 - CHARGING OF BENEFITS PAID DUE TO FEDERAL DISASTER

Current through Register Vol. 35, No. 13, July 16, 2024
Each contributing employer's account shall not be subject to
				  potential pro rata benefit charges during the period wherein a claimant's
				  eligibility for unemployment benefits is directly attributable to
				  unavailability of work due to a federally certified disaster which results in
				  the suspension or termination of operations by such employer. Any nonprofit
				  organization or governmental unit electing to make payments in lieu of
				  contributions shall not be relieved of charges for benefits paid to an
				  individual whose eligibility for unemployment benefits is directly attributable
				  to unavailability of work due to a federally certified
				  disaster.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 400 - TAX ADMINISTRATION › Section 11.3.400.425 - NOTICE OF TAX DETERMINATIONS FINAL AND APPEALS

Current through Register Vol. 35, No. 13, July 16, 2024
A. Finality of decision: The department shall
				give written notice to any employer, employing unit or claimant of every
				determination made by the department which could alter or affect the employer's
				or employing unit's tax liability or the claimant's monetary eligibility under
				the law. Such determination shall be deemed to be the final decision of the
				department, unless an appeal is initiated pursuant to Subsection B of
				11.3.500.8
				NMAC.
B. Stay pending appeal: Legal
				action, including the issuance of 10 day notices and warrants of lien and levy,
				shall not be taken on accounts that have an appeal pending within the
				department.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 400 - TAX ADMINISTRATION › Section 11.3.400.426 - APPLICATION OF UNDERPAYMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
In the event an employing unit fails to submit payment in an
				  amount sufficient to satisfy the total amount of outstanding debt for any
				  current or past-due contributions, interest or penalty, the amount of the
				  underpayment shall be applied in the following order: first, to any
				  contributions and excess claims premiums due, second, to any interest due and
				  third, to any penalties due, from the oldest debt to the newest.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 400 - TAX ADMINISTRATION › Section 11.3.400.427 - ADEQUATE RESERVE DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
The department shall ensure that the fund sustains an
				  adequate reserve.
A. An adequate
				reserve shall be determined to mean that the funds in the fund available for
				benefits equal the total amount of funds needed to pay between 18 and 24 months
				of benefits at the average of the five highest years of benefits paid in the
				last 25 years.
B. For the purpose
				of sustaining an adequate reserve, the department shall determine a reserve
				factor to be used when calculating an employer's contribution rate based upon a
				formula that will set the reserve factor in proportion to the difference
				between the amount of funds available for benefits in the fund, as of the
				computation date, and the adequate reserve, within the following guidelines:
(1) 1.0000 if, as of the computation date,
				there is an adequate reserve;
(2)
				between 0.5000 and 0.9999 if, as of the computation date, there is greater than
				an adequate reserve; and
(3)
				between 1.0001 and 4.0000 if, as of the computation date, there is less than an
				adequate reserve.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 400 - TAX ADMINISTRATION › Section 11.3.400.428 - EMPLOYER RESPONSES

Current through Register Vol. 35, No. 13, July 16, 2024
The employer is required to respond timely and accurately to
				  all inquiries from the department. If the department does not receive timely or
				  adequate responses, the department will, at its discretion, take action based
				  on the information at hand based which may result in assessed penalties or
				  employer liabilities. Absent a showing of good cause, the department will not
				  reverse determinations as a result of the employer's failure to appropriately
				  respond.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Department of Workforce Solutions, P.O. Box 1928,
				  Albuquerque, NM 87103
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
NMSA 1978 Sections
				  51-1-1 to
				  51-1-59.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
January 1, 2003, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A. "Adjudicatory
				body" means the appeal tribunal, the board of review or other commissions or
				body within the department holding an adjudicatory hearing.
B. "Adjudicatory hearing" means a judicial or
				quasi-judicial hearing upon either the law or the evidence or both which allows
				the parties to present evidence, objections to evidence, documents and
				witnesses as well as cross-examine opposing parties' witnesses and
				evidence.
C. "Administrative law
				judge or ALJ" means the individual who conducts appeal tribunal hearings and
				makes decisions on issues arising from determinations issued by the department.
				This term is synonymous with the term "hearing officer" as set forth in Section
				51-1-8 NMSA
				1978.
D. "Authorized
				representative" means an individual who, by virtue of his position within the
				department, is designated by the secretary to perform certain specific tasks on
				behalf of the department.
E. "Good
				cause" means a substantial reason, one that affords a legal excuse, or a
				legally sufficient ground or reason. In determining whether good cause has been
				shown for permitting an untimely action or excusing the failure to act as
				required, the department may consider any relevant factors including, but not
				limited to, whether the party acted in the manner that a reasonably prudent
				individual would have acted under the same or similar circumstances, whether
				the party received timely notice of the need to act, whether there was
				administrative error by the department, whether there were factors outside the
				control of the party that prevented a timely action, the efforts made by the
				party to seek an extension of time by promptly notifying the department, the
				party's physical inability to take timely action, the length of time the action
				was untimely, and whether any other interested party has been prejudiced by the
				untimely action. However, good cause cannot be established to accept or permit
				an untimely action or to excuse the failure to act, as required, that was
				caused by the party's failure to keep the department directly and promptly
				informed by written, signed statement of the claimant's, employer's or
				employing unit's correct mailing address. A written decision concerning the
				existence of good cause need not contain findings of fact on every relevant
				factor, but the basis for the decision must be apparent from the
				order.
F. "Practice manual" means a
				resource maintained by the department consisting of department procedures and
				guidelines based on federal and state statutes and regulations, Department of
				Labor directives and guidance, and decisions of the Board of Review or district
				court judges.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.8 - PRESENTATION OF APPEALS OF INITIAL DETERMINATIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A. Any interested party aggrieved by a
				determination of the department may file an appeal to the appeal tribunal
				within 15 days from the date of transmission of the determination. Any written
				communication clearly demonstrating a desire to appeal a determination of the
				department will be regarded as an appeal. Appeals shall be transmitted to the
				department by U.S. mail, by fax or by electronic filing using the department's
				online system. All appeals should be transmitted to the department in a format
				indicating the interested party's desire to appeal. For any issues of
				timeliness with regard to faxed appeals, the time and date affixed on the
				department's receiving device will be presumptively the date and time of
				submission. For any issues of timeliness with regard to appeals submitted via
				U.S. mail, the postmark date on the appeal envelope will presumptively be the
				date and time of submission. For any issues of timeliness with regard to
				appeals filed electronically through the department's online system, the date
				and time that the department's online system "electronically stamps" the appeal
				will be presumptively the date and time of submission.
B. All interested parties will be given
				notice of any hearing or review before the appeal tribunal as provided for in
				11.3.500.9
				and
				11.3.500.12
				NMAC.
C. Unless otherwise provided
				by statute or a specific rule of the department, the time for the appeal of any
				determination from one level to another within the department is 15 calendar
				days from the date of the transmission of the decision or determination, with
				the first day commencing on the calendar date after the date of
				transmission.
D. The time for
				filing any appeal within the department may be extended only upon a showing of
				good cause.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.9 - ADJUDICATORY PROCEEDINGS GENERALLY

Current through Register Vol. 35, No. 13, July 16, 2024
A. Right to representation: In any
				adjudicatory hearing before the department:
(1) Any party may self-represent, be
				represented by an attorney at law or by any other person qualified to represent
				the party in the matters under consideration. The secretary may bar attorneys
				and authorized representatives from appearing on behalf of others in
				proceedings before the department if, the attorney or authorized
				representative's previous conduct has established to the department's
				satisfaction that the attorney or authorized representative is unlikely to
				provide competent representation in future proceedings.
(2) A partnership may be represented by any
				of its employees, members, or duly authorized representative. A corporation or
				association may be represented by an officer, employee or any duly authorized
				representative. Any governmental entity may be represented by an officer,
				employee, or any other authorized person.
(3) The presiding officer or the secretary
				may, for lack of qualifications or other sufficient cause, bar any person from
				representing any party, in such circumstances, the reasons for such bar shall
				be set out in the record of proceedings.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.10 - HEARING PROCEDURE BEFORE THE APPEAL TRIBUNAL

Current through Register Vol. 35, No. 13, July 16, 2024
A. Conduct of adjudicatory hearings:
(1) Adjudicatory hearings before the appeal
				tribunal shall be conducted in such a manner that all parties are afforded
				basic rights of due process and that all pertinent facts necessary to the
				determination of the rights of the parties are obtained. All hearings and
				proceedings will be conducted informally in such a manner as to ascertain the
				substantial rights of the parties and will not be governed by common law or
				statutory rules as to the admissibility of evidence or by technical rules of
				procedure, but the procedures shall afford the parties equally and impartially
				the right to:
(a) call and examine witnesses
				and to cross examine the opposing party's witnesses;
(b) introduce exhibits and offer rebuttal
				evidence;
(c) object to questions
				and to the introduction of improper or irrelevant testimony or evidence;
				and
(d) submit written expositions
				of the case, within the discretion of the administrative law judge.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.11 - REMOVAL ACTIONS

Current through Register Vol. 35, No. 13, July 16, 2024
At the order of the secretary, any proceeding before the
				  department or the appeal tribunal may be removed to the board of review. Such
				  removed actions shall be presented, heard and decided by the board of review in
				  the manner prescribed for appeal tribunal hearings.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.12 - PRESENTATION OF FURTHER APPEALS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				An interested party aggrieved by a decision of the appeal tribunal is entitled
				to appeal to higher authority. A written communication clearly demonstrating a
				desire to appeal a determination to higher authority shall be filed with the
				department. The information submitted with the appeal shall include a clear
				statement of the relevant facts and a clear statement of the party's basis for
				appeal.
B. Secretary decision: The
				secretary shall review the application and shall, within 15 days after receipt
				of the application for appeal, either affirm the decision of the administrative
				law judge, remand the matter to the appeal tribunal for an additional hearing
				or new decision, remand to the department for further investigation and
				determination, or refer the decision to the board of review for further review
				and decision on the merits of the appeal. Issues of timeliness shall be decided
				by the secretary, who may refer the decision to the board of review.
(1) Decision in writing: Following the
				conclusion of a review on an appeal, the cabinet secretary shall issue a
				decision. The decision shall be in writing, shall include findings of fact and
				conclusions of law, and shall be signed by cabinet secretary.
(2) Findings of fact shall be based
				exclusively on the record and matters officially noted.
(3) Publication of decision: Copies of any
				decision issued by the secretary shall be promptly transmitted to all
				interested parties to the appeal.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.13 - THE BOARD OF REVIEW

Current through Register Vol. 35, No. 13, July 16, 2024
A. The
				board of review's authority: In every case referred to the board of review by
				the secretary from an appeal tribunal decision the board of review may, in its
				discretion, hear and decide the case upon the record; it may entertain written
				arguments, or, after notice to all parties and in accordance with
				11.3.500.9
				NMAC it may conduct a hearing and take additional evidence before it.
B. Review of the record as an appellate or
				reviewing body: As a general practice and unless the board of review gives
				specific notice to the contrary, the board sits in its capacity as an appellate
				or reviewing body. As such, it reviews the record; it does not receive new
				evidence.
C. Remand by board of
				review to the appeal tribunal or the department: With an order directing that a
				determination or decision be made with regard to that issue, or that additional
				procedures be taken to perfect a determination or decision already issued, or
				to make other disposition in the matter, as the board of review, in its
				discretion, may deem necessary, the board of review may remand any claim or an
				issue involved in a claim; any issue developed from evidence presented at the
				hearing or apparent from the existing record:
(1) To the appeal tribunal for the taking of
				additional evidence or a hearing de novo. Hearings conducted by the appeal
				tribunal pursuant to a remand by the board of review shall be conducted after
				notice to all parties and in accordance with 11.3.500 NMAC. Unless directed
				otherwise by the board of review, the appeal tribunal shall issue a decision
				based upon the entire record before it, including the record of all the prior
				hearings. Parties to any additional hearing shall have the right to review the
				appeal tribunal recording made at any prior evidentiary hearing.
(2) To the department for fact-finding and
				issuance of an initial determination or redetermination.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.14 - INSPECTION OF DECISIONS

Current through Register Vol. 35, No. 13, July 16, 2024
Copies of all decisions of the cabinet secretary, board of
				  review and appeal tribunal shall be kept on file in accordance with the state
				  records center retention requirements at the department's office in
				  Albuquerque, New Mexico. A compilation of decisions of the appeal tribunal and
				  board of review designated significant by the secretary or the general counsel,
				  but with the parties' names and identifying information redacted and removed
				  shall be open for inspection. The redacted decisions shall be filed
				  chronologically but, from time to time, may be indexed by topic and offered as
				  a precedent manual.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 3 - EMPLOYMENT SECURITY › Part 500 - ADJUDICATORY HEARINGS, FILING OF APPEALS AND NOTICE › Section 11.3.500.15 - ADMINISTRATIVE ERROR

Current through Register Vol. 35, No. 13, July 16, 2024
Clerical mistakes in decisions or parts of the record and
				  errors arising from oversight or omission may be corrected by the department at
				  any time on its own initiative or on the request of any party. During the
				  pendency of an appeal to the judicial system, such mistakes may be corrected
				  before the official record is transmitted to the district court, and,
				  thereafter, while the appeal is pending, may be corrected with leave of the
				  appellate court.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 1 - GENERAL PROVISIONS › Section 11.4.1.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
The director is authorized by Section
				  52-5-4
				  NMSA 1978 (Repl. Pamp. 1991), to adopt reasonable rules and regulations to
				  implement the legislative purposes of the Workers' Compensation Act. The
				  Workers' Compensation Act specifically directs the adoption of definitions for
				  the phrases "bad faith" and "unfair claims processing" in Section
				  52-1-28.1
				  NMSA 1978 (Repl. Pamp. 1991). The rules on record confidentiality are adopted
				  pursuant to Section
				  52-1-21 NMSA
				  1978 (Repl. Pamp. 1991).
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 1 - GENERAL PROVISIONS › Section 11.4.1.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
This part defines words and phrases frequently used in the
				  rules adopted by the director and also establishes rules for review of agency
				  records.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 1 - GENERAL PROVISIONS › Section 11.4.1.8 - CONFIDENTIALITY

Current through Register Vol. 35, No. 13, July 16, 2024
A. All records of
				the WCA are confidential except:
(1) as
				provided in Section
				52-5-21 NMSA 1978;
(2) records required to be released by order
				of a court of competent jurisdiction;
(3) the identity of the insurance carrier for
				a particular employer, the fact that the employer is certified as a
				self-insurer or the fact that the administration has no record of compliance
				with the insurance requirement of the Act;
(4) any matter required to be made available
				to another state agency pursuant to statutes, joint powers agreements or
				memoranda of understanding; or
(5)
				as otherwise provided by law.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 2 - DATA REPORTING AND SAFETY REQUIREMENTS › Section 11.4.2.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
The director is authorized by Section
				  52-5-4,
				  NMSA 1978, to promulgate regulations to implement the act. The regulations
				  implementing the safety program requirements are adopted pursuant to Section
				  52-1-6.2,
				  NMSA 1978. The rules on gathering and reporting of statistical data are adopted
				  pursuant to Section
				  52-5-3,
				  NMSA 1978.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 2 - DATA REPORTING AND SAFETY REQUIREMENTS › Section 11.4.2.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
September 30, 2016, unless a later date is cited at the end
				  of a section.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 2 - DATA REPORTING AND SAFETY REQUIREMENTS › Section 11.4.2.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of 11.4.2 NMAC is to establish reporting and
				  safety requirements for employers. This rule creates a standardized method for
				  reporting data on work accidents, notifying workers about legal requirements
				  for making a claim, and complying with mandatory safety provisions of the
				  act.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 2 - DATA REPORTING AND SAFETY REQUIREMENTS › Section 11.4.2.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A. "American
				standard code for information interchange (ASCII)" means a code that follows
				the proposed standard for defining codes for information exchange between
				equipment produced by different manufacturers.
B. "Claims administrator" means the insurance
				carrier, third party administrator, self-insured association, self-insured
				employer, or any claims coordinator, if any, designated by the employer or
				another claims payer to provide claims processing services on workers'
				compensation claims. These services include receiving and sending workers'
				compensation claims information to the WCA, employer, insurance carrier, and
				injured worker.
C. "EDI" means
				electronic data interchange.
D.
				"Loss run" means a computer generated report, listing or file that provides
				uniquely identifying and financial data of each individual claim for a group of
				claims occurring during a particular period for an insured or
				employer.
E. "Industry" means a
				business, or all businesses, as the context requires, that have identical two
				digit NAICS codes as determined by the WCA.
F. "NAICS code" means a designator of the
				principal business of an employer assigned by the WCA pursuant to the current
				version of the North American industry classification system, a publication of
				the executive office of the president, office of management and budget, United
				States.
G. "Experience modifier" is
				a calculation that compares the losses of an individual risk (employer) to
				average losses for all other risks in that industry classification and state.
				The experience modifier is used to adjust the insurance premiums of an
				individual risk according to the risk's loss experience.
H. "FROI" means first report of injury data
				(IAIABC 148 format). FROI also refers to WCA form E-1 and WCA form
				E-1.2.
I. "SROI" means subsequent
				report of injury data required to complete the notice of benefit payment
				(IAIABC A49 format). SROI also refers to WCA form E-6.
J. "TA" means transmission
				accepted.
K. "TE" means
				transmission accepted with errors.
L. "TR" means transmission
				rejected.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 2 - DATA REPORTING AND SAFETY REQUIREMENTS › Section 11.4.2.8 - DATA COLLECTION

Current through Register Vol. 35, No. 13, July 16, 2024
A. General
				provisions:
(1) Paper copies of FROI and SROI
				will not be accepted by the WCA as of January 1, 2017. Beginning January 1,
				2017, FROI and SROI data shall only be submitted through EDI or the WCA
				website.
(2) It is the claims
				administrator's or an uninsured employer's responsibility to timely submit all
				data required under the data collection rules.
(3) Time frames for submission of reports are
				not waived when the WCA acknowledges and returns an erroneous submission that
				needs correction.
(4) It is the
				responsibility of the claims administrator to report to the WCA required
				financial, legal and medical claims activity for the insured including
				reporting of the first dollar of indemnity benefits paid by, or on behalf of,
				an employer who has a deductible policy.
(5) It is the responsibility of the claims
				administrator to provide a loss run to the WCA upon request for reconciliation
				of a noted discrepancy.
(6) Claims
				administrators that file any required report at the time of the mediation
				conference, either with the mediator or at the clerk of the courts office, have
				not met their filing obligation with the WCA and must electronically file all
				required FROI and SROI data. The date of actual filing is the date of
				acceptance by the WCA, which will be used to determine compliance with filing
				requirements.
(7) Electronic filing
(a) A claims administrator shall file
				electronically with the WCA.
(b)
				EDI trading partner profile must be on record with the WCA before electronic
				filings can be accepted. A sample EDI trading partner profile is available on
				the WCA website.
(c) The
				transmission format is the international association of industrial accident
				boards and commissions (IAIABC) 148 and A49 record scheme. Transmission header
				and trailer records are also required under this format. The transmission
				record formats are also available on the WCA website.
(d) Electronic transmissions must be in the
				ASCII format. The file may be transmitted by electronic transmission via the
				internet.
(e) Electronic mailboxes
				must be registered with the management information systems (MIS) bureau of the
				WCA.
(f) Receipts for all TA, TE,
				and TR transmissions will be returned electronically.
(g) TR codes must be corrected within 30
				days.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 2 - DATA REPORTING AND SAFETY REQUIREMENTS › Section 11.4.2.9 - SAFETY

Current through Register Vol. 35, No. 13, July 16, 2024
A. Annual
				inspections:
(1) All employers, as identified
				in Section 52-1 -6.2 NMSA 1978, are required to have an annual safety
				inspection. All other employers are encouraged to do so.
(2) Any employer who purchases or renews a
				policy of workers' compensation insurance with a premium liability of $15,000
				or more shall, within 60 days of the policy issuance or renewal, submit proof
				of an annual safety inspection to the WCA. Self-insured employers shall submit
				proof of an annual safety inspection to the WCA within 60 days of completing an
				inspection.
(3) Standards for
				annual inspections: The minimum standards for the annual safety inspection are
				contained in the WCA publication, annual safety inspections. This publication
				may be obtained from the WCA's website.
(4) Who may conduct the inspection:
(a) A safety consultant from the
				WCA.
(b) A senior manager or
				dedicated safety professional employed by the business. The WCA may be
				contacted to provide training on how to conduct a proper safety
				inspection.
(c) A third party
				safety organization or safety professional.
(d) A safety professional from the insurance
				company.
(5) Employers
				shall submit an affidavit listing the address of all facilities that were
				included in the inspection to the WCA safety program on a form approved by the
				director. Though the responsibility for reporting is with the employer, the
				insurance carrier may report completed inspections, provided the insurance
				carrier or a safety organization or safety professional retained by the carrier
				conducted the inspection.
(6)
				Failure to comply with the annual safety inspection requirement may subject an
				employer to penalties under Section 52-1 -6.2 NMSA 1978.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 2 - DATA REPORTING AND SAFETY REQUIREMENTS › Section 11.4.2.10 - ACCIDENT NOTICE POSTERS AND ACCIDENT NOTICES

Current through Register Vol. 35, No. 13, July 16, 2024
A. Every employer shall post and keep posted
				in conspicuous places on its business premises, in areas where notices to
				employees and applications for employment are customarily posted, an accident
				notice poster stating the requirement that workers notify employers of
				accidents. The accident notice poster is available at the WCA at no charge to
				the employer on a form approved by the director.
B. Every employer must keep attached to the
				accident notice poster an adequate supply of notice of accident forms approved
				by the director.
C. Any employer
				may submit to the director a proposal for approval of a notice of accident form
				or accident notice poster. No form shall be approved except in writing, signed
				by the director.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
Workers' Compensation Administration.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This part governs all employers and workers subject to the
				  act.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Section
				  52-5-4
				  NMSA 1978 (Repl. Pamp. 1991), as amended, authorizes the director of the WCA to
				  adopt reasonable rules and regulations for effecting the purposes of the act.
				  Sections
				  52-5-20
				  to
				  52-5-22
				  NMSA 1978 (Repl. Pamp. 1991), as amended, contain certain payment deadlines and
				  requirements for reporting by insurer. Section
				  52-1-28.1
				  NMSA 1978 (Repl. Pamp. 1991), specifically directs the WCA to create
				  regulations on unfair claims processing practices and bad faith. Section
				  52-1-12.1
				  NMSA 1978 (2016) directs the director to promulgate rules governing
				  post-accident drug and alcohol testing.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
June 1, 1996 unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule is intended to regulate the manner of payment of
				  workers' compensation claims, to provide for post-accident drug and alcohol
				  testing, and to clarify the parties' mutual obligations of prompt payment,
				  cooperation and information reporting.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
See
				  11.4.1.7
				  NMAC.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.8 - PAYMENT OF CLAIMS

Current through Register Vol. 35, No. 13, July 16, 2024
A. If an
				accidental injury or occupational disease occurs to a worker during the course
				of employment and results in lost time to the worker of more than seven
				cumulative days the employer shall file an E1.2 report with the WCA, and shall
				concurrently provide a copy to the worker.
B. The employer shall pay the worker the
				first installment of compensation benefits on a compensable claim no later than
				14 days of the date of filing of the E1.2 report with the WCA.
C. If a claim is denied, the employer shall,
				upon the request of the worker, provide a written statement of the basis for
				the denial.
D. Compromise payments
				by the employer shall not be construed as an admission of liability by any
				person or party.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.9 - LATE PAYMENT OF CLAIMS

Current through Register Vol. 35, No. 13, July 16, 2024
A. The WCA
				shall determine the timeliness of initial payments to workers.
B. Upon request of the WCA, an employer shall
				provide documentation to verify the timeliness of initial payments.
C. If an employer is identified by the WCA as
				having made initial payments on an untimely basis, the WCA may require the
				employer to implement a plan to prevent future late payments, and may require
				the employer to furnish proof of compliance with the plan.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.10 - INSURERS' REPORTING DUTY TO EMPLOYER

Current through Register Vol. 35, No. 13, July 16, 2024
A. Upon written request of an employer, the
				insurer carrying the employer's workers' compensation insurance shall provide a
				list of workers' compensation claims made against that employer, which shall
				contain the information specified in Section
				52-5-20
				NMSA 1978 (Repl. Pamp. 1991).
B.
				Upon written request of an employer, the insurer carrying the employer's
				workers' compensation insurance shall provide the employer with notice of any
				proposed settlement of any claim against that employer.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.11 - MILEAGE BENEFITS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Employer shall pay worker's mileage, transportation, meal and commercial
				lodging expenses for travel to HCPs pursuant to this rule. Payment shall be
				made only to the injured worker and within 30 days of the employer's receipt of
				an original itemized receipt that complies with the requirements of this rule:
(1) for travel to HCPs of 15 miles or more,
				one way, from the worker's residence or place of employment, depending upon the
				point of origin of travel, mileage shall be reimbursed at the mileage
				reimbursement rate set by the New Mexico Department of Finance and
				Administration regulations in effect on the date of travel;
(2) actual reimbursement for the cost of a
				ticket on a common carrier, if applicable;
(3) actual reimbursement up to $15.00 for any
				one meal with up to three meals total and $30.00 total reimbursed for a 24 hour
				period; and,
(4) actual
				reimbursement up $85.00 for the cost of overnight commercial lodging in the
				event of required travel of at least 150 miles one way from worker's residence
				or place of employment, depending upon the point of origin of
				travel.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.12 - POST-ACCIDENT DRUG AND ALCOHOL TESTING

Current through Register Vol. 35, No. 13, July 16, 2024
A.
GENERAL PROVISIONS
(1) This section establishes regulations for
				post-accident drug and alcohol testing pursuant to Section
				52-1-12.1
				NMSA 1978.
(2) These rules are not
				intended to supersede other laws and are only intended to establish
				post-accident testing protocols and cut off levels as required by Section
				52-1-12.1
				NMSA 1978. Nothing in these rules shall prohibit an employer from conducting
				any drug or alcohol testing of employees which is otherwise permitted by
				law.
(3) If the worker requires
				emergency medical attention, medical treatment shall not be delayed to collect
				a drug or alcohol sample, provided that sample collection may occur in
				conjunction with the provision of medical treatment.
(4) A party may call a health care provider,
				toxicologist or similar forensic specialist as an expert witness to assist the
				workers' compensation judge in determining the degree to which intoxication or
				influence contributed to the worker's injury or death.
New Mexico Administrative Code › Title 11 - LABOR AND WORKERS' COMPENSATION › Chapter 4 - WORKERS' COMPENSATION › Part 3 - PAYMENT OF CLAIMS, POST-ACCIDENT DRUG AND ALCOHOL TESTING, AND CONDUCT OF PARTIES › Section 11.4.3.13 - CONDUCT OF PARTIES

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Worker's duties:
(1) Worker shall answer
				reasonable requests from the employer regarding work status.
(2) When a worker is receiving disability
				benefits, worker shall report to employer, within 15 days, any return to work,
				any written medical release to return to work provided to worker, and any
				physical limitations imposed by a physician and provided to worker in
				writing.
(3) Worker shall, upon
				request, give employer the names, addresses, relationship and degree of
				dependency of all dependents, and may be required to make a verified statement
				regarding these matters.
(4) Worker
				may be required to sign the authorization form approved by the WCA to release
				medical information as a condition of receipt of workers' compensation
				benefits.