P.R. Laws tit. 11, § 4
In addition to the occupational diseases set forth in § 3 of this title, there shall be considered as such, for compensation purposes, any disease of the respiratory system of a tuberculous origin acquired in the course of work and as a consequence thereof by a person exposed to contact in the course of his daily work in hospitals, dispensaries, offices, or health centers devoted to the diagnosis and treatment of tuberculosis of the respiratory system and in laboratories in which is handled and examined infective tuberculous material, whether said hospitals, dispensaries, offices, centers and laboratories are operated by the Commonwealth or municipal governments or by private persons or entities, subject to the following conditions which establish, beyond any reasonable doubt, the connection of casuality between the disease on [of] the person suffering therefrom and his work:
(a) No person may begin to work in a hospital, dispensary, office or health center devoted to the diagnosis and treatment of tuberculosis of the respiratory system or in a laboratory in which is handled and examined infective tuberculous material, independently from the number of employees, without having been subjected before or within a month after assuming his duties, the determination that he does not suffer from tuberculosis of the respiratory system by the agency of the Department of Health that the Secretary may designate and without so being certified to the Manager of the State Insurance Fund, as provided by subsection (i) of this section. Said determination shall be made pursuant to the best practices of medicine in this field and shall always include the radiographic examination of the lungs.
(b) Every person working in a hospital, dispensary, office, or health center devoted to the diagnosis and treatment of tuberculosis of the respiratory system or in a laboratory in which is handled infective tuberculous material, irrespective of the number of employees, shall, at the time this act takes effect, within the month preceding or following said date, submit himself to examination at the agency which the Secretary of Health may designate, for the purpose of determining whether or not said person suffers from tuberculosis of the respiratory system. This determination shall be made pursuant to the best practices of medicine in this field and shall always include the radiographic examination of the lungs.
(1) Every person comprised within this clause on whom the determination is made that he is not suffering from tuberculosis of the respiratory system shall be so certified to the Manager of the State Insurance Fund.
(2) Every person comprised within this clause who is determined to be suffering from chronic tuberculosis of the respiratory system, classified as inactive according to the standards established by the National Tuberculosis Association of the United States, standard for the diagnosis of tuberculosis, 1950 edition, and as may subsequently be amended, may continue in his work, but shall not be entitled to compensation if the reactivation occurs before twenty-four (24) months have elapsed after this act has taken effect. The determination of inactivity shall be made by the agency of the Department of Health that the Secretary of Health may designate and shall be so certified, as prescribed in subsection (i) of this section.
(3) Every person comprised within this clause who is determined to be suffering from active tuberculosis of the respiratory system and who has been working for ninety days or over in a hospital, dispensary, office or health center devoted to the diagnosis and treatment of tuberculosis of the respiratory system or in a laboratory in which is handled infective tuberculous material, shall be considered as sick as a result of his work and as a consequence thereof and may avail himself of the provisions on compensation provided in this chapter, except if it is shown that he was suffering from active tuberculosis of the respiratory system on the date he began to render services.
(c) It shall be considered that the tuberculosis of the respiratory system has been acquired in the work and as a consequence thereof, if it reveals itself after ninety (90) days after beginning to work, although it was not present before; Provided, That those persons who are working at the time this act takes effect and continue to work on account of the examination having revealed that they are not suffering from tuberculosis of the respiratory system and acquire tuberculosis before ninety (90) days have elapsed since the date of the examination, shall be covered by the provisions of this chapter as to compensation, provided they have been working before this act takes effect for the time necessary to complete the ninety (90) days herein established.
(d) There may be employed in a hospital, dispensary, office or health center devoted to the diagnosis and treatment of tuberculosis of the respiratory system, any such persons who suffer or have suffered from chronic tuberculosis of the respiratory system provided it is classified as inactive, in accordance with the standards established by the National Tuberculosis Association of the United States, standard for diagnosis of tuberculosis, 1950 edition, as it may be subsequently amended and being certified as such to the Manager of the State Insurance Fund, as established in subsection (i) of this section, but such persons shall not be covered by the provisions on compensation established herein unless active tuberculosis of the respiratory system is revealed in them after twenty-four (24) months have elapsed after he began to work.
(e) Every employee of a hospital, dispensary, office or health center devoted to the diagnosis and treatment of tuberculosis or of a laboratory in which is handled infective tuberculous material, irrespective of the number of employees, shall be submitted to examination each six (6) months for the purpose of determining if he suffers from active tuberculosis of the respiratory system. This determination shall be made pursuant to the best practice of medicine in this field and shall always include the radiographic examination of the lungs. The Secretary of Health shall designate the agencies of the Department of Health which shall make the same, and the competent authorities of the hospital, dispensary, office or health center or laboratory are under obligation to see to it that this provision is complied with, as well as to send to the Manager of the State Insurance Fund the corresponding certificates, according to the provisions of subsection (i) of this section.
(f) Irrespective of the examination each six (6) months, every employee who ceases in his employment in a hospital, dispensary, office or health center devoted to the diagnosis and treatment of tuberculosis of the respiratory system, or in a laboratory in which is handled infective tuberculous material, irrespective of the number of employees, must be submitted to examination to determine if he suffers from active tuberculosis of the respiratory system. This determination shall be made according to the best practices of medicine and shall always include the radiographic examination of the lungs. This examination must be performed within a month prior to the termination of his services. Active tuberculosis of the respiratory system revealed after ninety (90) days of the last day worked shall not be entitled to compensation. The proper administrative authority shall inform the Manager of the State Insurance Fund of the result of this examination of cessation in each case and as provided in subsection (i) of this section.
Whenever the Manager, after the medical determination rendered in any case, arrives at the conclusion that no additional treatment can have the effect of rehabilitating the patient for work, he shall proceed to fix thereto the degree of disability he has contracted and, after the compensation has been liquidated, the case shall be closed for all purposes of law. The workman may appeal from such decision to the Industrial Commission within thirty (30) days after he is notified thereof.
(g) Any employee covered by this chapter who refuses to submit to the examinations herein provided, ipso facto forfeits any right to compensation under the provisions of this chapter, and such refusal shall be reported in writing to the Manager of the State Insurance Fund by the competent administrative authority.
(h) The Department of Health shall be under obligation so to examine such employees, both prospective and actual, at no cost whatsoever to them, before, during, and upon the termination of their employment, whether they are Commonwealth or municipal government employees or employees of private individuals or entities, giving these cases any priority necessary toward non-delay of the prompt employment of those who are employable. The Department of Health shall establish the procedure by which the reports concerning their own employees are to be sent to the Manager of the State Insurance Fund and shall remit to any private individuals or entities who are employees and to the competent municipal authorities the reports on their employees, the sending of which latter reports to the Manager of the State Insurance Fund shall be the responsibility of the said employers and competent municipal authorities.
(i) Private employers, whether individuals or entities, shall be under obligation to do such part as falls to them within the provisions of this chapter. If they have not done so in connection with any case in which the right to compensation is established or in which such right to compensation might have been established if they had done their part, the Manager of the State Insurance Fund shall, after paying such compensation, be under obligation to determine and collect from the employer the amount of the compensation, following for such determination and collection the procedure established for non-insured employers. In the case of a Commonwealth or municipal government employee who has contracted active tuberculosis of the respiratory system in connection with which the competent administrative authority has not fulfilled his part of the responsibilities fixed by this chapter, the Manager of the State Insurance Fund may, if the circumstances show that the right to compensation would have been clearly established if those responsibilities had been fulfilled, take steps, after paying the compensation, toward securing, in accordance with the procedure established by law, from the said Commonwealth or municipal government, the payment of the sum involved, resorting, if necessary, to the Legislature of Puerto Rico for a specific appropriation for that purpose; Provided, That the municipal legislatures and the Board of Commissioners of the Capital shall include in their budgets the amounts of the compensations granted by the Manager which they are bound to pay pursuant to the provision of this subsection.
(j) Employers who have hospitals, dispensaries, or health offices or centers devoted to the diagnosis and treatment of tuberculosis of the respiratory system, and in laboratories where infective tuberculous material is handled and examined, whether it be the Commonwealth or municipal government or private persons or entities, shall be under obligation to insure their employees independently of the number thereof and of the provisions of §§ 2 and 19 of this title and shall also be subject to the same penalties provided by this chapter for those employers who fail to comply with the law.
(k) It shall also be understood that all persons who were working on the date Act 401 of April 23, 1946 took effect at the places and in the manner prescribed by this Act, and those who began to work after that date, shall be equally protected by the provisions thereof, provided they have been the object of medical examinations which constitute authentic proof of having contracted the illness in the employment.
The Manager shall accept such examinations as final proof, even if they have been made by Public Health Units, Municipal Hospitals, District Hospitals or by any other hospital of the Commonwealth Government, or by private hospitals utilized by the Savings and Loan Fund Association of the Employees of the Commonwealth Government, when such examinations have been made to determine the admission of employees in said Association, and any other authentic proof. In cases in which the claimants are not Commonwealth Government employees, the Manager shall accept authentic medical proof that the illness was contracted in the course of the employment and as a result thereof.
The Manager shall review the claims decided by him under Act No. 401 of April 23, 1946, in connection with these provisions.
In every case in which the Manager, after the medical determinations rendered for the purpose, arrives at the conclusion that the continuance of the treatment shall not result in the rehabilitation of the patient for work, the said Manager shall proceed to fix to said patient the resulting disability, and the liquidation of the compensation granted shall have the effect of closing the case for all purposes of law. The workman may appeal from such decision to the Industrial Commission within thirty (30) days after he is notified thereof.
History —Apr. 18, 1935, No. 45, p. 250, added as § 3-A on Apr. 23, 1946, No. 401, p. 1092, § 1; May 14, 1952, No. 455, p. 938, § 1, eff. 90 days after May 14, 1952.