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According to the Regulations on Work-related Injury Insurance and the Measures for the Determination of Work-related Injuries, the determination of work-related injuries shall be made by the labor and social security administrative department of the coordinating area. At the present stage, the overall planning areas of various localities are not set up according to a unified administrative level, but are set according to specific conditions. This must be made clear.
According to the relevant regulations, work-related injury insurance** shall be coordinated in municipalities directly under the Central Government and cities divided into districts; The overall planning level of other regions, such as autonomous prefectures and regional administrative offices, shall be determined by each province or autonomous region. It should be noted that municipalities directly under the Central Government implement provincial-level overall planning, but they do not undertake the specific matters of work-related injury determination. To this end, the Regulations on Work-related Injury Insurance stipulate that the determination of work-related injuries shall be carried out by the provincial-level labor and social security administrative departments, and shall be carried out by the labor and social security administrative departments at the districted city level in accordance with the principle of territoriality.
In terms of nature, the determination of work-related injuries made by the administrative department of labor and social security is a specific administrative act, and if the relevant individual or employer is not satisfied with the determination of work-related injury, it may file an administrative reconsideration in accordance with the law; Those who are dissatisfied with the administrative reconsideration decision may initiate an administrative lawsuit in accordance with law. Such a provision is conducive to protecting the interests of the injured workers and the enterprises where they work. Legal basis:
Paragraph 3 of Article 17 of the Regulations on Work-related Injury Insurance shall, in accordance with the provisions of the first paragraph of this Article, be handled by the social insurance administrative department at the level of the city divided into districts where the employer is located in accordance with the principle of territoriality.
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The injured employee shall apply for recognition of work-related injury to the social insurance administrative department of the area where the employer is located, and the injured employee shall provide: labor contract, diagnosis certificate, copy of the company's business license, witness testimony and other materials.
According to the Regulations on Work-related Injury Insurance
Article 17 If an employee is injured in an accident or is diagnosed or appraised as an occupational disease in accordance with the provisions of the Law on the Prevention and Treatment of Occupational Diseases, the unit to which he belongs shall, within 30 days from the date of occurrence of the accident injury or the date of diagnosis or appraisal of an occupational disease, submit an application for recognition of work-related injury to the social insurance administrative department of the coordinating region. In case of special circumstances, the time limit for application may be appropriately extended with the consent of the social insurance administrative department.
If the employer fails to submit an application for recognition of work-related injury in accordance with the provisions of the preceding paragraph, the injured employee or his close relatives or trade union organization may, within one year from the date of occurrence of the accident injury or the date of diagnosis or appraisal of an occupational disease, directly submit an application for recognition of work-related injury to the social insurance administrative department of the coordinating area where the employer is located.
Matters that shall be determined by the provincial-level social insurance administrative department in accordance with the provisions of the first paragraph of this Article shall be handled by the social insurance administrative department at the districted-city level where the employer is located in accordance with the principle of territoriality.
If an employer fails to submit an application for determination of work-related injury within the time limit specified in the first paragraph of this Article, the employer shall bear the relevant expenses such as work-related injury benefits incurred during this period that comply with the provisions of these Regulations.
Article 18 The following materials shall be submitted to submit an application for determination of work-related injury:
1) Application form for determination of work-related injury;
2) Proof of the existence of an employment relationship (including a de facto employment relationship) with the employer;
3) Medical diagnosis certificate or occupational disease diagnosis certificate (or occupational disease diagnosis and appraisal certificate).
The application form for determination of work-related injury shall include basic information such as the time, place, and cause of the accident, as well as the degree of injury of the employee.
Where the materials provided by the applicant for work-related injury determination are incomplete, the social insurance administrative department shall inform the applicant of all the materials that need to be supplemented and corrected in writing at one time. After the applicant requests to supplement and correct the materials in accordance with the written notice, the social insurance administrative department shall accept it.
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If the employer participates in the insurance, the injury and work-related injury shall be determined in the place of insurance; If they are not insured, they shall apply for recognition at the place of injury.
Ministry of Human Resources and Social Security.
Opinions on Several Issues Concerning the Implementation of the Regulations on Work-related Injury Insurance (II).
Ministry of Human Resources and Social Security issued 2016 No. 29.
7. If the place of registration of the employer and the place of production and operation are not in the same overall planning area, in principle, it shall participate in work-related injury insurance for its employees in the place of registration; Employees who have not participated in work-related injury insurance in the place of registration may be insured by the employer in the place of production and business operation.
Labor dispatch entities that dispatch workers across regions shall participate in work-related injury insurance in accordance with the Interim Provisions on Labor Dispatch. If the construction enterprise participates in the insurance according to the project, it shall participate in the work-related injury insurance at the location of the construction project.
After an employee is injured in an accident or suffers from an occupational disease, he or she shall be identified for work-related injury and work ability appraisal in the place of insurance, and shall enjoy work-related injury insurance benefits in accordance with the provisions of the place of insurance; Employees who have not participated in work-related injury insurance shall be identified for work-related injuries and assessed their working ability at the place of production and operation, and the employer shall pay work-related injury insurance benefits in accordance with the provisions of the place of production and business operation.
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Legal analysis: Within one year from the date of the accident or the date of diagnosis or appraisal of an occupational disease, an injured employee may directly apply for recognition of work-related injury to the labor and social security administrative department of the coordinating area where the employer is located.
Legal basis: Regulations on Work-related Injury Insurance
Article 14 If an employee has any of the following circumstances, it shall be deemed to be a work-related injury:
1) Being injured in an accident during working hours and in the workplace due to work-related reasons;
2) Being injured in an accident while engaging in work-related preparatory or finishing work in the workplace before or after working hours;
3) Receiving violence or other accidental injuries during working hours and in the workplace due to the performance of work duties;
4) Suffering from occupational diseases;
5) During the period when they are out for work, they are injured due to work reasons, or their whereabouts are unknown;
6) Being injured in a motor vehicle accident while commuting to or from work;
7) Other circumstances that laws and administrative regulations provide shall be recognized as work-related injuries.
Article 15 An employee shall be deemed to have suffered a work-related injury under any of the following circumstances:
1) Died of a sudden illness during working hours and at work, or died within 48 hours after rescue efforts failed;
2) Suffering harm in emergency rescue and disaster relief or other activities to preserve national or public interests;
3) Employees who previously served in the army, were disabled due to war or duty injuries, and have obtained the certificate of revolutionary disabled soldiers, and were injured after arriving at the employer.
Where employees have any of the circumstances in items (1) or (2) of the preceding paragraph, they shall enjoy work-related injury insurance benefits in accordance with the relevant provisions of these Regulations; Employees who have the circumstances in item (3) of the preceding paragraph shall enjoy work-related injury insurance benefits other than a one-time disability subsidy in accordance with the relevant provisions of these Regulations.
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For injuries sustained in other places, an application for recognition of work-related injuries shall be submitted to the labor and social security administrative department of the area where the employer is located. The employer shall, within 30 days from the date of the accident, apply to the social insurance administrative department of the coordinating area for recognition of work-related injury.
Legal basis: Article 17 of the Regulations on Work-related Injury Insurance.
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Legal analysis: To apply for a work-related injury determination, you must go to the labor department where the injured employee's unit is located. If an employee has an accident, it is a work-related injury, and the employer needs to determine the work-related injury, determine the level of disability, and determine the work-related injury according to the disability situation.
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. Contains the head.
Hello landlord, according to the amount of medical treatment, in fact, you only need to compensate 200 on the line, but because of the facts and law involved, I think it will be 500-1000 yuan, good luck.
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