The following are some general frequently asked questions pertaining to the workers' compensation Uninsured Employers' Fund (UEF).
Uninsured Employers' Fund (UEF)
Frequently asked questions are separated into Question and Answer expandable categories. Click on the question below to expand the section to view the answer.
A1: The UEF (Uninsured Employers' Fund) was created in 2003. It provides benefits such as indemnity and medical payments to injured workers when their employer does not have workers' compensation insurance. The UEF law can be found in Chapter 52, Section 52-1-9.1 of the New Mexico Statutes Annotated (NMSA) 1978. The UEF rules can be found in Title 11, Chapter 4, Part 12 of the New Mexico Administrative Code.
A2: The UEF Administrator is an employee of the WCA. The WCA Director has authority over the UEF and instructs the UEF to make payments for a worker's claim. The UEF uses a third-party administrator (TPA) to help investigate claims involving the UEF. The TPA is responsible for making legally required indemnity and medical payments on behalf of the UEF.
A3: The WCA employs two attorneys who represent the UEF when it is named as a party in a complaint filed with the WCA. The attorneys report to the UEF Administrator. The attorneys appear as needed before WCA judges and in other courts to protect the UEF's legal interests.
A4: Each calendar quarter, workers contribute $2.00 and employers contribute $2.30 per employee. These fees are submitted to the New Mexico Taxation and Revenue Department and are transferred to the WCA. These fees serve as funding for both the WCA and the UEF.
A5: If the UEF is named in a complaint, the UEF will determine if the claim is subject to benefits. The UEF Administrator will review the claim with the assigned UEF attorney and the TPA to decide if the claim is eligible and compensible.
- A claim is considered eligible when the uninsured employer was required to have workers' compensation insurance and the worker was employed by that employer on the date of the injury.
- A claim is considered compensible if the injury happened during work hours. The worker's injury must be medically related to the workplace accident.
A6: The UEF has the right to challenge claims if the injury happened outside the worker's duties. Workers must give timely notice of an injury or it can be challenged. A worker's injury must be related to the workplace accident. These are examples of defenses the UEF may state as a reason to not pay benefits.
A7: Yes, there is a maximum amount.
- For injuries that happened on or after December 23, 2005, the limit is $40,000 for both medical and indemnity benefits.
- For injuries that happened on or after July 1, 2023, the limit is $60,000 for both medical and indemnity benefits.
- For injuries that happen on or after July 1, 2025, the limit is $75,000 for both medical and indemnity benefits.
A8: The UEF will try to recover all money paid to the injured worker. Frequently, a reimbursement agreement will be signed by the employer and the UEF that lists payment details. If the employer does not make payments to the UEF, legal action may be taken against the employer to obtain the funds.
A9: Parties are not required to have an attorney. Unrepresented parties will be held to the same standard as represented parties. UEF attorneys do not provide legal advice. It is recommended to seek legal representation. The WCA ombudsmen can help unrepresented parties involved in a workers' compensation claim. Ombudsmen are not attorneys and cannot provide legal advice. They can answer basic questions and provide general information. Contact an ombudsman toll free at 1-866-967-5667.
A10: The UEF may provide benefits to family members if a worker dies because of a workplace accident. The benefits paid are subject to the UEF maximum limit (see Q7). It is recommended that the parties seek representation in death cases.
