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 NOTICE:  The following information and claim forms are intended for use by State Insured Entities Only

Information Regarding “How To” File a Claim for Workers' Compensation Benefits

Follow the steps outlined below:
Reminder: The completed Doctor Visit / Modified Work Assignment form is to be returned to his/her employer at the conclusion of each and every doctor visit
  1. The injured Worker completes a Notice of Accident (NOA) with their Supervisor (to obtain this form contact your Agency Human Resource Bureau Representative)
  2. In conjunction with a Supervisor or the HR Representative, the injured worker will complete the forms included in the Worker’s Compensation packet.  Forms to be completed are identified in the Workers’  Compensation Injury Forms Packet (see Forms section below)
  3. Human Resources Bureau Representative and or the injured workers’ Supervisor will submit all completed forms to:

Risk Management Division/Workers Compensation Bureau
P.O. Box 6850
Santa Fe, New Mexico 87520
Fax to:  (505) 827-0685



Workers’ Compensation Injury Forms Packet

The forms identified below can be downloaded for your convenience and will assist you in filing a Workers’ Compensation Claim. For further assistance, please contact our Bureau by calling (505) 827-2711 or 1-800-510-5093.
NOTE: RMD/WCB will be unable to accept the Workers’ Compensation Claims submitted unless all forms are completely filled out and submitted to the WCB.
Note:  You may type directly into these forms. In order to do this, please download the latest Adobe Reader.