The Puerto Rico Industrial Commission was created by Law Number 45 of April 18, 1935, as amended, also know as “Workers Accident Compensation Act”, Puerto Rico Industrial Commission is the appellate forum with the faculty to review the decisions made by the Administrator of the State Insurance Fund Corporation (Administrator). The Commision has the faculty to revoke, modify or confirm the decisions made by the Administrator.
Either of the parties affected by the decision (the SIFC or the injured worker) can appeal, with or without attorney representation, the decision made by the Administrator within 30 days of the decision. Notification of the most common bases for an appeal are:
- When the Administrator determines that there is not a causal relationship between the accident and a health related issue or death.
- When the Administrator determines that the injury did not occurred while at work or as a direct consequence of the persons job.
- When the medical or hospital treatment is discontinued and the injured worker believes he or she still needs it.
- When the injured worker believes that he or she is not receiving adequate medical treatment.
- When the Administrator determines that infared worker's compensation does not proceed due to his or hers rejection to receive the recommended medical treatment.
- When the Administrator decides that the injured worker does not have a right to receive compensation, because he or she failed to seek medical treatment within the first five (5) working days after the accident occurs, except when there is just cause for such delay.
- When the Administrator and the injured worker disagree on the percentage of disability given.
- When the Administrator determines that the deceased injured worker does not have beneficiaries or one or more of the presumed beneficiaries are excluded from the compensation.