HOUSE BILL 562
46th legislature - STATE OF NEW MEXICO - second session, 2004
INTRODUCED BY
James G. Taylor
AN ACT
RELATING TO WORKERS' COMPENSATION; PROVIDING FOR AN INDEPENDENT MEDICAL EXAMINATION; PROVIDING FOR ACCESS TO INFORMATION REGARDING A WORKER'S STATUS; AMENDING A SECTION OF THE WORKERS' COMPENSATION ACT.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
Section 1. Section 52-1-25.1 NMSA 1978 (being Laws 1990 (2nd S.S.), Chapter 2, Section 10) is amended to read:
"52-l-25.l. TEMPORARY TOTAL DISABILITY--RETURN TO WORK.--
A. As used in the Workers' Compensation Act, "temporary total disability" means the inability of [the] a worker, by reason of accidental injury arising out of and in the course of his employment, to perform his duties prior to the date of his maximum medical improvement.
B. If, prior to the date of maximum medical improvement, an injured worker's health care provider releases the worker to return to work and [the] any employer offers work at the worker's pre-injury wage, the worker is not entitled to temporary total disability benefits.
C. If, prior to the date of maximum medical improvement, an injured worker's health care provider releases the worker to return to work and the employer offers work at less than the worker's pre-injury wage, the worker is disabled and shall receive temporary total disability compensation benefits equal to [sixty-six and] two-thirds [percent] of the difference between the worker's pre-injury wage and his post-injury wage.
D. If the worker returns to work pursuant to the provisions of Subsection B of this section, the employer shall continue to provide reasonable and necessary medical care pursuant to Section 52-l-49 NMSA l978."
Section 2. Section 52-1-51 NMSA 1978 (being Laws 1929, Chapter 113, Section 19, as amended) is amended to read:
"52-l-5l. PHYSICAL EXAMINATIONS OF WORKER--INDEPENDENT MEDICAL EXAMINATION--UNSANITARY OR INJURIOUS PRACTICES BY WORKER--TESTIMONY OF HEALTH CARE PROVIDERS.--
A. [In the event of a dispute concerning any medical issue, if the parties cannot agree upon the use of a specific independent medical examiner, either] If a party to a claim disputes the reasonableness or necessity of treatment, or the cause of the injury, that party may petition a workers' compensation judge for permission to have the worker undergo an independent medical examination. If a workers' compensation judge believes that an independent medical examination will assist the judge with the proper determination of any issue in the case, including the cause of the injury, the workers' compensation judge may order an independent medical examination upon the judge's own motion. The independent medical examination shall be performed immediately, pursuant to procedures adopted by the director, by a health care provider other than the designated health care provider, unless the employer and the worker otherwise agree.
B. In deciding who may conduct the independent medical examination, the workers' compensation judge shall not designate the health care provider initially chosen by the petitioner. The workers' compensation judge shall designate a health care provider on the approved list of persons authorized by the committee appointed by the advisory council on workers' compensation to create that list. The decision of the workers' compensation judge shall be final. The employer shall pay for any independent medical examination.
C. Only a health care provider who has treated the worker pursuant to Section 52-l-49 NMSA l978 or the health care provider providing the independent medical examination pursuant to this section may offer testimony at any workers' compensation hearing concerning the particular injury in question.
D. If, pursuant to Subsection C of Section 52-l-49 NMSA l978, the injured worker selects a new health care provider, the employer shall be entitled to periodic examinations of the worker by the health care provider he previously selected. Examinations may not be required more frequently than at six-month intervals; except that upon application to the workers' compensation judge having jurisdiction of the claim and after [resonable] reasonable cause therefor, examinations within six-month intervals may be ordered. In considering such applications, the workers' compensation judge [should] shall exercise care to prevent harassment of the claimant.
E. If the employer requests an independent medical examination or an examination pursuant to Subsection D of this section, the worker shall travel to the place at which the examination shall be conducted. Within thirty days after the examination, the worker shall be compensated by the party requesting the examination for all necessary and reasonable expenses incidental to submitting to the examination, including the cost of travel, meals, lodging, loss of pay or other like direct expense, but the amount to be compensated for meals and lodging shall not exceed that allowed for nonsalaried public officers under the Per Diem and Mileage Act.
F. No attorney shall be present at any examination authorized under this section.
G. Both the employer and the worker shall be given a copy of the report of the examination of the worker made by the independent health care provider pursuant to this section.
H. If a worker fails or refuses to submit to examination in accordance with this section, he shall forfeit all workers' compensation benefits that would accrue or become due to him except for [such] that failure or refusal to submit to examination during the period that he persists in such failure and refusal unless he is by reason of disability unable to appear for examination.
I. If any worker persists in any unsanitary or injurious practice that tends to imperil, retard or impair his recovery or increase his disability or refuses to submit to such medical or surgical treatment as is reasonably essential to promote his recovery, the workers' compensation judge may in his discretion reduce or suspend the workers' compensation benefits."
Section 3. Section 52-10-1 NMSA 1978 (being Laws 1990 (2nd S.S.), Chapter 2, Section 90) is amended to read:
"52-10-1. RELEASE OF MEDICAL RECORDS--ACCESS TO INFORMATION REGARDING A WORKER'S STATUS.--
A. A health care provider shall immediately release to a worker, that worker's employer, that employer's insurer, the appropriate peer review organization or the health care selection board all medical records, medical bills and other information concerning any health care or health care service provided to the worker, upon either party's written request to the health care provider for that information. Except for those records that are directly related to any injuries or disabilities claimed by a worker for which that worker is receiving benefits from his employer, the request shall be accompanied by a signed authorization for that request by the worker.
B. An employer or worker shall not be required to continue to pay any health care provider who refuses to comply with Subsection A of this section.
C. Any party to a claim, including a medical case manager, may contact a health care provider for the purpose of determining a worker's disability status, work restrictions or treatment plan. A party to a claim shall not attempt to coerce a health care provider."
Section 4. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2004.
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