Frequently Asked Questions About Injury and Disability
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Can I receive workers’ compensation if my injury was my fault?
Workers’ compensation is a no-fault system, so you’re entitled to benefits regardless of the cause of your accident.
New Mexico Workers’ Compensation
Under the New Mexico Workers’ Compensation Act, if an employee is hurt due to a work-related accident, he is entitled to receive workers’ compensation benefits regardless of fault. This means that the employee doesn’t have to prove negligence on the part of his employer in order to receive benefits. Claims can also be processed faster, since there is no burden of proof that must be met, and no long disputes regarding who is to blame for the accident. Workers’ compensation benefits an employee may receive include:
● Lost salary or wages.
● Compensation for permanent disability.
● Rehabilitation expenses.
● Retraining costs.
Workers’ Compensation Benefit Exceptions
Even when a worker is clearly at fault for the accident that caused his injuries, he is still entitled to receive workers’ compensation benefits, with a few exceptions. If the employer can successfully argue that any of these exceptions apply, the employee will be completely barred from receiving workers’ compensation benefits. These exceptions include:
● Injuries resulting from intoxication.
● Injuries sustained while performing an activity specifically forbidden by the employer.
● Injuries caused by horseplay.
● Intentional, self-inflicted injuries.
● Injuries sustained during a fight.
The Exclusive Remedy Provision
In New Mexico, injured employees are only entitled to receive workers’ compensation benefits from their employer, and nothing else. This is known as the exclusive remedy provision, and it applies even when the employer or a coworker caused a worker’s injuries due to gross negligence. Employees are barred from suing their employer for additional compensation, even when the employer is clearly at fault.
Receiving Workers’ Compensation Benefits
Workers’ compensation laws can be very complex, but an experienced attorney can help workplace injury victims receive the compensation they deserve. If you’ve been hurt on the job, you need professional legal representation. To learn more, contact the Injury & Disability Law Center by using the form on this page.
How much does it cost to hire a car accident attorney?
Personal injury attorneys are typically compensated under a contingency fee arrangement. Some injury victims are hesitant to pursue litigation, since they can’t cover the cost of legal services upfront. Contingency fees allow injury victims to pursue justice, and receive the compensation they need and deserve.
Contingency Fee Arrangements
Contingency fees are a percentage of the settlement due to personal injury attorneys when they are successful in recovering compensation for accident victims. In other words, the lawyer is only paid when he wins the case. This provides a number of benefits for clients, including:
● Lower risks. When a client enters into an hourly rate agreement with his attorney, he may face substantial legal bills regardless of the outcome of his case. With contingency fees, clients only pay if and when their attorney succeeds in securing their compensation.
● A better attorney-client relationship. When attorneys are paid on a contingency basis, their compensation is tied directly to the outcome of the case. This can make for a great partnership between the client and his attorney, since the lawyer has a strong financial incentive to reach a favorable settlement in a timely manner.
● The attorney has confidence in his client’s case. Since their own compensation is tied directly to the outcome, contingency fee attorneys are unlikely to accept cases they don’t believe are winnable. If an attorney is willing to risk losing out on legal fees based upon the outcome of a case, that case probably has a lot of merit.
● Representation against companies with deep pockets. Due to contingency fees, injury victims don’t have to be wealthy in order to secure quality legal representation. Huge corporations and insurance companies can easily afford attorneys to represent them, but few individuals can pay an experienced attorney hundreds of dollars per hour to pursue litigation.
You Need Representation
If you’ve been injured in a vehicle accident, you need experienced representation by a contingency fee attorney. Our consultations are confidential, free, and there is no obligation. To learn more, contact the Injury & Disability Law Center by using the form on this page.
Do I need to visit the doctor after a car accident, even if I’m not hurt?
You should see a doctor as soon as possible after your collision, even if you feel fine. You could have internal injuries that have not yet surfaced, jeopardizing your health. Promptly seeking medical help will also strengthen your vehicle accident claim. Here is a short overview of some common car accident injuries:
- Internal Injuries. Internal injuries caused by a vehicle collision can worsen over time when left untreated.
- Whiplash. Whiplash occurs when the head is suddenly thrust forward and then backward in a vehicle accident. The chronic pain caused by whiplash may take days, or even weeks, to develop.
- Concussion. Violent jolts to the body stemming from the impact of a vehicle collision may cause the brain to strike the inside of the skull with tremendous force. This can cause a concussion, leading to symptoms that include headaches, blurred vision, dizziness, lack of concentration, and memory lapses. While these symptoms can be very serious, they often do not surface immediately.
- Soft tissue injuries. Typical soft tissue injuries include strains, sprains, and tears to the tendons, muscles, and ligaments of the back, neck, and shoulders. Injury victims may not experience any pain or swelling until a week or more after the collision.
- Traumatic brain injury. Traumatic brain injuries are caused by a jolt to the head, and symptoms can take several weeks or more to emerge. These injuries may result in hearing problems, vision difficulties, and memory lapses.
Receiving a Medical Evaluation
If you’ve been involved in a vehicle accident, you should obtain a medical evaluation even if you don’t believe that you’re injured. If injury symptoms surface in the future, you’ll need documentation showing that you sought prompt medical treatment. Otherwise, the insurance adjuster will likely argue that your injuries aren’t serious. Your health insurance should cover any necessary medical treatments, and your insurance company can be repaid out of any future vehicle accident settlements you may receive. To protect your right to compensation, consult an attorney as soon as possible. To learn more, contact the Injury & Disability Law Center by using the form on this page.
What is the Compassionate Allowances program?
The process of qualifying for Social Security disability benefits can be extremely long and difficult. Compassionate Allowances are used to identify medical conditions that qualify for Social Security disability benefits, expediting the application process in order to provide benefits as quickly as possible.
How Compassionate Allowances Can Help
Social Security provides disability benefits for those individuals who have medical conditions that prevent them from working. These conditions primarily consist of some types of cancer, brain disorders, and rare childhood illnesses. The Compassionate Allowances program is designed to identify these types of claims, and help families in need by providing:
- Quick approval. Generally speaking, applying for Social Security disability payments is a lengthy process. The application itself is long and complicated, requiring numerous medical documents and testimonies regarding the victim’s condition. The decision process may then take as long as 6 to 12 months. Compassionate Allowances expedite this process dramatically, allowing families to receive the compensation they need while the remainder of the application is still being processed.
- No extra work. The Social Security disability application requires extensive documentation of the applicant’s medical condition. However, applying for a Compassionate Allowance doesn’t require any extra effort. When the Social Security office reviews the disability claim, they will refer to a list of Compassionate Allowances to determine if the applicant has a qualifying disorder. If so, the applicant will start receiving payments as soon as possible. These payments typically begin anywhere from just a few weeks to a couple of months after the application is filed.
- Retroactive payments. Qualifying applicants are entitled to receive retroactive pay for the period between the genesis of their disability and the approval of their application.
Qualifying for Compassionate Allowances
Speaking with an experienced disability attorney is the best way to determine eligibility for a Compassionate Allowance. He can help you complete applications, keep paperwork organized, and guide you through the appeals process, if needed. To learn more, contact the Injury & Disability Law Center by clicking the Live Chat button on this page.
Which types of lost-wage benefits are available for a work injury in New Mexico?
Lost wage payments intended to compensate injured New Mexico workers for wage loss are known as indemnity benefits.
Types of Indemnity Benefits
There are four types of indemnity benefits available through workers’ compensation in New Mexico:
- Temporary Total Disability (TTD). As you might guess from the name, these benefits are provided to workers who are temporarily unable to work due to an injury. TTD payments will be made until the employee returns to work, or until his doctor determines that his condition will no longer improve with further medical treatment. This is known as maximum medical improvement.
- Temporary Partial Disability (TPD). These benefits are available to injured workers who continue to work, but at a reduced wage or with reduced hours. TPD benefits will continue to be paid until the worker’s wages return to the normal rate or until maximum medical improvement has been reached.
- Permanent Total Disability (PTD). These are lifetime benefits that are paid to employees who have suffered debilitating injuries, and who are therefore unable to do any work. Workers who have completely lost the use of both of their hands, arms, legs, feet, or eyes (or any combination of two of these body parts) are entitled to receive PTD compensation. Employees who have suffered a severe brain injury may also qualify for permanent total disability benefits.
- Permanent Partial Disability (PPD). Workers who have permanent limitations, but who are still able to return to work, may be eligible for PPD benefits. These benefits are paid to employees for both scheduled losses and whole body impairments once maximum medical improvement has been reached. A scheduled loss involves an amputation or loss of use of a body part, for which an employee will receive two-thirds of his average weekly wage. All other permanent partial disabilities, such as back, head, neck, and lung injuries, are compensated as whole body impairments.
A Workers’ Compensation Attorney Can Help
As you can see, the rules applicable to indemnity benefits in New Mexico are complicated. You need the guidance of an experienced workers’ compensation attorney to ensure that you receive all of the benefits you’re entitled to. To learn more, contact the Injury & Disability Law Center by using the form on this page.
What is the most dangerous type of distracted driving?
There really is no such thing as a most dangerous form of distracted driving, since anything that takes a driver’s attention away from the road is dangerous. According to the National Highway Traffic Safety Administration, 3,450 people were killed in distracted driving accidents during 2016 alone.
Types of Driving Distractions
Unfortunately, our modern, always-connected lives provide plenty of opportunities for driver distraction. There are three primary types of driving distractions:
- Visual. Any person, object, or event that causes a driver to take his eyes off the road constitutes a visual distraction. It only takes a matter of seconds for a driver to miss spotting an obstacle in the road, drift out of his lane, or fail to notice that traffic is slowing ahead of him. Watching kids in the backseat, studying a map, or looking at the navigation system display are common visual distractions.
- Manual. If a driver takes one or both hands off the wheel, his vehicle can quickly drift into another lane. He also loses the ability to respond quickly to road hazards or other emergencies. A manual distraction is anything that causes a driver to remove his hands from the wheel, such as using an electronic gadget or reaching for items in the vehicle. Typical examples of manual distractions include texting, smoking, eating, and personal grooming.
- Cognitive. Even when a driver’s eyes are on the road and his hands are on the wheel—his mind may be elsewhere. He may be daydreaming, thinking about his plans for the evening, or reliving an argument he got into at work. Anything that causes a vehicle operator to think intently about something other than driving is a cognitive distraction, which can affect both judgment and reaction time. Talking with a passenger, driving under the influence of alcohol or drugs, and driving while fatigued are common cognitive distractions.
Receiving Compensation for Your Injuries
If you’ve been injured in a collision with a distracted driver, an experienced vehicle accident attorney can investigate to establish proof of the driver’s negligence and help you receive the compensation you deserve. To learn more, contact the Injury & Disability Law Center by clicking the Live Chat button on this page.
I used my personal health insurance for treatment following an accident caused by another driver. I settled with that driver's insurance, and now my health insurer is demanding to be reimbursed. Do I have to pay them?
When your health insurer pays for your medical expenses for treatment caused by someone else’s negligence, and you ultimately recover monetary damages from that negligent person, your health insurer has a right to be reimbursed (these are called rights of subrogation) from you out of the accident money you received.
Here is the reasoning - Your settlement money from the negligent driver’s insurance included payment to you for medical bills resulting from your treatment. But your health insurer also paid you (by paying the health care provider) for those same medical bills.
To allow you to be paid for the medical bills, while also having your own health insurance pay for those same bills, is the legal equivalent of “double dipping”. Instead, your health insurer has a legal right of subrogation (i.e. right of reimbursement) that requires you to reimburse them in the amount they paid on your behalf for treatment resulting from the accident.
Keep in mind, if you do not ultimately make a recovery from the responsible driver, either because they didn’t carry insurance, or for any other reason, you would not be required to reimburse your health insurer anything. Your health insurance company’s subrogation rights are triggered only upon your receipt of monetary damages from the negligent party.
This answer provides a simple explanation, but there are often more complex factors involving subrogation rights, including the amount that must be reimbursed. For this reason, we recommend seeking legal counsel to help ensure all of your legal rights and remedies are considered when dealing with issues of reimbursement.
Call us for a free consultation to see how we can help you.
Should I Use My Personal Health Insurance After an Accident in New Mexico?
After an accident, you should seek immediate medical attention. The most important thing is to get the treatment you need and do not let issues of insurance and payment prevent you from getting the proper treatment. Your safety and health will always be top priority!
If given the option, you should insist on using your own personal health insurance for all of your medical treatment, even if the accident was caused by another person.
Understandably, many people are hesitant to use their own health insurance to pay since their injuries were caused by someone else—shouldn’t the responsible party’s insurance have to pay? The answer is yes, they should!
Important Reasons to Use Your Personal Health Insurance After an Accident
One of the most common questions that I get asked in my personal injury practice is whether I should use my personal health insurance to pay for medical treatment after I've been in an accident that was caused by someone else.
The answer is, yes, every time. and here's why.
Anytime you've been in an accident, one of the main goals is going to ensure you don't have any lingering bills or ongoing debts after the accident. Using your personal health insurance is the best way to do that.
#1 – There could be a dispute as to who was at fault.
After an accident. you may think the other person was at fault. But you never quite know if there is going to be a dispute as to who caused the accident. It is not uncommon for there to be an argument as to who actually caused the accident. And since most of your medical treatment is going to take place soon after the accident. You should never assume that there's going to be that insurance to cover you because that may not be determined until a much later time. If you use your personal health insurance you eliminate the risk that that bill could go unpaid.
#2 - The other driver could be uninsured or underinsured.
You don't know if the accident was caused by an uninsured or underinsured driver. This is true even if the police report shows the other driver has insurance. Often times those listed policies have expired, so you can’t rely on the insurance provided to the police at the scene. Even if the other driver caused the accident, they may not actually carry the minimum insurance required because in New Mexico we have a very high rate of uninsured drivers – in fact, the third-highest in the United States. So you never quite know if there is insurance to cover your injuries, even if the other person was clearly at fault. You also don't know if they're going to have enough insurance to cover all of your bills. So again, use your personal health insurance to completely eliminate that as a possibility.
#3 - Health insurers pay discounted rates.
Your personal health insurance company – for instance, Blue Cross Blue Shield, Medicaid, Medicare, and virtually all health insurers—have contracts with medical providers that allow them to pay a reduced rate, called a “contract rate” for your medical treatment. This means it is in your best interest for your health insurer to pay those bills at a reduced contract rate, as opposed to the other drivers auto insurance company paying your medical bills, because the auto insurer will pay the full amount of those charged bills. This will help put more in your pocket when your claim is finished.
#4 – You can negotiate with your health insurer.
If you do ultimately receive a settlement and your health insurance has paid out on your behalf, you will have a legal obligation to pay them back. That's part of your contract agreement with them. But there are also some benefits under the law that allow you to negotiate down what you potentially have to reimburse to your health insurance company. Therefore, it will be in your best interest to negotiate the reimbursement owed to your health insurance company versus getting stuck with an unpaid medical bill.
IMPORTANT BONUS TIP - Don’t be surprised if the medical provider does not want to bill your personal health insurer and they instead want to bill the auto insurance for the person that hit you. This has to do with the economics of how much they make off of that medical treatment. My advice is to be persistent and insist the provider bill your health insurer—it may be the single most important step you can take to maximize your take-home pay from a settlement.
A Note of Caution: Do Not Delay Medical Treatment
Since medical treatment is typically required immediately after an accident, you do not want to delay medical treatment while the legal issues of the accident are sorted out. This is where New Mexico law provides the appropriate remedy.
Medical Payments Paid By Your Insurance Must Be Reimbursed
Keep in mind: New Mexico law provides reimbursement rights to your health insurer for benefits paid out on your behalf that were caused by another person’s negligence. That means if your health insurer pays for your medical expenses for treatment caused by someone else’s negligence, and you ultimately recover monetary damages from that negligent person, your health insurer has a right to be reimbursed (these are called rights of subrogation) from you out of the accident money you received.Quick Example:
You are driving and a negligent driver runs a stop sign and hits you. An ambulance arrives and transports you to the hospital. You remember reading something from The Injury and Disability Law Center that said to use your personal health insurance if you are in an accident. The hospital bills your personal health insurance for payment for your treatment. It is later determined that the other driver was at fault for causing the accident, and carried auto insurance. The negligent driver’s insurance company then pays you for your bodily injury damages from the accident, which include your medical bills. Your receipt of payment from the responsible party’s insurance for your damages triggers the legal right of your health insurance company to be reimbursed what they paid out for your treatment caused by the negligent driver.
Financial Burden is on the Wrongdoer
As you can see in the example, the law ultimately is designed to place the financial burden on the wrongdoer. In this example, the negligent driver. Even though your health insurance paid out initially, the wrongdoer paid for those damages through a settlement with you, and you are then able (and required) to pay your health insurer back. This process ensures there is no improper shifting of the financial burden unfairly to your health insurer, while at the same time allowing you to receive the timely medical treatment you need.
Contact Our Roswell Injury Law Office for Help
Our team would be happy to talk with you if you have additional questions about using your personal health insurance, ensuring your medical bills get paid, or any other questions you may have following a car wreck or other accident in New Mexico. Give us a call at (575) 300-4000 or fill out our contact form so we can discuss the details of your specific situation in a free consultation.
I don't like my workers' compensation treating doctor, can I change?
One of the most common questions we receive about worker’s compensation has to deal with changing doctors. To help explain the law on this issue I will use three examples:
Worker is injured on the job, and he/she goes to the Emergency Department for treatment, and then requires follow up medical care. Who gets to pick the doctor the worker must see for the follow-up treatment?
Answer – Employer. But do not lose hope just yet… Worker is not without rights and options.
What Does New Mexico Law Say?
New Mexico law allows the employer to initially (I repeat, initially) select which doctor you must see. The employer has two options. First, they can select the doctor and the injured worker is required to present for follow up treatment to that doctor. Alternatively, the employer can allow the injured worker to select which doctor to follow up with.
*Important Rule – An injured worker should first check with their employer about who is to select the doctor before continuing treatment. If the employer does not give direction about which doctor to see, the injured worker can select the doctor of their choice.
Let’s assume Employer instructed Worker to see a specific doctor who we’ll call “Employer Doctor”. Is Worker stuck with Employer Doctor permanently? Answer - No.
*Important Rule - If the employer selects the initial doctor, then worker has the automatic right to change to a doctor of worker’s choosing after 60 days of treatment.
After 60 days of treatment, Worker has the automatic right (no filing a motion or court hearing required) to change doctors. Worker must notify Employer by simply completing and sending to Employer a form called the “Notice of Change of Healthcare Provider” which can be found on the New Mexico Workers Compensation Administration's website.
Let’s now change the facts again and assume Employer did not instruct Worker to see Employer Doctor, and instead allowed Worker to choose the doctor either by expressly telling Worker to choose or by failing to give Worker direction on who to see. Worker then chooses to see “Worker Doctor”. Does Worker get to keep seeing Worker Doctor? Answer - Maybe.
*Important Rule – The same 60-day rule applies equally to both parties. If Worker makes the initial doctor selection, Employer has an automatic right to change doctors simply by completing and sending a Notice of Change of Healthcare Provider to Worker.
Let’s now change the facts again. This time, Worker chose Worker Doctor and treated for 60 days before Employer exercised the right to change Worker Doctor to Employer Doctor. Employer Doctor has been treating Worker for 60 days. Can Worker change back to his/her preferred doctor, Worker Doctor? Answer - Maybe.
*Important Lesson - Any further changes in doctor selection must happen through one of two ways: 1) Agreement of both parties; or 2) By filing a motion with the court and getting a judge to approve the change.
Understand Your Rights
It is impossible to know what a workers’ compensation judge may approve on an issue like that, but it is unlikely a judge will allow Worker or Employer to continue the carousel of changing doctors without a compelling reason to do so. Examples of compelling reasons could be mistreatment, lack of physician qualification, length of treatment, or any other reason that the Worker or Employer could demonstrate to justify another change in treating physician.
In summary, New Mexico law grants Workers important rights and remedies when it comes to selecting the Worker’s health care provider.
Speak To a Roswell New Mexico Workers' Comp Lawyer
Our workers' compensation attorneys are here to answer your questions and explain how workers’ compensation works in New Mexico. Call our office or fill out our contact form to schedule a free consultation.
Related Workers Compensation Information:
How do I know if my employer carries workers’ compensation insurance in New Mexico?
In New Mexico, almost all employers are required to carry workers’ compensation insurance in the event of an injury on the job. An employer who has personnel in the construction industry must provide workers' comp benefits. Other employers are also required to carry this insurance as long as it has three or more staff members. The owner and family members working in the business are considered employees under this requirement, making the law apply to more workers.
Although New Mexico requires employers to purchase workers’ compensation insurance, not all employees will do so.
Ways to Determine If Your Employer Provides Workers’ Comp
There are several things to check if your employer offers workers’ compensation benefits. These include the following:
- Poster. Under New Mexico law, employers are required to post a workers’ compensation poster in a conspicuous space where all staff members can see it. An employer is supposed to fill in the information regarding the workers’ compensation insurance company’s name and contact information on the poster. A Notice of Accident form must be attached to the poster for it to comply with state law.
- Online search. You can search online at the State of New Mexico Worker Compensation Administration to see if your employer is registered as having workers’ compensation insurance.
- Employer. If you cannot determine whether or not an employer carries workers’ compensation insurance, simply ask. An employer hopefully won't have any problem telling you this if complying with this New Mexico law.
- Experienced workers’ compensation attorney. You should consult with an experienced workers’ compensation attorney who can assist you in determining if your employer provides injury benefits. He can also explain your rights under workers’ compensation laws, file your claim, and negotiate your settlement so that you receive the benefits you deserve.
Do you have questions regarding your rights to workers’ compensation? Even if your employer complies with New Mexico law regarding this insurance, it doesn't mean you won't have to fight to receive what you're entitled to if injured on the job. We're here to answer your questions and explain how workers’ compensation works in New Mexico. Call our office or fill out our contact form to schedule a free consultation with one of our workers compensation attorneys.