industrial injury insurance treatment
Thirtieth employees who suffer from accidents or occupational diseases at work shall enjoy medical treatment for work-related injuries.
Workers with work-related injuries should seek medical treatment in medical institutions that have signed service agreements. In case of emergency, they can go to the nearest medical institution for first aid.
If the expenses required for work-related injury treatment meet the catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs and the hospitalization service standard of work-related injury insurance, they shall be paid from the work-related injury insurance fund. The catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs and the hospitalization service standard of work-related injury insurance shall be stipulated by the social insurance administrative department of the State Council in conjunction with the health administrative department of the State Council, the food and drug supervision and management department and other departments.
Food subsidies for hospitalization of workers with work-related injuries, and certificates issued by medical institutions and approved by agencies. The transportation and accommodation expenses required for workers with work-related injuries to seek medical treatment outside the overall planning area shall be paid by the work-related injury insurance fund, and the specific standards for fund payment shall be stipulated by the people's government of the overall planning area.
Workers with work-related injuries who treat diseases caused by non-work-related injuries do not enjoy medical treatment for work-related injuries, and are treated according to the basic medical insurance method.
The expenses for work-related injury rehabilitation treatment for workers with work-related injuries to medical institutions that have signed service agreements shall be paid by the work-related injury insurance fund if they meet the requirements.
Thirty-first administrative reconsideration or administrative litigation occurs after the social insurance administrative department makes a decision to identify work-related injuries, and during the administrative reconsideration and administrative litigation, the medical expenses for treating work-related injuries will not stop paying.
Article 32 Workers with work-related injuries may install artificial limbs, orthotics, artificial eyes, dentures, wheelchairs and other assistive devices due to their daily life or employment needs, and the required expenses shall be paid from the work-related injury insurance fund according to the standards stipulated by the state.
Article 33 If an employee suffers from an accident or occupational disease at work and needs to be suspended from work to receive medical treatment for work-related injuries, the original salary and welfare benefits will remain unchanged during the paid suspension, and the unit where he works will pay him monthly.
The paid shutdown period generally does not exceed 12 months. If the injury is serious or the situation is special, it may be appropriately extended upon confirmation by the Municipal Labor Ability Appraisal Committee with districts, but the extension time shall not exceed 12 months. After assessing the disability level, the injured workers shall stop the original treatment and enjoy the disability treatment in accordance with the relevant provisions of this chapter. Workers with work-related injuries who still need treatment after the expiration of paid shutdown shall continue to enjoy medical treatment for work-related injuries.
Workers with work-related injuries who can't take care of themselves need care during the paid shutdown period, and their units are responsible for it.
Thirty-fourth workers with work-related injuries who have been assessed as disabled and confirmed by the labor ability appraisal committee need life care, the work-related injury insurance fund will pay the life care fee on a monthly basis.
Life care fees are paid according to three different levels: completely unable to take care of themselves, mostly unable to take care of themselves or partially unable to take care of themselves, and their standards are 50%, 40% or 30% of the average monthly salary of employees in the overall planning area respectively.
Thirty-fifth workers who are disabled due to work are identified as first-class to fourth-class disabilities, retain their labor relations, quit their jobs, and enjoy the following benefits:
(a) according to the level of disability from the industrial injury insurance fund to pay a one-time disability allowance. The standard is: 27 months' salary for first-degree disability, 25 months' salary for second-degree disability, 23 months' salary for third-degree disability and 2 1 month salary for fourth-degree disability.
(2) Pay the disability allowance from the industrial injury insurance fund on a monthly basis. The standard is: 90% of my salary for first-degree disability, 85% for second-degree disability, 80% for third-degree disability and 75% for fourth-degree disability. If the actual amount of disability allowance is lower than the local minimum wage, the difference will be made up by the industrial injury insurance fund.
(three) after the workers with work-related injuries reach retirement age and go through retirement procedures, the work-related injury insurance fund will make up the difference.
Workers who are disabled due to work are identified as one to four levels of disability, and the employer and individual employees pay the basic medical insurance premium on the basis of disability allowance.
Thirty-sixth workers who are disabled due to work are identified as five or six disabled, and enjoy the following benefits:
(a) according to the level of disability from the industrial injury insurance fund to pay a one-time disability allowance. The standard is: my salary is level 5 disability 18 months, level 6 disability 16 months;
(two) to retain the labor relationship with the employer, and the employer shall arrange appropriate work. If it is difficult to arrange a job, the employer will pay a monthly disability allowance. The standard is: level 5 disability is 70% of my salary, level 6 disability is 60% of my salary, and the employer shall pay the social insurance premium that should be paid according to the regulations. If the actual amount of disability allowance is lower than the local minimum wage, the employer shall make up the difference.
Upon the employee's own proposal, the employee may terminate or terminate the labor relationship with the employer, and the work-related injury insurance fund shall pay the one-time medical subsidy for work-related injuries, and the employer shall pay the one-time disability employment subsidy. Specific standards for one-time medical subsidies for work-related injuries and one-time disability employment subsidies shall be formulated by the people's governments of provinces, autonomous regions and municipalities directly under the Central Government.
Thirty-seventh workers who are disabled due to work are identified as seven to ten disabled, and enjoy the following benefits:
(a) according to the level of disability from the industrial injury insurance fund to pay a one-time disability allowance. The criteria are: level 7 disability 13 months, level 8 disability 1 1 month, level 9 disability for 9 months and level 10 disability for 7 months;
(two) the expiration of the labor employment contract, or the employee himself proposes to terminate the labor employment contract, the industrial injury insurance fund pays a one-time medical subsidy for work-related injuries, and the employer pays a one-time disability employment subsidy. Specific standards for one-time medical subsidies for work-related injuries and one-time disability employment subsidies shall be formulated by the people's governments of provinces, autonomous regions and municipalities directly under the Central Government.
Thirty-eighth workers who need treatment for the recurrence of work-related injuries shall enjoy the treatment of work-related injuries stipulated in Articles 30, 32 and 33 of these Regulations.
Article 39 If an employee dies at work, his close relatives shall receive funeral subsidies, pension for supporting relatives and one-time work-related death subsidies from the industrial injury insurance fund in accordance with the following provisions:
(a) the funeral subsidy is the average monthly salary of employees in the overall planning area for 6 months.
(2) The pension for supporting relatives shall be paid to the relatives who provided the main source of livelihood before the death of the employee and were unable to work because of work according to a certain proportion of the employee's salary. The standard is: spouse 40%, other relatives 30%, widowed elderly or orphans 10%. The total approved pension of dependent relatives should not be higher than the salary of employees who died at work. The specific scope of supporting relatives shall be stipulated by the administrative department of social insurance of the State Council.
(three) the standard of one-time work death allowance is 20 times of the per capita disposable income of urban residents in the previous year.
If a disabled employee dies at work during the period of paid suspension, his close relatives shall enjoy the treatment stipulated in the first paragraph of this article.
If a disabled worker of Grade 1 to Grade 4 dies after the expiration of his unpaid leave, his close relatives may enjoy the treatment specified in Items (1) and (2) of the first paragraph of this article.
Fortieth disability allowance, pension for dependent relatives, and living nursing expenses shall be adjusted in a timely manner by the social insurance administrative department in the overall planning area according to the changes in the average salary and living expenses of employees. Measures for adjustment shall be formulated by the people's governments of provinces, autonomous regions and municipalities directly under the Central Government.
Forty-first employees who go out for work or whose whereabouts are unknown during emergency rescue and disaster relief shall be paid wages within 3 months from the month of the accident, and wages shall be stopped from the fourth month. The industrial injury insurance fund shall pay pensions to its dependent relatives on a monthly basis. Life is difficult, you can advance 50% of the one-time work death subsidy. If an employee is declared dead by the people's court, it shall be handled in accordance with the provisions of Article 39 of this Ordinance on the death of an employee due to work.
Forty-second injured workers in any of the following circumstances, stop enjoying the benefits of work-related injury insurance:
(a) the loss of the conditions for enjoying the treatment
(2) refusing to accept the appraisal of labor ability.
(3) refusing treatment.
Article 43 Where the employing unit is divided, merged or transferred, the successor unit shall bear the industrial injury insurance liability of the original employing unit; If the original employer has participated in work-related injury insurance, the successor unit shall go to the local agency to register the change of work-related injury insurance.
Where the employing unit conducts contracted operation, the responsibility for work-related injury insurance shall be borne by the unit where the employee's labor relations are located.
If an employee is injured by an industrial accident during the secondment period, the original employer shall bear the responsibility of industrial injury insurance, but the original employer and the secondment unit may agree on compensation measures.
If an enterprise goes bankrupt, the industrial injury insurance benefits that should be paid by the unit shall be distributed according to law at the time of bankruptcy liquidation.
Article 44 If an employee is sent to work abroad and should take part in local industrial injury insurance according to the laws of the country or region where he goes, he should take part in local industrial injury insurance, and his domestic industrial injury insurance relationship is terminated; Can not participate in local industrial injury insurance, its domestic industrial injury insurance relationship is not suspended.
Forty-fifth employees who suffer work-related injuries again and should enjoy disability allowance according to the regulations shall enjoy disability allowance according to the newly recognized disability grade.