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According to the Regulations of the People's Republic of China on Work-related Injury Insurance, 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 employer shall submit an application for work-related injury recognition to the labor and social security administrative department of the coordinating area within 30 days from the date of occurrence of the accident injury or the date of diagnosis or appraisal of the occupational disease. In case of special circumstances, the time limit for application may be appropriately extended with the consent of the labor and social security administrative department. It also stipulates that if the employee or his or her immediate family members 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.
What are the scope of work-related injuries?
1. Those who are engaged in the daily production or work of the unit or the work temporarily designated by the person in charge of the unit shall engage in work that is directly related to the major interests of the unit even though they have not been designated by the person in charge of the unit in an emergency.
2. Engaged in scientific experiments, inventions and creations and technological improvement work related to the unit with the arrangement or consent of the person in charge of the unit.
3. Occupational diseases caused by exposure to occupational harmful factors in the production and working environment.
4. During the production working hours and area, accidental injuries are caused by unsafe factors, or death due to sudden illness due to work tension or total loss of labor force after the first rescue.
5. Personal injury caused by the performance of duties.
6. Engage in rescue, disaster relief, rescue and other activities to safeguard the interests of the state, society and the public.
7. Disabled servicemen who have been disabled in the line of duty or war have been injured after recovering from their majors and working in the enterprise.
8. During the period of going out on business, due to work reasons, the person is injured or missing due to traffic accidents or other accidents, or dies due to sudden illness or loses labor force after the first rescue.
9. On the specified time and necessary route for commuting to and from work, there is a road traffic motor vehicle accident for which there is no personal responsibility or no primary responsibility.
10. Other circumstances stipulated by laws and regulations.
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Determine the level of disability and prosecute the claim; The standards for different household registrations are different.
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Legal Analysis: Specific Compensation Items and Standards: (1) Medical Expenses:
1.Requirements: **The expenses required for work-related injuries meet the standards of work-related injury insurance diagnosis and treatment items, work-related injury insurance drug lists, and work-related injury insurance hospitalization services.
2) Subsidies for hospital meals, transportation, and room and board; 1.Standards: The specific standards are stipulated by the people of the overall planning area; 2.
Requirements: The medical institution issues a diagnosis certificate, and the handling agency agrees, and the injured employee seeks medical treatment outside the overall planning area. (3) **** fee:
1.Standard: **The cost of work-related injury shall meet the requirements of the work-related injury insurance diagnosis and treatment items, the work-related injury insurance drug list, and the work-related injury insurance hospitalization service standards.
4) Assistive device fee: 1Standard:
Quota standards for work-related injury assistive devices in all provinces and municipalities directly under the Central Government. (5) Suspension of work and salary: 1
Standard: The original salary and benefits remain unchanged and are paid by the unit on a monthly basis.
Legal basis: Social Insurance Law of the People's Republic of China
Article 38 The following expenses incurred as a result of work-related injuries shall be paid from the work-related injury insurance in accordance with the provisions of the State: (1) medical expenses and expenses for work-related injuries (2) hospital meal subsidies (3) transportation and accommodation expenses for medical treatment outside the overall planning area (4) expenses required for the installation and configuration of disability assistive devices (5) living care expenses confirmed by the Labor Ability Appraisal Committee for those who are unable to take care of themselves (6) Disability subsidies for a large number of noisy departments and disability allowances received by disabled employees of grades 1 to 4 on a monthly basis (7) When the labor contract is terminated or dissolved, the one-time medical subsidy shall be enjoyed (8) In the case of work-related death, the funeral subsidy, the pension for dependent relatives and the work-related death subsidy received by the surviving family members (9) Labor ability appraisal fee.
Article 39 The following expenses incurred as a result of work-related injuries shall be paid by the employer in accordance with the provisions of the State: (1) wages and benefits during the work-related injury period, (2) disability allowance received by employees with grade 5 and 6 disabilities on a monthly basis, and (3) a one-time disability employment subsidy that shall be enjoyed when the labor contract is terminated or dissolved.
Article 41 Where an employee's employer fails to pay work-related injury insurance premiums in accordance with law, and a work-related injury accident occurs, the employer shall pay 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.
If the employer fails to repay, the social insurance agency may recover compensation in accordance with the provisions of Article 63 of this Law.
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1. Compensation standards for work-related injuries on construction sites.
1. In the case of work-related accidents on the construction site, the worker is entitled to the following work-related injury insurance benefits: if he is unable to take care of himself, the living care expenses confirmed by the Labor Ability Appraisal Committee; Medical expenses and expenses for work-related injuries; Transportation, accommodation and transportation expenses for medical treatment outside the co-ordination area; A one-time disability allowance and a monthly disability allowance for employees with disabilities of grades 1 to 4.
2. 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 work-related injury insurance** in accordance with national regulations:
1) Medical expenses and expenses for work-related injuries;
2) Hospitalization meal subsidy;
3) Transportation and accommodation expenses for medical treatment outside the co-ordination area;
4) The cost of installing and configuring assistive devices for the disabled;
5) If you are unable to take care of yourself, the living care expenses confirmed by the Labor Ability Appraisal Committee;
6) One-time disability allowance and monthly disability allowance for employees with disabilities of grades 1 to 4;
7) When the labor contract is terminated or terminated, the one-time medical compensation and deferred subsidy shall be enjoyed;
8) In the event of a work-related death, the funeral allowance, the pension for dependent relatives and the work-related death allowance received by the surviving family members;
9) Labor ability appraisal fee.
2. What are the conditions of work-related injuries on the construction site?
According to the Regulations on Work-related Injury Insurance, if a worker has any of the following circumstances in the course of work, it shall be recognized as a work-related injury:
1) 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) 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;
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Compensation standard for work-related injuries on the construction site:
1. For those who are unable to take care of themselves, the living care expenses confirmed by the Labor Ability Appraisal Committee;
2. Medical expenses and expenses for work-related injuries;
3. Transportation and accommodation expenses for medical treatment outside the overall planning area;
4. One-time disability subsidy and monthly disability allowance for disabled employees of grades 1 to 4.
In any of the following circumstances, it shall be found to be a work-related injury:
1) Injured in an accident during working hours and in the workplace due to work-related reasons;
2. Being injured by 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 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 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 work-related injury insurance** in accordance with national regulations:
1) Medical expenses and expenses for work-related injuries;
2) Hospitalization meal subsidy;
3) Transportation and accommodation 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 allowance and a monthly disability allowance for employees with disabilities of grades 1 to 4;
7) A one-time medical subsidy to be enjoyed when the labor contract is terminated or dissolved;
8) In the event of a work-related death, the funeral allowance, the pension for dependent relatives and the work-related death allowance received by the surviving family members;
9) Labor ability appraisal fee.
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. >>>More
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