Puerto Rico workers' compensation

How To Claim Puerto Rico Workers’ Compensation Benefits

In Puerto Rico, workers’ compensation coverage is mandatory for all employees. Unless you’re a federal employee, all claims are handled within the territory and approved requests are paid directly through the State Insurance Fund Corporation (SIFC). Any Puerto Rican who gets hurt or sick on the job and wants to file a workers’ comp claim should follow the specific steps set in place by government officials. Below, we list the usual steps to file a Puerto Rico workers’ compensation claim, plus statistical insights from the last five years of the program’s history.



How to File Your Puerto Rico Workers’ Compensation Claim

All employers on the island are required to carry Puerto Rico workers’ compensation coverage. Federal employees, however, must file their Puerto Rico workers’ compensation claims through the U.S. government. This insurance policy protects everyone when a workplace injury or illness occurs. According to the Puerto Rico Industrial Commission, here’s how to file your claim:

  1. If you get sick or hurt on the job, notify your employer immediately.
  2. Your employer must then report the injury or illness to the SIFC within five days to start your claim. If you develop an occupational illness, the statute of limitations for filing your claim is normally three years from your date of medical diagnosis.
  3. In most cases, your employer selects your primary treating physician (PTP), who you must see during the first 30 days of your treatment.
  4. After the first 30 days, you may choose a different physician from the providers listed in your employer’s network.
  5. If your claim’s approved, you’ll be notified within 60 days of your filing date.
  6. In the event your SIFC manager denies your claim, you can download forms for filing your appeal directly from the Puerto Rico Industrial Commission’s website.

We realize that no two claims are identical, so your individual process may vary. For information about PR workers’ compensation benefits in English, see the Social Security Administration’s page.

Puerto Rico Workers’ Compensation Statistics

The annual workers’ compensation report from the Bureau of Labor Statistics (BLS) includes data for nearly all states and territories. This report lists total workers’ comp claims filed, how many employees missed work, and claims data across all job sectors. Our chart below shows exactly where Puerto Rico workers’ compensation claims fell from 2011 to 2015.

 

The statistics above show a few interesting trends – primarily that total claims filed fell by 9,900 between 2011-2015. Then, we see that 7,500 fewer people missed work, changed jobs or had restrictions from 2011 to 2015. The service jobs sector shows relatively little change, during this five-year period. However, we may see radically different numbers in the coming years due to Hurricane Maria’s impact, which damaged most of the island’s infrastructure.

You May Qualify for Legal Assistance

If the workers’ compensation process seems confusing, you’re not alone. That’s why we encourage you to speak with a knowledgeable advocate for free before starting your claim. A workers’ compensation advocate in our network would be happy to call and give you free advice by phone.

Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!

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