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 in the event of a workplace injury or illness. 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. To get your claim started, your employer must report the injury or illness to the SIFC within five days after the incident occurred. 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 Puerto Rico workers’ compensation claims are identical, so your individual process may vary. For information about Puerto Rico workers’ compensation benefits in English, see the Social Security Administration’s page.

Puerto Rico Workers’ Compensation Statistics

The annual workers’ compensation report published by the Bureau of Labor Statistics (BLS) includes data for nearly every state and U.S. territory. This report lists the total number of workers’ comp claims filed, how many employees missed work, and claims data across all job sectors broken down by year. Our chart below shows exactly where Puerto Rico workers’ compensation claims fell from 2011 to 2015.

The Puerto Rico workers’ compensation statistics above show a few interesting trends – primarily that the total claims filed fell by 9,900 between 2011 and 2015. Then, we see that 7,500 fewer people missed work, changed jobs are were given 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.

Get Your Puerto Rico Workers’ Compensation Questions Answered for Free

If the Puerto Rico workers’ compensation process seems confusing, you’re not alone. That’s why we encourage you to speak with a knowledgeable advocate about your situation for free before starting your claim. A workers’ compensation advocate in our network would be happy to meet with you to discuss your injury or illness in person.

To schedule your free evaluation with a Puerto Rico workers’ compensation advocate in your area, click the button below now.

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