STATE OF NEW MEXICO WORKERS COMPENSATION ADMINISTRATION _____________________________, WCA NO:_____________________ Worker, VS. _____________________________, and Employer, _____________________________, Insurer, WAIVER OF DISQUALIFICATION _______________________, appearing for the Worker/Employer/Insurer waive the right to disqualify a judge in the above captioned cause as provided under New Mexico Workers Compensation Administration Rule 4.4.12.2.3. _____________________________ ____________________________________ Counsel for Worker/Pro Se Counsel for Employer ______________________________ ____________________________________ ______________________________ ____________________________________ ______________________________ ____________________________________