New Mexico Mutual

Selection of Health Care Provider Rules and Regulations

For informational purposes only, not intended to be an exhaustive listing

As with all parts of workers’ compensation the selection of heath care provider is a much regulated procedure. Failure to follow the established rules could result in medical care not being paid for, or medical opinions being found not admissible in Court.

The following is not intended to be an complete listing of the current rules and regulations dealing with selecting a health care provider. For more information please contact the Workers’ Compensation Administration.

  • An employer is required to provide reasonable and necessary medical care in a timely manner after a work related injury.
  • The employer is given the right to either initially select the health care provider, or they may give that right to the injured worker. The initial selection of health care provider stays in effect for at least 60 days.  
  • The employer must notify the worker of their decision to initially select or not to select to the worker in writing. 
  • Emergency medical care is not considered to be a choice by either party.
  • After 60 days the party that did not make the initial selection has the right to make a written change to a health care provider of their choice. This will allow a redirection of medical care to a new health care provider who will remain the authorized treating health care provider for the remainder of the claim.
  • This redirection requires the completion of a Notice of Change of Health Care Provider. Should you wish to redirect your health care to another provider, please contact the Workers’ Compensation Administration.
  • If you receive a Notice of Change of Health Care Provider, notifying you of our exercising our right to change your health care provider, you do have the right to file an objection. Again please contact the Workers’ Compensation Administration.
  • The Objection to Notice of Change of Health Care Provider is to be filed with the Workers’ Compensation Administration. A hearing will then be scheduled in front of a Workers’ Compensation Administration Judge no later than 7 days after the filing of the form.

A judge will determine who the authorized health care provider will be.