Sanchez v. U-Haul Co. of N.M.

CourtNew Mexico Court of Appeals
DecidedJune 25, 2025
StatusUnpublished

This text of Sanchez v. U-Haul Co. of N.M. (Sanchez v. U-Haul Co. of N.M.) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sanchez v. U-Haul Co. of N.M., (N.M. Ct. App. 2025).

Opinion

The slip opinion is the first version of an opinion released by the Clerk of the Court of Appeals. Once an opinion is selected for publication by the Court, it is assigned a vendor-neutral citation by the Clerk of the Court for compliance with Rule 23-112 NMRA, authenticated and formally published. The slip opinion may contain deviations from the formal authenticated opinion.

1 IN THE COURT OF APPEALS OF THE STATE OF NEW MEXICO

2 Opinion Number:__________

3 Filing Date: June 25, 2025

4 No. A-1-CA-41123

5 RICARDO SANCHEZ,

6 Worker-Appellant,

7 v.

8 U-HAUL COMPANY OF NEW 9 MEXICO and NEW HAMPSHIRE 10 INSURANCE COMPANY,

11 Employer/Insurer-Appellees.

12 APPEAL FROM THE WORKERS’ COMPENSATION ADMINISTRATION 13 Anthony Couture, Workers’ Compensation Judge

14 Dorato & Weems, LLC 15 Derek Weems 16 Albuquerque, NM

17 for Appellant

18 Hoffman Kelley Lopez LLP 19 Jeffrey Federspiel 20 Albuquerque, NM

21 for Appellees 1 OPINION

2 DUFFY, Judge.

3 {1} Ricardo Sanchez (Worker) appeals the Workers’ Compensation Judge’s

4 (WCJ) order granting Worker’s application for bad faith and unfair claim processing

5 under NMSA 1978, Section 52-1-28.1(B) (1990) of the Workers’ Compensation Act

6 (WCA). The WCJ awarded two benefit penalties to Worker, one for bad faith and

7 one for unfair claim processing. Worker argues that the WCJ erred in (1) assessing

8 only two benefit penalties, (2) failing to consider violations of common law and

9 statutory duties as a basis for additional bad faith or unfair claim processing penalties

10 under Section 52-1-28.1(B), and (3) calculating the amount of the benefit penalties.

11 We disagree with Worker on the first and second issues but agree with Worker on

12 the third issue, and we therefore affirm in part and reverse in part.

13 BACKGROUND

14 {2} Worker suffered a work-related injury on August 10, 2017, when he fell while

15 using a floor buffer to clean the inside of a moving truck. Worker was diagnosed

16 with a lumbar strain and given work restrictions of twenty-five pounds. U-Haul

17 Company of New Mexico and New Hampshire Insurance Company (collectively,

18 Employer/Insurer) began paying Worker temporary total disability (TTD) benefits

19 in the amount of $467.08 per week. 1 {3} Employer/Insurer, believing it had the right to select a second healthcare

2 provider (HCP) under NMSA 1978, Section 52-1-49 (1990), changed Worker’s HCP

3 from Concentra to Dr. Paul Legant. Dr. Legant determined Worker was at maximum

4 medical improvement (MMI) and assigned Worker a two percent whole person

5 impairment rating. Employer/Insurer ceased paying Worker TTD benefits in

6 October 2017, but delayed over three months before beginning to pay Worker

7 permanent partial disability (PPD) benefits, which, at the two percent impairment

8 rating, amounted to just $9.34 per week.

9 {4} Worker disputed that he was at MMI, and the parties agreed Worker would

10 undergo an independent medical evaluation by a panel of two doctors. The panel

11 concluded that Worker had not yet reached MMI. On February 22, 2019, nearly a

12 year and a half after the work accident, the WCJ issued a compensation order finding

13 that Worker had not reached MMI. The WCJ determined that Worker was entitled

14 to TTD benefits in the amount of $499.97 per week dating back to September 11,

15 2017. Employer/Insurer paid Worker $36,683.76 in back-owed benefits.

16 {5} Worker received TTD benefits until he reached MMI on August 14, 2020. On

17 April 1, 2021, the WCJ entered a stipulated compensation order regarding Worker’s

18 PPD benefits. The parties agreed that Worker was entitled to modified PPD benefits

19 at seventy percent, or $349.98 per week, based on Worker’s fourteen percent whole

20 person impairment rating and modifiers of fifty-six percent.

2 1 {6} After Worker’s indemnity benefits had been settled, Worker filed an

2 application for bad faith and unfair claim processing, alleging that Employer/Insurer

3 had committed thirty-three separate acts of unfair claim processing and bad faith in

4 the course of handling Worker’s claims for benefits. The WCJ found that

5 Employer/Insurer “unintentionally” violated Section 52-1-49 regarding the

6 healthcare selection process, which resulted in an unreasonable delay in payment of

7 benefits to Worker and amounted to unfair claim processing. The WCJ also

8 determined that Employer/Insurer attempted to circumvent restrictions against ex

9 parte communication with Worker’s health care providers by assigning a nurse case

10 manager for litigation purposes, which delayed Worker’s care and amounted to bad

11 faith. The WCJ assessed a fine against Employer/Insurer in the amount of $4,694.69

12 for unfair claim processing, and another fine in the amount of $4,694.69 for bad

13 faith. Worker appeals.

14 DISCUSSION

15 {7} Worker’s claims on appeal center on the number of penalties awarded by the

16 WCJ and their amount under Section 52-1-28.1(B), which states, “If unfair claim

17 processing or bad faith has occurred in the handling of a particular claim, the

18 claimant shall be awarded, in addition to any benefits due and owing, a benefit

19 penalty not to exceed twenty-five percent of the benefit amount ordered to be paid.”

20 As we explain, Worker has not demonstrated error in the WCJ’s determination that

3 1 Worker was entitled to two penalties under Section 52-1-28.1(B), and Worker did

2 not preserve his argument that common law or Insurance Code violations can serve

3 as a basis for additional penalties under Section 52-1-28.1(B); but we agree with

4 Worker that the WCJ’s calculation of the benefit amount was not in accordance with

5 Section 52-1-28.1(B).

6 {8} To the extent Worker asks us to review the WCJ’s factual findings, our review

7 is for substantial evidence under a whole record standard. See Dewitt v. Rent-A-Ctr.,

8 Inc., 2009-NMSC-032, ¶ 12, 146 N.M. 453, 212 P.3d 341. To the extent Worker

9 asks us to review “a workers’ compensation judge’s interpretation of statutory

10 requirements and the application of the law to the facts, we apply a de novo standard

11 of review.” Baker v. Endeavor Servs., Inc., 2018-NMSC-035, ¶ 15, 428 P.3d 265.

12 To the extent Worker asks us to review the WCJ’s discretionary decisions

13 concerning the amount of the benefit penalties, our review is for abuse of discretion.

14 See Romero v. Laidlaw Transit Servs., Inc., 2015-NMCA-107, ¶ 8, 357 P.3d 463.

15 I. The WCJ’s Assessment of Two Benefit Penalties

16 {9} Worker first asserts that the WCJ erred by assessing only two benefit

17 penalties—one penalty for unfair claim processing and one penalty for bad faith. We

18 understand Worker to argue that the WCJ should have assessed additional penalties

19 for each of Worker’s alleged violations, rather than two penalties “for the myriad

20 bad conduct employer engaged in to affect all aspects of benefits entitlement.”

4 1 Worker focuses on how many penalties are permitted by Section 52-1-28.1(B)—a

2 question that is not clearly answered by the plain language of the statute and remains

3 unanswered by New Mexico precedent. During oral argument in this case, the parties

4 agreed that Section 52-1-28.1(B) allows for multiple penalties to address separate

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