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As long as the injury is in the workplace or at work, it is within the scope of work-related injuries. I didn't have to reimburse myself for canceling the work-related injury before, and I have no responsibility. It is that I voluntarily gave up the benefits of work-related injury insurance.
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The process of work-related injury claim is generally as follows: apply for work-related injury recognition - receive work-related injury determination decision - submit work-related injury treatment application materials - receive work-related injury benefits. Legal References:
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) 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 to be enjoyed when the labor contract is terminated or dissolved; (8) In the case of work-related death, the funeral allowance, pension for dependent relatives and work-related death allowance received by the surviving family members; (9) Labor ability appraisal fee.
Lawyer Li Huiqiang consulted me.
Lawyer Lee Wai Keung.
2019-03-13 15:18:41Answer.
Regulations on Work-related Injury Insurance》 Article 33 Where 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 unit to which he or she belongs shall be responsible.
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I don't think the industry and commerce are writing their own words, and if it's fake, they will be held legally responsible.
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The business really fell and shot again, and it was canceled in advance before it was reported, and what responsibility should be reviewed.
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Summary. In this case, there is no need to refund, you can take the medical bill invoice and go to the work-related injury insurance to directly reimburse the full amount. There is no way to return the personal account of the medical insurance card after the relevant reimbursement has been made, and you can only apply for the relevant unit for relevant reimbursement for yourself, and you can only reduce your economic losses in this way.
If I am injured at work and reported to private medical insurance and have not been reimbursed, can I cancel it?
Hello dear, glad to answer for you. If you are injured at work and are not reimbursed by personal medical insurance, can you revoke it?
The boss let me do it.
Yes, if you suffer a work-related injury and report to the private medical insurance and are not reimbursed, you can cancel it.
Uh-huh. In this case, there is no need to refund, you can take the medical bill invoice and go to the work-related injury insurance to directly reimburse the full amount. There is no way to return the personal account of the medical insurance card after the relevant reimbursement, and you can only apply to the relevant unit for your own unchecked reimbursement, and you can only reduce your financial loss in this way.
Can you still get injured in this way?
The boss had to talk privately, so I made a personal medical insurance, and I reported it, but I haven't been reimbursed.
How to undo. If there is no reimbursement, there is no need to revoke it.
Didn't the information be submitted?
Well, if you don't reimburse, it won't be a fraudulent insurance.
If you don't belong to it, you can not be reimbursed.
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The medical expenses that are not reimbursed in the work-related injury insurance shall be borne by the employer or the employee in accordance with the law. The following expenses incurred due to work-related injuries can be paid from 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.
Article 38 of the Social Insurance Law 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) 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 at the first to first level of the skin; (7) A one-time medical subsidy to be enjoyed when the labor contract is terminated or dissolved; (8) In the case of work-related death, the funeral allowance, pension for dependent relatives and work-related death allowance received by the surviving family members; (9) Labor ability appraisal fee.
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Legal analysis: If the work-related injury expenses have not been reimbursed, the employer will not bear it, except for the employer who is willing to bear it, the practice in most areas in judicial practice is that the employer does not bear it. If there are no clear provisions in laws and regulations, the employer and the injured employee shall negotiate.
If 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.
Legal basis: Regulations on Work-related Injury Insurance
Article 39 If an employee dies on the job, his close relatives shall receive a funeral subsidy, a pension for dependent relatives and a one-time work-related death subsidy from the work-related injury insurance** in accordance with the following provisions:
1) The funeral subsidy is 6 months of the average monthly wage of employees in the overall area in the previous year;
2) The pension for dependent relatives shall be paid to the relatives who provided the main livelihood of the employee who died on the job and were unable to work according to a certain proportion of the employee's own salary. The standard is: 40% per month for spouses, 30% per month for each other relative, and 10% per month for each elderly person or orphan who is alone or orphaned.
The sum of the approved pensions for dependent relatives shall not be higher than the wages of the employee who died in the course of work. The specific scope of support for relatives shall be prescribed by the social insurance administrative department;
3) The standard of one-time work-related death allowance shall be 20 times the per capita disposable income of urban residents in the previous year. Where a disabled employee dies as a result of a work-related injury during the period of suspension of work with pay, his close relatives shall enjoy the benefits provided for in the first paragraph of this article. Where an employee with a disability of the first to fourth grades dies after the expiration of the period of suspension with pay, his close relatives may enjoy the benefits provided for in items (1) and (2) of the first paragraph of this article.
Article 40: Disability allowances, pensions for dependent relatives, and living care expenses shall be adjusted by the social insurance administrative department of the coordinating region in a timely manner on the basis of changes in the average wages and cost of living of employees. The adjustment measures shall be formulated by the people of provinces, autonomous regions, and municipalities directly under the Central Government.
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All those within the scope of reimbursement stipulated by the state can be reimbursed.
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Individuals can report work-related injuries to the Labor Bureau.
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If the employer does not handle the work-related injury determination within one month of the work-related injury, the person can go to the Social Security Bureau to handle the work-related injury within one year. Because the employer does not report the work-related injury in time, the expenses cannot be reimbursed, and the unit bears the relevant expenses.
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 immediate family members 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 labor and social security 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.
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Legal analysis: When a worker suffers a work-related injury, and does not do a work-related injury appraisal after the injury is like a burning date, the worker can apply to the Human Resources and Social Security Bureau for work-related injury identification, and 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 work-related injury recognition within one year.
Legal basis: Article 17 of the Regulations on Work-related Injury Insurance If the employer fails to submit an application for work-related injury recognition and dismantling in accordance with the provisions of the preceding paragraph, the injured employee or his immediate family members or trade union organization may directly submit an application for work-related injury recognition to the labor and social security administrative department of the co-ordinating area where the employer is located within one year from the date of occurrence of the accident injury or the date of diagnosis or appraisal of the occupational disease.
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Legal analysis: The unreimbursed part of the work-related injury expenses can generally be borne by the individual employee and the employer through negotiation. The labor ability appraisal fee shall be paid from the work-related injury insurance**, and if the employer fails to pay the work-related injury insurance premium in accordance with the law, the employer shall pay it.
If the employer does not pay, it shall be paid in advance from the work-related injury insurance** and repaid by the employer.
Legal basis: Article 38 of the Social Insurance Law of the People's Republic of China The following expenses incurred due to stool slag 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 to be enjoyed when the labor contract is terminated or dissolved; (8) In the case of death due to work-delayed accompaniment, the funeral allowance, pension for dependent relatives and work-related death allowance received by the surviving family members; (9) Labor ability appraisal fee.
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**If the expenses required for work-related injury meet the requirements of work-related injury insurance diagnosis and treatment items, work-related injury insurance drug Zhengming catalog, and work-related injury insurance hospitalization service standards, they shall be paid from work-related injury insurance**.
Due to the lack of clear provisions in laws and regulations, there are different approaches in judicial practice in judicial practice as to whether the injured employee or the employer should bear the medical expenses that exceed the catalogue and service standards.
Legal basis: Regulations on Work-related Injury Insurance
Article 30 [Medical Treatment for Work-related Injuries] Employees who are injured in accidents or suffer from occupational diseases due to their 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 administrative department of social insurance in conjunction with the administrative department of health, 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**.
Article 31: [Payment of Expenses for Reconsideration Litigation] Where an administrative reconsideration or administrative lawsuit occurs after the social insurance administrative department makes a decision to determine a work-related injury, the payment of medical expenses for the work-related injury shall not be stopped during the period of administrative reconsideration and administrative litigation.
Article 32 [Assistive Devices Allocated by Work-Injured Employees] Due to the needs of daily life or employment, work-related injuries may be fitted with prostheses, orthoses, prosthetic eyes, dentures, wheelchairs and other assistive devices upon confirmation by the Labor Ability Appraisal Committee, and the included expenses for relieving the need shall be paid from the work-related injury insurance** in accordance with the standards prescribed by the state.
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