How to deal with the workers compensation process, how to process workers compensation?

The basic process of a workers' compensation claim is as follows:

1. After the accident occurs, apply to the Human Resources and Social Security Bureau for the identification of work-related injury, the company needs to report within one month of the accident, if the company does not apply, the injured employee or his close relatives shall apply for recognition within one year;

2. If there is a disability that affects the ability to work after the injury is relatively stable, the applicant shall apply to the labor ability appraisal committee for the labor ability appraisal;

3. Obtain compensation according to the appraisal of labor ability level;

4. If there is no labor contract and other evidence proving the existence of labor relationship, and it is impossible to apply for work-related injury determination, you can first apply for labor arbitration to confirm the existence of labor relationship with the employer.

Work-related injury handling process:

1. After a work-related injury occurs, you need to go to the Social Security Bureau to confirm whether the employer has purchased work-related injury insurance for yourself.

If the employer has purchased work-related injury insurance, it can require the employer to declare the work-related injury within one month; If not, it is necessary to collect evidence of the employment relationship as soon as possible and report the work-related injury within one year.

Regardless of whether the employer has work-related injury insurance, employees can declare work-related injuries, which is a prerequisite for future claims. Care must be taken to file within one year.

2. After the Social Security Bureau identifies the work-related injury and the medical treatment period expires, the applicant can submit an application for labor ability appraisal to the Social Security Bureau.

The labor ability appraisal agency shall be the appraisal agency designated by the Social Security Bureau, which is different from the general judicial appraisal institution, and is divided into 10 levels, with the highest level being level 1 and the lowest level being level 10.

3. The medical treatment period is different for different injuries.

During the medical treatment period, the employee is not required to go to work, and if the employer has such a request, the employee can also refuse it. During the medical treatment period, the employer is required to pay the employee according to the average salary in the 12 months before the injury, and many employers propose that it is illegal to pay only the basic salary or the minimum wage.

During the medical treatment period, if the employee needs to be hospitalized**, it is best to be hospitalized**. This is because you can ask for food allowance during hospitalization and lost work expenses for accompanying staff. If you are not hospitalized, both of these are more difficult to achieve.

4. If there is any objection to the result after the appraisal of the working ability, the applicant may apply for re-appraisal to the labor ability appraisal committee at the next higher level within 15 days from the date of receipt of the result.

If the disability level is not assessed, you can only ask for the salary of the leave of absence (i.e. during the medical treatment period), food allowance during hospitalization, lost work expenses and medical expenses.

If you are assessed as disabled, you can go to the Social Security Bureau to go through the claim procedures.

5. Claims.

Before the termination of the labor relationship, the Social Security Bureau only pays a one-time disability subsidy, and if the employer does not purchase work-related injury insurance, the employer will pay compensation.

After the termination of the labor relationship, the employer shall pay a one-time employment subsidy, and the Social Security Bureau shall pay a one-time medical subsidy. If you have not purchased work-related injury insurance, the employer shall bear it.

Legal analysis: The algorithm of social security during the employee's work-related injury is consistent with the employee's treatment in the employer before the injury, and the employee's social security needs to continue to be paid by the employer during the work-related injury, and the amount and time of payment have not changed from before, and the employer needs to bear the employee's medical expenses, nursing expenses and lost work expenses during the injury and recuperation period. Legal basis:

Article 7 of the Social Insurance Law of the People's Republic of China The social insurance administrative department is responsible for the social insurance administration of the whole country, and other relevant departments are responsible for the relevant social insurance work within the scope of their respective duties. The local people's social insurance administrative departments at or above the county level are responsible for the social insurance management work in their respective administrative regions, and other relevant departments of the local people's social insurance at or above the county level are responsible for the relevant social insurance work within the scope of their respective duties. Article 8 Social insurance agencies provide social insurance services and are responsible for social insurance registration, records of individual rights and interests, payment of social insurance benefits, and so forth.

Article 9 Trade unions shall safeguard the legitimate rights and interests of employees in accordance with the law, and shall have the right to participate in the study of major social insurance matters, participate in the social insurance supervision committee, and supervise matters related to the social insurance rights and interests of employees.

The claim process for workers' compensation insurance is as follows:1. The accident injury is recognized as a work-related injury by the local social security department and the appraisal conclusion issued by the local labor ability committee;

2. Apply for work-related injury insurance benefits at the social insurance agency with the work-related injury certificate;

3. The social insurance agency examines the application of the applicant for work-related injury insurance;

4. The social insurance agency shall issue work-related injury insurance compensation to the work-related injury insurance applicant in accordance with the law.

1. Procedures for reporting work-related injuries; The employer shall, within 15 days from the date of the occurrence of the work-related accident or the date of diagnosis of the occupational disease, submit a work-related injury report to the local labor administrative department. 2. Procedures for determining work-related injuries; The procedure for the social insurance agency to investigate and determine whether a work-related injury (fatality) accident is a work-related injury. 3. Procedures for the identification of work-related injuries; Work-related injury appraisal refers to the act of assessing the disability level of an employee who applies for work-related injury appraisal on the basis of his or her work-related injury determination (i.e., after going through the procedure for determining the completion of the injury) after the completion of his or her medical treatment or the expiration of the medical treatment period.

4. Negotiate compensation procedures; After the work-related injury appraisal, if the employer does not purchase labor insurance for the employee, it can negotiate with the employee on the amount of compensation.

5. Labor arbitration procedures; If the dispute cannot be resolved through negotiation with the employer, the arbitration procedure may be initiated in accordance with the labor arbitration regulations.

6. Procedures for court proceedings; Those who are dissatisfied with labor arbitration may file a lawsuit with the court for resolution. Those who are dissatisfied with the judgment of the court of first instance may appeal to the court of second instance in accordance with law.

7. Enforcement procedures; If the employer fails to pay the compensation fee after the arbitration or judgment takes effect, it may file an application for enforcement with the court enforcement bureau in accordance with the effective legal documents, and the court will enforce it.

Legal basis: Article 66 of the Regulations on Work-related Injury Insurance.

Where an employee of a unit that does not have a business license or has not been registered or filed in accordance with law, or an employee of a unit whose business license has been revoked or whose registration or filing has been revoked in accordance with law, is injured in an accident or suffers from an occupational disease, the unit shall give a lump sum compensation to the disabled employee or the close relatives of the deceased employee, and the compensation standard shall not be lower than the work-related injury insurance benefits provided for in these Regulations; Where an employer uses child labor to cause disability or death as a result of child work, the employer shall give a lump sum compensation to the child worker or the child's close relatives, and the compensation standard shall not be lower than the work-related injury insurance benefits provided for in these Regulations. The specific measures shall be prescribed by the social insurance administrative department.

Where the close relatives of the disabled or deceased employees provided for in the preceding paragraph have a dispute with the employer over the amount of compensation, and the child laborers or close relatives of the child laborers provided for in the preceding paragraph have a dispute with the employer over the amount of compensation, it shall be handled in accordance with the relevant provisions on the handling of labor disputes.

Hello, dear, 1. The work-related injury reporting procedure unit shall submit a work-related injury report to the local labor administrative department within 15 days from the date of the work-related accident or the date of diagnosis of the occupational disease. II. Procedures for Determining Work-related Injuries The procedures for the social insurance agency to investigate work-related injuries (fatalities) and determine whether they are work-related injuries. III. Work-related Injury Appraisal ProceduresWork-related injury appraisal refers to the assessment of the disability level of an employee who applies for work-related injury appraisal after the completion of his or her medical treatment or the expiration of his or her medical treatment on the basis of his or her determination of work-related injury.

4. After the appraisal of work-related injuries in the compensation procedure is negotiated, the amount of compensation can be calculated according to the appraisal standard. 5. If the labor arbitration procedure cannot be resolved through negotiation with the employer, the arbitration procedure may be initiated in accordance with the labor arbitration regulations. 6. If the court is dissatisfied with the labor arbitration in the trial procedure, it may file a lawsuit with the court for resolution.

Those who are dissatisfied with the judgment of the court of first instance may appeal to the court of second instance in accordance with law. 7. If the employer fails to pay the compensation fee after the arbitration or judgment takes effect, it may file an application for enforcement with the court enforcement bureau in accordance with the effective legal documents, and the court will enforce it.

Article 30 of the Regulations on Work-related Injury Insurance Employees who are injured in accidents or suffer from occupational diseases due to work shall enjoy medical treatment for work-related injuries.

There is no such thing as an injury for an employee. It is only whether it can be recognized as a work-related injury. Once it is recognized as a work-related injury.

Employees are not responsible. Procedure: ** Go home to recuperate after the end.

Generally three to six months. Severe on a case-by-case basis. After recovery, the Labor Bureau can identify the level of work-related injury and functional deficiency.

Once the results are out, it can be calculated according to local standards.

Legal Analysis:1The two parties shall negotiate in advance; 2.

If the negotiation cannot be resolved, a complaint can be filed with the local labor and social security supervision agency; 3.If there is still a dispute after the report, the employee may submit a written application to the local labor dispute arbitration commission for arbitration within 60 days from the date of occurrence of the work-related injury compensation dispute; 4.If you are dissatisfied with the arbitral award, you may file a lawsuit with the people's court.

Legal basis: Article 5 of the Law on Mediation and Arbitration of Labor Disputes In the event of a labor dispute, if the parties are unwilling to negotiate, fail to negotiate or fail to perform after reaching a settlement agreement, they may apply to the mediation organization for mediation; If the applicant is unwilling to mediate, fails to mediate, or fails to perform after reaching a mediation agreement, he or she may apply to the Labor Dispute Arbitration Commission for arbitration; If a person is dissatisfied with an arbitral award, he or she may file a lawsuit in the people's court, except as otherwise provided by this Law.

The determination of work-related injury is to determine whether the accident injury that occurred is considered a work-related injury. It can only be determined by the social insurance administrative department, and generally by the local human resources and social security administrations, and other organs have no right to make a determination of whether it is a work-related injury.

Note: When applying for work-related injury determination, it is necessary to submit a certificate of labor relationship, and if it cannot be provided, it is necessary to determine the labor relationship through labor arbitration and civil litigation first.

secondly, the appraisal of labor ability;

For those with disabilities, it is necessary to conduct a labor ability appraisal to determine the level of disability, and then determine the work-related injury compensation items and compensation standards.

Note: If you are not satisfied with the conclusion of the first labor ability appraisal, you can conduct another appraisal with the provincial or autonomous region-level labor ability appraisal committee within 15 days from the day after receiving the appraisal conclusion.

Thirdly, labor arbitration;

For those who cannot resolve the above-mentioned work-related injury treatment disputes through negotiation, the injured employee needs to apply for labor arbitration first, and the labor dispute arbitration commission will make a ruling through the ** trial.

Thirdly, civil litigation;

Those who are dissatisfied with the ruling of the labor arbitration commission may file a civil lawsuit within 15 days from the day after receiving the award, and the people's court shall make a civil judgment on the work-related injury insurance benefits of the lawsuit.

The steps for processing workers' compensation are as follows:

1. Work-related injury reporting procedures;

2. Procedures for determining work-related injuries;

3. Work-related injury appraisal procedures;

4. Negotiate compensation procedures;

5. Labor arbitration procedure;

6. Court trial procedures;

7. Execution procedures;

8. Grievance procedure.

The scope of work-related injuries is the premise for the determination of work-related injuries, and is generally directly stipulated by law. The provisions of work-related injury insurance laws and international labor conventions on the scope of work-related injuries in various countries and regions mainly adopt a general legislative model, an enumerated legislative model, and a mixed legislative or legal model. Work-related injury insurance premiums are based on the principle of fixed income and balanced income and expenditure, and the rate is determined by the first step.

The State determines the differential rates of different industries according to the degree of work-related injury risk, and determines a number of rate grades in each industry according to the use of work-related injury insurance premiums and the incidence of work-related injuries.

Laws and Regulations

Regulations on Work-related Injury Insurance

Article 37 Where an employee is assessed as having a disability of Grade 7 to Grade 10 due to work-related disability, he or she shall enjoy the following benefits:

1) A one-time disability subsidy shall be paid according to the level of disability from work-related injury insurance, and the standard is: 13 months' salary for grade 7 disability, 11 months' salary for grade 8 disability, 9 months' salary for grade 9 disability, and 7 months' salary for grade 10 disability;

2) If the labor or employment contract is terminated upon expiration, or the employee himself or herself proposes to terminate the labor or employment contract, the work-related injury insurance shall pay a one-time medical subsidy for work-related injuries, and the employer shall pay a one-time disability employment subsidy. The specific standards for one-time medical subsidies for work-related injuries and one-time employment subsidies for disability shall be prescribed by the people of provinces, autonomous regions and municipalities directly under the Central Government. Article 62 Where an employer fails to participate in work-related injury insurance, the employer shall pay all work-related injury insurance benefits in accordance with the prescribed standards.

The salary of the person who calculates the one-time work-related injury and disability subsidy refers to the average monthly salary paid in the 12 months before the work-related injury or occupational disease suffered by the injured worker. If the salary is higher than 300% of the average salary of employees in the overall planning area, it shall be calculated according to 300% of the average salary of employees in the overall planning area; If the salary of the employee is lower than 60% of the average salary of employees in the overall planning area, it shall be calculated according to 60% of the average salary of employees in the overall planning area.

Workers' Compensation Process:

1. To apply for recognition of work-related injury, the unit or individual shall apply to the local labor department for recognition of work-related injury;

2. Apply for labor ability appraisal to determine the level of disability;

3. For treatment review, employees or units determine the corresponding treatment according to the hospital's ** invoice.

Legal basis:Article 30 of the Regulations on Work-related Injury Insurance.

Employees who are injured in accidents or suffer from occupational diseases due to work are entitled to medical treatment for work-related injuries.

Employees who are injured at work should seek medical treatment in a medical institution that has signed a service agreement with Sun Jingpai, and in case of emergency, they can first go to the nearest medical institution for first aid.

**If the expenses required for work-related injuries meet the requirements of work-related injury insurance diagnosis and treatment items, work-related injury insurance drug lists, and work-related injury insurance hospitalization service standards, they shall be paid from work-related injury insurance**. The catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs, and the hospitalization service standards of work-related injury insurance shall be prescribed by the social insurance administrative department in conjunction with the health administrative department, the food and drug supervision and administration department and other departments.

The food subsidy for the hospitalization of the employee for the work-related injury, as well as the certificate issued by the medical institution and the consent of the handling agency of the newspaper, the transportation, accommodation and accommodation expenses required by the injured employee to seek medical treatment outside the overall area shall be paid from the work-related injury insurance, and the specific standard of payment shall be stipulated by the people of the overall area.