New Mexico Workers' Compensation Acknowledgment Form

State:
Multi-State
Control #:
US-537EM
Format:
Word; 
Rich Text
Instant download

Description

This is an acknowledgement form regarding workers' compensation. The form states that the employee has read and understands the workers' compensation guidelines.

How to fill out Workers' Compensation Acknowledgment Form?

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FAQ

Workers' compensation provides workers with:Payment for medical care resulting from a work-related injury or illness. Payments for a worker who is permanently partially disabled once maximum medical improvement is reached. Payments for a worker who has a permanent impairment or is permanently totally disabled.

Compensation is 66 2/3 percent of the injured New Mexico workers wage. Minimum weekly payment is $36 or the workers actual wage if it is less. Maximum weekly payment is 100 percent of the New Mexico sate average weekly wage or $669.21. Maximum number of payments is for the lifetime of the injured New Mexico worker.

The average cost for workers' comp in Texas is 55 cents per $100 of payroll, according to the National Academy of Social Insurance, but there are many factors that impact premiums. Additionally, many carriers charge a minimum premium of $250 annually for a workers' compensation policy.

Form CA-7 is used by federal workers seeking to claim compensation for traumatic injuries suffered while on the job, as well as those who may have sustained an occupational disease during the performance of work-related duties.

In Mexico, the term workers' compensation is not used. The general term is riesgos de trabajo or job risks.

Who needs workers' comp insurance in New Mexico? New Mexico imposes strict workers' compensation insurance rules on employers. All businesses with three or more employees must provide workers' comp coverage, and construction businesses of any size are required to carry coverage.

Contact the Employer Compliance Bureau at (505) 841-6851 to determine eligibility. A business not located in the state that employs workers in New Mexico engaged in activities required to be licensed under the CID must carry workers' compensation insurance.

Some states however prohibit the sale of workers compensation by private insurers and, instead, require employers to purchase coverage from a government-operated fund. North Dakota, Ohio, Wyoming, and Washington are the four states with this specific requirement and are referred to as monopolistic states.

Workers' Compensation Assessment Fee The fee is similar to a tax, and is $4.30 per employee per calendar quarter. Employers contribute $2.30, multiplied by the number of covered employees working on the last working day of the quarter.

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New Mexico Workers' Compensation Acknowledgment Form