New Mexico Required Postings and Forms
The adjusting of the claims in this state are handled by Broadspire. Once a claim is reported to EMPLOYERS, the report will be sent to Broadspire for assignment. The contact information for Broadspire is:
P.O. Box 14348
Lexington, KY 40512
Toll Free: 800-452-9405
Please print and post the following notices, both in English and Spanish, in a conspicuous location frequented by employees such as the break room, lunch room or time clock. If you have multiple office locations be sure to post the notices at each location.
- Workers' Compensation Act Poster
- Notice of Accident or Occupational Disease Disablement Poster (Form NOA-1-W)
The following forms need to be completed and submitted to EMPLOYERS when a work-related injury occurs:
- Form E 1.2 Employers’ First Report of Injury. You need to complete this form and send a copy to EMPLOYERS and the New Mexico Workers’ Compensation Administration within 10 days of knowledge of any alleged work-related injury or illness that results in more than seven days of lost work. This form must be filed even if your company disputes the worker’s claim of work-related injury or illness. Please provide a copy to the employee and keep a copy for your records.
- Wage Statement. This form enables us to calculate the correct compensation that may be owed to your injured employee. Please complete the form and submit it to EMPLOYERS within seven days after your knowledge of any work-related injury or illness that has caused your employee to be disabled for more than three calendar days.
- Accident Investigation Report. This basic accident form should be completed by the employee’s supervisor/manager as soon after the accident as possible. Please send the report to the following EMPLOYERS address as soon as it has been completed by the supervisor/manager: EMPLOYERS Claim Department, P.O. Box 32036, Lakeland, FL 33802-2036. You should keep a copy on file for your records.
- Off-Site Transitional Duty Program - Helping Your Injured Employees Get Back to Work
A successful transition back to work relies on the collaborative efforts of the manager/supervisor, the injured employee and their adjuster. As a manager/supervisor, learn what you can do to help facilitate a successful return to work.