Representing the Injured Workers of New Mexico

You are entitled to all reasonable medical care necessary to treat your work injury, including prescription medicine and physical therapy.

The Fogel Law Firm
205 Truman NE, Albuquerque NM 87108
Phone Pat or Mike: (505) 255-9092; State Wide: 1-866-400-9092
FAX: (505) 255-9101

Get and use the forms you need…

In order to collect compensation for your work-related injury, you will need to fill out a number of forms. You will need your doctor to fill out some forms as well. We have provided some of the less complex forms in a downloadable PDF format. To view and print the PDF files, you will need Adobe Acrobat Reader, free software from Adobe.

If you do not have Adobe Acrobat Reader installed on your computer, you may download it by clicking the button below:

Under “Forms…,” a brief explanation of the form and the form's name are provided. “Download form,” allows you to download a PDF of the blank form, which you will fill out.

If you have trouble downloading the PDF(s), try clicking and holding the link and choosing “download to disk” or “save link document as” or “save link target as” or a similar item from the menu (menu options will vary depending upon which browser you are using).

If you have trouble understanding the forms, you may contact the State of New Mexico Workers' Compensation Administration, or you may wish to consult an attorney.

Forms…

WORKERS' COMPENSATION COMPLAINT — This form must be filed with the State of New Mexico Workers' Compensation Administration. It is your initial complaint that indicates you are seeking compensation.

• download form

SUMMONS FOR WORKERS' COMPENSATION COMPLAINT — This form is sent to your employer and his or her insurance provider. It directs them to serve a written response to your Worker's Compensation Complaint.

• download form

WORKER'S AUTHORIZATION FOR DISCLOSURE OF PROTECTED HEALTH INFORMATION FOR WORKERS' COMPENSATION PURPOSES (HIPAA COMPLIANT) — This form allows your medical records to be released to your employer, his or her insurance provider and to the State of New Mexico Workers' Compensation Administration.

• download form

HEALTH CARE PROVIDER QUESTIONNAIRE — Take this form to your doctor. He or she will need to fill it out and return it to the State of New Mexico Workers' Compensation Administration. There are only two (2) lines on this form that you will need to fill out.

• download form

CHANGE OF HEALTH CARE PROVIDER — You have the right to change your doctor (see faq). You will need this form to do so.

• download form