Workers' Compensation Claim Forms

Workers' Compensation Claim Forms, completed for employees who have experienced a work related injury, must be signed by a supervisor and submitted to the OHR. Do not send the forms directly to Risk Management/Workers' Compensation.

OHR will check the forms for completeness and send the originals to the Workers' Compensation Unit of Risk Management. Copies of the claims are kept in OHR for federal reporting.

The Workers' Compensation Unit of Risk Management works directly with the employee and is responsible for the processing of claims.

The following five forms must be used every time a claim is filed:

Please submit all applicable forms to:

NM Human Services Department
Office of Human Resources
Medical Issues Coordinator
P.O. Box 2348
Santa Fe, NM 87504-2348