New Mexico Administrative Code
Title 11 - LABOR AND WORKERS' COMPENSATION
Chapter 4 - WORKERS' COMPENSATION
Part 4 - CLAIMS RESOLUTION
Section 11.4.4.8 - OMBUDSMAN RULES
Universal Citation: 11 NM Admin Code 11.4.4.8
Current through Register Vol. 35, No. 18, September 24, 2024
A. An ombudsman shall provide information and facilitate communication regarding the act. An ombudsman is required to maintain a neutral position when providing information or facilitating communication. When responding to inquiries, an ombudsman shall:
(1) confer with workers, employers,
insurers, HCPs or other interested persons;
(2) provide information or facilitate
communication, when requested, about:
(a)
individual rights and responsibilities established by the act;
(b) medical proof required to establish or
deny the right to workers' compensation;
(c) HCP selection;
(d) mediation conferences, related forms, and
other administrative practices and procedures;
(e) determination of disability;
(f) the right to representation by a lawyer
or the right to proceed as a pro se party; and
(g) other disputes arising under the
act;
(3) help workers,
employers, insurers, HCPs or other interested parties complete administrative
forms for submission to the administration;
(4) actively inquire into matters presented
by workers, employers, insurers, HCPs or other interested persons. An ombudsman
shall contact the parties involved and attempt to resolve the problem
informally; and
(5) refer all
inquiries concerning uninsured employers to the WCA employer compliance
bureau.
B. When responding to inquiries, an ombudsman shall not:
(1) practice law or give legal
advice;
(2) act as an advocate for
any person;
(3) attend a mediation
conference as a representative of a party;
(4) provide assistance to any party after the
filing of a rejection of a recommended resolution;
(5) provide assistance to a party represented
by an attorney;
(6) offer an
opinion on whether to accept or reject a settlement offer or a recommended
resolution; or
(7) be called as a
witness in a mediation conference or adjudication proceeding before a WCA
judge.
Disclaimer: These regulations may not be the most recent version. New Mexico may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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