It s been 8 months since I had a work injury, and I went to the medical insurance at that time, can

I have been injured for 8 months. At that time, I went to medical insurance. It is not possible to report a work-related injury for appraisal at this time. Workers' compensation insurance and medical insurance belong to two different systems, and only one can be chosen.

Medical insurance is a type of insurance that compensates for the medical expenses incurred by illness. Social insurance is a social insurance in which an employee is provided with necessary medical services or material assistance by the society or enterprise when he or she is sick, injured or gives birth. For example, China's publicly-funded medical care and labor insurance medical care.

The medical expenses of Chinese employees are jointly borne by the state, units and individuals, so as to reduce the burden on enterprises and avoid waste. In the event of an insurance liability event, it is necessary to pay the insurance premium on a pro-rata basis.

Work-related injury insurance refers to a social insurance system in which workers or their surviving family members receive material assistance from the state and society when they suffer from accidental injuries or occupational diseases resulting in temporary or permanent loss of working ability and death at work or under specified special circumstances.

Determination of Work-related Injury Insurance If a worker temporarily loses his or her ability to work due to a work-related injury or occupational disease, no matter what the cause of the work-related injury, the responsibility lies with the individual or the enterprise, and he or she is entitled to social insurance benefits, that is, the principle of compensation without negligence.

Work-related injury insurance, also known as occupational injury insurance. Work-related injury insurance is a social security system that concentrates the work-related injury insurance premiums paid by employers through the method of social co-ordination, establishes work-related injury insurance, and gives workers and their practical statutory medical treatment and necessary economic compensation when they suffer accidental injuries or occupational diseases in production and business activities, resulting in death, temporary or permanent loss of working ability. This compensation covers both medical and ** expenses as well as basic living expenses.

It's too late! If an individual or unit submits an application for work-related injury recognition within one month after the injury, the procedure of labor ability appraisal will be followed after that!

Yes, it is usually necessary to go through procedures such as work-related injury identification, work-related injury expense reimbursement, and disability identification.

When the work-related injury is identified, it is necessary to fill in the work-related injury identification application form, provide the first diagnosis certificate, the ID card of the injured employee and other materials, and it is recommended to go to the local work-related injury department to obtain the application form and a description of the materials.

In the process of medical treatment for work-related injuries, employees injured at work are requested to explain to the medical institution that it is a work-related injury, and the hospital will pay attention to it when taking medication.

The general work-related injury reimbursement is 100%. Of course, this is only for medical expenses, and the company will pay employees as usual during the period of suspension of work. In the case of a disability rating, a disability employment allowance will be paid at the time of termination (in some cases of disability, the company cannot voluntarily disable) or termination.

Work-related injuries** are subject to disability benefits and disability medical benefits in addition to medical expenses.

Legal Analysis: Yes. If an employee is injured in an accident or suffers from an occupational disease due to work-related reasons, and the work-related injury is recognized, he or she shall enjoy work-related injury insurance benefits; Among them, those who lose their ability to work after the appraisal of their ability to work enjoy disability benefits.

The determination of work-related injuries and the evaluation of labor ability shall be simple and convenient.

If an employee is at work due to one of the following circumstances, it shall not be deemed to be a work-related injury:

1) Intentional crime;

2) Drunkenness or drug abuse;

3) self-harm or suicide;

4) Other circumstances provided for by laws and administrative regulations.

Legal basis: Social Insurance Law of the People's Republic of China

Article 36 Where an employee is injured in an accident or suffers from an occupational disease due to work-related reasons, and the work-related injury is recognized, he or she shall enjoy work-related injury insurance benefits; Among them, those who lose their ability to work after the appraisal of their ability to work enjoy disability benefits.

The determination of work-related injuries and the evaluation of labor ability shall be simple and convenient.

Article 37 If an employee is at work due to any of the following circumstances, it shall not be deemed to be a work-related injury:

1) Intentional crime;

2) Drunkenness or drug abuse;

3) self-harm or suicide;

4) Other circumstances provided for by laws and administrative regulations.

Legal analysis: You can get the certificate to reimburse the medical expenses. Bring a copy of your ID card, work-related injury certificate, invoice, and case list to the social security department to report the account.

After the grade is appraised later, the grade can also be used to apply to the handling department to receive work-related injury benefits such as disability allowance based on the appraisal conclusion. If the unit is an insured unit, the medical expenses do not need to wait for the appraisal level, and then the disability treatment will be submitted by the unit to the Social Security Bureau after there is a specific level, and the relevant expenses will be paid by the work-related injury**. If the unit is not an insured unit, after all expenses have been graded, labor arbitration will be filed, and the labor department will claim the expenses, and the expenses will be paid by the unit.

Legal basis: Regulations on Work-related Injury Insurance Article 20 The social insurance administrative department shall make a decision on the determination of work-related injury within 60 days from the date of acceptance of the application for work-related injury determination, and notify the employee or his close relatives and the employee's unit in writing of the application for work-related injury determination. The social insurance administrative department shall make a decision on the determination of work-related injury within 15 days of accepting an application for work-related injury determination where the facts are clear and the rights and obligations are clear.

Where it is necessary to base a decision on the determination of work-related injuries on the basis of the conclusion of the judicial organ or the relevant administrative department, the time limit for making a determination of work-related injury is suspended during the period that the judicial organ or the relevant administrative department has not yet made a conclusion. Where the staff of the social insurance administrative department has an interest in the applicant for work-related injury determination, they shall recuse themselves.

Those who have not participated in work-related injury insurance shall be refunded the reimbursement amount and enjoy work-related injury insurance benefits after accepting the punishment; Those who have participated in work-related injury insurance shall be refunded the reimbursement amount of medical insurance, and the reimbursement shall be made according to the work-related injury.

After the medical insurance reimbursement is completed, the employee can still report the work-related injury, and the employee does not make a work-related injury determination in time after the injury is first reimbursed by medical insurance, and then if it is recognized as a work-related injury, he or continues to enjoy the work-related injury insurance benefits, and the expenses that need to be borne by the work-related injury insurance cannot be reimbursed by the medical insurance. Employees should file their own work-related injury claims within one year of the accident.

If it is a work-related injury, you can apply for a recognition of work-related injury. The following medical expenses are not covered by basic medical insurance**:

1. It should be paid from work-related injury insurance**;

2. It should be borne by a third party;

3. It should be borne by public health;

4. Seeking medical treatment abroad.

Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.

The compensation items for work-related injury claims are as follows: medical expenses, food allowance during hospitalization, living care expenses, wages during work-related injuries, and transportation and accommodation expenses. Medical expenses, food allowance during hospitalization, living care expenses, wages during work-related injuries, transportation and lodging expenses, assistive device expenses, one-time disability allowance, disability allowance, one-time medical allowance for work-related injuries, and one-time disability employment allowance.

1. What is the procedure for applying for work-related injury recognition?

To submit an application for work-related injury determination, the applicant shall fill in the Application Form for Work-related Injury Determination and submit the following materials:

1. A copy of the labor and employment contract or other supporting materials for the existence of labor relations (including de facto labor relations) and personnel relations with the employer;

2. Post-injury diagnosis certificate or occupational disease diagnosis certificate (or occupational disease diagnosis and appraisal certificate) issued by a medical institution.

Where the application materials submitted by the applicant for work-related injury determination meet the requirements, are within the jurisdiction of the social insurance administrative department, and are within the time limit for acceptance, the social insurance administrative department shall accept it.

After receiving the application for work-related injury determination, the social insurance administrative department shall review the materials submitted by the applicant within 15 days, and make a decision to accept or not accept the application if the materials are complete; If the materials are incomplete, the applicant shall be informed in writing of all the materials that need to be supplemented and corrected at one time. After receiving all the supplemental and corrective materials submitted by the applicant, the social insurance administrative department shall make a decision to accept or not accept the application within 15 days.

After a work-related injury occurs, if the employee does not go to the work-related injury determination, some of the medical expenses incurred can be reimbursed by medical insurance, and those within the scope of medical insurance can not be borne by themselves. If it is later determined that it is a work-related injury, it can continue to claim work-related injury compensation and require the employer to pay additional compensation, such as disability allowance, disability compensation and suspension salary.

After the occurrence of a work-related injury, follow the principle of nearby rescue, and the medical expenses of the work-related injury incurred in the non-work-related injury insurance answering Huai designated medical institutions; 3.The medical expenses of the work-related injury insurance insured in the city incurred in the local medical institution during the business trip, study assignment, and long-term work in a different place due to cheating; 4.Medical expenses for work-related injuries caused by work-related injury insurance participants who have been approved to transfer to other places**; 5.

Work-related injury medical expenses that do not fall within the scope of work-related injury insurance** payment, and are reviewed by the social security agency and meet the conditions for the advance payment of work-related injury insurance**; 6.Other work-related injury medical expenses (**) that meet the requirements of the policy.

Legal basis: Article 30 of the Social Insurance Law of the People's Republic of China The following medical expenses are not included in the scope of payment of basic medical insurance**

1) It should be paid out of work-related injury insurance**;

2) It shall be borne by a third party;

3) It should be borne by public health;

4) Seeking medical treatment outside the country.

Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.