A. After an injury to a worker and subject to the requirements of the Workers’ Compensation Act [52-1-1 NMSA 1978], and continuing as long as medical or related treatment 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.
B. 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.
C. After the expiration of the initial sixty-day period set forth in Subsection B 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 B of this section.
D. If a party objects to the choice of health care provider made pursuant to Subsection C of this section, then he shall file an objection to that choice pursuant to Subsection E 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 F 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 E, F and G 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.
E. 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 change of a health care provider.
F. 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.
G. 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.
H. In all cases where the injury is such as to permit the use of artificial members, including teeth and eyes, the employer shall pay for the artificial members.
HISTORY:
1953 59-10-19.1, enacted by Laws 1959, ch. 67, § 27; 1963, ch. 269, § 3; 1965, ch. 252, § 4; 1971, ch. 261, § 5; 1973, ch. 240, § 9; 1977, ch. 275, § 3; 1987, ch. 235, § 21; 1990 (2nd S.S.), ch. 2, § 20.
Notes to Decisions
Denial of reimbursement claims.
Selection of health care provider.
Generally.
Employer waived its right to redesignate worker’s primary health care provider by entering into partial lump-sum agreement with worker under 52-5-14C NMSA 1978, which stated that medical treatment was to remain open for life with worker’s treating physician or his referral; the agreement was enforceable because it was not ambiguous and precluded objection to a change of providers by either party under 52-1-49C NMSA 1978, 52-1-49D NMSA 1978, and 52-1-49E NMSA 1978. Ramirez v. Johnny's Roofing Inc., 1999-NMCA-038, 127 N.M. 83, 977 P.2d 348, 1999 N.M. App. LEXIS 14 (N.M. Ct. App. 1999).
52-1-49 NMSA 1978 requires an employer to furnish all reasonable and necessary medical expenses incurred by the workman for a job-related injury. Smith v. Trailways Bus Sys., 1981-NMCA-041, 96 N.M. 79, 628 P.2d 324, 1981 N.M. App. LEXIS 717 (N.M. Ct. App. 1981).
In a workmen’s compensation proceeding, the trial court did not err in ordering an employer and its carrier to pay a bill for medical services rendered to an employee where the bill was prima facie proof of reasonableness and where the evidence of the employee’s indebtedness to the doctor was received without objection. Glover v. Sherman Power Tongs, 1980-NMCA-076, 94 N.M. 587, 613 P.2d 729, 1980 N.M. App. LEXIS 883 (N.M. Ct. App. 1980).
Pursuant to former 59-10-19.1, 1953 Comp. (now 52-1-49 NMSA 1978), the employee’s failure to show that certain medical treatment was reasonably necessary precluded awarding a recovery for those expenses in a workmen’s compensation action that he filed against an employer and an insurer. Williams v. Gallup, 77 N.M. 286, 421 P.2d 804, 1966 N.M. LEXIS 2766, 1966 N.M. LEXIS 2808 (N.M. 1966).
Appeal.
Workers’ Compensation Administration Order denying an employer and its insurer’s objection to a worker’s notice of change in health care provider was not a final appealable order where the employee had claims for benefits and medical expenses pending before the agency. Kellewood v. BHP Minerals Int'l, 1993-NMCA-148, 116 N.M. 678, 866 P.2d 406, 1993 N.M. App. LEXIS 143 (N.M. Ct. App. 1993).
Jurisdiction over an appeal from a workers’ compensation judge’s order designating the health care provider selected by a worker as the worker’s health care provider; because the worker had not yet filed a claim for benefits and the only proceedings before the workers’ compensation administration were proceedings concerning the change of health care providers, the judge’s order fully disposed of all issues between the parties that were brought before the judge. Albuquerque v. Sanchez, 1992-NMCA-038, 113 N.M. 721, 832 P.2d 412, 1992 N.M. App. LEXIS 30 (N.M. Ct. App. 1992).
Applicability.
Under 52-1-49 NMSA 1978, the employer generally has the right in the first instance to select the physician or surgeon to care for the injured employee. The injured employee may not recover for medical services independently incurred by him unless the employer has failed to provide such services. Cardenas v. United Nuclear Homestake Partners, 1981-NMCA-117, 97 N.M. 46, 636 P.2d 317, 1981 N.M. App. LEXIS 779 (N.M. Ct. App. 1981).
A workmen’s compensation claimant was not entitled to recover from his employer and its insurer the amount paid by Medicare for medical services rendered following a workplace accident; under former 59-10-19.1A, 1953 Comp., the employer was required to furnish all reasonable medical services to an injured workman unless the workman refused to allow them to be furnished, and the claimant waived his right to require that the cost of the services be included in the award where he did not permit defendants to furnish such services. Hedgecock v. Vandiver, 1970-NMCA-117, 82 N.M. 140, 477 P.2d 316, 1970 N.M. App. LEXIS 650 (N.M. Ct. App. 1970).
There is nothing to show that the legislature intended former 59-10-19.1, 1953 Comp. (now 52-1-49 NMSA 1978) to operate other than prospectively. Noffsker v. K. Barnett & Sons, 1963-NMSC-156, 72 N.M. 471, 384 P.2d 1022, 1963 N.M. LEXIS 2017 (N.M. 1963).
Attorney’s fees.
Order awarding an employee attorney fees for legal services rendered in a proceeding to change her health care provider pursuant to 52-1-49 NMSA 1978 was not final or appealable because the workers’ compensation claim filed by the employee was pending at the time the attorney fees order was entered and pursuant to 52-1-54M NMSA 1978, fees could not be paid until the claim was settled or adjudged. Alcala v. St. Francis Gardens, 1993-NMCA-134, 116 N.M. 510, 864 P.2d 326, 1993 N.M. App. LEXIS 123 (N.M. Ct. App. 1993).
Attorney fee for taking a doctor’s deposition was improper under former 59-10-13.9, 1953 Comp. because the terms “cost” and “expense” did not include such attorney’s fees, as the Workers’ Compensation Act under former 59-10-19.1B, 1953 Comp. (now 52-1-49 NMSA 1978) clearly spelled out the areas in which attorney fees could be granted, and the section did not authorize attorney’s fees for the taking of a doctor’s deposition. Gregory v. Eastern N.M. Univ., 1970-NMCA-018, 81 N.M. 236, 465 P.2d 515, 1970 N.M. App. LEXIS 552 (N.M. Ct. App. 1970).
Although a trial court properly granted an injured employee’s motion requiring the employer and its insurer to furnish the employee with an artificial arm pursuant to 59-10-19.1E, 1953 Comp. (now 52-1-49 NMSA 1978), there was no statutory basis for an award of attorney’s fees on account of the presentation of the claim for the artificial member where the statutes that authorized assessment of attorney’s fees against the employer were not applicable. Cromer v. J. W. Jones Constr. Co., 1968-NMCA-027, 79 N.M. 179, 441 P.2d 219, 1968 N.M. App. LEXIS 451 (N.M. Ct. App. 1968), overruled, Schiller v. Southwest Air Rangers, 1975-NMSC-018, 87 N.M. 476, 535 P.2d 1327, 1975 N.M. LEXIS 824 (N.M. 1975).
Authority of judge.
Workers’ compensation judge had authority to designate a health care provider because 52-1-49D NMSA 1978 granted the judge jurisdiction to hear the objection and expressly provided that the judge should make a decision as set forth in 52-1-49F NMSA 1978. Albuquerque v. Sanchez, 1992-NMCA-038, 113 N.M. 721, 832 P.2d 412, 1992 N.M. App. LEXIS 30 (N.M. Ct. App. 1992).
Burden of proof.
After an employer has made a selection of a physician for an injured employee and the employee makes a second selection under 52-1-49C NMSA 1978, any further changes in physicians places the burden of proving that the present physician’s care is unreasonable upon the party seeking to change physicians. Chavez v. Intel Corp., 1998-NMCA-175, 126 N.M. 335, 968 P.2d 1198, 1998 N.M. App. LEXIS 152 (N.M. Ct. App. 1998).
Where an employer chose a physician for an injured employee, the employee selected a replacement physician, and then the parties agreed to a third physician to replace the second physician, it was error under 52-1-49F NMSA 1978 for the trial court to place upon the employer the burden of proving that the third physician’s care was unreasonable after the employee sought to change physicians again. Chavez v. Intel Corp., 1998-NMCA-175, 126 N.M. 335, 968 P.2d 1198, 1998 N.M. App. LEXIS 152 (N.M. Ct. App. 1998).
Workers’ compensation judge correctly placed the burden of proving the unreasonableness of the care provided on the objecting party, which was the employer, pursuant to 52-1-49D NMSA 1978; workers’ compensation administration rule was consistent with the statute and was thus not void. Albuquerque v. Sanchez, 1992-NMCA-038, 113 N.M. 721, 832 P.2d 412, 1992 N.M. App. LEXIS 30 (N.M. Ct. App. 1992).
Employee did not initially met his burden of showing that certain supplemental medical expenses were reasonable where the bills were not introduced into evidence; however, the court held that at the new trial, the bills were prima facie evidence that the expenses were reasonable if they were for treatment of the same injury or condition reflected in earlier bills. The court noted that the necessity factor would be established because there was prior medical testimony and evidence regarding the employee’s treatment. Pritchard v. Halliburton Servs., 1986-NMCA-018, 104 N.M. 102, 717 P.2d 78, 1986 N.M. App. LEXIS 587 (N.M. Ct. App. 1986).
Compensation.
Where an employer failed to offer or provide medical services to an injured employee, the limitation of 52-1-49 NMSA 1978 was not applicable to the employee; the employer was liable for the medical services that the employee obtained for herself from her own doctor until the employee was notified by the employer’s counsel that “any further medical treatment” not authorized by the company would have to be at her own expense. Sedillo v. Levi-Strauss Corp., 1982-NMCA-069, 98 N.M. 52, 644 P.2d 1041, 1982 N.M. App. LEXIS 852 (N.M. Ct. App.), cert. denied, 98 N.M. 336, 648 P.2d 794, 1982 N.M. LEXIS 2937 (N.M. 1982).
Injured employee was entitled to reimbursement for her medical expenses where the company doctors ignored diagnostic information and failed to advise either the employee or the employer of a condition requiring attention; a nurse’s comment to the employee expressed no more than a passive willingness to provide medical aid and did not rise to the fulfillment of the employer’s statutory duty to provide adequate medical care. Sedillo v. Levi-Strauss Corp., 1982-NMCA-069, 98 N.M. 52, 644 P.2d 1041, 1982 N.M. App. LEXIS 852 (N.M. Ct. App.), cert. denied, 98 N.M. 336, 648 P.2d 794, 1982 N.M. LEXIS 2937 (N.M. 1982).
Compliance.
Because an employer and its insurer had not met the applicable test under former 59-10-19.1, 1953 Comp., a certain amount of an employee’s medical expenses should have been awarded. Trujillo v. Beaty Elec. Co., 1978-NMCA-021, 91 N.M. 533, 577 P.2d 431, 1978 N.M. App. LEXIS 541 (N.M. Ct. App. 1978).
Former 59-10-19.1A, 1953 Comp. (now 52-1-49 NMSA 1978) did not require the payment of all of the employee’s medical costs because former subsection D provided that the employer was not obliged to furnish additional services where he provided for “adequate” services. Gregory v. Eastern N.M. Univ., 1970-NMCA-018, 81 N.M. 236, 465 P.2d 515, 1970 N.M. App. LEXIS 552 (N.M. Ct. App. 1970).
On appeal from the denial of an employee’s application for an order requiring his employer and its insurer to furnish hospital, medical and surgical services, the employee had not complied with the provisions of the applicable statute, former 59-10-19.1, 1953 Comp. (now 52-1-49 NMSA 1978), and therefore could not take advantage of those provisions. Valdez v. McKee, 1966-NMSC-102, 76 N.M. 340, 414 P.2d 852, 1966 N.M. LEXIS 2659 (N.M. 1966).
Construction.
Term “artificial member” as used in 52-1-49 NMSA 1978 refers to prosthetic devices that are attached to, or used in immediate proximity to, an injured worker’s body, and does not include the entire cost of a wheelchair-accessible van; thus, for a worker paralyzed in a work-related accident, an employer’s responsibility was limited to the modification of the worker’s van to make it usable by the worker. Fogleman v. Duke City Auto. Servs., 2000-NMCA-039, 128 N.M. 840, 999 P.2d 1072, 2000 N.M. App. LEXIS 26 (N.M. Ct. App.), cert. denied, 129 N.M. 207, 4 P.3d 35, 2000 N.M. LEXIS 156 (N.M. 2000).
Construing 52-1-49 NMSA 1978 in its entirety, it was apparent that the legislature intended that an employer was required to provide appropriate “reasonable” and “adequate” medical treatment in a timely manner; the statute did not impose an arbitrary duty on the employer to act in every instance at the time of an accident. Eldridge v. Aztec Well Servicing Co., 1987-NMCA-042, 105 N.M. 660, 735 P.2d 1166, 1987 N.M. App. LEXIS 689 (N.M. Ct. App.), cert. denied, 105 N.M. 644, 735 P.2d 1150, 1987 N.M. LEXIS 3563 (N.M. 1987).
Reasonable travel expenses necessarily incurred in receiving medical treatment came within the language of 52-1-49A NMSA 1978, which required an employer to furnish all reasonable surgical, physical rehabilitation services, medical, osteopathic, chiropractic, dental, optometric, and hospital services and medicine to an employee after an injury as long as medical or surgical attention was reasonably necessary. Gonzales v. Bates Lumber Co., 1981-NMCA-052, 96 N.M. 422, 631 P.2d 328, 1981 N.M. App. LEXIS 736 (N.M. Ct. App. 1981).
Nothing in former 59-10-19.1, 1953 Comp. (now 52-1-49 NMSA 1978), or any other section of the Workmen’s Compensation Act of New Mexico, suggests that an injured employee may presently recover judgment against an employer, or an insurer, for medical expenses which may at some time in the future prove necessary as a result of injury. Hales v. Van Cleave, 1967-NMCA-006, 78 N.M. 181, 429 P.2d 379, 1967 N.M. App. LEXIS 149 (N.M. Ct. App.), cert. denied, 78 N.M. 198, 429 P.2d 657, 1967 N.M. LEXIS 2877 (N.M. 1967).
Costs.
In an action for workers’ compensation benefits, the trial court properly held that the cost of furnishing a claimant with an artificial arm as required by 59-10-19.1E, 1953 Comp. (now 52-1-49 NMSA 1978) was not included in the statutory limitation on medical expenses in 59-10-19.1B, 1953 Comp. (now 52-1-49 NMSA 1978), but the cost of training him to use the arm was so included. Cromer v. J. W. Jones Constr. Co., 1968-NMCA-027, 79 N.M. 179, 441 P.2d 219, 1968 N.M. App. LEXIS 451 (N.M. Ct. App. 1968), overruled, Schiller v. Southwest Air Rangers, 1975-NMSC-018, 87 N.M. 476, 535 P.2d 1327, 1975 N.M. LEXIS 824 (N.M. 1975).
Denial of benefits.
An employer is not precluded from selecting a health care provider for an injured worker even after it has denied the worker’s claim for benefits. Grine v. Peabody Natural Res., 2006-NMSC-031, 140 N.M. 30, 139 P.3d 190, 2006 N.M. LEXIS 334 (N.M. 2006).
Denial of reimbursement claims.
Workmen’s compensation claimant was found to have been properly denied reimbursement for the installation of a hot tub in his home under 52-1-49 NMSA 1978 because substantial evidence in the record supported the hearing officer’s finding that the hot tub was medically unnecessary and unreasonable. Davis v. Los Alamos Nat'l Lab., 1989-NMCA-023, 108 N.M. 587, 775 P.2d 1304, 1989 N.M. App. LEXIS 33 (N.M. Ct. App. 1989).
Discretion.
Decision of the New Mexico Workers’ Compensation Administration denying the employer’s motion in limine to exclude a physician’s report in a claim by the employee against the employer for workers’ compensation was reversed; the report was inadmissible testimony pursuant to 52-1-51C NMSA 1978 because it was neither testimony of an authorized health care provider under 52-1-49 NMSA 1978 nor testimony of a qualified independent medical examiner agreed to by the parties or ordered by the workers’ compensation judge pursuant to 52-1-51A NMSA 1978. Jurado v. Levi Strauss & Co., 1995-NMCA-129, 120 N.M. 801, 907 P.2d 205, 1995 N.M. App. LEXIS 127 (N.M. Ct. App.), cert. denied, 120 N.M. 715, 905 P.2d 1119, 1995 N.M. LEXIS 440 (N.M. 1995).
Where the employer and employee had agreed upon which physicians were to examine the employee, and the employee obtained a medical report from another physician, the trial court improperly denied the employer’s motion in limine seeking to exclude the physician’s report because it was not prepared by a qualified health care provider pursuant to 52-1-49 NMSA 1978, nor a physician agreed upon by the parties pursuant to 52-1-51 NMSA 1978. Jurado v. Levi Strauss & Co., 1995-NMCA-129, 120 N.M. 801, 907 P.2d 205, 1995 N.M. App. LEXIS 127 (N.M. Ct. App.), cert. denied, 120 N.M. 715, 905 P.2d 1119, 1995 N.M. LEXIS 440 (N.M. 1995).
Duty of employer.
Obligation of an employer to furnish reasonably necessary medical services under 52-1-49A NMSA 1978 also included a duty to pay necessary future reasonable medical and nursing maintenance expenses arising out of the work-related disability. St. Clair v. County of Grant, 1990-NMCA-087, 110 N.M. 543, 797 P.2d 993, 1990 N.M. App. LEXIS 87 (N.M. Ct. App. 1990).
Eligibility.
Medical benefits recoverable under 52-1-49 NMSA 1978 are limited to those types of injuries which are defined in 52-1-24 NMSA 1978 and which are not otherwise expressly excluded from coverage. Douglass v. State, Regulation & Licensing Dep't, 1991-NMCA-041, 112 N.M. 183, 812 P.2d 1331, 1991 N.M. App. LEXIS 153 (N.M. Ct. App.), cert. denied, 112 N.M. 77, 811 P.2d 575, 1991 N.M. LEXIS 168 (N.M. 1991).
Employer provision of care.
Former 59-10-19.1, 1953 Comp. (now 52-1-49 NMSA 1978) states that after injury, and continuing as long as medical or surgical attention is reasonably necessary, the employer shall furnish all reasonable surgical, physical rehabilitation services, medical, osteopathic, chiropractic, dental, optometry and hospital services and medicine, not to exceed the sum of $40,000 unless the workman refuses to allow them to be so furnished. In case the employer has made provisions for, and has at the service of the workman at the time of the accident, adequate surgical, hospital and medical facilities and attention and offers to furnish these services during the period necessary, then the employer shall be under no obligation to furnish additional surgical, medical or hospital services or medicine than those so provided. Garcia v. Genuine Parts Co., 1977-NMCA-007, 90 N.M. 124, 560 P.2d 545, 1977 N.M. App. LEXIS 569 (N.M. Ct. App.), cert. denied, 90 N.M. 254, 561 P.2d 1347, 1977 N.M. LEXIS 1168 (N.M. 1977).
Evidence.
Insurer failed to state a claim for reimbursement of workmen’s compensation benefits, because there was no evidence benefits were paid for an injury for which the worker was otherwise compensated under former 59-10-19.1B, 1953 Comp. (now 52-1-49 NMSA 1978). Security Ins. Co. v. Chapman, 1975-NMSC-052, 88 N.M. 292, 540 P.2d 222, 1975 N.M. LEXIS 848 (N.M. 1975).
—Insufficient.
Although a bill for medical services rendered was prima facie proof of the reasonableness of the medical treatment for which payment was sought in a workers’ compensation case, a claimant’s testimony that he incurred “about” $1,500 in doctor bills and “about” $600 in drugstore bills was insufficient under 52-1-49A NMSA 1978 to sustain an award; because the bills in evidence totaled $526, the claimant was entitled to recover that amount. Di Matteo v. County of Dona Ana, 1985-NMCA-099, 104 N.M. 599, 725 P.2d 575, 1985 N.M. App. LEXIS 633 (N.M. Ct. App. 1985).
—Sufficient.
New Mexico Workers’ Compensation Administration’s order denying an injured employee his request for an independent medical examination pursuant to 52-1-51A NMSA 1978 was reversed, where the employee made a prima facie showing of eligibility for an independent medical examination, presenting evidence that a medical dispute existed between medical care providers authorized to treat him under 52-1-49 NMSA 1978, and that the health care providers met the criteria of 52-1-51C NMSA 1978. Gutierrez v. J & B Mobile Homes, 1999-NMCA-007, 126 N.M. 494, 971 P.2d 1284, 1998 N.M. App. LEXIS 167 (N.M. Ct. App. 1998).
Trial court did not err in refusing to approve the bill of one doctor after ordering payment of two other doctor’s bills where the evidence showed that the denied bill was incurred by the claimant after the date that the trial court found the claimant was no longer disabled; the claimant failed to justify payment of the bill under the requirements of 52-1-4B NMSA 1978 because the claimant did not give the employer the right to select the physician. Cardenas v. United Nuclear Homestake Partners, 1981-NMCA-117, 97 N.M. 46, 636 P.2d 317, 1981 N.M. App. LEXIS 779 (N.M. Ct. App. 1981).
Employer was liable for the expenses the employee incurred as a result of the 1978 accident where the evidence proved that the expenses were reasonable and necessary. Smith v. Trailways Bus Sys., 1981-NMCA-041, 96 N.M. 79, 628 P.2d 324, 1981 N.M. App. LEXIS 717 (N.M. Ct. App. 1981).
Expert.
Under 52-1-49, 52-3-15 NMSA 1978 the employer had the right, after 60 days, to change the worker’s health care provider and did not do so; exclusion of the treating physician’s testimony was not an option available to the employer. Banks v. IMC Kalium Carlsbad Potash Co., 2003-NMCA-016, 133 N.M. 199, 62 P.3d 290, 2002 N.M. App. LEXIS 108 (N.M. Ct. App. 2002), aff'd, 2003-NMSC-026, 134 N.M. 421, 77 P.3d 1014, 2003 N.M. LEXIS 227 (N.M. 2003).
Findings.
A workers’ compensation claimant was not entitled to medical expenses under 52-1-49 NMSA 1978 for unauthorized medical expenses; the claimant incurred the expenses with a physician of his own choice simultaneously with the medical care provided by the employer and the medical service provided by the employer was adequate. Montoya v. Anaconda Mining Co., 1981-NMCA-113, 97 N.M. 1, 635 P.2d 1323, 1981 N.M. App. LEXIS 781 (N.M. Ct. App. 1981).
Future benefits.
Trial court erred in denying an impaired worker’s request for future medical benefits under the workmen’s compensation law, because under 52-1-49 NMSA 1978 he had a substantive right to them that was conferred by statute. Gearhart v. Eidson Metal Prods., 1979-NMCA-019, 92 N.M. 763, 595 P.2d 401, 1979 N.M. App. LEXIS 821 (N.M. Ct. App. 1979).
Future medical benefits.
Once a compensable injury is found, the Workmen’s Compensation Act grants, as a substantive right, necessary and reasonable future medical treatment to the injured worker pursuant to this section, and the trial court is without authority to limit or restrict in advance future medical benefits once a compensable injury is established. Graham v. Presbyterian Hosp. Ctr., 1986-NMCA-064, 104 N.M. 490, 723 P.2d 259, 1986 N.M. App. LEXIS 625 (N.M. Ct. App. 1986).
Future medical expenses.
Because a trial court cannot practically determine an employee’s future medical needs at the time of entry of a judgment finding disability, 52-1-49 NMSA 1978 authorizes entry of a judgment directing the payment of a worker’s reasonable and necessary future medical expenses, with any reductions under 52-1-47D NMSA 1978 and invests the court with continuing jurisdiction to enforce such orders. McMains v. Aztec Well Serv., 1994-NMCA-126, 119 N.M. 22, 888 P.2d 468, 1994 N.M. App. LEXIS 162 (N.M. Ct. App. 1994).
Where a trial court undertook to determine an award of attorney fees, the present value of the workman’s compensation award, to be considered under 52-1-54D NMSA 1978 for purposes of determining attorney fees, should not have included future medical expenses, required by 52-1-49 NMSA 1978 to be furnished by the employer; medical expenses were compensation for purposes of awarding attorney fees, but such expenses were those that had already occurred, not expenses that might occur in the future. Board of Educ. v. Quintana, 1985-NMSC-020, 102 N.M. 433, 697 P.2d 116, 1985 N.M. LEXIS 1938 (N.M. 1985).
Health care.
Language of 52-4-1C NMSA 1978 does not provide an injured employee the right to select his or her own doctor in the first instance or a right to insist on a different doctor than the one provided by the employer unless the services of that doctor prove unsatisfactory; rather, it seems to codify an exception that an employee may seek independent medical treatment at the employer’s expense if the medical services provided by the employer are not adequate and so construed, the statute is not inconsistent with 52-1-49 NMSA 1978. Bowles v. Los Lunas Sch., 1989-NMCA-081, 109 N.M. 100, 781 P.2d 1178, 1989 N.M. App. LEXIS 81 (N.M. Ct. App.), cert. denied, 109 N.M. 131, 782 P.2d 384, 1989 N.M. LEXIS 302 (N.M. 1989).
Health care provider.
Under the authority of 52-5-14A NMSA 1978, an employer was found to have waived the right to redesignate a worker’s primary health care provider by entering into partial lump-sum settlement with the worker under 52-5-12C NMSA 1978, which stated that medical treatment was to remain open for life with worker’s treating physician or his referral; employee did not waive the right to challenge the employer’s redesignation of the primary health care provider by failing to file an objection to the employer’s notice of change of the health care provider under 52-1-49C, D, and E NMSA 1978 because the employer, who had waived its statutory right to order a change of the employee’s health care provider, could not invoke the procedural requirements regarding the exercise of that right since the terms of the agreement could only be changed in accordance with 52-5-9 NMSA 1978. Ramirez v. Johnny's Roofing Inc., 1999-NMCA-038, 127 N.M. 83, 977 P.2d 348, 1999 N.M. App. LEXIS 14 (N.M. Ct. App. 1999).
Although an employer was found to have waived right to redesignate a worker’s primary health care provider by entering into partial lump-sum settlement with the worker under 52-5-12C NMSA 1978, which stated that medical treatment was to remain open for life with worker’s treating physician or his referral, the matter was remanded for a determination of whether the back surgery sought by the employee was reasonably necessary under 52-1-49A NMSA 1978. Ramirez v. Johnny's Roofing Inc., 1999-NMCA-038, 127 N.M. 83, 977 P.2d 348, 1999 N.M. App. LEXIS 14 (N.M. Ct. App. 1999).
Workers’ compensation judge’s properly ruled that he would treat an employer’s objection under 52-1-49D NMSA 1978 to a worker’s choice of health care provider the same as a request for change of health care provider under 52-1-49E NMSA 1978. Albuquerque v. Sanchez, 1992-NMCA-038, 113 N.M. 721, 832 P.2d 412, 1992 N.M. App. LEXIS 30 (N.M. Ct. App. 1992).
Jurisdiction.
In a workers’ compensation matter, the trial court had continuing jurisdiction under 52-1-38 NMSA 1978, 52-1-49 NMSA 1978 and 52-1-56 NMSA 1978 to enforce its original judgment requiring defendants to pay all reasonably necessary future medical benefits to the claimant, including future home nursing and attendant care expenses; the decision was nevertheless subject to compliance with the provisions of Rules 1-059 or 1-060 NMRA to provide proof of such expenses. St. Clair v. County of Grant, 1990-NMCA-087, 110 N.M. 543, 797 P.2d 993, 1990 N.M. App. LEXIS 87 (N.M. Ct. App. 1990).
Liability.
Workman’s compensation carrier that represented it would pay for injured employees’ medical services could be held liable for interference with contractual relationship between the employees and the chiropractor when the chiropractor was not paid; the Workmen’s Compensation Act imposes the obligation for payment of reasonable medical treatment to an injured workman on the employer-insurer, 52-1-49 NMSA 1978, not to the treating physician. Speer v. Cimosz, 1982-NMCA-029, 97 N.M. 602, 642 P.2d 205, 1982 N.M. App. LEXIS 808 (N.M. Ct. App.), cert. denied, 98 N.M. 50, 644 P.2d 1039, 1982 N.M. LEXIS 2926 (N.M. 1982).
Medical benefits.
Terms “reasonable” and “necessary,” as used in 52-1-49A and 52-1-49B NMSA 1978, appear to describe the same standard. Bowles v. Los Lunas Sch., 1989-NMCA-081, 109 N.M. 100, 781 P.2d 1178, 1989 N.M. App. LEXIS 81 (N.M. Ct. App.), cert. denied, 109 N.M. 131, 782 P.2d 384, 1989 N.M. LEXIS 302 (N.M. 1989).
Medical care.
In a worker’s compensation procedure, a worker’s compensation judge erred in not admitting testimony of two physicians with respect to health care rendered before they became the worker’s authorized providers because the worker’s employer failed to object. DeWitt v. Rent-A-Center, Inc., 2009-NMSC-032, 146 N.M. 453, 212 P.3d 341, 2009 N.M. LEXIS 404 (N.M. 2009).
Employee fell and hurt his hip in a work related accident for which the employer and insurer paid medical costs and disability payments and then the employee recovered against a third-party tortfeasor. Contrary to contentions of employer and insurer, which argued that because the jury did not award future medical benefits it was improper for the workers’ compensation judge to award them, there was no error when the workers’ compensation judge awarded future medical expenses to the employee because 52-1-49 NMSA 1978 specifically provided for such continuing medical care by the employer and insurer. Garcia v. GE, 1999-NMCA-139, 128 N.M. 291, 992 P.2d 304, 1999 N.M. App. LEXIS 119 (N.M. Ct. App.), cert. denied, 128 N.M. 148, 990 P.2d 822, 1999 N.M. LEXIS 312 (N.M. 1999).
Notice.
Although a worker did not comply with the 10-day notice requirement of 52-1-49C NMSA 1978, the employer did not show prejudice because it could still have objected within three days, as provided for by 52-1-49D NMSA 1978, and thereby notified the worker of its unwillingness to pay for care received from the worker’s new doctor; the worker’s failure to comply with the requirement did not preclude him from choosing a new health care provider. Albuquerque v. Sanchez, 1992-NMCA-038, 113 N.M. 721, 832 P.2d 412, 1992 N.M. App. LEXIS 30 (N.M. Ct. App. 1992).
Worker’s notice of change of health care provider substantially complied with 52-1-49C NMSA 1978 where the letter informed the employer that he was designating “Dr. Thorpe at Lovelace Medical Center” as his treating physician; this information adequately informed the employer of the name and location of the worker’s doctor. Albuquerque v. Sanchez, 1992-NMCA-038, 113 N.M. 721, 832 P.2d 412, 1992 N.M. App. LEXIS 30 (N.M. Ct. App. 1992).
Parties.
Workers’ Compensation Act imposes the obligation for payment of reasonable medical treatment to an injured worker on the employer-insurer pursuant to 52-1-49 NMSA 1978, but the obligation is to the worker and not to the treating physician. Speer v. Cimosz, 1982-NMCA-029, 97 N.M. 602, 642 P.2d 205, 1982 N.M. App. LEXIS 808 (N.M. Ct. App.), cert. denied, 98 N.M. 50, 644 P.2d 1039, 1982 N.M. LEXIS 2926 (N.M. 1982).
Procedure.
Under 52-1-49B NMSA 1978, and former 52-1-56C, an insurer’s action for reimbursement for workmen’s compensation benefits paid to an injured worker was sufficient to state a valid cause of action for breach of contract because there was an agreement to protect the insurer’s interest in return for the insurer not intervening in the worker’s malpractice action against the doctor who treated him. Transamerica Ins. Co. v. Sydow, 1981-NMCA-121, 97 N.M. 51, 636 P.2d 322, 1981 N.M. App. LEXIS 777 (N.M. Ct. App. 1981).
Reasonable and necessary.
Workers' compensation judge (WCJ) erred in denying a worker's claim for reimbursement because no substantial evidence supported the WCJ's conclusion that medical marijuana used pursuant to the Lynn and Erin Compassionate Use Act was not reasonable and necessary medical care for the worker under the Workers' Compensation Act; the worker's authorized health care provider treated the worker with traditional pain management that failed and adopted a treatment plan based on medical marijuana. Maez v. Riley Indus., 2015-NMCA-049, 347 P.3d 732, 2015 N.M. App. LEXIS 7 (N.M. Ct. App. 2015).
Fact that a worker's authorized treating health care provider (HCP) did not provide the worker a prescription as defined in the regulations did not support the conclusion that medical marijuana was not reasonable and necessary medical care for the worker because the HCP signed the certification for the worker to qualify for the Lynn and Erin Compassionate Use Act medical marijuana program; the certification was the functional equivalent of a prescription. Maez v. Riley Indus., 2015-NMCA-049, 347 P.3d 732, 2015 N.M. App. LEXIS 7 (N.M. Ct. App. 2015).
No substantial evidence supported the conclusion that medical marijuana used pursuant to the Lynn and Erin Compassionate Use Act was not necessary medical care for the worker under the Workers' Compensation Act because the worker's health care provider adopted a treatment plan that called for medical marijuana, and by the very nature of such treatment, medical marijuana was a necessary component; the HCP certified that the worker had unrelieved symptoms that failed other medical therapies. Maez v. Riley Indus., 2015-NMCA-049, 347 P.3d 732, 2015 N.M. App. LEXIS 7 (N.M. Ct. App. 2015).
Workers' compensation judge (WCJ) erred in denying a worker's claim for reimbursement when substantial evidence in the record as a whole did not support the proposition that a worker's health care provider (HCP) certified the worker for medical marijuana treatment merely because he had made that choice; the record, which included the HCP's medical reports, did not support a conclusion that traditional pain medication was the sole reasonable and necessary treatment, precluding any other. Maez v. Riley Indus., 2015-NMCA-049, 347 P.3d 732, 2015 N.M. App. LEXIS 7 (N.M. Ct. App. 2015).
Worker's treatment under a program authorized by the Lynn and Erin Compassionate Use Act that has been determined by a workers' compensation judge to be reasonable and necessary treatment is embraced within the New Mexico Workers' Compensation Act. Therefore, an employer could have been ordered to pay for medical marijuana that could treat an injured worker's chronic and severe pain from a back injury. Vialpando v. Ben's Auto. Servs., 2014-NMCA-084, 331 P.3d 975, 2014 N.M. App. LEXIS 50 (N.M. Ct. App.), cert. denied, 331 P.3d 924, 2014 N.M. LEXIS 283 (N.M. 2014).
When understood in conjunction with the workers' compensation regulations, this statute requires only that a health care provider have the responsibility for the provision of the reasonable and necessary services, not that each and every service must be provided by a health care provider. Vialpando v. Ben's Auto. Servs., 2014-NMCA-084, 331 P.3d 975, 2014 N.M. App. LEXIS 50 (N.M. Ct. App.), cert. denied, 331 P.3d 924, 2014 N.M. LEXIS 283 (N.M. 2014).
Employer did not successfully challenge an order for an injured worker's reasonable and necessary treatment under a program authorized by the Lynn and Erin Compassionate Use Act based on an assertion that it violated federal law because it failed to identify any federal statute that it would have been forced to violate. Vialpando v. Ben's Auto. Servs., 2014-NMCA-084, 331 P.3d 975, 2014 N.M. App. LEXIS 50 (N.M. Ct. App.), cert. denied, 331 P.3d 924, 2014 N.M. LEXIS 283 (N.M. 2014).
Reasonable and necessary.
The city, an employer, was not obligated to pay for the employee’s health care services provided by doctors because they were not “reasonable and necessary” as required by 52-1-49A NMSA 1978 in a workers’ compensation dispute; the employee was treated for an anxiety disorder that her doctors contended was a condition that she suffered as a result of the injuries she suffered on the job. Vargas v. City of Albuquerque, 1993-NMCA-136, 116 N.M. 664, 866 P.2d 392, 1993 N.M. App. LEXIS 130 (N.M. Ct. App. 1993).
Rehabilitation.
Summary judgment for an employer was found to have been properly granted under former 52-1-69 NMSA 1978 in connection with an employee’s action under the Workmen’s Compensation Act, 52-1-1 NMSA 1978 to 52-1-69 NMSA 1978, which asked for a determination of permanent disability, past and future medical expenses, rehabilitation expenses, and attorney’s fees upon the allegation that he had unpaid medical expenses and prescribed rehabilitation for which the employer refused to pay, because there was no evidence that the employer promised to pay for the vocational rehabilitation, because the employee failed to establish his need for rehabilitation services as required under former 52-1-50. Garcia v. Albuquerque Pub. Sch., 1983-NMCA-056, 99 N.M. 741, 663 P.2d 1198, 1983 N.M. App. LEXIS 722 (N.M. Ct. App. 1983).
Remedies.
Where a worker, who suffered an injury in a work-related accident for which his employer paid medical costs and disability payment, recovered damages against a third-party tort-feasor, but the jury apportioned the comparative negligence of the worker at 60 percent and that of the tortfeasor at 40 percent, the workers’ compensation judge correctly concluded that the worker was entitled to, and the employer and insurer were obligated to provide, reasonable and necessary medical care in the future under 52-1-49 NMSA 1978 even though the jury did not award future medical expenses. Garcia v. GE, 1999-NMCA-139, 128 N.M. 291, 992 P.2d 304, 1999 N.M. App. LEXIS 119 (N.M. Ct. App.), cert. denied, 128 N.M. 148, 990 P.2d 822, 1999 N.M. LEXIS 312 (N.M. 1999).
Where an employer did not offer or make provision for payment of an employee’s accident-related medical expenses, the employer never signified more than a “mere passive willingness” to furnish medical care. Therefore, under former 59-10-19.1, 1953 Comp., the employee was entitled to out-of-pocket medical expenses. Trujillo v. Beaty Elec. Co., 1978-NMCA-021, 91 N.M. 533, 577 P.2d 431, 1978 N.M. App. LEXIS 541 (N.M. Ct. App. 1978).
Requirements.
Before defendant, an employer and its insurer, could avoid liability under former 59-10-19.1B, 1953 Comp. (now 52-1-49 NMSA 1978), they must have provided medical services or they must have affirmatively offered the services; assuming defendants did in fact pay two medical bills incurred by plaintiff on her own initiative, that assumption showed no more than a passive willingness to respond. Not having offered medical services, former 59-10-19.1B, 1953 Comp. was not applicable. Garcia v. Genuine Parts Co., 1977-NMCA-007, 90 N.M. 124, 560 P.2d 545, 1977 N.M. App. LEXIS 569 (N.M. Ct. App.), cert. denied, 90 N.M. 254, 561 P.2d 1347, 1977 N.M. LEXIS 1168 (N.M. 1977).
Former 59-10-19.1, 1953 Comp. (now 52-1-149 NMSA 1978) did not require a workman’s compensation claimant to establish a causal connection between an injury for which he was awarded benefits and the need for additional medical and surgical services three years after the injury; all that the statute required was that the medical and surgical attention be reasonably necessary not exceeding the five-year period following the injury. Mirabal v. Robert E. McKee, Gen. Contractor, Inc., 77 N.M. 213, 421 P.2d 127, 1966 N.M. LEXIS 2812 (N.M. 1967).
Selection of health care provider.
Under this section, the workers’ compensation judge erred in favoring the worker’s choice of a health care provider over the employer’s objection where the worker’s selection of her provider was not her second selection and she did not prove that the care of her current provider was unreasonable. Chavez v. City of Albuquerque, 2010-NMCA-022, 147 N.M. 741, 228 P.3d 525, 2009 N.M. App. LEXIS 292 (N.M. Ct. App. 2009).
The Uninsured Employer’s Fund did not have the authority to select or change a worker’s health care provider under 52-1-49 NMSA 1978, which gave the right to change a health care provider after an initial selection to “the party” who did not make the initial selection, because the term “party” within the statute referred only to an employer or a worker and not to another interested party. Johnson v. Hoyt & Son Tree Serv., 2007-NMCA-072, 141 N.M. 849, 161 P.3d 894, 2007 N.M. App. LEXIS 42 (N.M. Ct. App. 2007).
Where a worker was transferred to a rehabilitation hospital after an injury, the rehabilitation hospital was the initial health care provider (HCP), and was presumed to have been selected by the employer, because the employer had notice of the injury and failed to communicate its decision regarding selection of an HCP within a reasonable period of time. Howell v. Marto Elec., 2006-NMCA-154, 140 N.M. 737, 148 P.3d 823, 2006 N.M. App. LEXIS 149 (N.M. Ct. App. 2006).
Although employer had the right to make initial health care provider (HCP) selection for worker who suffered heart attack on the job, where employer failed to select HCP in compliance with statutory requirements, testimony by HCP selected by employer was inadmissable. Grine v. Peabody Natural Res., 2006-NMSC-031, 140 N.M. 30, 139 P.3d 190, 2006 N.M. LEXIS 334 (N.M. 2006).
Subsections A, B.
Award made to a claimant for vocational rehabilitation was to be set aside on remand if it was found that the rehabilitation request had not been made within 120 days from the date of release from the treating health care provider. Under 52-1-49A NMSA 1978, an employer is required to furnish all reasonable medical services. Except that under 52-1-49B NMSA 1978, in case the employer has made provisions for and has at the service of the worker at the time of the accident adequate medical or related services or facilities and offers to furnish these services or facilities during the period necessary, then the employer shall be under no obligation to furnish additional medical or related services than those so provided. Apodaca v. Payroll Express, 1993-NMCA-141, 116 N.M. 816, 867 P.2d 1198, 1993 N.M. App. LEXIS 159 (N.M. Ct. App. 1993).
Time limitations.
In adopting the amendments to 52-1-24, 52-1-26, 52-1-49, and 52-1-4-1 NMSA 1978, the legislature did not intend to abrogate the rule recognized in Smith v. Dowell Corp. or Whittenberg v. Graves Oil & Butane Co., or the precedent upon which they relied, so as to limit the commencement of the running of the statute of limitations in workers’ compensation cases to situations where a worker was actually told by a health care provider that he had suffered a permanent impairment. Montoya v. Kirk-Mayer, Inc., 1995-NMCA-104, 120 N.M. 550, 903 P.2d 861, 1995 N.M. App. LEXIS 100 (N.M. Ct. App. 1995).
Although defendant insurer had begun to pay workmen’s compensation benefits to plaintiff claimant, the payments had been stopped for more than a year before the claimant filed an action, and, in an appeal by the claimant from a trial court’s dismissal of the action as to defendant insurer on the ground that his claim was barred by the one-year statute of limitations, the Supreme Court of New Mexico determined that the limitation began to run when there had been a failure or refusal to pay any “installment” of compensation to which the claimant was entitled, “installment” meant the semi-monthly benefits established under the New Mexico Workmen’s Compensation Act and not medical payments, and neither the payment of medical benefits nor the making of an offer of settlement, which allegedly led the claimant to believe compensation would be paid, tolled the limitation. Garcia v. New Mexico State Highway Dep't, 1956-NMSC-048, 61 N.M. 156, 296 P.2d 759, 1956 N.M. LEXIS 1064 (N.M. 1956).
Waiver.
Employee was not entitled to reimbursement of a doctor’s bill pursuant to 52-1-49A, B NMSA 1978 where the employer and its insurer made a direct offer of medical services of a doctor of their choice and the employee declined and sought treatment on his own. Tafoya v. S & S Plumbing Co., 1981-NMCA-150, 97 N.M. 249, 638 P.2d 1094, 1981 N.M. App. LEXIS 806 (N.M. Ct. App. 1981), cert. denied, 98 N.M. 50, 644 P.2d 1039, 1982 N.M. LEXIS 2956 (N.M. 1982).
When paid.
Where an employee conceded that there could ordinarily be no failure to pay any compensation until the first installment became due, which was 31 days after an injury became compensable, and a statement by the president of his employer five days after the employee’s injury did not change that principle, when the employee filed his claim 12 days after his injury no compensation was due and the employee’s claim for such benefits was properly denied. However, there was no time limitation on the employee’s claim for medical expenses and he was not prohibited from recovering them. Martinez v. Wester Bros. Wholesale Produce Co., 1961-NMSC-177, 69 N.M. 375, 367 P.2d 545, 1961 N.M. LEXIS 1666 (N.M. 1961).
Worker request.
Where workmen’s compensation benefits were paid to an injured worker by an employer and then terminated, pursuant to former 59-10-19.1A, D, 1953 Comp. (now 52-1-49 NMSA 1978), no request by the worker for further services was necessary, and the employer could not avoid liability for medical expenses based on the worker’s failure to request the additional services. Provencio v. New Jersey Zinc Co., 1974-NMCA-048, 86 N.M. 538, 525 P.2d 898, 1974 N.M. App. LEXIS 688 (N.M. Ct. App.), cert. denied, 86 N.M. 528, 525 P.2d 888, 1974 N.M. LEXIS 1436 (N.M. 1974).
Workers’ compensation.
Employer who was current in the payment of compensation for an injury who was sued by the employee through a written election to sue the employer instead of two physicians who allegedly misdiagnosed and treated him had no cognizable suit against the employer who was current in the payment of compensation benefits to include medical payments; 52-1-49B NMSA 1978 did not provide an exemption which authorized common law damages as to the alleged malpractice by the physicians against the employer. Fields v. D & R Tank & Equip. Co., 1985-NMCA-061, 103 N.M. 141, 703 P.2d 918, 1985 N.M. App. LEXIS 575 (N.M. Ct. App. 1985).
In a workmen’s compensation case, a trial court committed reversible error by limiting future medical benefits under the workmen’s compensation law because the worker had a substantive right to them that was conferred by 52-1-49 NMSA 1978. Gearhart v. Eidson Metal Prods., 1979-NMCA-019, 92 N.M. 763, 595 P.2d 401, 1979 N.M. App. LEXIS 821 (N.M. Ct. App. 1979).
Employer’s offer of surgical care up to a lesser sum than that provided by former 59-10-19.1, 1953 Comp. (now 52-1-49 NMSA 1978) of the workmen’s compensation statute was improper, and the employee was not required to accept it. Bennett v. Lane Plumbing Co., 1976-NMCA-122, 89 N.M. 790, 558 P.2d 59, 1976 N.M. App. LEXIS 645 (N.M. Ct. App. 1976).
Insurer’s action for reimbursement of workers’ compensation benefits, which prohibited double recoveries, was properly dismissed; the insurer failed to prove that the recovery of a settlement by the insured against a hospital was for the original work-related injury or the subsequent negligence by the hospital that the insured sued for. Security Ins. Co. v. Chapman, 1975-NMSC-052, 88 N.M. 292, 540 P.2d 222, 1975 N.M. LEXIS 848 (N.M. 1975).
Trial court did not err by denying the employee’s request that the employee and its insurer pay for his surgery occurring after October 1, 1968, pursuant to former 59-10-19.1A, 1953 Comp. (now 52-1-49 NMSA 1978) the employer was not required to provide additional service, as it provided for adequate services through two specialists and another neurosurgeon. Gregory v. Eastern N.M. Univ., 1970-NMCA-018, 81 N.M. 236, 465 P.2d 515, 1970 N.M. App. LEXIS 552 (N.M. Ct. App. 1970).
Determination that the employer and insurer provided adequate treatment under former 59-10-19.1D, 1953 Comp. (now 52-1-49 NMSA 1978) was supported by substantial evidence because two specialists had recommended the continued conservative treatment that the employee was receiving treatment and another neurosurgeon testified that the employee had not suffered from a herniated disc prior to his surgery. Gregory v. Eastern N.M. Univ., 1970-NMCA-018, 81 N.M. 236, 465 P.2d 515, 1970 N.M. App. LEXIS 552 (N.M. Ct. App. 1970).
Employee’s award in a workmen’s compensation action against an employer and an insurer could not have included a recovery for two of the medical bills the employee introduced; the employee did not meet his burden under former 59-10-19.1, 1953 Comp. of showing that that treatment was reasonably necessary as to his compensable injury. Williams v. Gallup, 77 N.M. 286, 421 P.2d 804, 1966 N.M. LEXIS 2766, 1966 N.M. LEXIS 2808 (N.M. 1966).
Medical and surgical treatment which an employee is entitled to receive under former 59-10-19, 1953 Comp. is incidental to, and a concomitant part of, a compensable injury for which the employer is liable under the Act; the employer is only liable for such services where the employee would be entitled to compensation, therefore, prior to the acknowledgment of liability by the employer or a determination thereof in a court proceeding, a district court is without power to compel the employer to furnish medical, surgical, and hospital services to its employees. State ex rel. J. P. (Bum) Gibbins, Inc. v. District Court of Fifth Judicial Dist., 1958-NMSC-118, 65 N.M. 1, 330 P.2d 964, 1958 N.M. LEXIS 1367 (N.M. 1958).
Research References and Practice Aids
Cross references.
Temporary total disability; return to work, 52-1-25.1 NMSA 1978.
Physical examinations of worker; independent medical examination; unsanitary or injurious practices by worker; testimony of health care providers, 52-1-51 NMSA 1978.
Case management, 52-4-3 NMSA 1978.
Claims; informal conferences, 52-5-5 NMSA 1978.
New Mexico Law Review.
Comment: A Comparison Of Workers’ Compensation In The United States And Mexico, Renee L. Camacho, 26 N.M. L. Rev. 133 (1996).