N.M. Admin. Code § 1.6.4.13

Current through Register Vol. 35, No. 21, November 5, 2024

Section 1.6.4.13 - JOB-RELATED INJURY OR ILLNESS CLAIMS MANAGEMENT

A. Each agency shall adopt a workers' compensation claims management procedure approved by RMD that complies with all relevant laws, regulations, policies, directives, guidance, and other requirements.

B. Each agency shall have written procedures for:

(1) workers' compensation claims management;

(2) early return to work for workers with job-related injuries or illnesses; and

(3) new employee orientation programs that include job safety and workers' compensation training.

C. Each agency shall have written policies providing for the following items, as they apply to job-related injury or illness claims:

(1) training, appropriate to each supervisor, on the supervisor's and responsibilities regarding job-related injuries and workers' compensation claims;

(2) methods for record keeping and filing job-related injury and illness claims;

D. Claims records retained by agencies and submitted to the RMD shall contain the following:

(1) Mandatory documents:

(a) notice of accident (WCA form NOA-1, as may be amended);

(b) employer's first report of injury or illness (WCA form E1.2, as may be amended);

(c) Authorization to release medical information (WCA mandatory form, per Subparagraph (c) of Paragraph (2) of Subsection R of 11.4.4.9 NMAC, as may be amended);

(2) Other records, documents, statements, and evidence appropriate to the claim.

E. The policies required by this rule shall address:

(1) injured employee responsibilities - At a minimum, injury reporting procedures, administration and documentation details, and compliance with the medical treatment plan;

(2) employer responsibilities - At minimum, job-related injury or illness reactive procedures, contact protocol, employer involvement in all phases of job-related injury or illness claim management, and accountability measures;

(3) identifying job roles and modifying job functions to accommodate a worker placed on restricted or modified work status and procedures and authorities to implement this program;

(4) implementing controls to reduce the likelihood of job-related injuries or illnesses reoccurring.

F. Every effort shall be made to implement an early return to work program that includes, at a minimum, the requirements of Section 52-1-25.1 NMSA 1978. No state employee shall be terminated from employment because of a job-related injury or illness or because of physical circumstances resulting from a job-related injury or illness unless the state agency has provided advance notice to RMD.

G. Vacant positions resulting from job related injuries or illnesses shall not be filled, except by temporary employment, unless provided for elsewhere by law.

(1) A position may be permanently filled if there is documented medical diagnosis or evidence that an employee with a job-related injury or illness has reached maximum medical improvement or that the employee's impairment or condition is permanent and that the employee cannot perform the essential functions of the particular job.

(2) A position may be permanently filled if there is a critical need and that need cannot be satisfied with temporary employment, and the agency has made a "good faith" effort to do so, and the other provisions of this rule have been satisfied.

N.M. Admin. Code § 1.6.4.13

1.6.4.13 NMAC - Rp, 1.6.4.13 NMAC, 7/1/2007, Adopted by New Mexico Register, Volume XXIX, Issue 23, December 11, 2018, eff. 12/11/2018