As in the 50 states that we have looked at, Puerto Rico has a mandatory system of workers’ comp for all of its employers. That means that all employers on the U.S. territory must follow along and provide workers’ comp insurance to all of its workers in case one of them gets hurt on the job.
Unlike some of the other 50 states though, in Puerto Rico the workers’ comp insurance is not provided by independent insurance agencies and companies. Instead, there is a government sponsored workers’ compensation state fund that all employers must buy in to, unless of course they are self-insured in the territory.
We remember what that means right? Self-insurance basically means what it sounds like—the employer has decided to insure themselves for workers’ comp, meaning that they set aside their own money to pay for any workers’ comp injury and disability claims that may come down the pike. This is different than traditional insurance, where you pay an insurance company a set premium for their insurance product, no matter if there is an actual claim or not. Then the insurance company can invest that premium how they choose and make money off it. In self-insurance, you don’t pay a premium. You don’t actually pay anything until one of your workers actually gets hurt.
In Puerto Rico, there are some notable exceptions to the blanket workers’ comp rule, whether or not you are self-insured or if you buy coverage through the state fund. For one, farm workers and sharecroppers in the territory are covered by the workers’ comp, as are domestic workers.
But no matter what the employee does, it is the workers’ comp agency that decides what doctors they go to when they are hurt. All workers, though, when hurt get full medical coverage for their injuries and for any emergencies that might occur right after the accident.
Let’s not forget the other half of the equation here. As an employer, sure, you have a lot of responsibilities toward your employees when it comes to buying workers’ comp insurance and making your workplace safe for them in the first place
But when it comes to your employees themselves, they have certain responsibilities when it comes to what to do when they are actually injured. In order to make the whole workers’ comp process run smoothly from the time they are injured to the time that they return to work after their injuries, it is up to the employees to do certain things, such as simply reporting their injuries when they first occur.
One of the best ways that you could teach your employees about their responsibilities, or just to remind them because many already know this general rule about injury reporting, is to post a workers’ comp poster in your work sites, along with all of your other workers’ comp and labor law compliance materials and posters.
The Puerto Rico workers’ comp poster will explain in general but informative terms how the system workers, and what role the employees play in it. It will tell them how to report an injury, and what contact information for injury reporting there is within your organization, and within the Puerto Rico workers’ comp division. It will also tell them that your insurance for workers’ comp is bought through the state fund, and it will provide the number of a contact there in case it is needed by your employees.
Don’t forget about the part on how it is the state fund that picks what medical help an employee gets after their injury. This could solve a lot of confusion, because many employees may not understand why they cannot just go to the doctor of their choice.