The Fund for truckers and owners

They are Articles 2-A to 2-E of Act 45-1935: the provisions letting a self-employed trucker and an owner of a farm, workshop or small business who works with their hands buy their own State Insurance Fund protection, with what each covers and what to do when injured.

For the Article 2-A policy: being a natural person, a trucker, authorised by the Public Service Commission to provide cargo-transport services for pay on Puerto Rico’s public roads to the general public or a private person; it includes one operating their truck transporting or loading aggregates and the operators who work on a percentage basis as lessee drivers. For the Article 2-D benefits: appearing as an employer insured with the Fund and, being an owner, sharecropper or lessee, supervising and personally carrying out manual labour on the farm, workshop or small-scale business, or qualifying as a small farmer per the definition the Fund and the Department of Agriculture establish. Excluded from those benefits are employers who mainly exercise supervisory, directive or administrative functions.

• For the trucker: holding the Public Service Commission’s authorisation to provide cargo-transport services for pay on Puerto Rico’s public roads.Verified against the official source
• Paying for the policy: Article 2-A says “this policy must be paid by the trucker themselves”, and Article 2-D conditions the manual-work employer’s benefits on a per capita premium the Administrator may impose.Verified against the official source
• For the manual-work employer: supervising and personally carrying out manual labour on the farm, workshop or small-scale business. Employers who mainly exercise supervisory, directive or administrative functions are excluded.Verified against the official source

• For the injured trucker: the claim on the form the State Insurance Fund Corporation provides, with the detailed circumstances of the accident or illness, the date, hour and place, and the names and addresses of witnesses if any (Article 2-B).
• For the employer doing manual labour: a sworn declaration setting out in detail the circumstances under which the alleged work accident occurred and the names of eyewitnesses (Article 2-E).

1. 1

   Step 1: The trucker’s policy, and who pays for it

   Article 2-A authorises the Fund to issue “a worker-insurance policy in favour of the natural person who is a trucker, authorised by the Public Service Commission to provide cargo-transport services for pay on Puerto Rico’s public roads to the general public or a private person”. It expressly includes one operating their truck transporting or loading aggregates and the operators who work on a percentage basis as lessee drivers. And it says who pays for it, plainly: “This policy must be paid by the trucker themselves and extends them protection as an employee in every case where they suffer a work accident or occupational illness, as this Act establishes.”

2. 2

   Step 2: Aggregates truckers: partial cover

   The Act treats separately the aggregates trucker covered by Act No. 1 of 16 May 1972, who operates their own truck, and the operators who work on a percentage basis as lessee drivers. For them the Fund will issue, subject to the regulation it promulgates and at the interested party’s request, “a worker-insurance policy giving them partial cover for medical and hospital services, in case they suffer an accident, injuries or a health condition in the course of and as a consequence of their labour or work, on payment of the corresponding premium”. Partial cover, and only medical and hospital.

3. 3

   Step 3: And the option of greater cover

   The Act does not tie them to partial cover. “Notwithstanding the above, the aggregates trucker or the operators who work on a percentage basis as lessee drivers transporting or loading aggregates shall have the option of taking a worker-insurance policy with greater protection, as offered by the Corporation for the other categories of truckers covered by this Article.” It is an option, and it has to be asked for: the Act offers it, it does not impose it.

4. 4

   Step 4: If the trucker is injured: you must file

   Article 2-B is the step that decides whether you are treated. “When any trucker under the worker-insurance policy suffers an injury or illness at work, they must file, within the term the law provides, the claim for their case using the form the State Insurance Fund Corporation provides.” And what must go in it: “the detailed circumstances under which the alleged accident or occupational illness occurred, the date, hour and place, as well as the names and addresses of witnesses, if any”.

5. 5

   Step 5: Without that report there are no services, except emergency

   The sentence closing Article 2-B is the one worth knowing before you need it: “Presentation of that report is required in order to receive the medical and hospital services as well as the other benefits granted in this Act, with the exception of emergency treatment.” Emergency treatment falls outside the requirement; everything else does not.

6. 6

   Step 6: Claiming what does not come from work must be repaid

   Article 2-C is one line and it sets the consequence. “Any trucker who avails themselves of this Act’s benefits where it was not an injury or condition derived from work shall be obliged to reimburse the State Insurance Fund Corporation for the expenses incurred.” It is not a fine: it is repaying what the Fund spent.

7. 7

   Step 7: The owner who works with their hands

   Article 2-D opens the Fund to another figure. The Administrator shall extend, subject to regulation and at the interested party’s request, “the medical and hospital benefits provided by this Act to persons appearing as employers insured with the State Insurance Fund who, being owners, sharecroppers or lessees, supervise and personally carry out manual labour on their farms, workshops or small-scale businesses, or qualify as small farmers… and suffer an injury in the course of and as a consequence of their labour or work”. Note what is extended: medical and hospital benefits. It does not say dietas or disability compensation.

8. 8

   Step 8: The per capita premium and the separate classifications

   The Act explains how it is paid and how it is accounted for. The Administrator “may impose on the employers taking these benefits, or those qualifying as small farmers, a per capita premium computed on the cost experience of the activity they engage in”. And it adds: “separate classifications shall be kept for those activities, and the experience accumulated from their operation shall be kept separate from all other experience for statistical and premium-rate purposes”. The actual figure of that premium is not in the Act: the regulation fixes it, and we did not read it.

9. 9

   Step 9: Who is left out

   The exclusion is short and decisive. “Excluded from the benefits of these provisions are employers who mainly exercise supervisory, directive or administrative functions.” The word carrying the weight is “mainly”: the article covers someone who supervises and also personally carries out manual labour, not someone who only directs.

10. 10

    Step 10: The spouse and the unwaged children

    Article 2-D closes with an extension almost nobody asks for. “At the request of the employer or of those qualifying as small farmers, the cover may also be extended on the same conditions to their spouse and to children who earn no wage, provided they perform manual labour on the insured farm, workshop or small business, and pay the per capita premium imposed.” Three conditions: that it be requested, that they do manual labour in the insured business, and that the per capita premium be paid for them.

11. 11

    Step 11: The injured employer’s sworn declaration

    Article 2-E imposes the step equivalent to the trucker’s report, but as a sworn declaration. When the person covered by those provisions suffers an injury at work, they “must give a sworn declaration setting out in detail the circumstances under which the alleged work accident occurred, as well as the names of the eyewitnesses to it”. And it provides for the case where they cannot: “If the injury is of such a nature that it does not immediately allow the employer to give that sworn declaration, it must be given by one of their workers who witnessed the accident or, failing that, by a close relative of the injured employer.”

12. 12

    Step 12: Without the declaration there are no services, except first aid

    The Act closes the block with the same mechanism it used for the trucker. “Giving that sworn declaration to the State Insurance Fund shall be an indispensable requirement for receiving the medical and hospital services that workers protected by the State Insurance Fund receive, with the exception of first-aid treatment in emergency cases.” And it adds the counterpart: anyone availing themselves of those benefits without being entitled “shall be obliged to reimburse the State Insurance Fund any payment it improperly incurred for medical and hospital services”.

The policy is applied for at the State Insurance Fund Corporation, and both the aggregates trucker’s policy and the manual-work employer’s benefits are granted “at the interested party’s request” and subject to the regulation the Fund promulgates. The injured trucker’s claim is filed on the form the Fund itself provides; the injured employer’s sworn declaration is given to the Fund. The authorisation to carry cargo for pay is granted by the Public Service Commission. The Act publishes no addresses, phone numbers, form numbers or premiums in these articles, and we read none here, so we do not invent them.

• Assuming the self-employed trucker is automatically covered: the Act authorises a policy, and that policy “must be paid by the trucker themselves”.
• Believing the aggregates trucker’s cover is the same as the others’: the Act gives them partial cover for medical and hospital services.
• Not asking for the greater-protection option: the Act expressly recognises it for the aggregates trucker and the percentage-basis lessee drivers.
• Receiving treatment and not filing the claim: without that report there are no medical and hospital services or other benefits, except emergency treatment.
• Filing without the detailed circumstances, the date, hour, place and witnesses: they are what Article 2-B requires the form to contain.
• Availing yourself of the benefits for an injury not derived from work: the expenses incurred must be reimbursed to the Fund.
• Believing Article 2-D gives the owner dietas: what the Act extends are the medical and hospital benefits.
• Asking for the manual-work employer’s benefits while mainly exercising supervisory, directive or administrative functions: those employers are excluded.
• Not extending the cover to a spouse and unwaged children when they do manual labour in the insured business: the Act allows it on request and on paying the per capita premium.
• Not giving the sworn declaration because the injury prevents you: the Act allows a worker who witnessed it or, failing that, a close relative to give it.

These are the government pages this guide is based on.

• Corporación del Fondo del Seguro del Estado (CFSE)

  Fondo del Seguro del Estado

  bvirtualogp.pr.gov