Official website of the Government of Puerto Rico

Rights and Obligations of the Injured

What is the Compensation System?

The SIFC administers a social security system that protects workers who are injured or have occupational diseases. This guarantees:

• Medical and hospital care
• Financial compensation for disability or death
• Protection for the beneficiaries of the affected worker

Work Accident vs. Occupational Illness

Work accident: Injury suffered while performing employment-specific functions, without the need for an external event.

Occupational illness: A physical or emotional condition caused by work factors, which appears without a specific identifiable moment.

Requirements for Receiving Benefits

For a case to be compensable:

• The accident must happen during work functions
• It must happen at the place and time of work

Excluded are:

• Self-inflicted injuries
• Accidents under the influence of alcohol/drugs
• Offences committed by the worker
• Crude recklessness

Medical Treatment

Injured people have the right to treatment in:

• CFSE local, regional and intermediate dispensaries
• Industrial Hospital
• Contracted supplier network

Important:

• Bra treatment only covered in serious cases (e.g. permanent spinal cord injury)
• In case of Relapse, reactivation of the case may be requested up to 3 years after discharge

Economic Compensations

Transient Disability (Diets):

• 66% 2/3 of the weekly wage
• Minimum $30/Maximum $100
• Up to 312 weeks

Permanent Partial Disability:

• Compensation according to severity
• $12,000 cap
• Cannot be combined with diets

Total Permanent Disability:

• Lifetime payment (unless you choose a profitable investment)
• It is determined by medical, statutory or socioeconomic criteria

Employment Reserve (Article 5A)

The employer must reserve the worker's position for 360 days. The worker must:

• Be incapacitated and take advantage of Act No. 45
• Request reinstallation within 15 days After discharge
• Fulfill essential functions of the position
• That the position still exists at the time of applying

Deadlines for Filing Claims

Work Accident:

• You have 5 days from the event to attend the CFSE
• The medical exam must be done at the CFSE
• You can lose compensation if you default without valid justification

Valid causes:

• Appropriate or effective external treatment
• Serious injury
• Ignorance of employment origin
• Good faith believing that the employer notified

Occupational Disease:

• Up to 3 years after the condition causes disability

Appeals and Industrial Commission

Appeals:

• Uninsured employers can appeal within 30 days
• Surcharges, classifications and audits can also be appealed.

Industrial Commission: Agency | Government of Puerto Rico

• Quasi-judicial forum to resolve disputes between CFSE, workers and employers
• It represents the public interest

Free Legal Advice

The Bureau of Opinions and Legislation provides legal guidance on the Compensation Act.

Call (787) 781-8577 for help.