N.M. Admin. Code § 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.
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