Frequently asked questions
As an injured worker insured by New Mexico Mutual, you are entitled to receive many benefits and services to help you recover. You also have an important role to play in the healing process. Below are answers to the questions we receive most often from injured workers. If you have more questions, please call us at 505-345-7260.
Claims Management Frequently Asked Questions
What’s the difference between a medical only claim and a lost time claim?
Claims resulting from a work-related injury fall into two groups: medical only claims (80%) and lost time claims (20%). A lost time claim occurs when a worker misses more than seven calendar days (one week) of work due to the injury. Although most work-related injuries are not serious enough for a worker to lose more than three workdays, it is still important that workers report the injury to their employer immediately.
What do I do if I am injured while working?
It is very important that any time you are injured on the job you report the incident to your employer immediately. Although the law requires that injuries be reported to the employer within 15 days, all accidents should be reported, regardless of if an injury occurred or not. Seek medical care. If it is an emergency, go to the nearest hospital emergency room and then contact your employer.
Will I receive a W2?
No, workers’ compensation benefits are not considered taxable income.
Do I have a co-pay for my medical care?
No, you will have no out of pocket costs for medical care.
I am missing time from work. When can I expect to receive a check?
Lost time benefits are generally paid every 14 days. The first 7 days missed from work is considered to be a waiting period and is not paid unless a full 28 days are missed from work. Your first check should be issued 14 days from the first day you began missing work, and will likely be for one week. Your adjuster can provide more specific information.
Do I have to accept a modified duty position from my employer?
If your employer is able to make a job offer that accommodates the restrictions the authorized treating health care provider has placed, you must accept the job, or face losing wage benefits. If the light duty position pays less than your regular pay, 66 2/3% of the difference will be paid to you, see Temporary Total/Temporary Partial Disability.
What should I do if I receive a bill for medical care?
Please send a copy of the bill to your claims adjuster. It is also wise to contact the provider and remind them that the care you are receiving is covered by Workers’ Compensation and all bills should be sent to the adjuster, at:
P.O. Box 27810
Albuquerque, NM 87125
What about prescription medication?
We use a prescription benefit manager company for billing of all prescriptions, called Alius. A prescription card will be sent to you. The first time you fill a prescription take the Alius information to your pharmacy.