The Council is relying on the Workers' Compensation Administration to address many of these problems

Mdannemann

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• Publié par: Phewyig
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• Langue: English

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Advisory Council on Workers' Compensation and Occupational Disease Disablement

Annual Report for 2008

PAGE 1

Annual Report of the

Advisory Council on Workers' Compensation

and Occupational Disease Disablement - 2008

The Advisory Council on Workers' Compensation and Occupational Disease

Disablement is a statutory body created by the Workers’ Compensation Law of New

Mexico, whose members are appointed by the Governor to represent employers and

workers.

Our duty is to report annually to the Governor and Legislature concerning the

state of the workers' compensation system and to make recommendations regarding rules

and legislation.

Mission

The mission of the Advisory Council on Workers' Compensation and

Occupational Disease Disablement is:

•

to monitor the performance of the workers' compensation and occupational

disease disablement system; and

•

to make recommendations to the Governor, Legislature, regulatory agencies

and participating industries, related to the adoption of rules and legislation

and the method and form of statistical data collections;

in order to assure the quick and efficient delivery of indemnity and medical

benefits to injured and disabled workers at a reasonable cost to employers.

There were no changes or amendments made to the Workers' Compensation Act

during the 2008 session.

Recommendations for the 2009 Legislative Session are:

The Advisory Council

supports

:

•

Presumptive Causation for Firefighters

•

Lump Sum and Disputed Claims Settlement

Summary of positions on specific issues:

The Advisory Council will support:

•

Amending the Workers' Compensation Act to create a presumption that

certain illnesses contracted by municipal fire members as defined in the

Public Employees Retirement Act in 10-11-2 M (4)NMSA 1978, are caused as

a result of their employment.

These illnesses are specified forms of cancer linked to minimum years of service

and illnesses diagnosed through exposure as a result of their duties.

This does not

include pre-existing illnesses which are excluded from coverage.

While the

presumption is rebuttable in all instances by the employer, the burden of proof of

Advisory Council on Workers' Compensation and Occupational Disease Disablement

Annual Report for 2008

PAGE 2

causation to obtain workers’ compensation benefits would be shifted from the

firefighter to the employer.

•

Amending the Workers' Compensation Act to allow a

worker and the

employer/insurer to elect to resolve a claim for injury as long as all parties

are in full agreement of the appropriateness of the resolution

with a

lump sum payment.

This will allow for claims that are disputed to be settled by agreement of all

parties, thereby allowing the insurance company to close out the claim at a

predictable cost.

This bill expands the provisions under which a claim can be

paid out in a lump sum under the Act.

It will allow the parties to resolve a claim

in which a dispute exists to be settled by mutual agreement, thereby avoiding time

and cost of litigation and allowing the insurance carriers to close out a claim at a

predictable cost and provide finality to workers while still being paid out under

the jurisdiction of the Workers’ Compensation Administration.

It will allow

workers to receive the entire cost of the claim in one lump sum providing finality,

maximizing their benefit and spending power.

Premiums.

In filing requests approved by the Department of Insurance, overall rate

reductions of 4.9 percent were approved for the voluntary market for 2008 that went into

effect on January 1, 2008. Overall rate reductions of 6.7 percent have been approved for

the voluntary market for 2009 that will go into effect on January 1, 2009.

There was a

premium reduction of 11.1 percent for the assigned risk pool in 2008 that was effective

on January 1, 2008.

A 1.3 percent overall premium reduction has been approved for

2009 for the Assigned Risk Pool that will be effective on

January 1, 2009.

Not all businesses are eligible for these premium reductions.

Businesses with a

poor safety record and a high number or severity of work-related injuries will continue to

pay premiums based on their individual experience.

Status Report on the Workers' Compensation Administration

The New Mexico Workers’ Compensation Administration (WCA) has been fully

engaged to achieve its primary goal: a better workplace for New Mexicans through

responsive and effective services. The WCA’s key customers are New Mexico’s workers

and employers.

To accomplish its mandate to provide excellent services to New Mexicans under

the Workers' Compensation Act and to maintain balance in the system, the WCA

maintains its culture through the WCA’s:

Vision:

One team, one goal: A better New Mexico for Workers and Employers.

Advisory Council on Workers' Compensation and Occupational Disease Disablement

Annual Report for 2008

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Mission

:

To assure the quick and efficient delivery of indemnity and medical benefits to injured

and disabled workers at a reasonable cost to employers.

Core Values:

Used in all internal and external interactions:

RESPECT:

R

espect,

E

thics,

S

ervice,

P

rofessionalism,

E

xcellence,

C

ourtesy,

T

eamwork.

Pillars of the WCA:

The WCA has identified four “pillars” as the foundation to support the WCA’s

ultimate responsibilities:

1)

Promote safety in the workplace.

2)

Ensure compliance with the Workers’ Compensation Act.

3)

Resolve Workers’ Compensation disputes accurately and timely.

4)

Ensure balance is maintained in the Workers’ Compensation System.

Legislative Memorials:

The 2007 Legislative Session assigned the WCA two memorials for action:

•

Senate Memorial 73

stating the Director of the Workers' Compensation

Administration to appoint and convene a task force to review the current law and

valuation of “loss of use” of various parts of the body; and,

•

House Memorial 52

stating the Workers' Compensation Administration will

create a task force to study the fiscal and policy implications of requiring

mandatory workers’ compensation coverage for farm and ranch laborers.

The

Loss of Use Task Force

has met numerous times and continues to compile

data and is attempting to construct parameters for the valuation of various scheduled

injuries. The task force has determined that as this is a highly complicated issue and the

need to be studied in a deliberate manner remains. The Loss of Use Task Force will not

be able to make recommendations to the legislature for the 2009 session.

The

Farm and Ranch Task Force

has met numerous times and continues the

process of defining the issues and scope of mandatory insurance coverage.

The

complexity of this issue is such the members determined they will need more time for

study.

A legislative proposal drafted by the New Mexico Center for Law and Poverty

was presented to the task force to remove the farm and ranch labor exemption from

mandatory workers’ compensation insurance coverage.

The task force vote was five

votes to remove the exemption and four votes to not accept the legislation and one

abstention (insurance representative).

The task force had not established or agreed on a

majority rule in the conduct of its voting procedures.

This vote demonstrates the two

major stakeholders have not reached any consensus position to support this legislative

Advisory Council on Workers' Compensation and Occupational Disease Disablement

Annual Report for 2008

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proposal or attained any measure of compromise. The vote was a solid split between the

farm and ranch representatives (4 votes) and the labor advocates (5 votes).

The Farm & Ranch Task Force retained the resolution they had submitted to the Advisory

Council in August.

“The Farm and Ranch Task Force agree that as a matter of principle

employers should provide insurance coverage to workers injured on the job.

The task force was not able to reach an agreement on how to accomplish this

goal.

As a result of this the members of the task force have agreed to make no

further recommendation for legislative change.”

The New Mexico Department of Agriculture sent a letter to the Advisory Council

that recommends continuing the farm and ranch exemption at this time but for the task

force to continue to look for ways to provide coverage.

It is unfortunate the major stakeholders have not been able to reach a

consensus position to resolve this issue.