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  • Complaint Form - New Mexico Workers Compensation Administration - Workerscomp State Nm

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STATE OF NEW MEXICO WORKERS' COMPENSATION ADMINISTRATION , Worker, v. , and WCA No.: , Employer/Insurer. WORKERS' COMPENSATION COMPLAINT 1. 2. 3. 4. 5. 6. 7. 8. Type of injury: Accidental Work Injury.

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Workers' compensation provides workers with: Payments for temporary indemnity benefits if an injured worker is unable to work and earn a paycheck. Survivor benefits for survivors of those killed on the job. Dispute resolution through the WCA's ombudsman, mediation and administrative court system.

What Is the New Mexico Personal Injury Statute of Limitations? If you sustained injuries in a personal injury accident, you typically have three years to file a lawsuit from the date of the accident. That covers various claims, including auto accidents, slip and falls, dog bites, medical malpractice, etc.

Form E 1.2 Employers' First Report of Injury. You need to complete this form and send a copy to EMPLOYERS and the New Mexico Workers' Compensation Administration within 10 days of knowledge of any alleged work-related injury or occupational disease that results in more than seven days of lost work.

New Mexico Workers' Compensation Laws Workers' Comp Statute Section§ 52-1-1, et seq.New Mexico Occupational Disease Disablement Law Statute Section§ 52-3-1, et seq.Time LimitsNotice to employer: 15 days (§ 52-1-29) 1 year to file a claim (§ 52-1-31)3 more rows • Dec 11, 2018

Other ways to file. Fax: Complete the Employers' First Report of Injury or Illness form and fax it to 505-345-0656. Standard Mail: Complete the Employers' First Report of Injury or Illness form and mail it to New Mexico Mutual, PO Box 27810, Albuquerque NM 87125.

Form E 1.2 Employers' First Report of Injury. You need to complete this form and send a copy to EMPLOYERS and the New Mexico Workers' Compensation Administration within 10 days of knowledge of any alleged work-related injury or occupational disease that results in more than seven days of lost work.

Worker Notify employer within 15 days of accident or injury. Complete Notice of Accident form or otherwise notify in writing and submit to employer.

Workers' compensation provides workers with: Payments for temporary indemnity benefits if an injured worker is unable to work and earn a paycheck. Survivor benefits for survivors of those killed on the job. Dispute resolution through the WCA's ombudsman, mediation and administrative court system.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232