How to calculate medical expenses after retirement due to work related injuries

The medical expenses after retirement are work-related injury insurance benefits and should be borne by the employer that has not paid social insurance in accordance with the law. If the employee's injury is determined to be a work-related injury, the employee does not need to bear the cost, and the employer and the industrial injury insurance should jointly bear the liability for compensation. Medical expenses should be reimbursed by workers' compensation insurance**.

Because the reimbursement needs to be completed or after the labor ability appraisal, then the preliminary medical expenses should be paid by the unit.

Regulations on Work-related Injury Insurance

The 33rd Clan imitates the Bureau.

If an employee is injured in an accident or suffers from an occupational disease due to work and needs to suspend work to receive medical treatment for work-related injuries, the original salary and benefits shall remain unchanged during the period of suspension with pay, and shall be paid by the employer on a monthly basis.

The period of leave without pay is generally not more than 12 months. If the injury is serious or the circumstances are special, it may be appropriately extended upon confirmation by the labor ability appraisal committee at the districted city level, but the extension shall not exceed 12 months. After the work-related injury is assessed, the original benefits shall be suspended and the disability benefits shall be enjoyed in accordance with the relevant provisions of this Chapter.

If the injured employee still needs to be ** after the expiration of the period of suspension of work with pay, he or she shall continue to enjoy the medical treatment of work-related injury.

If an injured employee who is unable to take care of himself needs nursing care during the period of suspension of work with pay, the employer shall be responsible for it.

Legal analysis: After the work-related injury is identified, the medical expenses incurred by the employee shall be reimbursed by the unit to the medical insurance agency with the conclusion of the work-related injury, a copy of the discharge summary, a detailed list of medical expenses, and valid reimbursement documents. If an employee suffers a work-related injury, he or she can claim compensation from work-related injury insurance** based on the identified disability level after the work-related injury identification and work-related injury disability level appraisal.

Legal basis: Article 38 of the Social Insurance Law of the People's Republic of China The following expenses incurred due to work-related injuries shall be paid from the work-related injury insurance in accordance with national regulations: (1) medical expenses and expenses for work-related injuries; (2) Subsidies for in-hospital meals; (3) Transportation and lodging expenses for medical treatment outside the overall planning area; (4) The cost of installing and configuring assistive devices for the disabled; (5) For those who are unable to take care of themselves, the living care expenses confirmed by the Labor Ability Appraisal Committee; (6) A one-time disability subsidy and a monthly disability allowance for disabled employees of grades 1 to 4; (7) A one-time medical subsidy that shall be enjoyed when the contract is terminated or terminated; (8) In the case of a work-related death, the funeral allowance, the pension for supporting relatives and the death subsidy for the pre-filigent worker received by the surviving family; (9) Labor ability appraisal fee.

There is no correlation between work-related injuries and retirement, and there is no subsidy for employees who retire after work-related injuries. If the injured employee reaches the retirement age and goes through the retirement procedures, the disability allowance will be suspended and the basic pension insurance benefits will be enjoyed.

A one-time worker's compensation medical benefit is a medical benefit that is identified as:

The medical expenses for work-related injuries paid to the employee in a lump sum by the injured employee with a grade 5 or 6 disability who propose to terminate or terminate the labor relationship with the employer, or the work-related injury medical expenses paid to the employee in a lump sum if the injured employee who is identified as having a grade 7 to 10 disability himself or herself proposes to terminate the labor contract or terminate the labor contract upon the expiration of the contract. Employees who receive a one-time medical subsidy for work-related injuries must terminate or dissolve the labor relationship with the employer, otherwise, the injured employee has no right to claim a one-time medical subsidy for work-related injuries. Considering the impact of subsequent medical treatment, employment and disability on the production, labor and daily life of the disabled employee, which are mainly caused by the work-related accident, a certain degree of compensation should be given, including a one-time medical subsidy for work-related injuries.

Article 36 of the Regulations on Work-related Injury Insurance If an employee is identified as a Grade 5 or Grade 6 disability due to work-related disability, he or she shall enjoy the following benefits: (1) A one-time disability subsidy shall be paid from the work-related injury insurance ** according to the level of disability, and the standard is: 18 months' salary for Grade 5 disability and 16 months' salary for Grade 6 disability; (2) Retain the labor relationship with the employer, and the employer shall arrange appropriate work.

If it is difficult to arrange work, Lu Xisong will be paid a monthly disability allowance by the employer, the standard is: 70% of his salary for grade 5 disability and 60% of his salary for grade 6 disability, and the employer shall pay all social insurance premiums payable for him in accordance with regulations. If the actual amount of the disability escort allowance is lower than the local minimum wage standard, the employer shall make up the difference.

Upon the request of the injured employee, the employee may terminate or terminate the labor relationship with the employer, and the work-related injury insurance** shall pay a one-time medical subsidy for work-related injury, 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 37 Employees who are assessed as having a disability of grade 7 to 10 due to work-related disability 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 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 employment subsidy for disability. 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.