Injured workers in New Mexico are eligible for a series of workers’ compensation benefits. These benefits vary depending on the severity of your injury and your ability to work, but you may receive medical treatment, disability benefits, and survivors’ benefits. Learn more about New Mexico’s benefit calculations below. (To receive these benefits, you must first file a New Mexico workers’ comp claim.)
Temporary disability benefits are paid while you are recovering and actively receiving treatment for your injury. Unless you are unable to work for more than 28 days, you will not receive disability benefits for your first seven days off work. In New Mexico, you can receive either temporary total benefits or temporary partial benefits. The state sets a maximum temporary disability benefit each year.
If you’re unable to perform any type of work while recovering from your injury, you will be eligible for temporary total disability (TTD) benefits. TTD benefits are two-thirds of your average weekly wage (AWW), up to the state’s maximum benefit ($796.77 in 2017). You will continue to receive these benefits until you return to work or until your doctor determines your injury will no longer improve with treatment (this is called maximum medical improvement or “MMI”).
You are eligible for temporary partial disability (TPD) benefits if you’re able to return to work during your recovery but earn less than normal. TPD benefits are two-thirds of the difference between your pre-injury and post-injury wages. For example, suppose you earned $700 per week before your injury, but you are now working a light-duty job that pays only $275. Your weekly TPD benefit would be $283.33 ($700 - $275 = $425; .667 x $425 = $283.33). TPD benefits are paid until your wages return to their normal rate or you reach MMI, and they are subject to the same maximum as TTD.
Once you reach MMI, your doctor will evaluate you for a permanent disability. Permanent total disability (PTD) benefits are paid to workers with debilitating injuries who are unable to do any work. However, only certain types of injuries qualify for PTD benefits in New Mexico. Under state law, you are permanently and totally disabled if you:
PTD benefits are two-thirds of your AWW, up to the state’s maximum benefit—in other words, the same as your TTD rate. PTD benefits are paid as long as you are disabled (potentially a lifetime).
If you have permanent limitations but can return to work, you may be eligible for permanent partial disability (PPD) benefits. New Mexico pays PPD benefits for both scheduled losses and whole body impairments.
A scheduled loss involves an amputation or loss of use of a body part listed in New Mexico’s schedule of losses. You will receive two-thirds of your average weekly wage, up to the state’s maximum weekly benefit, for the number of weeks stated in the schedule. The schedule lists several body parts; here are some examples:
If you have a partial loss of a listed body part, you will receive benefits for a proportionate number of weeks. For example, if you have lost 40 percent of the use of your leg, you will receive 80 weeks of benefits (40% of 200 weeks = 80 weeks.)
All other permanent partial disabilities—such as injuries to your back, neck, head, and lungs—are compensated as “whole body impairments.” Once you reach MMI, a doctor will evaluate you and determine how much total body function you have lost (stated as a percentage). This percentage is commonly called an impairment rating.
If you return to work and are earning your pre-injury wages, your whole body impairment benefit is based solely on your impairment rating. However, if you now earn less than your pre-injury wages, your impairment rating will be adjusted upwards based on your age, education, and ability to transition to other work.
If your impairment rating is less than 80 percent, you will receive up to 500 weeks of benefits. If your impairment rating is 80 percent or more, you will receive up to 700 weeks of benefits. You will receive two-thirds of your average weekly wage, up to the state’s maximum weekly benefit, per week.
Example: Suppose you are able to earn your pre-injury average weekly wage of $600, and you have a 10% impairment rating. You would receive two-thirds of your average wages per week, which is $400. You would then multiply your impairment rating of 10% by 500 weeks, for a total of 50 weeks. Your total award would be $20,000 ($400 x 50 weeks).
New Mexico has one of the more complicated PPD systems. If you have questions about how much you should receive in benefits, contact an experienced New Mexico workers’ comp lawyer.
If an injury or illness results in death, the worker’s family may receive death benefits. Surviving spouses, minor children, and other dependents are eligible for survivor benefits. This benefit amount varies, depending on the worker’s marital status and number of dependents, but it cannot be more than the state’s maximum benefit. Additionally, the insurance company must pay up to $7,500 for burial and funeral expenses.