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Regulations on Work-related Injury Insurance

Benefits of Work-related Injury Insurance

Article 3 Employees who suffer from accident injuries or occupational diseases due to work shall enjoy medical benefits for work-related injuries.

employees who treat work-related injuries should seek medical treatment at the medical institution that signed the service agreement, and in case of emergency, they can go to the nearest medical institution for first aid.

if the expenses required for the treatment of work-related injuries meet the catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs and the hospitalization service standard of work-related injury insurance, they shall be paid from the work-related injury insurance fund. The catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs and the hospitalization service standard of work-related injury insurance shall be stipulated by the social insurance administrative department of the State Council in conjunction with the health administrative department of the State Council, the food and drug supervision and management department and other departments.

the food allowance for employees' hospitalization for work-related injuries, as well as the transportation and accommodation expenses required for employees' medical treatment outside the overall planning area, are paid from the work-related injury insurance fund, and the specific standards for the fund payment are stipulated by the people's government of the overall planning area.

workers who are injured at work who treat diseases not caused by work-related injuries do not enjoy medical treatment for work-related injuries, and shall be treated according to the basic medical insurance measures.

the expenses for the injured workers to go to the medical institutions that have signed the service agreement for work-related injury rehabilitation shall be paid from the work-related injury insurance fund if they meet the requirements.

article 31 in case of administrative reconsideration or administrative litigation after the social insurance administrative department has made a decision that it is deemed as a work-related injury, the medical expenses for treating the work-related injury of employees will not be stopped during the administrative reconsideration and administrative litigation.

Article 32 Workers with work-related injuries may install artificial limbs, orthotics, artificial eyes, dentures and wheelchairs and other auxiliary devices due to their daily life or employment needs, and the required expenses shall be paid from the work-related injury insurance fund according to the standards stipulated by the state.

Article 33 If an employee suffers from an accident or occupational disease at work and needs to suspend work to receive work-related injury medical treatment, the original salary and welfare benefits will remain unchanged during the period of suspension with pay, and the unit where he works will pay him monthly.

the period of shutdown with pay is generally not more than 12 months. Serious injury or special circumstances, confirmed by the municipal labor ability appraisal committee, can be appropriately extended, but the extension shall not exceed 12 months. After assessing the disability level, the injured workers shall stop the original treatment and enjoy the disability treatment in accordance with the relevant provisions of this chapter. Workers with work-related injuries who still need treatment after the expiration of shutdown with pay will continue to enjoy medical treatment for work-related injuries.

if the injured workers who can't take care of themselves need nursing during the period of shutdown with pay, the unit where they work is responsible.

article 34 if the injured worker has been assessed with disability grade and confirmed by the labor ability appraisal Committee to need life care, the life care fee shall be paid monthly from the work injury insurance fund.

The living nursing fee is paid according to three different levels: life can't take care of itself at all, most of life can't take care of itself or part of life can't take care of itself, and the standard is 5%, 4% or 3% of the average monthly salary of employees in the overall planning area respectively.

Article 35 If an employee is identified as a first-class to fourth-class disability due to work, he/she will retain his/her labor relationship and quit his/her post, and enjoy the following benefits:

(1) Pay a one-time disability subsidy from the industrial injury insurance fund according to the disability level, with the standard as follows: the first-class disability is 27 months, the second-class disability is 25 months, the third-class disability is 23 months and the fourth-class disability is 21 months.

(2) Pay monthly disability allowance from the industrial injury insurance fund. The standard is: 9% of my salary for first-degree disability, 85% for second-degree disability, 8% for third-degree disability and 75% for fourth-degree disability. If the actual amount of disability allowance is lower than the local minimum wage standard, the work-related injury insurance fund will make up the difference < P > (3) After the workers with work-related injuries reach retirement age and go through retirement procedures, they will stop issuing disability allowance and enjoy the basic old-age insurance benefits in accordance with state regulations. If the basic old-age insurance benefits are lower than the disability allowance, the work-related injury insurance fund will make up the difference.

if an employee's work-related disability is identified as level 1 to level 4 disability, the employer and the employee shall pay the basic medical insurance premium based on the disability allowance.

Article 36 Employees who are disabled at work and are identified as level 5 or level 6 are entitled to the following benefits:

(1) Pay a one-time disability subsidy from the industrial injury insurance fund according to the level of disability, with the standards as follows: level 5 disability is my salary for 18 months, and level 6 disability is my salary for 16 months;

(2) retain the labor relationship with the employer, and the employer will arrange appropriate work. If it is difficult to arrange a job, the employer will pay a monthly disability allowance. The standard is: 7% of my salary for level 5 disability and 6% of my salary for level 6 disability, and the employer will pay the social insurance premiums that should be paid for it according to the regulations. If the actual amount of disability allowance is lower than the local minimum wage, the employer shall make up the difference.

upon the employee's own proposal, the employee can dissolve or terminate the labor relationship with the employer, and the work-related injury insurance fund will pay the one-time medical subsidy for work-related injuries, and the employer will pay the one-time disability employment subsidy. The specific standards of one-time medical subsidy for work-related injuries and one-time disability employment subsidy shall be formulated by the people's governments of provinces, autonomous regions and municipalities directly under the Central Government.

Article 37 Employees who are identified as being disabled at level 7 to level 1 due to work-related disability shall enjoy the following benefits:

(1) Pay a one-time disability subsidy from the industrial injury insurance fund according to the disability level, with the standards as follows: level 7 disability is 13 months, level 8 disability is 11 months, level 9 disability is 9 months, and level 1 disability is 7 months;

(2) If the labor or employment contract expires, or the employee himself proposes to terminate the labor or employment contract, the industrial injury insurance fund will pay the one-time medical subsidy for work-related injuries, and the employer will pay the one-time disability employment subsidy. The specific standards of one-time medical subsidy for work-related injuries and one-time disability employment subsidy shall be formulated by the people's governments of provinces, autonomous regions and municipalities directly under the Central Government.

article 38 employees who suffer from work-related injuries and need treatment are entitled to work-related injury treatment as stipulated in articles 3, 32 and 33 of these regulations.

Article 39 If an employee dies at work, his close relatives shall receive funeral subsidies, dependent relatives' pensions and one-time work-related death subsidies from the work-related injury insurance fund according to the following provisions:

(1) The funeral subsidies shall be the average monthly salary of the employees in the last year in the overall planning area for six months

(2) The dependent relatives' pensions shall be paid to the relatives who provided the main source of livelihood and were unable to work before the death of the employee. The standard is: 4% for spouse, 3% for other relatives, and 1% for the elderly or orphans. The sum of the approved pensions for dependent relatives should not be higher than the wages of employees who died at work. The specific scope of supporting relatives shall be stipulated by the administrative department of social insurance of the State Council < P > (3) The standard of one-time work-related death allowance is 2 times of the per capita disposable income of urban residents in the previous year.

if a disabled employee dies due to work-related injuries during the period of suspension with pay, his close relatives shall enjoy the treatment specified in the first paragraph of this article.

if a disabled worker of grade 1 to grade 4 dies after the expiration of the period of suspension with pay, his close relatives can enjoy the treatment stipulated in items (1) and (2) of the first paragraph of this article.

Article 4 Disability allowance, pension for dependent relatives and living nursing expenses shall be adjusted by the administrative department of social insurance in the overall planning area according to the changes in the average salary and living expenses of employees. Measures for adjustment shall be formulated by the people's governments of provinces, autonomous regions and municipalities directly under the Central Government.

article 41 if an employee has an accident while going out for work or his whereabouts are unknown during emergency rescue and disaster relief, he will be paid wages within 3 months from the month of the accident, and wages will be stopped from the fourth month. The industrial injury insurance fund will pay monthly pension to his dependent relatives. Life is difficult, you can advance 5% of the one-time work-related death subsidy. If an employee is declared dead by the people's court, it shall be handled in accordance with the provisions of Article 39 of this Ordinance on the death of an employee due to work.

Article 42 Employees who suffer from work-related injuries shall cease to enjoy the benefits of work-related injury insurance under any of the following circumstances:

(1) Those who have lost the conditions for enjoying the benefits

(2) Those who refuse to accept the labor ability appraisal

(3) Those who refuse to receive treatment.

article 43 if the employing unit is divided, merged or transferred, the successor unit shall bear the industrial injury insurance liability of the original employing unit; If the original employer has participated in work-related injury insurance, the successor unit shall go to the local agency to handle the change registration of work-related injury insurance.

if the employer carries out contracted operation, the responsibility for work-related injury insurance shall be borne by the unit where the employee's labor relations are located.

if an employee is injured by a work-related accident during the secondment period, the original employer shall bear the responsibility of work-related injury insurance, but the original employer and the seconded unit may agree on compensation measures.

if an enterprise goes bankrupt, the industrial injury insurance benefits that should be paid by the unit shall be allocated according to law at the time of bankruptcy liquidation.

article 44 if an employee is sent to work abroad and should take part in local industrial injury insurance according to the laws of the country or region where he is going, he will take part in local industrial injury insurance, and his domestic industrial injury insurance relationship will be terminated; Can not participate in local industrial injury insurance, its domestic industrial injury insurance relationship is not suspended.

article 45 if an employee suffers a work-related injury again and should be entitled to disability allowance according to the regulations, he shall be entitled to disability allowance according to the newly recognized disability grade.