N.M. Admin. Code § 11.4.4.8

Current through Register Vol. 35, No. 21, November 5, 2024

Section 11.4.4.8 - OMBUDSMAN RULES

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.

N.M. Admin. Code § 11.4.4.8

2/24/92, 6/1/96; 11.4.4.8 NMAC - Rn, 11 NMAC 4.4.8, 6/13/03, Adopted by New Mexico Register, Volume XXV, Issue 18, September 30, 2014, eff. 10/1/2014, Adopted by New Mexico Register, Volume XXVIII, Issue 22, November 28, 2017, eff. 1/1/2018, Adopted by New Mexico Register, Volume XXXIII, Issue 24, December 27, 2022, eff. 1/1/2023