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STATE OF NEW MEXICO WORKERS COMPENSATION ADMINISTRATION, Worker, v., Uninsured Employer, WPA No.: NEW MEXICO UNINSURED EMPLOYERS FUND, Statutory Third Party. WORKERS COMPENSATION COMPLAINT 1. 2.3.

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How to fill out uninsured employer

01

Gather necessary information: You will need the employer's name, address, and contact information.

02

Complete the form: Fill out the uninsured employer form accurately and completely. Include all required information, such as the dates of employment and the employee's job description.

03

Provide supporting documentation: Attach any relevant documents, such as witness statements or medical records, to support your claim.

04

Submit the filled form: File the completed uninsured employer form with the appropriate authority or agency, usually the state's workers' compensation board or department.

05

Follow up: Keep copies of the form and any supporting documents for your records. Stay in touch with the authority or agency to track the progress of your claim and respond promptly to any additional requests.

Who needs uninsured employer?

01

Workers who have been injured or experienced work-related illnesses while working for an employer who does not have workers' compensation insurance.

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What is uninsured employer?

An uninsured employer is an employer who does not have workers' compensation insurance coverage.

Who is required to file uninsured employer?

Employers who do not have workers' compensation insurance coverage are required to file as uninsured employers.

How to fill out uninsured employer?

To fill out uninsured employer status, employers must submit a specific form provided by the state labor department.

What is the purpose of uninsured employer?

The purpose of uninsured employer filing is to ensure that all employees are covered by workers' compensation insurance in case of work-related injuries.

What information must be reported on uninsured employer?

Employers must report their business information, number of employees, and reasons for not having workers' compensation insurance coverage.

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