How the Workers’ Compensation Legal Process Works in New Mexico: What to Expect After Filing a Claim
If you are injured on the job, New Mexico law requires you to notify your employer in writing of the date of your injury, how you were injured, and to what body part the injury occurred. The employer has 30 days to investigate before benefits are payable.
If you’ve been injured on the job and you’re receiving workers’ compensation benefits, it’s natural to feel uncertain about what comes next. At the Victor Titus Law Firm in Farmington, we know this can be a confusing and stressful time. You may be wondering:
Will I lose my job?
Will I keep getting benefits?
What if something changes?
What happens if we have to go to court?
How long will benefits be paid or medical care be provided?
This guide is here to walk you through what to expect during the legal process, from filing a complaint to potential settlement. Our goal is to help you feel informed and supported every step of the way.
When You’re Receiving Benefits
If you have given written notice of your injury to employer but no benefits are being provided, you need to contact a lawyer immediately.
If you’re already receiving disability checks and getting appropriate medical treatment, that’s a good start. During this time, our team will collect your medical records, payroll history, and documentation of the benefits you’ve received to make sure you’re getting all of the benefits you deserve. This ensures that if anything changes—like if benefits stop or medical care is denied—we are ready to act quickly on your behalf.
Filing a Complaint with the Workers’ Compensation Administration (WCA)
The WCA acts as the court for the determination of any disputes in what medical or money benefits should be paid. If your benefits are cut off unfairly or you’re not getting the treatment you need, we can file a formal Complaint with the WCA. Once this is filed, the system kicks into motion:
The WCA will schedule a mediation conference, usually held over Zoom, within about 60 days.
At mediation, both sides—you and your employer’s insurance company—will present evidence and attempt to come to an agreement.
This step is designed to resolve disputes without a trial. However, not all mediations end in agreement. If you and the insurance company can’t settle, the mediator will issue a Recommended Resolution (RR) in writing to both parties.
What Happens After Mediation
Once the RR is issued, each party has 30 days to accept or reject it:
If both sides accept, the RR becomes binding and enforceable by the WCA.
If either side rejects, the RR is of no effect and the case proceeds to trial.
Going to Trial
If the case isn’t settled through mediation, it will be assigned to a Workers’ Compensation Judge for a formal hearing. This is not a quick process. It can take six to nine months to get a trial date. Including the initial mediation timeline and RR review period, it can take a year or more to receive a final decision if a case goes to trial.
Throughout this time, our team stays in close contact with you, keeping you informed and prepared for each step.
Understanding the Benefits You May Receive
Even while the legal process unfolds, we work to ensure you get the benefits you’re entitled to. Here are a few key terms we often explain to clients:
Temporary Disability is money paid to you until you reach maximum medical improvement (MMI). This is usually two-thirds of your average weekly wage, based on your income before the injury. If you earned $750/week before taxes, your comp rate, if totally disabled, would be $500/week (because comp benefits are not taxed).
Permanent Partial Disability: After MMI, your injury may still limit your abilities. Benefits depend on whether the injury is to a “scheduled” body part (like a leg or hand) or “non-scheduled” (like your back or shoulder).
Example: If a knee injury results in permanent loss of function, your payout may be based on the degree of use lost in the injured body part over a scheduled number of weeks. This is payable whether you work or not.
Offsets: If you received unemployment or kept working in some capacity after your injury, those earnings may reduce your weekly benefit amount.
These calculations can get complicated—we’re here to make sure everything is done fairly and legally.
What If You Choose to Settle?
Many (but not all) workers’ compensation cases end in a lump-sum settlement. This means agreeing to close your case in exchange for a one-time payment. Before this can happen, a settlement hearing must be held and the settlement must be approved by a judge.
The hearing is usually a short formality, but it’s important. The judge will ask questions to make sure you:
Are not under the influence of anything that affects your judgment
Understand the terms of the settlement
Know that you’re giving up the right to reopen your case later—even if your condition gets worse
Have had the chance to discuss everything with your attorney
This is your chance to speak honestly. If the judge believes the agreement is fair and that you understand what you’re agreeing to, they will approve the settlement.
One situation that will prevent a lump settlement is if you are on or may soon qualify for Medicare if you have or plan to apply for social security or medicare within 30 months of settlement. In this situation, special rules apply—including restrictions on using Medicare to pay for future treatment related to your work injury (which can be Medicare fraud). We will walk you through these rules to avoid any legal issues.
Let Us Guide You
At Victor Titus Law Firm, we take pride in standing beside injured workers throughout the Four Corners region. We understand the legal system, but more importantly, we understand the stress and pain you’re going through.
You deserve to be treated fairly. You deserve medical care that helps you heal. And you deserve every penny of compensation the law allows.
If you’re not sure what to do next, or if your benefits have been denied or delayed, contact us today at (505) 326-6503 for a free consultation.