P.R. Laws tit. 11, § 3
Any worker or employee who is injured or suffers [an] occupational disease within the conditions of this chapter as established in § 2 of this title thereof shall be entitled to:
(a) Medical assistance.— To medical attendance and such medicine as may be prescribed, including hospital services when necessary; but when, in the judgment of the Manager of the State Fund, such medical or hospital services should be discontinued, the workman or employee may appeal to the Industrial Commission.
(1) Worker claims shall be closed for all legal purpose after three (3) years as of the definitive closing date of the case, except regarding the following conditions when the ill-effects may become evident after a longer term has elapsed:
(A) Cytotoxic
(B) Exposure to asbestos
(C) Exposure to mercury
(D) Exposure to lead
(E) Exposure to cadmium
(F) Exposure to radium
(G) AIDS
(H) Hepatitis C
(I) Exposure to beryllium
These conditions shall be evaluated according to established medical protocols.
(2) Applications for reopening cases shall only be processed when filed within a term not to exceed three (3) years as of the definitive closing date of the claim, subject to the following conditions:
(A) When clear and convincing medical evidence exists indicating that the condition has worsened or there has been a relapse.
(B) When the injury that was originally compensated has been the sole cause of said worsening or relapse, without the intervention of any factor or cause foreign to the original accident.
(C) When allegations of secondary conditions are involved, these must have been caused, hastened, worsened by the original condition, without the intervention of any agent foreign to the original accident.
(D) When the injured worker or employee requests in writing that the case be reopened.
(b) Temporary disability.— If the disability is of a temporary or transitory nature, a compensation equal to sixty-six and two thirds percent (66⅔ %) of the wages he/she was earning or would have earned on the day the accident occurred, but for such accident, during the period he/she is disabled for work and payable at the end of each week. The period for such payment shall in no case exceed three hundred and twelve (312) weeks; Provided, That in no case shall such payment exceed one hundred dollars ($100) or be less than thirty dollars ($30) a week. The worker or employee shall be entitled to compensation from the day he/she presents him/herself to the physician for treatment. Provided, That in such cases where an injured worker, in the judgment of the Manager, requires a referral to vocational training or retraining as part of the treatment, the injured worker shall receive the aforementioned compensation, but in no case shall be paid for more than twenty-six (26) weeks. During the period of disability for work, no public employee or officer may receive, with the exception of the period during which he/she is enjoying regular vacation leave or sick leave, any sum for weekly compensation, which added to the salary he/she may be receiving from the government agency for which he/she works, exceeds the regular salary of his/her position.
(1) Accidents continuing under investigation.—
(A) In those cases where the accident continues under investigation of the State Insurance Fund during a term to be fixed by regulations and which shall not exceed sixty (60) days to determine if same is one of the accidents covered by this chapter and that the Manager may consider meritorious, he shall order advance payments to the injured workman chargeable to the per diems to which such workman may be entitled.
(B) The advances made in accordance with this subsection shall be paid chargeable to the Advance Payment for the Payment of Temporary Disabilities [Fund] hereunder created.
(C) The advances shall be made in accordance with the terms of clauses (1)–(3) of this subsection and of the regulations approved by the manager within his/her faculties under the law, but same shall not exceed the total of the maximum per diems to which the workman would be entitled in accordance with the law in force at the time of the occurrence of the accident and the manager shall ascertain in every case that the economic solvency of the State Insurance Fund is protected.
(D) If as a result of said investigation the manager should determine that the accident is one covered by this chapter, he shall continue paying to the injured workman the per diems for temporary disability to which he is entitled in accordance with the law.
(2) Result of investigation and final findings.—
(A) If the result of the Manager’s investigation and final findings was that the injury of the workman or employee who received the advance payments was not caused by a work accident, the State Insurance Fund shall have a claim and a preferential lien on the insurance or any other plan, both public and private, that the injured person may have.
(B) For the purposes of obtaining said reimbursement with the urgency required by the public policy and for the purposes of clauses (1)–(3) of this subsection, the Manager of the State Insurance Fund shall certify to the Director of the Office or to the corresponding government bureau or the private entity or person involved, for purposes of reimbursement, an invoice containing the liquidation of the payments made chargeable to the Advance Payment Fund for the Payment of Temporary Disability, and such payments shall be reimbursed immediately in accordance to those submitted. Said payments by reason of reimbursement shall be covered into the Advance Payment Fund hereunder created.
(C) The Manager of the State Insurance Fund may obtain the reimbursement provided for in this clause, through a judicial claim if necessary, which shall be transacted summarily and following the same procedure as an injunction, or if in any case the Manager of the State Insurance Fund so determines through the regular procedure.
(D) The right of subrogation of the Manager of the State Insurance Fund recognized in this chapter applies in the same measure and scope to all cases that may arise under clauses (1)–(3) of this subsection.
(3) Special fund.—
(A) There is hereby created a Special Fund in the State Insurance Fund which shall constitute and shall be known as the “Advance Payment Fund for the Payment of Temporary Disabilities.”
(B) The Manager is hereby authorized to make periodical transfers from the General Fund of the State Insurance Fund to the Advance Payment Fund for the purposes that at all times same [the Advance Payment Fund] be sufficiently solvent to comply with the provisions of clauses (1)–(3) of this subsection.
(C) The Manager of the State Insurance Fund shall establish the standards and the necessary procedure to the effect of determining the form and amounts which the agency shall periodically transfer from its unencumbered funds to the Advance Payment Fund for the Payment of Temporary Disabilities to keep it solvent and to transact and reimburse to this Fund the payments made to injured workmen chargeable to same in conformity with clause (1) of this subsection.
(D) The Advance Payment Fund for the Payment of Temporary Disabilities shall be administered by the Manager of the State Insurance Fund, exclusively to be used as advance payment for temporary disabilities to workmen who suffer accidents while such accident is under investigation to determine whether same is or not a work accident protected under this chapter.
(E) The money corresponding to said Fund shall not be consolidated with other funds and shall be kept in a separate account in the books of the State Insurance Fund.
(c) Permanent partial disability.— Permanent partial disability shall be deemed to be the loss of one foot or leg, one hand, one arm, one eye, one or more fingers or toes, and any ankylosis or dislocation, when ligaments have been torn and where restoration is not complete. For the permanent partial disabilities specified below, the injured worker or employee shall receive additional compensation consisting of sixty-six and two thirds percent (66⅔ %) of the wages which were received, or would have been received by him but for such accident, on the day of the accident, for the number of weeks specified in the following table; Provided, That in no case shall there be paid to the worker or employee more than sixty-five dollars ($65), or less than twenty dollars ($20) a week; and Provided, further, That in no case shall a sum greater than twelve thousand dollars ($12,000) be paid.
TABLE OF COMPENSATIONS Arms: For the loss of an arm at or above the elbow for 300 weeks For the loss of the right forearm at either the upper or lower third for 225 weeks For the loss of the left forearm at either the upper or lower third for 200 weeks In cases of loss of the left forearm at either the upper or lower third, the compensation corresponding to the loss of the right forearm at the upper or lower third shall be granted when the said left forearm is the able limb. Legs: For loss of one leg by amputation, including pelvi-section (pelvitomy) for 300 weeks For loss of one leg by disarticulation at the level of the coxofemoral for 275 weeks For loss of one leg by amputation at the upper third of thigh for 250 weeks For loss of one leg by amputation at the lower third of thigh for 225 weeks For loss of one leg by amputation at or below the knee with unsatisfactory stump for 200 weeks For loss of one leg by amputation at or below the knee with a satisfactory stump as to length, configuration and general condition for 175 weeks For loss of one foot by disarticulation at the level of tibiotarsal articulation (disarticulation) for 175 weeks For loss of one foot by amputation at or below the ankle for 160 weeks For an ankylosed knee in a defective position for 150 weeks For an ankylosed knee in a good position for 120 weeks For an ankylosed ankle in a defective position for 125 weeks For an ankylosed ankle in a good position for 100 weeks For the loss of the big toe at the joint of metatarsus and phalanx for 30 weeks For the loss of the big toe at the second joint for 10 weeks For the total loss of any toe for 15 weeks Hands: For the loss of the right hand at the wrist for 200 weeks For the loss of the left hand at the wrist for 180 weeks In cases of loss of the left hand at the wrist, the compensation corresponding to the right hand shall be granted when said left hand is the able hand. For the loss of the thumb with the metacarpal bone for 75 weeks For the loss of the second phalanx of a thumb for 30 weeks For the loss of the first and second phalanges of a thumb for 35 weeks For total loss of the index finger for 40 weeks For the loss of the index finger at the second phalanx for 30 weeks For the loss of the index finger at the third phalanx for 20 weeks For the total loss of middle finger for 30 weeks For the loss of the middle finger at the third phalanx for 10 weeks For the loss of the middle finger at the second phalanx for 20 weeks For the loss of the ring finger for 25 weeks For the loss of the ring finger at the second phalanx for 20 weeks For the loss of the ring finger at the third phalanx for 10 weeks For the loss of the little finger for 15 weeks For the loss of the little finger at the second phalanx for 10 weeks For the loss of the little finger at the third phalanx for 5 weeks Hearing and Voice: For the total loss of hearing for 200 weeks For the total loss of hearing in one ear only for 50 weeks For the total loss of voice for 200 weeks Permanent visual disabilities shall be determined and evaluated by the manager of the State Insurance Fund on the expert report of an oculist; Provided, That partial disabilities shall be determined according to the percentage of the total disability that they represent, taking into consideration the industrial vision efficiency of both eyes and applying therefor the factors one (1) and three (3) for the worse and the better eye, respectively; and/or any other guideline more liberally established hereafter and Provided, further, That ten percent (10%) total permanent disability shall be compensated for the loss of the eyeball by enucleation, evisceration, or extreme atrophy, in addition to the visual disability resulting therefrom. The complete and permanent functional loss of any member, which affects the industrial capacity of the workman or his earning capacity, shall be considered as a total loss of said member as if it had been amputated. Compensation for any other unspecified permanent partial disability shall be graded in accordance with the disability that most resembles the corresponding disability specified in the foregoing table, and compensation shall be given for such number of weeks that most resembles the disability taken as a basis for grading the disability not specified in the table; Provided, That the disabilities resulting from the loss of function of three (3) or more digits, and disabilities resulting from the loss of function of the thumb and/or index fingers (pincer functions) shall be graded as said disability affects the hand; Provided, further, That the disabilities that result from the loss of teeth shall be graded as they affect the physiological functions of the worker; Provided, also, That the compensation for any partial disability accepted by this chapter, except as hereinafter provided, shall never exceed twelve thousand dollars ($12,000), regardless of the number of accidents suffered by the worker; and Provided, further, That in case a scar, burn or any change in physiognomy disfigures the face or head or neck or one or both hands or arms of the injured person, the Industrial Commission, at the request of the manager of the State Insurance Fund or of the injured worker or employee, shall decide, in accordance with the seriousness of the injury, how much compensation should be allowed on this account. In no case shall a sum greater than three thousand dollars ($3,000) be paid for disfiguration of the face, head or neck of the injured worker and, in the case of disfiguration of the hands or arms it shall not be greater than one thousand six hundred dollars ($1,600). In cases where the hands or arms are disfigured, no compensation shall be paid on this account if the disfiguration was taken into consideration when fixing any compensation for disability of said hand or arm. The Industrial Commission shall grade this compensation while taking into consideration the seriousness of the disfiguration and the profession, trade and sex of the injured person; and Provided, also, That in cases of hernia and as the result of an accident suffered in the course of work and as a consequence thereof, it shall be proven to the satisfaction of the Manager of the State Insurance Fund on the basis of a statement made by a physician:
(1) That an accident, other than mere strain, causing or aggravating the hernia, occurred.
(2) That the hernia appeared in either of these two (2) forms immediately after an accident and as a result thereof.
(3) A pre-existent hernia shall be considered as being aggravated when the aggravation is produced by a direct trauma on the hernia or by an extraordinary strain or in case of acute strangulation or incarceration when they occur immediately after an accident or as a result thereof, and when a pre-existent hernia becomes symptomatic after a work accident.
In any case entitled to compensation, in which a surgical operation is necessary, the Manager of the State Insurance Fund shall have the right to order a medical examination, and if it is shown by said examination that the workman or employee has any chronic disease or is otherwise in a physical condition that ordinarily determines that such operation would be unsafe, the workman or employee shall receive his compensation for disability under the general provisions of this chapter, even when he does not submit to such operation. If the examination does not show the existence of any disease or physical condition showing any danger in this operation, and the workman or employee, knowing the result of said examination, still persists in refusing to submit to such operation, he shall be entitled to only one half (½) of the compensation ordinarily belonging to him under this chapter.
(d) Total permanent disability.— If, as a result of the injury or disease, the worker’s or employee’s case were resolved to be a total permanent disability case, the worker or employee shall continue to receive a sum equal to sixty-six and two thirds (66 2 / 3 %) of the wages received on the day of the accident for such time as said total disability may last, but in no case shall there be paid more than four hundred and thirty dollars ($430) a month nor less than one hundred and thirty dollars ($130) a month; Provided, That the payment of this pension shall be retroactive to the date of the accident, but the retroactive payment shall never exceed twelve (12) months; and, Provided, That at the request of the beneficiary, and in lieu of a life pension, the Manager may pay the compensation to the beneficiary, in part or in whole, and in one single payment, provided the latter justifies a profitable investment in the judgment of the Manager, and to which effects the compensation shall be computed on the basis of five hundred forty (540) weeks for a term that, added to the term during which the injured person had already received the monthly compensation payments shall not exceed five hundred forty (540) weeks, in which cases, the weeks shall be computed at a rate of sixty-six and two thirds percent (66 2 / 3 %) of the weekly wage which the beneficiary was receiving on the day of the accident, or would have received had it not been for the accident, but in no case shall weeks of more than one hundred dollars ($100), nor less than thirty dollars ($30) be computed. Provided, further, That the total compensation to be paid shall in no case exceed thirty-two thousand four hundred dollars ($32,400). If after the investment is made there is a balance left, it shall be paid at a rate of three hundred dollars ($300) a month, unless the beneficiary should opt for a subsequent investment.
When, in the judgment of the Administrator, the physical or mental condition of the disabled person requires the continuous assistance of another person, he/she may authorize an additional payment of not more than eighty dollars ($80) a month on behalf of the relative or person who will care for the disabled person as long as the need exists. In addition, he/she may offer medical assistive equipment, services, and assistive technology equipment when deemed pertinent after the proper specialized evaluation.
The total and permanent loss of industrial vision in both eyes; the loss of both feet at or above the ankle; the loss of both hands at or above the wrist; the loss of one hand or one foot; total mental disturbances which are incurable, and such injuries that bring about the total and permanent disability of the worker or employee to engage in any kind of paid job or occupation shall be deemed a total disability.
In those cases of total permanent disability in which, as a result of a compensable accident or occupational disease, the worker or employee has the need to use a special device or assistive technology equipment prescribed by a physician of the State Insurance Fund Corporation, upon final discharge, the administrator shall provide said special device or assistive technology equipment; Provided, That said special device shall not be replaceable for any reason whatsoever. In the event that the injured person intends to build a specially-designed dwelling for his/her use in order to facilitate his/her mobility or to adapt the one he/she owns, or to remodel its accesses for the aforementioned purposes, the administrator shall grant, as an additional benefit, a sum not greater than one thousand three hundred dollars ($1,300) to be invested in the achievement of such purposes. The investment of said sum shall be supervised by the administrator so as to make sure that it will be used to the benefit of the injured worker or employee. Provided, That if a worker or employee is totally and permanently disabled due to the total and permanent loss of industrial vision in both eyes; the loss of both feet at or above the ankle; the loss of both hands at or above the wrist; the loss of one hand and one foot; or for becoming paraplegic or quadriplegic, or for having permanently lost the function of both legs in such a way that he/she is bound to move about in a wheelchair, and despite said condition, he/she is rehabilitated in any other area of industry, neither the benefits nor the compensation he/she is entitled to for his/her permanent and total disability shall be suspended, even if the Industrial Commission determines that said disability has ceased. Provided, further, That workers with injuries to the spinal cord who have been rendered totally disabled are entitled to receive treatment, special devices, assistive technology, and spinal cord therapy as long as necessary.
(d-1) Disabilities not comprised in compensation table.— In those cases where the permanent partial disability cannot be properly fixed in accordance with the Compensation Table inserted above, the same shall be graded according to the general physiological functions of the worker or employee and the compensation shall be computed on the basis of four hundred and fifty (450) weeks as a maximum and shall not exceed twelve thousand dollars ($12,000).
(d-2) Definition of week and day.— For the purpose of computing the compensations provided in this chapter, it shall be understood that the week consists of five (5) working days, and the working day of eight (8) hours, except where from the facts investigated it arises that the workman or employee worked regularly more than forty (40) hours a week.
(d-3) Pre-existing disabilities.— In all cases where a workman, by reason of a labor accident, suffers the aggravation or augmentation of a former disability not resulting from a labor accident, the disability resulting from the accident shall be compensated, including the former disability; but in those cases where the workman suffers the aggravation or augmentation of a pre-existing disability caused by a former accident and for which he received the corresponding compensation there shall be deducted from the compensation to which he may be entitled for the total disability resulting therefrom, the amount of the compensation he received for his pre-existent disability; Provided, That in all cases where a workman suffers the aggravation or augmentation of a pre-existent disability and said aggravation or augmentation results in the total and permanent loss of the member or organ affected, or results in the total and permanent loss of the general physiological functions, the workman shall be compensated for the total disability without taking into consideration the pre-existent disability even if he received compensation therefor; and, Provided further, That the additional cost resulting from the application of this provision shall be paid chargeable to the Reserve Fund for Disasters and shall not be taken into consideration for the purposes of the Merit Rating System which is hereinafter provided.
In all cases in which the death of a worker or employee occurs for any cause not related to the injury received in the accident for which injury any compensation was given, or a total or permanent disability is recognized or is pending adjudication, the following procedure shall apply:
(1) If the injured person has chosen an investment, the remainder of his compensation shall be paid to the beneficiaries in monthly payments of four hundred thirty dollars ($430) subject to the limitations imposed by the first paragraph of subsection (e)(3)(C) of this section; should there be beneficiaries other than the widow, children or concubine, the distribution shall be made subject to the provisions of subsection (e)(3) of this section.
(2) If the injured person has not chosen an investment, the total compensation shall be computed by multiplying five hundred forty (540) weeks by his weekly compensation equivalent to sixty-six and two thirds percent (66 2 / 3 %) of the weekly wage which the injured worker was receiving on the date of the accident, or would have received had it not been for the accident, but in no case shall weeks be computed of more than one hundred dollars ($100), nor less than thirty dollars ($30). Total compensation shall, in no case, exceed thirty-two thousand four hundred dollars ($32,400). From the total compensation thus computed, there shall be deducted the amount paid to the injured worker prior to his death, and the remainder shall be paid to his beneficiaries in the manner and with the limitations provided in clause (1) of this subsection.
(3) Subject to the limitations provided in clauses (1) and (2) of this subsection, for the purposes of making an investment which, in the Manager’s judgment would be beneficial, he may advance up to fifty percent (50%) of the total worth of the future monthly payments at the time of the investment to the surviving spouse or concubine. Once the investment has been made, the monthly payments made to the spouse or concubine, chargeable to the remainder, shall be reduced proportionally in such a way that the term of payment of the remaining sum at the time the investment is made shall remain unaltered, without taking into account the minimum monthly payments provided in this chapter. The Manager of the State Insurance Fund may authorize more than one investment to the same spouse or concubine, but never more than one in a period of three (3) consecutive years. The monthly payments to be charged to the remainder shall cease if the spouse or concubine should remarry, live in concubinage, or die. If one of the situations indicated above should occur, and there are dependent minors entitled to benefits, their monthly payments shall be increased, preferably by distributing the monthly payment received by the spouse or concubine chargeable to the remainder, to the dependent minors. In the absence of dependent minors, the Manager of the State Insurance Fund shall be obliged to redistribute the compensation among the other beneficiaries. The Manager of the State Insurance Fund shall investigate everything connected with the investment to be made and to determine that it is safe before authorizing the investment, shall be bound to see to it that the investment is profitable for the spouse or concubine as well as for the minor beneficiaries, if any.
In all cases where death occurs to a workman or employee for any reason independent of the injury received in an accident, for which there has been accepted or is pending acceptance a partial permanent disability, the Manager of the State Insurance Fund shall, upon previous justifying evidence [having] been presented for the purpose, grant and cause payment of the unpaid balance of any compensation corresponding to said partial permanent disability belonging or due to the injured workman or employee up to the time of his death, to be made to those who depended for their support on the deceased workman or employee, in whose rights they are expressly subrogated. The total compensation to be granted shall include any payment by reason of transitory disability to which the workman is entitled and which has not been paid before his death. Provided, That the payments to the persons who depended on the workman shall be made within a term not to exceed twelve (12) months, as determined by the Manager.
(e) Compensation in case of death.—
(1) If, as a result of the accident suffered under the conditions specified in § 2 of this title, the death of the worker or employee occurs within three (3) years from the time of the accident and as a consequence thereof, the Manager shall pay funeral expenses up to a maximum of one thousand five hundred dollars ($1,500) in addition to such other expenses for medical attendance, hospitalization and medicines as may have been incurred by order of the Manager of the State Insurance Fund Corporation. In like manner these expenses shall be payable when the death of the workman or employee occurs by reason of a compensable occupational disease, provided it occurs within the term of three (3) years from the date on which the disability was manifested, as it may be determined by the claim of the interested party; Provided, That nothing which is provided above shall be construed in the sense of denying authority to the Manager of the State Insurance Fund to pay funeral expenses in cases of the death of a workman or employee hospitalized by the State Insurance Fund, or in those cases where the autopsy of a deceased workman or employee is performed after the said Manager of the State Insurance Fund has taken jurisdiction in the case to investigate the cause of the accident or death, regardless of any final determination with regard to causal relation.
(2) Should the deceased worker or employee leave a widow; parents; children, including posthumous, adoptive and foster children; grandparents; foster father or foster mother; grandchildren; brothers or sisters, including foster brothers or sisters; concubine; and relatives within the fourth degree of consanguinity or second degree of affinity, [they] shall receive, upon qualifying under the regulations established herein, a compensation equal to sixty-six and two thirds percent (66 2 / 3 %) of the wages the worker or employee received or, but for the accident, would have received on the day of the accident, payable at the end of each month, with a minimum monthly payment of one hundred thirty dollars ($130) and a maximum of four hundred thirty dollars ($430), for a maximum period of five hundred forty (540) weeks, except as hereinafter provided for cases in which the beneficiaries are the widow, parents or children of the deceased worker.
(3) The Manager of the State Insurance Fund shall distribute the compensation among the abovementioned relatives who depended totally or partially for their subsistence on the earnings of the deceased worker or employee at the time of his death; Provided, That the Manager shall observe the following rules to determine the beneficiaries of the deceased worker or employee:
(A) The compensation shall be distributed among the aforesaid dependents according to the condition, needs, and degree of relationship and dependence of each, as determined by the Manager of the State Insurance Fund in accordance with the facts.
(B) For the purposes of the compensation, that woman who at the time of the death of the workman or employee and during the last three (3) years prior thereto has lived with the workman or employee honorably as husband and wife, in a status of public concubinage, shall be considered entitled to the corresponding share of the compensation.
(C) The right to compensation of the surviving spouse, concubine or male concubine as a dependent of the deceased worker or employee shall cease if she/he marries or lives in concubinage. In such case, or in case of the death of the surviving spouse, concubine or male concubine, monthly payments to the dependent minors shall be increased by distributing the monthly payment which the surviving spouse, concubine or male concubine received among the dependent minors. In the absence of minor dependents the Manager shall have the obligation of redistributing the compensation among the other beneficiaries. When there are dependent minors, payments in their favor shall be suspended upon their attaining eighteen (18) years of age, unless they are permanently handicapped for work due to their mental condition or physical handicaps, or shall continue up to the age of twenty-five (25) if they are pursuing studies.
Provided, further, That in order to make an investment which in the judgment of the Manager would be profitable, he may advance to the surviving spouse, concubine or male concubine up to fifty percent (50%) of the commuted value of future monthly payments at the moment of the investment. The commuted value of the future monthly payments shall be computed actuarially based on the interest rate and actuarial tables determined by the Manager of the State Insurance Fund in regulations to that effect. Once the investment is made, the monthly payments to the surviving spouse, concubine or male concubine charged to the remainder shall be proportionally reduced in accordance with the actuarial determination based on the interest rate and actuarial tables used to compute the commuted value of future monthly payments, without taking into consideration the minimum monthly installments provided in this chapter.
Provided, That the Manager of the State Insurance Fund may authorize more than one investment by the same surviving spouse, concubine or male concubine but never more than one during a period of three (3) consecutive years. Monthly payments charged to the remainder shall cease if the spouse, concubine or male concubine marries, lives in concubinage or dies. If there are dependent minors entitled to benefits, their monthly payments shall be increased by distributing among those dependent minors the monthly payment[s] received by the spouse, concubine or male concubine chargeable to the remainder at the moment it ceased. In the absence of dependent minors, the Mmanager shall have the obligation of redistributing the compensation among the other beneficiaries.
Before authorizing the investment, the Manager of the State Insurance Fund shall investigate everything related to the intended investment and if he determines that there is no risk whatsoever, he shall have the obligation of ensuring that the investment is beneficial to the surviving spouse, concubine or male concubine, as well as to the minor beneficiaries if they exist.
(D) In cases where brothers or foster brothers over eighteen (18) years of age appear as possible beneficiaries, they shall be considered as such only if the Manager of the State Insurance Fund shall determine that they are permanently disabled for work by reason of their mental condition or physical handicaps and were mainly dependent on the earnings of the deceased workman or employee.
(E) In cases where relatives of the workman or employee of the third or fourth degree of consanguinity or first or second degree of affinity appear as possible beneficiaries, they shall be considered as such only if the Manager of the State Insurance Fund shall determine that they are permanently disabled for work by reason of their mental condition or physical handicaps or advanced old age and were mainly dependent on the earnings of the deceased workman or employee.
(F) If the beneficiaries of the deceased worker or employee were the widow, father, mother, child, including posthumous and adoptive children, or concubines, the compensation shall be paid indefinitely, except as provided in paragraph (C) of this clause.
If the beneficiaries of the deceased worker were the widow or the concubine, they shall only be entitled to receive a total compensation amounting to fifty percent (50%) of the wages the worker or employee was receiving on the day of the accident, payable at the end of each month, which shall not be less than one hundred thirty dollars ($130) nor exceed the sum of four hundred thirty dollars ($430).
When the widow or concubine concurs with only one child, the total compensation to be distributed among the beneficiaries shall be increased by ten percent (10%) of the wages the worker was receiving on the day of the accident. If several children or other beneficiaries concur with them, the total compensation shall be increased by five percent (5%) for each additional beneficiary, but in no case shall the total payment exceed eighty-five percent (85%) of the wages of the worker or employee on the day of the accident, nor shall it be greater than five hundred thirty dollars ($530) a month. When the sole beneficiaries are the children of the worker, including posthumous or adoptive children, the total compensation payable shall not exceed sixty percent (60%) of the wages of the worker or employee, and shall be through monthly payments fluctuating between one hundred thirty ($130) and four hundred thirty dollars ($430) a month. If there were no widow, concubine or children, including posthumous or adoptive children, and the beneficiaries were only the father or mother alone or concurrent with other beneficiaries of a lower category, the total compensation to be paid shall not exceed eighteen thousand five hundred dollars ($18,500); Provided, That for the purposes of an investment which, in the judgment of the Manager, would be profitable, the latter may advance to the father or mother of the deceased worker or to both, up to fifty percent (50%) of their share in the compensation. The monthly payments chargeable to the remainder of the compensation shall be reduced proportionally in accordance with the actuarial determination.
(G) If at the time of the death of the worker or employee there are no beneficiaries of those designated in paragraph (F) of this clause, it shall suffice that one of the beneficiaries of the deceased worker or employee be a grandparent, the foster father or mother, a foster child, a grandchild, or a brother or sister for the total compensation payable not to exceed nine thousand five hundred dollars ($9,500).
(H) If at the time of the death of the worker or employee none of the beneficiaries designated under paragraphs (F) and (G) of this clause exist, it shall suffice that one of the beneficiaries of the deceased worker or employee is a foster brother, or a relative of the deceased worker or employee of the third or fourth degree of consanguinity, or first or second degree of affinity, for the total compensation to be paid shall not exceed six thousand dollars ($6,000).
(I) By request of an interested party and for the purpose of meeting peremptory needs arising from the death of the worker or employee, or related to the payment of debts previously contracted by the worker or employee or for the repair and maintenance of the widow’s home, or to school, medical, medicines or special feeding expenses for the widow or other beneficiaries, the Manager may make, as an advance, an initial payment of seven hundred sixty dollars ($760) to the widow, two hundred thirty dollars ($230) to each parent, and seventy-five dollars ($75) to each of the remaining beneficiaries up to a total maximum of one thousand five hundred dollars ($1,500). When the widow is not present among the beneficiaries, the Manager may double the above amounts, but the total payment of the advances shall not exceed a total maximum of one thousand five hundred dollars ($1,500). The Manager of the State Insurance Fund Corporation shall settle the form of the liquidation of the compensation and the payment therof.
(f) Form of payment.— The compensation that corresponds to the partially disabled worker or employee shall be paid in the following manner:
(1) When the compensation is not greater than one thousand five hundred dollars ($1,500), the same shall be paid in one lump sum. If it exceeds it, an initial payment of up to one thousand five hundred dollars ($1,500) shall be made to the worker or employee, and the balance shall be paid at the rate of one hundred and fifty dollars ($150) a month, starting on the date of the decision of the case.
(2) When the compensation is greater than one thousand five hundred dollars ($1,500), it shall be the duty of the Administrator of the State Insurance Fund to require the worker or employee to devote the amount of the compensation, in whole or in part, to the purchase of a farm and/or a dwelling, the acquisition of a lucrative business, assistive technology equipment, or any other profitable investment.
As soon as the workman or employee or his beneficiaries inform the Manager of the State Insurance Fund of their decision as to the investment that they wish to make with the compensation or a part thereof, with all necessary data, reports and proofs, the Manager shall investigate everything in connection with the investment desired, and if it is proven to him that there is no risk whatsoever in making said transaction, and that the investment will be profitable to the workman or employee and will promote the ends sought by this chapter, he shall authorize the investment.
When the beneficiaries, in cases of death as a consequence of labor accidents, are minors or incapacitated persons, the compensation shall be paid through the father or mother or guardian. However, no such payments shall be made through the father or mother who has abandoned or neglected his or her obligations toward the child before the death of the workman occurred; and in such case, the payment shall be made through such person as may have had the minor beneficiary under his care and attention before the death of the workman.
The Manager of the State Insurance Fund is hereby empowered to adopt such regulations as he may consider necessary with regard to the investments of compensations accruing to workmen or employees or their beneficiaries.
If the beneficiaries are minors or incapacitated persons, the Manager of the State Insurance Fund shall adopt such measures as he may deem proper and shall submit the case [to] the Industrial Commission to appoint the guardian pursuant to § 13 of this title.
(g) Rights of minors.— In the case of workmen under eighteen (18) years of age employed in violation of the laws in force on the date of employment who suffer injuries or contract occupational diseases in accordance with the terms of this chapter, the compensation accruing to them in case of disability, or to their beneficiaries in case of death, shall be double the amount accruing to a workman eighteen (18) years of age legally employed; Provided, That the employer shall pay the additional compensation provided herein, the amount of which shall constitute a lien on all the property of the employer and shall be paid in the manner provided in this chapter for the collection of the compensation in cases of uninsured employers; and Provided, also, That the Manager of the State Insurance Fund shall, before collecting such additional compensation from the employer, transfer the record to the Industrial Commission, in order that the latter may give the employer and the workman opportunity to be heard in their defense.
(h) Rights of beneficiaries.— The assignment, sale, or conveyance of the rights of workmen, employees or their beneficiaries to receive compensation payments, or any contract relative thereto, shall be null, and the compensations allowed under this chapter to such workmen, employees, or beneficiaries shall not be attached, nor shall any workman, employee or beneficiary be deprived of the possession thereby by any judicial proceedings whatsoever.
(i) Table of occupational diseases and their causes.— The diseases enumerated in the following table shall be considered derived from the occupation when contracted by workmen or employees in the course of the occupations therein listed, when the last exposure to the risk of contracting the disease was within twelve (12) months prior to the date of the disability caused thereby due to the nature of any of the processes described in said table, except as hereinafter provided:
Name of Disease Description of Process (1) Anthrax Handling of wool, hair, hides or skins. (2) Glanders or carbuncles Care of equine animals suffering from glanders or carbuncles. (3) Lead poisoning Any industrial process involving the use of lead or its preparations or compounds, including the use of paints containing such agent or any of its derivatives. (4) Mercury poisoning Any industrial process involving the use of mercury or its preparations or components. (5) Phosphorus poisoning Any industrial process involving the use of phosphorus or its preparations or components. (6) Arsenic Poisoning Any industrial process involving the use of arsenic or its preparations or compounds. (7) Poisoning by benzol or niter, or their derivatives of amide, denitrate, anilin and others Any industrial process involving the use of benzol, niter, amide and its derivatives of benzol or its preparations and compounds. (8) Silicosis, provided the silicosis is the determining cause of disability or death Industries generally recognized as being exposed to the risks of silicosis, such as silicon, rock and marble quarries; works dealing with thecrushing and grinding of stone; pulverization of silicon in ceramic goods factories; glass and tile factories. (9) Poisoning by gasoline, naphtha, or other volatile petroleum product Any industrial process involving the use of gasoline, benzine, naphtha, or other volatile petroleum product. (10) Poisoning by carbon bisulphide Any industrial process involving the use of carbon bisulphide or its preparations or compounds. (11) Poisoning by wood alcohol Any industrial process involving the use of wood alcohol or its preparations. (12) Infection or inflammation of the skin on contact with compound, irritant or lubricating oils, dust, liquids, smoke, gases, or vapors Any industrial process involving the handling or use of compound, irritating or lubricant oils, or involving contact with dust, liquids, smoke, gases, or vapors. (13) Epitheliomatous cancer or ulceration of the skin or of the corneal surface of the eye, due to coal, pitch, tar, or their compounds Handling or industrial use of coal, pitch, tar, or their compounds. (14) Compressed air poisoning Any industrial process carried on in compressed air. (15) Brass or zinc poisoning Any industrial process involving the manufacture, founding or refining of brass or the melting or casting of zinc. (16) Carbon dioxide poisoning Any process involving the evolution or resulting in the escape of carbon dioxide. (17) Poisoning by manganese dioxide Any process involving the grinding or pulverizing of manganese dioxide or resulting in the escape of manganese dioxide. (18) Poisoning by radium and radioactive substances Any industrial process or occupation requiring the use of, or direct contact with radium or radioactive substances, or the use of X rays or ultraviolet rays, or involving direct exposure to the effects thereof. (19) Poisoning by hydrocyanic acid or its derivatives Any industrial process requiring the use of hydrocyanic acid or its derivatives. (20) Sulfurous anhydride poisoning Any industrial process producing or discharging sulfur dioxide gases due to the formation of liquid sulfurous anhydride. (21) Poisoning by hydrogen sulfide Any industrial process involving the use of or exposure to direct contact with or inhalation of hydrogen sulfide. (22) Poisoning by inhalation of gases such as ammonium, hydrocyanic acid, acetylene, nitrogen oxides, and phosgene Any industrial process involving the use or preparation of these gases. (23) Poisoning by contact with, inhalation or ingestion of, volatile dissolvents such as carbon tetrachloride, trichlorethylene, ether, amyl acetate and the like Any process involving the use or handling of these volatile substances. (24) Selenium, tellurium, beryllium and cadmium poisoning Any industrial process involving the use of or contact with selenium, tellurium, beryllium, cadmium, and their compounds. (25) Poisoning by chromium and its compounds Any industrial process involving the use of chromium and its derivatives. (26) Poisoning by nickel carbonyl or its sequel Any industrial process involving nickel carbonyl. (27) Poisoning by formaldehyde and its preparations Any industrial process involving the use of or requiring direct contact with formaldehyde or its preparations. (28) Chlorine poisoning Any industrial process involving the use of or direct contact with chlorine and its compounds. (29) Ammonia poisoning Any industrial process involving the use of or direct contact with ammonia or its compounds. (30) Cataract in persons working in glass factories Any process in the manufacture of glass requiring exposure to the glare of melted glass. (31) Poisoning by methyl chloride or other halogen hydrocarbons Any industrial process involving the use of or direct contact with methyl chloride or other halogen hydrocarbons. (32) Poisoning by sulfuric, hydrochloric or hydrofluoric acid Any industrial process involving the use of or direct contact with sulfuric, hydrochloric, or hydrofluoric acid. (33) Respiratory, gastro-intestinal or physiological nervous disorders or disorders of the eyes, due to contact with petroleum and its gases Any industry or employment involving the use of or direct contact with petroleum products and gases. (34) Disability as a result of bursitis or synovitis Any industrial process involving continuous rubbing, pressure, or vibrations of the parts affected. (35) Asbestosis Any industrial process involving exposure to or direct contact with asbestos dust. (36) Carbon monoxide poisoning Any process or occupation involving direct exposure to carbon monoxide in buildings and closed places. (37) Poisoning by tetrachlormethane, or by substances used as, or together with, cellulose acetate or nitrocellulose solvents Any industrial process involving the use of or requiring direct contact with substances used as or together with cellulose acetate or nitrocellulose solvents. (38) Inflammation of the cornea or infections of the skin on contact with cane fuzz Any employment entailing exposure of the workman to contact with cane fuzz. (39) Brucellosis Any occupation requiring the handling of bovine, caprine or porcine cattle, protection under the law being limited to acute cases when the hemoculture test on the patient is openly positive. (40) Mogigraphia or clerk’s cramp Any occupation involving the need of handwriting or stenographic signs more or less continuously by using a pencil, pen or any other instrument producing similar effects. (41) Bagassosis Occupational disease acquired when working with sugarcane bagasse. (42) Any occupational disease acquired when working in the baking of bread and its by-products.
In addition to the occupational diseases included in the preceding table, all diseases acquired in the course of work as a consequence of a risk peculiar to the particular industry, process, occupation or employment and as a result of direct exposure of the workman or employee to the said risk in the normal performing of his work shall be considered compensable occupational diseases, provided the last exposure to the risk of contracting the disease was within twelve (12) months prior to the date on which the first manifestations of the disability caused thereby were observed, without prejudice to the provisions hereinafter established.
Except as otherwise provided elsewhere in this chapter, contagious-type, epizootic, endemic, and epidemic diseases shall not be considered as occupational, except when contracted by laboratory personnel exposed to the risk thereof in the course of their work by reason of [the] handling or examining [of] infectious material.
The right of a workman or employee to claim compensation for a disability originating from a disease caused by compressed air or by retarded pathological changes of a malignant character in the bones, blood or lungs, caused by occupational exposure to or contact with arsenic, benzol, beryllium, cadmium, chromium, lead, fluorine, or exposure to X-rays, radium, or radioactive substances, or other substances of whatever nature, that may produce retarded effects in the human organism, shall not be impaired by the lapse of the twelve-month term after the last exposure, as provided above, if it is determined by a physician that the effects of the disease may be produced after a greater lapse of time.
The claims in cases of occupational diseases shall be established within a period of time not to exceed three (3) years, reckoning from the date on which the workman learned of the nature of the disability and its relation to the work, or could have learned through the exercise of reasonable diligence.
The Manager of the State Insurance Fund is hereby authorized and empowered to add to this table all those diseases which, as determined after due investigation, should be considered compensable occupational diseases.
History —Apr. 18, 1935, No. 45, p. 250, § 3; Apr. 26, 1940, No. 74, p. 530, § 1; Apr. 25, 1942, No. 52, p. 502, § 1; May 14, 1943, No. 162, p. 524, § 1; May 15, 1945, No. 284, p. 1036, § 1; May 2, 1950, No. 163, p. 444, § 1; July 1, 1953, No. 115, p. 410; June 16, 1956, No. 52, p. 158; June 22, 1957, No. 94, p. 439, § 3; June 25, 1959, No. 79, p. 211, § 1; June 24, 1960, No. 101, p. 277; June 22, 1962, No. 92, p. 239; June 24, 1963, No. 74, p. 234; June 9, 1965, No. 13, p. 23, § 1; June 21, 1968, No. 103, p. 192, § 1; June 28, 1969, No. 103, p. 288, § 1; May 31, 1972, No. 53, p. 121, § 1; May 30, 1974, No. 49, Part 1, p. 211, § 1; May 30, 1984, No. 41, p. 109; July 1, 1986, No. 53, p. 184, § 1; July 1, 1986, No. 57, p. 198, § 1; July 10, 1986, No. 97, p. 303, § 1; July 10, 1986, No. 98, p. 306, § 1; July 10, 1986, No. 99, p. 310, § 1; May 18, 1987, No. 19, p. 54, § 1; June 19, 1987, No. 41, p. 139, § 1; July 2, 1987, No. 90, p. 353, § 1; Apr. 22, 1988, No. 20, p. 85, § 1; June 3, 1988, No. 40, p.155, § 1; July 5, 1988, No. 61, p. 278, § 1; June 30, 1989, No. 16, p. 71; July 20, 1989, No. 31, p. 105; Dec. 23, 1998, No. 299, § 1; Oct. 16, 1999, No. 314, § 1; Sept. 7, 2004, No. 257, § 1; Sept. 8, 2004, No. 263, § 2; Dec. 29, 2009, No. 206, § 2, eff. 60 days after Dec. 29, 2009.