Xiao He talked about how to determine the liability of work related injury insurance under the speci

1) Illegal employment.

If an employee of a unit without a business license or without registration or filing in accordance with the law, or a unit whose business license has been revoked or whose registration or filing has been revoked in accordance with the law, is injured in an accident or suffers from an occupational disease, the unit shall give a one-time compensation to the immediate family members of the disabled employee or the deceased employee, and the compensation standard shall not be lower than the work-related injury insurance benefits provided for in the Regulations on Work-related Injury Insurance;

If an employer uses child labor to cause disability or death as a result of child work, the employer shall pay a lump sum compensation to the child worker or the child's immediate family members, and the compensation standard shall not be lower than the work-related injury insurance benefits provided for in the Regulations on Work-related Injury Insurance.

2) Change of unit.

In the event of a division, merger or transfer of an employer, the successor unit shall bear the work-related injury insurance liability of the original employer; If the original employer has already participated in the work-related injury insurance, the successor unit shall go to the local agency to change the registration of the work-related injury insurance.

3) Contracted operation.

If the employer implements contracted operation, the liability for work-related injury insurance shall be borne by the unit where the employee's labor relationship is located.

4) Secondment If an employee is injured in a work-related accident during the period of secondment, the original employer shall bear the work-related injury insurance liability, but the original employer and the secondment unit may agree on compensation methods.

5) The whereabouts of the employee are unknown.

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If an employee has an accident or is missing during the rescue and disaster relief due to work, the salary shall be paid within 3 months from the month of the accident, and the salary shall be suspended from the 4th month, and the work-related injury insurance** shall pay the pension to the dependent relatives on a monthly basis. If you have difficulties in life, you can advance 50% of the one-time work-related death allowance. Where an employee is declared dead by a people's court, it is to be handled in accordance with the provisions on the employee's death due to work.

After an employee suffers a work-related injury, the employer shall bear the work-related injury insurance liability. Among them, if the employer has participated in the work-related injury insurance, the work-related injury insurance** and the employer shall jointly pay the work-related injury insurance benefits according to the regulations; If the employee fails to participate in the work-related injury insurance, the employer shall pay the work-related injury insurance benefits in accordance with the regulations. The term "employee" here refers to a worker who has an employment relationship with an employer (including those who have signed a labor contract and those who have not signed a labor contract but have a de facto labor relationship), including part-time employees who are employed in two or more units at the same time.

Witness testimony is not required to apply for a work-related injury determination. According to the Regulations on Work-related Injury Insurance, if the injured employee is injured in an accident during working hours and in the workplace due to work-related reasons, the injured employee or his relatives may apply to the Human Resources and Social Security Bureau for recognition of work-related injury within one year. If the employee or his close relatives believe that it is a work-related injury, but the employer does not consider it to be a work-related injury, the employer shall bear the burden of proof.

When an employee applies for a work-related injury determination, it is sufficient to provide a certificate of labor relationship and a diagnosis certificate from a medical institution, and no other witness testimony is required.

Regulations on Work-related Injury Insurance

Article 14 In any of the following circumstances, an employee shall be deemed to have suffered 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 18 The following materials shall be submitted to submit an application for recognition 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.

Article 19 After accepting an application for recognition of work-related injuries, the social insurance administrative department may, according to the needs of the examination, conduct an investigation and verification of the accident injury, and the employer, employees, trade union organizations, medical institutions, and relevant departments shall provide assistance. The diagnosis of occupational diseases and the appraisal of diagnostic disputes shall be carried out in accordance with the relevant provisions of the Law on the Prevention and Treatment of Occupational Diseases. The social insurance administrative department will no longer conduct investigation and verification of those who have obtained a certificate of diagnosis of an occupational disease or an appraisal of an occupational disease in accordance with the law.

If the employee or his close relatives believe that it is a work-related injury, but the employer does not consider it to be a work-related injury, the employer shall bear the burden of proof.

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Determination of work-related injuries under special circumstances: If an employee buys groceries or picks up children on the way to and from work, and suffers a traffic accident for which he or she is not primarily responsible on the way before or after doing errands, it shall be recognized as a work-related injury; Employees who work in vocational departments are injured while participating in activities organized by the internal organs of the unit without authorization, shall be found to be a work-related injury; When the physiological needs are temporarily solved in the course of work, if the employee is injured due to unsafe factors in the unit, it shall be deemed to be a work-related injury; Other.

[Legal basis].Article 14 of the Regulations on Work-related Injury Insurance.

In any of the following circumstances, it shall be found to be a work-related injury:

6) Injured in a traffic accident for which he or she is not primarily responsible, or by an accident involving urban rail transit, passenger and passenger ferries, or trains while commuting to or from work.

According to Article 14 of the Regulations on Work-related Injury Insurance, work-related injuries mainly include the following types: 1. Injured in an accident during working hours and in the workplace due to work-related reasons; Here, it is necessary to understand and grasp the essence of "accidents" as "accidental losses or disasters", which are gradual (such as chronic poisoning, schistosomiasis infection, etc.) and sudden (such as the collapse of the work frame, injuries caused by falling objects from heights, etc.), and should not be confined to a sudden situation. 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 the performance of work duties, violent force and other accidental injuries; 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 motor vehicle accident on the way to and from work; 7. Other situations that shall be recognized as work-related injuries as stipulated by laws and administrative regulations.

Article 15 of the Regulations on Work-related Injury Insurance stipulates that an employee shall be deemed to have suffered a work-related injury under any of the following circumstances: 1. During working hours and at work, he or she dies of sudden illness or dies within 48 hours after rescue fails; 2. Suffering harm in activities to safeguard national interests or public interests, such as emergency rescue and disaster relief; 3. Employees who originally 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.

Legal analysis: If an employee has any of the following circumstances, it shall be recognized as a work-related injury: suffering from an occupational disease; Injured in an accident due to work reasons during working hours and in the working open file rock site; Other.

Work-related injury insurance benefits: transportation and accommodation expenses for medical treatment outside the overall planning area; the cost of installing and configuring disability assistive devices; Medical expenses and expenses for work-related injuries; Other.

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 a work-related illness 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 have lost their ability to work after the appraisal of their ability to work shall enjoy disability benefits.

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

Article 37: Where an employee is at work due to any of the following circumstances, it is not to be found 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.

According to the regulations on work-related injury insurance, the provisions on the determination of work-related injuries are: if the employee is injured in an accident due to work-related reasons during working hours and in the workplace; Circumstances such as being injured in an accident while engaging in work-related preparatory or finishing work in the workplace before or after working hours shall be found to be a work-related injury.

[Legal basis].

Article 14 of the Regulations on Work-related Injury Foot and Shed Insurance shall be deemed to be a work-related injury if an employee has any of the following circumstances: (1) he or she is injured in an accident due to work reasons during working hours and in the workplace; 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) During the period of going out for work, the person is injured or the whereabouts of an accident are unknown; 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.

Legal analysis: If an employee has one of the following circumstances, it shall be recognized as a work-related injury: suffering from an occupational disease; Injured in an accident during working hours and in the workplace due to work-related reasons; Other.

Work-related injury insurance benefits: transportation and accommodation expenses for medical treatment outside the overall planning area; the cost of installing and configuring disability assistive devices; Medical expenses and expenses for work-related injuries; Other.

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: Where an employee is at work due to any of the following circumstances, it is not to be found 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.