The work related injury is not determined whether the company can compensate for it

If it is not a work-related injury, the employer does not need to bear the liability for work-related injury compensation.

However, if an employee of an enterprise is injured not due to work, the employer shall provide a certain period of medical treatment. During the medical treatment period, the employer shall pay sick leave pay, and the specific standard shall be determined in accordance with the labor contract or rules and regulations, and the minimum shall not be less than 80% of the local minimum wage standard.

At the same time, employees can enjoy basic medical insurance benefits in accordance with the law in the process of medical treatment. If the employer fails to pay the premium, the employer may be required to bear the part of the medical expenses.

Legal basis: Provisions on the Medical Treatment Period for Sick or Non-work-related Injuries of Enterprise Employees

Article 2 The period of medical treatment refers to the time limit within which an employee of an enterprise may not terminate a labor contract due to illness or non-work-related injury, stop working, receive medical treatment, and take rest.

Article 3 When an employee of an enterprise needs to stop working for medical treatment due to illness or non-work-related injury, he or she shall be given a medical treatment period of three to 24 months according to his actual working years and the number of years he has worked in the unit

1) Where the actual working experience is less than 10 years, three months for those who have worked in the unit for less than 5 years; Six months for more than five years.

2) Where the actual working experience is more than 10 years, the working experience in the unit is less than 5 years, and 6 months is the actual working experience; 9 months for those between five and ten years; 12 months for between 10 and 15 years; 18 months for between 15 and 20 years; 24 months for more than 20 years.

Circular of the Ministry of Labor on Printing and Distributing the "Opinions on Several Issues Concerning the Implementation of the Labor Law of the People's Republic of China".

59. During the period of illness or non-work-related injury**, the enterprise shall pay the employee sick leave pay or sickness relief expenses in accordance with the relevant regulations during the prescribed medical treatment period, and the sick leave pay or sickness relief expenses may be paid lower than the local minimum wage standard, but shall not be lower than the minimum wage standard8

It's not that the work-related injury has not been recognized, but that before the disability level appraisal conclusion is reached, it is too early to talk about compensation.

Legal analysis: If the company does not compensate for the work-related injury, it can first negotiate with the company to settle it, and if the negotiation fails, it can apply to the mediation organization for mediation, and if it is unwilling to mediate, the mediation fails or does not perform after reaching a mediation agreement, it can apply for labor arbitration, and if it is not satisfied with the arbitration award, it can file a lawsuit with the people's court.

Legal basis: Regulations on Work-related Injury Insurance

Article 14 An employee shall be deemed to have suffered a work-related injury under any of the following circumstances:

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) Injured by violence or other accidents during working hours and in the workplace due to the performance of work duties;

4) Suffering from occupational diseases;

5) Injured or unaccounted for in an accident while away for work;

6) Injured in a traffic accident or an accident involving urban rail transit, passenger ferry, or train for which they are not primarily responsible;

7) Other circumstances that laws and administrative regulations provide shall be recognized as work-related injuries.

Article 30 Employees who are injured in accidents or suffer from occupational diseases due to work shall enjoy medical treatment for work-related injuries.

Employees who are injured at work shall seek medical treatment in a medical institution that has signed a service agreement, 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 transportation, accommodation and accommodation expenses required for the work-related injury employee to seek medical treatment outside the co-ordination area shall be paid from the work-related injury insurance, and the specific standard of payment shall be stipulated by the people of the co-ordination area.

Injured employees are not entitled to medical treatment for work-related injuries and shall be dealt with in accordance with the basic medical insurance measures.

If the work-related injury employee goes to the medical institution that has signed the service agreement to carry out the work-related injury**, if it meets the requirements, it shall be paid from the work-related injury insurance**.

If it is determined that the jury is not a work-related injury, the company does not need to compensate. If the employer or the injured employee applies to the Human Resources and Social Security Bureau for a work-related injury determination, and the Human Resources and Social Security Bureau makes a decision not to recognize the work-related injury, it is not a work-related injury, and the employer does not need to bear the liability for work-related injury compensation, and the employer does not need to compensate. If a work-related injury occurs, the worker needs to actively take the actual injury himself/herself.

**After completion, the worker should go to the work-related injury appraisal agency designated by the labor department to conduct the work-related injury appraisal to ensure his legitimate rights and interests and claim compensation.

What are the criteria for determining work-related injuries?

1. Being injured in an accident during working hours and in the workplace due to work 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. During working hours and in the workplace, due to violence and other accidental injuries due to the performance of work duties;

4. Suffering from occupational diseases;

5. During the period of going out for work, the person is injured due to work reasons or the whereabouts of the accident are unknown;

6. Being injured in a traffic accident or an accident involving urban rail transit, passenger ferry, or train that is not the person's primary responsibility while commuting to or from work;

7. Other circumstances that shall be recognized as work-related injuries as provided by laws and administrative regulations.

Legal basisArticle 36 of the Social Insurance Law of the People's Republic of China.

If an employee is injured in an accident or suffers from an occupational reed digging disease due to work reasons, and is recognized as a work-related injury, 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.

Legal analysis: if it is not recognized as a work-related injury, if the employer is at fault for the occurrence of the accident, it needs to bear the liability for compensation according to the proportion of fault; if there is no fault, there is generally no obligation to compensate; However, if a non-work-related death is involved, the employer shall also be liable for compensation for the non-work-related death without fault, and the specific compensation standard shall refer to the local regulations of the province or city where it is located.

Legal basis: Article 20 of the Regulations on Work-related Injury Insurance stipulates that 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. 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 a decision to determine a work-related injury needs to be based on 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 when 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.

The parties may request the work-related injury insurance** to be paid in advance. Paragraph 2 of Article 62 of the Regulations on Work-related Injury Insurance stipulates that: "If an employee of an employer who is required to participate in work-related injury insurance in accordance with the provisions of these Regulations but does not participate in work-related injury insurance suffers a work-related injury, the employer shall pay the expenses in accordance with the work-related injury insurance benefits and standards stipulated in these Regulations."

That is, the employer is directly liable for the work-related injury of an employee who has not participated in work-related injury insurance, but this does not mean that if the employer refuses to compensate or is unable to compensate, the employee has no way to claim compensation. Article 41 of the Social Insurance Law stipulates that: "If an employee's employer fails to pay work-related injury insurance premiums in accordance with the law, and a work-related accident occurs, the employer shall pay the work-related injury insurance benefits."

If the employer does not pay, it shall be paid in advance from the work-related injury insurance**. The work-related injury insurance benefits paid in advance from the work-related injury insurance** shall be reimbursed by the employer. "According to Paragraph 2 of Article 6 of the Interim Measures for Advance Payment of Social Insurance**, if the employer refuses to pay all or part of the expenses, the employee or his close relatives may apply in writing to the social insurance agency for advance payment of work-related injury insurance benefits with the work-related injury determination decision and relevant materials.

That is, when a worker encounters a work-related injury and encounters "no one to supervise", he can apply for work-related injury insurance** to pay in advance.

What to do after an employee is injured at work.

It is recommended to apply for work-related injury recognition first according to the process, and the compensation amount can only be finalized after waiting for the appraisal level.

1. To apply to the Human Resources and Social Security Bureau (formerly the Labor Bureau) for work-related injury identification, 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. Materials to be submitted: application form for work-related injury determination (**generally ** of the Human Resources and Social Security Bureau), proof of labor relationship with the employer, medical diagnosis certificate, etc.;

2. If there is a disability that affects the ability to work after the injury is relatively stable, the applicant shall apply for labor ability appraisal and apply to the labor ability appraisal committee of the city divided into districts (generally established in the human resources and social security bureau at the same level);

3. According to different disability levels, the compensation obtained is different. The main compensation is: medical expenses, one-time disability allowance, one-time employment allowance, one-time medical allowance, salary during the period of suspension of work, food allowance, nursing expenses, etc.;

4. There are many procedures for protecting the rights of work-related injuries, if you are not familiar with it, it is best to entrust a lawyer**.

1. Work-related injuries. Work-related accidents (also known as labor accidents) refer to accidents such as personal injury and acute poisoning that occur when in-service workers are engaged in production-related activities in the production area and during working hours. In a broad sense, work-related accidents also include the suffering from occupational diseases.

According to the basic spirit of the Regulations on Work-related Injury Insurance, the work-related accidents referred to in China's work-related accident compensation are in a broad sense. Workers who suffer work-related accidents can enjoy a one-time disability allowance and disability allowance depending on the situation.

2. If the work-related injury cannot be determined, no compensation is required.

If there are no other special circumstances, the work-related injury cannot be recognized, which means that it is not a work-related injury.

According to Article 14 of the Regulations on Work-related Injury Insurance, 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) Injured by violence or other accidents during working hours and in the workplace due to the performance of work duties;

4) Suffering from occupational diseases;

5) Injured or unaccounted for in an accident while away for work;

6) Injured in a traffic accident or an accident involving urban rail transit, passenger ferry, or train for which they are not primarily responsible;

7) Other circumstances that laws and administrative regulations provide shall be recognized as work-related injuries.

Article 15 In any of the following circumstances, an employee shall be deemed to have suffered a work-related injury:

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.

III. Precautions for Claims.

1. To apply for work-related injury determination, it is necessary to submit the materials that need to be submitted skillfully. To submit an application for recognition of work-related injury, the applicant shall submit the Application Form for Determination of Work-related Injury, proof of the existence of labor relationship with the employer, medical diagnosis certificate or occupational disease diagnosis certificate, and submit the application to the labor and social security administrative department of the coordinating area where the employer is located.

2. Statute of limitations: After an employee is injured in a work-related accident or is diagnosed with an occupational disease, the time limit for applying for recognition of work-related injury shall be one year, and the employer shall do so within 30 days.

3. The time limit for determining work-related injuries is two months. The administrative department for labor and social security shall make a decision on the designation of work-related injury suspects within 60 days from the date of acceptance of the application for work-related injury determination. Those who are dissatisfied with the determination of work-related injuries may apply for administrative reconsideration in accordance with the law; Those who are dissatisfied with the reconsideration decision may initiate an administrative lawsuit in accordance with law.

If the work-related injury is not reported to the company, the employee can self-declare the work-related injury, otherwise he may not be compensated as he deserves.

Legal basis: Article 17 of the Regulations on Work-related Injury Insurance stipulates that 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 where he or she is located shall, within 30 days from the date 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 area. In case of special circumstances, with the consent of the social insurance administrative department, the time limit for application may be extended at the end of the year.