The voting period for this IRR has begun and will extend through March 18, 2026. A ballot for this IRR was sent to the voting body via email on February 26, 2026. The voting body is comprised of current IAIABC jurisdictional and EDI members in good standing. Each eligible organization is allowed one vote per IRR. It is the responsibility of the designated voter (or the alternate, if the designated voter is not available) to discuss the issue up for vote with all stakeholders within their organization and vote accordingly.

The final 14-day review period has begun for this IRR and will extend through February 25, 2026. Please respond with any final feedback or objections.

Claims Committee,

Charles internal conversation is in the attached proposed resolution.  This resolution will proceed with removing PY from the Claim Type Code N definition and adding a new bullet.  

Please review the proposed resolution starting on page 3.  If there are no comments, this IRR will move to 14 day review on February 5, 2026.  

From Claims Committee meeting on 12/17/2025, Charles will talk internally about the possibility of using Claim Type Code = W (Lost Time with No Paid Indemnity) which may more closely align with the NM specific needs.  It will be mid-to-late January before we can move this IRR forward.  

Hi everyone!  

I am posting the following on behalf of Charles from NM.

During the Claims Committee meeting in Wilwaukee, Charles read the Population Restriction rule currently in their Edit Matrix.  We thought it would be helpful to place that rule here for reference:

Also, Charles was asked to provide examples of applicable situations based on actual submissions to the WCA of a PY with Claim Type Code = N in Release 1.0.  They are as follows:

Example 1: A worker files a Complaint for Benefits and names a company as his employer at the time of the accident. The named employer contends that the worker was an independent contractor, not an employee, and denies the claim. After legal proceedings, the Court finds that the worker was an independent contractor and is not entitled to indemnity, medical, or any other benefits. The employer pays their attorneys’ fees for the legal proceedings and reports the payment on the PY with Claim Type Code = N to the Workers’ Compensation Administration (WCA) with no other benefits listed on the claim.

Example 2: A worker files a Complaint for Benefits asking for medical and indemnity benefits. A WCA mediator’s evaluation indicates that a judge would likely find that the worker did not suffer an accidental injury or illness relating to his employment, and recommends the case be dismissed. Both parties accept the recommended resolution. The employer pays their attorneys’ fees and reports the payment on the PY with Claim Type Code = N to the WCA with no other benefits listed on the claim.

Example 3: A worker is killed in a work-related incident and is pronounced dead at the scene. No medical is paid due to the immediacy of the death. Because there are no eligible dependents, the compensation is limited to the funeral expenses pursuant to 52-1-46 (A) NMSA. The employer pays the funeral expenses and reports the payment on the PY with Claim Type Code = N to the WCA with no other benefits listed on the claim.

We will discuss this IRR further when the Claims Committee meets on November 13th, but please feel free to post any questions here ahead of time.