New Mexico § 52-3-15 - Disablement compensation restrictions; medical and related services; selection of health care provider; artificial members

§ 52-3-15. Disablement compensation restrictions; medical and related services; selection of health care provider; artificial members

A. No compensation shall be allowed for the first seven days after the employee has

suffered disablement unless such disablement continues for a period of more than four

weeks after the disablement occurs, or in any case, unless the employer is notified

thereof within the period specified in Section 52-3-16 NMSA 1978 . B. After disablement and continuing so long as medical and surgical attention is reasonably

necessary, the employer shall, subject to the provisions of this section, provide

the worker in a timely manner reasonable and necessary health care services from a

health care provider. C. The employer shall initially either select the health care provider for the injured

worker or permit the injured worker to make the selection. Subject to the provisions of this section, that selection shall be in effect during

the first sixty days from the date the worker receives treatment from the initially

selected health care provider. D. After the expiration of the initial sixty-day period set forth in Subsection C

of this section, the party who did not make the initial selection may select a health

care provider of his choice. Unless the worker and employer otherwise agree, the party seeking such a change

shall file a notice of the name and address of his choice of health care provider

with the other party at least ten days before treatment from that health care provider

begins. The director shall adopt rules and regulations governing forms, which employers

shall post in conspicuous places, to enable this notice to be promptly and efficiently

provided. This notice may be filed on or after the fiftieth day of the sixty-day period set

forth in Subsection C of this section. E. If a party objects to the choice of health care provider made pursuant to Subsection

D of this section, then he shall file an objection to that choice pursuant to Subsection

F of this section with a workers' compensation judge within three days from receiving

the notice. He shall also provide notice of that objection to the other party. If the employer does not file his objection within the three-day period, then he

shall be liable for the cost of treatment provided by the worker's health care provider

until the employer does file his objection and the workers' compensation judge has

rendered his decision as set forth in Subsection G of this section. If the worker does not file his objection within the three-day period, then the

employer shall only be liable for the cost of treatment from the health care provider

selected by the employer, subject to the provisions of Subsections F, G and H of this

section. Nothing in this section shall remove the employer's obligation to provide reasonable

and necessary health care services to the worker so long as the worker complies with

the provisions of this section. F. If the worker or employer disagrees with the choice of the health care provider

of the other party at any time, including the initial sixty-day period, and they cannot

otherwise agree, then he shall submit a request for a change of health care provider

to a workers' compensation judge. The director shall adopt rules and regulations governing forms, which employers

shall post in conspicuous places, to submit to a workers' compensation judge a request

for a change of a health care provider. G. The request shall state the reasons for the request and may state the applicant's

choice for a different health care provider. The applicant shall bear the burden of proving to the workers' compensation judge

that the care being received is not reasonable. The workers' compensation judge shall render his decision within seven days from

the date the request was submitted. If the workers' compensation judge grants the request, he shall designate either

the applicant's choice of health care provider or a different health care provider. H. If the worker continues to receive treatment or services from a health care provider

rejected by the employer and not in compliance with the workers' compensation judge's

ruling, then the employer is not required to pay for any of the additional treatment

or services provided to that worker by that health care provider. I. In all cases where the disablement is such as to permit the use of artificial members,

including teeth and eyes, the employer shall pay for such artificial members.