P.R. Laws tit. 11, § 203
(a) Benefit payment.— Disability benefits shall be paid in the amount indicated in subsection (d) of this section to an insured worker who suffers the loss of wages as a result of disability due to illness or injury not connected with employment, subject to all conditions, limitations and provisions of this section. Provided, That under this section no benefits shall be paid for disability caused by an automobile accident covered by §§ 2051 et seq. of Title 9, known as the Automobile Accident Social Protection Act.
(b) Status of insured.—
(1) An individual shall be considered as insured worker if he has received wages of at least $150 in a covered employment during his base year. His base year shall be the first 4 of the last 5 consecutive calendar quarters which immediately precede the date of filing the application for benefits.
(2) “Disability period” shall be the period during which a person has been continuously disabled. The subsequent disability periods caused by the same illness or accident, or related thereto, shall be considered as a single disability period if the subsequent periods occur in a lapse of less than 90 days.
(c) Waiting period and duration of benefits.—
(1) Disability benefits shall be paid commencing on the eighth day of the disability and thenceforth while said disability lasts, but not for more than 26 weeks in any disability period nor in any period of 52 consecutive calendar weeks; Provided, That for purposes of this section there shall not be deducted from the maximum period of benefits the days paid or payable by reason of vacation or sick leave provided by mandatory decrees, collective bargaining agreements or provision of law.
(2) If the claimant is interned in a duly authorized hospital, complying with the prescription of a physician, health official or court of justice, within the first seven (7) days of a disability period, benefits shall be paid commencing with the first day of the hospitalization.
(3) An individual who is disabled during a continued period of unemployment, within a benefit year, in which he served a waiting period as required by §§ 701–717 of Title 29, and who but for the disability would be entitled to receive unemployment insurance benefits, benefits shall be paid commencing with the first day of disability. Provided, That no waiting period shall be required in the case of agricultural workers who become disabled during a continuous unemployment period within a benefit year.
(4) Upon the arising of subsequent disability periods caused by the same illness or accident, or connected thereto, they shall be deemed as recurrent stages thereof if the subsequent periods occur in a time span of ninety (90) days or less. Provided, That in these cases the waiting period elapsed in the first stage of the claim will not be required.
(d) Amount of benefits.—
(1) Benefits for injury or illness.—
(A) Nonagricultural workers.— The weekly benefit amount shall be the highest amount allocated in Column C of the following table under which the worker qualifies due to the fact that his insured wages in his base year and the insured wages in the quarter of highest income during his base year comply with the corresponding requirements indicated in Columns A and B. The requirements in Columns A and B correspond to the benefit amount as it appears in the same line. “Base year highest income quarter covered wages” means the wages payable to the worker for insured work in that calendar quarter of his base year in which the total of said wages was the highest:
Column A Column B Column C Base year highest income quarter Base year covered wages, covered wages, Weekly-Benefit of at least: of at least: Amount $ 37.50 $ 150.00 $ 12.00 97.51 216.00 13.00 140.41 270.00 14.00 183.31 300.00 15.00 226.21 330.00 16.00 269.11 360.00 18.00 312.01 390.00 20.00 338.01 420.00 21.00 364.01 450.00 22.00 390.01 480.00 23.00 416.01 510.00 24.00 442.01 540.00 25.00 468.01 570.00 27.00 494.01 600.00 28.00 520.01 630.00 29.00 546.01 660.00 30.00 572.01 690.00 31.00 598.01 720.00 33.00 624.01 750.00 34.00 650.01 780.00 35.00 676.01 810.00 36.00 702.01 840.00 37.00 728.01 870.00 39.00 754.01 900.00 40.00 780.01 930.00 41.00 806.01 960.00 42.00 832.01 990.00 43.00 858.01 1,020.00 45.00 884.01 1,050.00 46.00 910.01 1,080.00 47.00 936.01 1,110.00 48.00 962.01 1,140.00 49.00 988.01 1,170.00 51.00 1,014.01 1,200.00 52.00 1,040.01 1,230.00 53.00 1,066.01 1,260.00 54.00 1,092.01 1,290.00 55.00 1,118.01 1,320.00 57.00 1,144.01 1,350.00 58.00 1,170.01 1,380.00 59.00 1,196.01 1,410.00 60.00 1,222.01 1,440.00 61.00 1,248.01 1,470.00 63.00 1,274.01 1,500.00 64.00 Does not apply 5,200.00 65.00 Does not apply 5,300.00 66.00 Does not apply 5,400.00 68.00 Does not apply 5,500.00 69.00 Does not apply 5,600.00 70.00 Does not apply 5,700.00 72.00 Does not apply 5,800.00 73.00 Does not apply 5,900.00 74.00 Does not apply 6,000.00 75.00 Does not apply 6,100.00 76.00 Does not apply 6,200.00 78.00 Does not apply 6,300.00 79.00 Does not apply 6,400.00 80.00 Does not apply 6,500.00 81.00 Does not apply 6,600.00 83.00 Does not apply 6,700.00 84.00 Does not apply 6,800.00 85.00 Does not apply 6,900.00 87.00 Does not apply 7,000.00 88.00 Does not apply 7,100.00 89.00 Does not apply 7,200.00 90.00 Does not apply 7,300.00 91.00 Does not apply 7,400.00 93.00 Does not apply 7,500.00 94.00 Does not apply 7,600.00 95.00 Does not apply 7,700.00 97.00 Does not apply 7,800.00 98.00 Does not apply 7,900.00 99.00 Does not apply 8,000.00 100.00 Does not apply 8,100.00 102.00 Does not apply 8,200.00 103.00 Does not apply 8,300.00 104.00 Does not apply 8,400.00 105.00 Does not apply 8,500.00 106.00 Does not apply 8,600.00 108.00 Does not apply 8,700.00 109.00 Does not apply 8,800.00 110.00 Does not apply 8,900.00 112.00 Does not apply 9,000.00 113.00
(B) Agricultural workers.—
(i) The weekly benefit amount for an agricultural worker that more than fifty percent (50%) of whose insured wages in his base year were paid for agricultural services as specified in § 202(j)(1)(C) of this title shall be the highest amount allocated in Column B of the following table in that line of the Column A, under which the total wages paid to an individual for insured work in his base year appear:
(Column A) (Column B) Annual Wages Weekly Benefits $ 150.00 $ 12.00 200.01 13.00 250.01 14.00 300.01 15.00 350.01 16.00 400.01 17.00 450.01 18.00 500.01 19.00 550.01 20.00 600.01 21.00 650.01 22.00 700.01 23.00 750.01 24.00 800.01 25.00 850.01 26.00 900.01 27.00 950.01 28.00 1,000.01 29.00 1,050.01 30.00 1,100.01 31.00 1,150.01 32.00 1,200.01 33.00 1,250.01 34.00 1,300.01 35.00 1,350.01 36.00 1,400.01 37.00 1,450.01 38.00 1,500.01 39.00 1,550.01 40.00 1,600.01 41.00 1,650.01 42.00 1,700.01 43.00 1,750.01 44.00 1,800.01 45.00 1,850.01 46.00 1,900.01 47.00 1,950.01 48.00 2,000.01 49.00 2,050.01 50.00 2,100.01 51.00 2,150.01 52.00 2,200.01 53.00 2,250.01 54.00 2,300.01 and above 55.00
(ii) When a worker qualifies to receive benefits for work specified in paragraphs (A) and (B) as well as in paragraph (C) of subsection (j)(1) of § 202 of this title, he may choose, in his discretion, whether to claim benefits under the table set forth in paragraph (A) of this clause or under the table set forth in paragraph (B) of this clause hereof, or he may leave it to the discretion of the Secretary that he be paid the benefit amount that is the highest; Provided, That when the worker has made his selection, the same shall be final as to that disability period.
(2) Pregnancy benefits.— When a worker is disabled due to pregnancy, she shall receive the benefits provided in, clause (1) of this subsection. Provided, however, That the temporary disability benefits payable for any period during which the employee who is disabled by pregnancy receives benefits under the Act to Protect Working Mothers, §§ 467–474 of Title 29, shall consist of the difference between the benefits payable under said act and seventy-five percent (75%) of her weekly wage. The amount between the benefits paid by the employer under the provisions of the Act to Protect Working Mothers and the benefits payable under this clause cannot be less than the weekly benefits that would pertain to the worker under the provisions of clause (1) of this subsection.
(e) Apportionment.— A week shall be any period of seven (7) consecutive days commencing on Sunday at 12:01 a.m. and ending on Saturday at 12:00 midnight and a “day” shall be a period of 24 hours, commencing and ending at midnight. In cases of any period of disability of less than one week, payable benefits shall be computed in one seventh (1/7) part of the weekly-benefit amount for each day of disability. The total of benefits for a fraction of a week shall be computed to the complete ($1) highest dollar.
(f) Other benefits.—
(1) Death benefits.— Upon the sudden death of an insured worker as a result of an injury or accident otherwise compensable under this chapter, or if as a result of an injury or disease compensable under this chapter, the death of a worker occurs within the period of fifty-two (52) calendar weeks immediately following the date on which the disability began, there shall be paid, in addition to the benefits owed, the amount of four thousand dollars ($4,000), as the Secretary may prescribe by regulations, to the person or persons whom the Secretary may declare who depended directly on the insured worker. Said regulations do not necessarily have to be in harmony with the provisions of law on descendants and distributions applicable to estates. Provided, That no benefits shall be paid under this section for deaths due to automobile accidents covered by §§ 2051 et seq. of Title 9.
The following persons shall be deemed as beneficiaries of the insured worker, with the rights and limitations established hereinbelow:
(A) The surviving spouse and all the children, including adopted and foster children. Provided, That when the persons who depended on the insured at the time of his death were minors or mentally disabled, the benefits corresponding to these beneficiaries shall be delivered to the person who was or will be in charge of said minors or disabled persons if, after conducting the corresponding investigation, it is advisable to deliver the same to such persons, thus causing the Secretary of Labor and Human Resources, his agents or employees to be hereby released from all future liability upon making the payment in the manner indicated. It is further Provided, That in the case of parents who are separated or divorced, the mother and the children shall not be affected if the father has neglected his obligations towards them, thus being forced to depend on social welfare or relatives for their support.
Children eighteen (18) years of age or less shall be deemed to be dependents unless they are permanently physically disabled, or up to twenty-five (25) years of age if they are students.
(B) The man or woman who had been living, honestly and publicly, as man and wife with the worker during the last three (3) years prior to the death of the latter and the parents of the insured worker, including foster parents, if they depended on the insured worker for their support.
(C) Grandparents, and in their absence, siblings, nephews, nieces, grandchildren and cousins, up to the fourth degree of consanguinity and the second of affinity, and to all the remaining relatives that depended on the insured worker for their support because they are unable to look after themselves and have no other means of subsistence.
(D) Any person who is under eighteen (18) years of age, or over eighteen (18) years who has physical or mental defects and who depended on the insured worker and is unable to support himself without the help of the worker.
A receipt from the person or persons to whom the payment is made will totally release the Fund, the Director, the Administrator of a private plan and the Secretary from any liability with respect to said benefit.
The dependents of the deceased worker must file their claim under this subsection, within the period of six (6) months following the death of the worker, in the manner the Secretary may prescribe by regulations. However, the Director may extend the period of the claim for just cause. However, no claim filed after the lapse of a year from the date of the worker’s death shall be deemed entitled to benefits by the Director or the Secretary.
(2) Benefits for dismemberment.—
(A) If the injuries suffered by the worker as a result of an accident or illness compensable under this chapter, except for injuries caused by or in connection with an automobile accident covered by §§ 2051–2065 of Title 9, result in any of the disabilities indicated in paragraph (C) of this clause within the period of 52 calendar weeks immediately following the date of the accident or the beginning of the illness, the sum provided for said disability will be paid.
(B) If the worker dies within the 30 days immediately following the date in which any disability compensable under paragraph (A) hereof may occur, there shall be deducted from the death benefit established by subsection (f)(1) of this section any amount paid by virtue of paragraph (C) of this subsection.
(C) The following benefits for dismemberment shall be paid in case the disabilities set forth hereinbelow occur:
Total and permanent loss of sight in both eyes $4,000 Loss of both feet at or above the ankle 4,000 Loss of both arms at or above the wrist 4,000 Loss of one arm and one leg 4,000 Loss of one arm at or above the wrist 3,000 Loss of one leg at or above the ankle 3,000 Loss of one hand or one foot 2,500 Total and permanent loss of sight in one eye 2,500 Loss of at least three fingers or three toes 2,000 In the event that an individual suffers more than one of the disabilities mentioned above in the same accident, the maximum amount for all the disabilities shall be 4,000
(D) The worker must file his claim under this subsection within six (6) months following the date when the dismemberment occurred, in the manner prescribed by the Secretary by regulations. However, the Director may extend the period of the claim for just cause. Nevertheless, no claim filed after the lapse of a year from the date of the dismemberment shall be considered entitled to benefits by the Director or the Secretary.
(g) Limitations.— No person shall be eligible for disability benefits:
(1) In any period during which he is not under the care of a duly-licensed physician or chiropractor, authorized under Act No. 493, approved May 15, 1952, an Act to Regulate the practice of the Profession of Chiropractic in Puerto Rico, §§ 151–169 of Title 20. A claimant who is outside Puerto Rico at the time of his disability must be under the care of a physician or chiropractor duly authorized to practice in the jurisdiction wherein claimant is residing.
(2) During any disability period caused by or related to an abortion, except in cases of induced abortions for medical reasons or if complications arise as a result thereof.
(3) In any day of disability during which the worker rendered services (in a work covered or not) whether or not for remuneration.
(4) For any disability on account of premeditated injuries or illness intentionally caused by himself or by injuries received by the claimant in the commission of an unlawful act.
(5) In the amount in which the disability benefits during any period, in addition to any compensation that he continues receiving from his employer or from a fund to which the employer has contributed, may exceed the regular weekly salary of full-time work that he was receiving immediately preceding his disability.
(6) In any period during which the claimant is receiving retirement or pension payment, public or private, unless after he begins to receive said retirement or pension said worker has rendered services in an insured employment for at least fifteen (15) weeks.
(7) During any disability period in which he is in prison, confined or secluded in an institution as a dipsomaniac, drug addict or sexual psychopath by order of a competent court.
(8) In any period during which claimant is receiving benefits under §§ 681 et seq. of Title 29, unless said claimant has been covered by the approval of the employer’s elective coverage pursuant to § 207(e) of this title, in which case the worker shall receive the weekly benefit he is eligible for in the Program, provided, that said payment, added to the benefits received under §§ 681 et seq., of Title 29 does not exceed the regular weekly wages he earned before the disability.
(9) During any disability period caused by or in connection with an automobile accident covered by the Automobile Accident Social Protection Act, §§ 2051—2065 of Title 9.
(h) Refund for wages or benefits paid.—
(1) If a worker otherwise eligible for disability benefits is ineligible for said benefits during one or more days because he received full pay from his employer on those days, the disability benefits payable for those days shall be paid to the employer provided he meets the following requirements:
(A) The employer requests the corresponding refund in writing within two (2) months after the payment of the last day of the period for which the refund is claimed;
(B) the worker files with the Director a disability benefit claim and verification of wages paid by the employer during the disability period in the blank form prescribed by the Secretary;
(C) evidence of the worker’s disability is submitted to the Director in accordance with subsection (k) of this section, and
(D) the employer has certified to the Director, on the blank form prescribed by the Secretary, the payment of the wages involved in the claim.
On no account shall said payment exceed the total amount of wages paid to the worker, nor shall it correspond to a disability period for which the vacation or sick leave provided by mandatory decree, collective bargaining agreement or law is paid or is payable.
Upon prescribing regulations to enforce this clause, the Secretary may require the employers to file in advance with the Director their plans or practices for the voluntary payment of wages during disability periods and to provide the necessary requirements to avoid refunds under this subsection if the employing unit unduly restricts the payment of wages to its employees during disability periods.
For the purposes of this clause, voluntary payment shall be understood to be the full payment of wages made voluntarily by the employer and not by obligation or duty.
(2) If the Fund or the Administrator of a Private Plan should make benefit payments to a worker for a period for which no such payment should have been made because neither of them is the worker’s insurer, the Fund or the Administrator of a Private Plan may request the insurer who was liable for paying the claim to reimburse the amount of the benefits paid by mistake.
(i) Duplication of benefits.—
(1) No disability benefits shall be paid with respect to any week during which benefits are received under the Employment Security Act, §§ 701—717 of Title 29, or the Unemployment Insurance Act from any state or from the United States.
(2) No disability benefits shall be paid for any period for which work accident compensation benefits are paid except as provided hereinbelow:
(A) If a claimant otherwise eligible for disability benefits claims benefits under the Workmen’s Accident Compensation Act, §§ 1–42 of this title, and said claim is questioned under the provisions of said sections on the basis that the disability did not arise in the course of the employment or from an occupational disease he shall be eligible, in the first place, to receive benefits under this chapter for his disability.
(i) The benefits payable under this clause shall be computed in accordance with subsection (d) of this section; Provided, That in no case shall more than sixty-five dollars ($65) nor less than twelve dollars ($12) be paid weekly.
If the worker is subsequently eligible to receive compensation benefits under the Workmen’s Accident Compensation Act, §§ 1–42 of this title, the Director, in the name of the Fund, or the Administrator of a private plan which is paying disability benefits under such circumstances shall have a lien on the adjudication for the refund of the disability benefits payable under this subsection, notwithstanding any other provision of law to the contrary.
If, on the other hand, the State Insurance Fund should decide that the worker’s injury or illness is of a nonoccupational nature, the Director or the Administrator of a private plan which has paid disability benefits under this subsection shall reconsider the initial determination, assigning to the worker the weekly benefit amount he is entitled to in accordance with the schedules in subsection (d) of this section or on the basis of the benefit formula of a private plan approved under the provisions of § 205 of this title, as the case may be.
In the cases in which the State Insurance Fund should decide that the worker’s injury or illness is non-occupational and the worker had received benefit payments for temporary disability from said Fund, said payments shall be deducted from the disability benefits to which he is entitled hereunder. This deduction shall never be for an amount exceeding the disability benefits to which he is eligible. The amount thus deducted shall be reimbursed to the State Insurance Fund by the Disability Benefit Fund upon the filing by the State Insurance Fund Manager of a certified invoice containing the liquidation of payments made to the worker. Notwithstanding the provisions of subsection (k) of this section, for the purpose of paying the disability benefits provided herein to a worker who had received benefit payments for temporary disability from the State Insurance Fund on account of an injury or illness which has finally been found to be non-occupational, the filing date of the claim shall be understood to be the filing date of the case in the State Insurance Fund.
(B) No disqualification shall apply on the basis of the payment of compensation for labor accidents if the payments are made on account of a different permanent partial disability incurring prior to the disability for which benefits are claimed.
(3) No disability benefits shall be paid for any period for which benefits, compensation or other payments have been paid or adjudicated, regardless of whether their payment has begun, under any employer liability act, under any temporary disability act, benefits for illness, any similar act or disability benefits under the United States Social Security Act; Provided, That this provision shall not be applicable if the payments are received for a different permanent, partial disability incurred prior to the disability for which she is claiming benefits, nor when benefits are received under the Act to Protect Working Mothers as provided in subsection (d)(2) of this section.
(4) The Fund shall not pay disability benefits for any day of disability with respect to which benefits are payable under a private plan approved under § 205 of this title unless said payment is a payment prorated due to concurrent employment on the last day of employment preceding the disability. The Secretary shall prescribe by regulations the prorating of benefits if a worker is eligible for benefits in more than one plan due to concurrent employment on the last day of employment preceding the disability.
(5) The Secretary shall by regulation prescribe the prorating of benefits if a worker is eligible for benefits under more than one plan due to concurrent employment in his last day of employment preceding the disability.
(j) Payment in case of injuries caused by a third party.— If a workman eligible to disability benefits is disabled due to an injury caused through negligence or fault of a third person, said workman shall be eligible to said disability benefits, but the Fund or the administrator of a private plan paying disability benefits, shall hold a lien on any sum recovered from the third person whether it be through the execution of a judgment, contract or through any other method, after deducting the reasonable and needed expenses, including the counsel fees incurred at the time such recovery is made up to the limit of the total amount of the benefits paid for the disability. The rights, limitations and proceedings above mentioned shall also be applied to actions and recovery under the Employers Liability Act and § 688, Title 46 of the United States Code and under the Maritime Doctrine of Maintenance, Wages and Cure.
(k) Claims and proof.— The claims for disability benefits shall be made in accordance with the regulations prescribed by the Secretary. To be eligible for benefits:
(1) The claimant shall file his initial claim for disability benefits and any subsequent claim on the blank form prescribed by the Secretary. The claim shall be filed no later than three (3) months from the date the disability began, except that the Director may, for good cause, extend the period for filing the claim. However, no claim filed after one year has elapsed from the date the disability began shall be considered by the Director or by the Secretary as entitled to benefits.
(2) The claimant shall submit in support of his claim a certificate from a duly authorized physician, or a certificate from the custodian of the medical records of a hospital or medical center, in the absence of the corresponding physician, on the blank form prescribed by the Secretary, containing a statement of the medical data within his knowledge, his conclusion with respect to the disability of the claimant, and his opinion on the probable duration of the disability. The corresponding certificate of a chiropractor shall be sufficient, if so authorized by his practice.
(3) The claimant shall submit to all such reasonable medical examinations as may be required by the Director and shall submit any information which is reasonably connected with the determination of his right to benefits that may be required by the Director.
(l) Payments due to minors, disabled persons and dependents of a deceased worker.—
(1) Benefits due and payable to a deceased or judicially declared incompetent person shall be paid, in accordance with such regulations as the Secretary shall prescribe, to the person or persons that the Secretary may declare depend directly on the beneficiary workman. Such regulation need not conform to the statutes applicable to the descent and distribution of decedent’s estates. A receipt from the person or persons to whom the payment is made shall fully discharge the Fund, the Director and the Secretary from liability for such benefits.
(2) When it is determined that the dependent who is entitled to receive any benefit under this chapter is a minor or a disabled person, compensation shall be made through the parent or guardian. However, such payments shall not be made through any parent who may have abandoned a child or neglected his/her obligations toward the child, in which case such payments shall be made through the person who has had the child-beneficiary under his/her care and attention at the time of his/her entitlement to said rights.
The Secretary, with the assistance of the Legal Division, may intervene through a special administrative procedure in the handling and determination of designations of special guardians in the case of disabled adults who are not able to manage their goods or take care of themselves, and in the case of minors, exclusively, for the effects of the payment of the benefits under this chapter. In such cases, procedural guarantees shall be provided to safeguard the rights of the parties concerned. The Director shall submit the case file to the Secretary of Labor, with a report on the investigation carried out, its conclusions and recommendations of law.
(3) Insured workers who are under the legal age shall be eligible to receive disability or dismemberment benefit payments, subject to those limitations the Secretary may provide by regulations.
(m) Waiver of rights void.— Any agreement by an individual to waive, release or commute his rights to benefits or any other rights under this chapter except in those cases where it is therein authorized shall be void. Any agreement by an individual performing service for an employer to pay all or any portion of any contribution required under this chapter from such employer, shall be void. No employer shall require or accept the waiver of any right hereunder by any individual in his employ, or discriminate in regard to the hiring or tenure of work or any conditions or work or any individual on account of his claiming benefits under this chapter, or in any manner obstruct or impede the claiming of benefits hereunder.
(n) Assignment of benefits.— Any assignment, pledge or encumbrance of any right to benefits which are or may become due or payable under this chapter shall be void, except in cases authorized therein; and such rights to benefits shall be exempt from levy, execution, attachment, order for the payment of attorney fees, or any other remedy whatsoever provided for the collection of debt; and benefits received by any individual, so long as they are not mingled with other funds of the recipient, shall be exempt from any remedy whatsoever for the collection of all debts, except debts incurred for necessities furnished to such individual or his spouse or dependents during the time when such individual was disabled. Any waiver of any exemption provided for in this subsection shall be void.
(o) Penalty for wilful misrepresentation.— If during a specific week it should be discovered that within the 24 calendar-month-period immediately preceding said week, a person has made a false statement or given information on some material fact knowing it to be false, or who wilfully conceals a material fact, with the intention of committing fraud to obtain benefits not payable hereunder, he shall not be eligible for said week, nor shall he be eligible for benefits in any other seven (7) weeks in which he would have otherwise been entitled to benefits, in a period of 52 consecutive calendar weeks after the onset of the disability.
(p) Recovery and recoupment.—
(1) Any person who makes or induces another to make a statement or presentation of a material fact knowing it to be false or who knowingly conceals or induces another to conceal a material fact and, as a result thereof, receives any sum as benefits to which he was not entitled under this chapter shall be liable to repay such sum to the Secretary, in the Secretary’s discretion, to be returned to the Fund within the term of two (2) years from the date the Secretary makes such determination, or to have such sum deducted from any future benefits payable to him under this chapter.
(2) No redetermination or decision shall be construed to authorize the recovery of the amount of any benefits paid to a claimant or the deduction of such amount from future benefits payable to him, unless the written notice of such redetermination or decision specifies that he is liable to repay to the Fund the amount of benefits paid to him by reason of the concealing or misrepresentation of a material fact as specified in subsection (o) of this section, as well as the nature of such concealing or misrepresentation of facts and the days or weeks for which said benefits were paid.
(3) In any case in which, under this subsection, a claimant is liable to repay any amount to the Secretary to be returned to the Fund, such amount shall be collected without interest.
(q) Reinstatement after disability.— In cases of disability for work pursuant to the provisions of this chapter, the employer is compelled to protect the employment position held by the worker at the onset of the disability and to reinstate him/her in the same position, subject to the following conditions:
(1) That the worker petition the employer to be reinstated in his/her employment position within the term of fifteen (15) days, from and after the date the worker was discharged from the hospital, provided said petition has not been made after a lapse of one (1) year from the date of onset of the disability;
(2) that the worker is mentally and physically capable to discharge said employment at the time of requesting such reinstatement from the employer, and
(3) that said employment is available when the worker requests reinstatement. It shall be understood that the employment is available when it is vacant or another worker is engaged therein. It shall be presumed that the employment was vacant when same was filled by another worker within the thirty (30) days following the date in which the reinstatement petition was made.
If the employer should fail to comply with the provisions of this subsection, he shall be compelled to pay the worker or his beneficiaries the wages that said worker would have earned if he had been reinstated and the employer shall also be liable for the damages he has caused the worker. The worker or his beneficiaries may initiate and prosecute the proper claim for reinstatement and/or damages through an ordinary action in court or through the procedure for the claiming of wages, established in §§ 3118–3132 of Title 32.
History —June 26, 1968, No. 139, p. 354, § 3; May 30, 1970, No. 83, p. 205, § 3; May 31, 1972, No. 85, p. 204, § 2; May 30, 1974, No. 47, Part 1, p. 204, § 1; Nov. 12, 1975, No. 24, p. 828, § 2; June 23, 1976, No. 19, p. 732, § 1; July 26, 1979, No. 191, p. 527, § 2; June 3, 1985, No. 23, p. 74, § 1; June 28, 1985, No. 38, p. 138, §§ 1—3; July 1, 1988, No. 51, p. 237, § 3; Dec. 30, 1995, No. 262, § 2.