Article 2 All kinds of enterprises and individual indust
Article 2 All kinds of enterprises and individual industrial and commercial households (hereinafter referred to as employers) with employees within the administrative area of this Municipality shall participate in work-related injury insurance according to law and pay work-related injury insurance premiums for all employees or employees (hereinafter referred to as employees).
Article 3 The registration of industrial injury insurance shall be subject to the real-name registration system of insured employees, which shall be reviewed once a year. The employer shall publicize the relevant information about participating in work-related injury insurance in the unit.
Employers and workers shall abide by laws and regulations on labor safety production and occupational disease prevention and control, implement safety and health regulations and standards, prevent industrial accidents, and avoid and reduce occupational hazards.
If an employee is injured by an accident, the employer must implement medical rescue measures for work-related injuries to ensure that the employee is treated in time.
Article 4 The municipal labor security administrative department is responsible for the work of industrial injury insurance in the whole city.
Cities, districts and counties set up industrial injury insurance agencies (hereinafter referred to as agencies) to undertake industrial injury insurance affairs.
The Municipal Committee of Labor Ability Appraisal is responsible for the work of labor ability appraisal of workers with work-related injuries in this Municipality.
Article 5 Departments of finance, personnel, civil affairs, health, production safety supervision and management, trade unions, disabled persons' federations and other organizations at all levels shall cooperate with the administrative department of labor security to do a good job in work-related injury insurance. Sixth industrial injury insurance fund to implement municipal social pooling. Industrial injury insurance premiums shall be collected by local tax authorities.
The administrative departments of labor security, finance and auditing shall, in accordance with the Regulations on Work-related Injury Insurance and these Measures, supervise the revenue and expenditure and management of work-related injury insurance funds.
Article 7 The work-related injury insurance fund consists of the work-related injury insurance premium paid by the employer, the interest of the work-related injury insurance fund and other funds that should be included in the work-related injury insurance fund according to law.
Article 8 The employing unit shall pay work-related injury insurance premiums in full and on time on a monthly basis. Individual employees do not pay work-related injury insurance premiums. Work-related injury insurance premiums shall be paid according to the following provisions:
(a) the amount of work-related injury insurance premium paid by the employer is the product of the total average monthly salary of employees in the previous year multiplied by the unit payment rate.
(2) If the average wage of employees in the employing unit is lower than 60% of the average monthly wage of employees in this Municipality in the previous year, 60% of the average monthly wage of employees in this Municipality in the previous year shall be the payment base; If the average wage of employees is higher than 300% of the average monthly wage of employees in this Municipality in the previous year, 300% of the average monthly wage of employees in this Municipality will be used as the base of payment, and more than some employers will no longer pay.
(three) individual industrial and commercial households with employees pay work-related injury insurance premiums based on the average monthly salary of employees in this Municipality last year.
Article 9 The rate of industrial injury insurance shall be determined according to the principle of fixed income by expenditure and balance of payments, and the industry differential rate and floating rate shall be implemented. Industry differential rates shall be implemented in accordance with the standards formulated by the state. The floating rate is within the industry rate level, and the agency shall adjust it within the scope stipulated by the state according to the incidence of work-related injuries, the use of work-related injury insurance premiums and the degree of occupational diseases in the previous year.
When the agency determines the payment rate of the employer for the first time, it shall determine it according to the business license of the employer as a legal person or the business scope of the business license and the benchmark rate of the industry category in the Industrial Injury Insurance Industry Risk Classification Table. If the business scope is cross-industry, it shall be determined according to high-risk industries.
Article 10 The industrial injury insurance fund shall be deposited in the special financial revenue account of the social security fund, and shall be managed by two lines of revenue and expenditure, which shall be used for special purposes, and shall be spent according to the following items:
(a) medical expenses for work-related injuries of disabled employees;
(2) Disability allowance for employees with one to four industrial injuries;
(3) One-time disability allowance;
(4) Living nursing expenses;
(5) Funeral subsidies;
(6) Pension for supporting relatives;
(seven) a one-time work death grant;
(eight) the purchase cost of auxiliary equipment;
(9) Rehabilitation expenses for work-related injuries;
(ten) the appraisal fee for the labor ability of employees with work-related injuries;
(eleven) other expenses stipulated by laws and regulations.
Eleventh work-related injury insurance premiums shall not be reduced. If the employer fails to pay the work-related injury insurance premium, its work-related injury insurance benefits have been paid by the work-related injury insurance fund before payment, and employees who have suffered work-related injuries during the unpaid period. The treatment of work-related injury insurance during the suspension period shall be paid by the employer in accordance with the items and standards stipulated in the Regulations on Work-related Injury Insurance and these Measures, and shall be supplemented by the work-related injury insurance fund after payment.
Article 12 The municipal labor and social security administrative department shall draw 65,438+00% from the industrial injury insurance fund collected in that year, and establish the risk reserve for the payment of industrial injury insurance benefits for major accidents in this city. When the reserve is insufficient to pay, it shall be paid by the municipal finance. Thirteenth work-related injuries identified by the principle of territorial management.
The employer shall notify the agency within 24 hours after the industrial accident. The application for ascertainment of work-related injuries shall be submitted by the employing unit to the administrative department of labor security within 30 days from the date of accident injury or occupational disease diagnosis. Under special circumstances, with the consent of the administrative department of labor security, the application time limit may be appropriately extended.
If the employing unit fails to apply for work-related injury identification in accordance with the provisions of the preceding paragraph, the workers with work-related injuries or their immediate family members and trade unions may directly apply to the administrative department of labor and social security for work-related injury identification within 1 year from the date of accident injury or occupational disease diagnosis.
If the employer fails to file an application for work-related injury identification within the prescribed time limit, the employer shall bear the relevant expenses such as work-related injury treatment in line with the provisions of these measures during this period.
Article 14 When applying for work-related injury identification, an application form for work-related injury identification shall be filled in and the following materials shall be submitted:
(a) the identity certificate of the injured employee, a copy of the text of the labor contract, or proof of the existence of labor relations (including factual labor relations) with the employer;
(2) First-visit medical records, hospitalization medical records, diagnosis certificates issued by medical institutions or occupational disease diagnosis and identification.
Fifteenth belongs to the following circumstances, should provide relevant certification materials:
(a) industrial accidents, should be submitted to the agency for the record and the accident investigation report of the employer;
(2) When identifying occupational diseases, the original materials (or health records) of toxic and harmful operations, as well as the medical records and occupational disease diagnosis and identification books of medical institutions with the right to diagnose occupational diseases shall be submitted;
(three) due to the performance of duties by violence, should be submitted to the public security organs or the people's court verdict or other valid proof;
(four) due to motor vehicle accidents, should be submitted to the public security traffic management department of the responsibility book or other effective legal documents and related certificates;
(five) during the period of going out to work, if you are injured due to work reasons, you should submit the certificate of the public security department or other certificates; If the whereabouts of the accident are unknown and it needs to be identified as work-related death, it shall be submitted to the people's court for a death ruling;
(six) in working hours and jobs, sudden illness or death within 48 hours after rescue, it shall submit the rescue materials and death certificates of medical institutions;
(seven) in the rescue and disaster relief activities to safeguard national interests and public interests, it shall submit a certificate issued by the relevant departments of the people's government at or above the county level;
(eight) belong to the demobilized and demobilized soldiers who are disabled in the line of duty and because of the war, and the old injury has recurred, they should submit the certificate of the disabled revolutionary servicemen and the identification certificate of the recurrence of the old injury made by the labor ability appraisal committee.
If it is impossible to provide relevant certification materials due to special circumstances, it shall explain the situation in writing.
If the materials provided by the applicant for work-related injury identification are incomplete, the administrative department of labor and social security shall inform the applicant of all the materials that need to be corrected in writing within 15 working days. The applicant shall make corrections to all materials within 30 days from the date of notification.
If the application materials provided by the applicant are complete and fall within the jurisdiction of the administrative department of labor security and within the time limit for acceptance, the administrative department of labor security shall accept it and issue a notice of acceptance.
Article 16 In any of the following circumstances, the administrative department of labor security may reject the application and issue a notice of rejection.
(a) does not meet the requirements of the application time limit;
(two) the basic facts of the injury are unclear and the materials are incomplete;
(three) does not meet the requirements of jurisdiction or no written agency relationship;
(four) the parties bring a lawsuit to the people's court on the treatment of work-related injuries, and the facts identified by the people's court are not within the scope of work-related injuries;
(five) after arbitration by the labor arbitration institution and the implementation of work-related injury treatment, or after mediation by labor arbitration, the two sides reached an agreement on work-related injury treatment and implemented it;
(six) other circumstances that do not conform to the provisions of these measures.
Article 17 After accepting the application for ascertainment of a work-related injury, the administrative department of labor security may investigate and verify the accident injury according to the needs of examination. Employers, workers with work-related injuries, trade unions, medical institutions and relevant departments shall assist in the investigation and provide evidence. The administrative department of labor and social security may also entrust the administrative department of labor and social security or other relevant departments to investigate and verify according to the needs of the work. The administrative department of labor security will no longer investigate and verify the personnel who have obtained the occupational disease diagnosis certificate or occupational disease diagnosis and appraisal certificate according to law.
If the employee or his immediate family members think it is a work-related injury and the employer does not think it is a work-related injury, the employer shall bear the burden of proof. If the employing unit refuses to provide evidence, the administrative department of labor security may make a conclusion of work-related injury identification based on the evidence provided by the injured employee.
Article 18 The administrative department of labor and social security shall make a work-related injury determination decision within 60 days from the date of accepting the application for work-related injury determination, and serve the notice of work-related injury determination decision to the employees (or their immediate family members) and their units within 65 working days from the date of making the work-related injury determination decision, and send a copy to the work-related injury insurance agency.
The time for handling labor relations disputes according to legal procedures is not included in the time limit for determining work-related injuries. Nineteenth labor ability appraisal implementation of national labor ability appraisal standards. Labor ability appraisal mainly includes the following contents:
(a) identification of the degree of labor dysfunction;
(two) identification of the degree of self-care disorders;
(3) Confirmation of the extension of shutdown period;
(4) Confirmation that work-related injuries directly lead to diseases;
(5) Confirmation of auxiliary equipment configuration;
(six) identification of dependent relatives who have completely lost their ability to work;
(seven) other matters stipulated by laws and regulations.
Twentieth workers injured at work, after treatment, the injury is relatively stable, there is disability, affecting the ability to work, it should be carried out to identify the ability to work.
The employing units, employees with work-related injuries or their immediate family members shall apply to the Municipal Labor Ability Appraisal Committee for labor ability appraisal, and provide the following information:
(a) the conclusion of the administrative department of labor security;
(two) medical diagnosis certificate, medical records and related inspection results report issued by the industrial injury medical department.
Twenty-first units or individuals applying for appraisal, if they are not satisfied with the appraisal conclusion made by the Municipal Labor Ability Appraisal Committee, may apply to the Provincial Labor Ability Appraisal Committee for re-appraisal within 15 days from the date of receiving the appraisal conclusion.
Twenty-second injured workers and their relatives, the unit or agency from the date of the conclusion of the appraisal 1 year later, that the residual situation has changed, you can apply for re-examination and appraisal of labor ability. If the appraisal conclusion has not changed, the appraisal fee shall be borne by the applicant. Article 23 Employees who are injured at work and suffer from occupational diseases shall be treated and enjoy medical treatment for work-related injuries.
Treatment of work-related injuries should be sought in medical institutions that have signed service agreements. In case of emergency, you 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 stipulated by the state, they shall be paid by the work-related injury insurance fund.
If an employee is hospitalized due to a work-related injury, the unit to which he belongs shall issue a hospital food subsidy according to 70% of the food subsidy standard of the unit on business trip. Workers with work-related injuries who need to be treated in different places shall be certified by medical institutions, reported to the agency for examination and approval, and go through the referral procedures. The required transportation, room and board expenses shall be reimbursed by the unit with reference to the standards for business trips of employees of the unit.
Workers with work-related injuries who treat non-work-related diseases do not enjoy medical treatment for work-related injuries, which shall be implemented in accordance with the basic medical insurance measures of this Municipality.
Twenty-fourth employees need to suspend work for medical treatment because of work-related injuries or occupational diseases. During the paid suspension, the original salary and welfare benefits will remain unchanged and will be paid by the unit on a monthly basis. After the assessment of the disability rating of the injured workers, the original treatment shall be stopped from the second month after the appraisal conclusion is made by the labor ability appraisal committee, and they shall enjoy the disability treatment in accordance with the relevant provisions of the Regulations on Industrial Injury Insurance and these Measures.
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 during the paid shutdown period shall be responsible for life care by their units.
During the period of paid shutdown, the employer shall not terminate or terminate the labor relationship with the injured workers.
Twenty-fifth injured workers need to install and configure assistive devices, the work-related injury medical service institutions put forward suggestions, confirmed by the labor ability appraisal committee, to the work-related injury assistive devices service institutions to install and configure. The cost is directly solved by the agency and the service agency of industrial injury AIDS.
Article 26 If an employee is identified as a first-class or fourth-class disability due to work-related disability, he/she shall retain his/her labor relationship, quit his/her post, and be executed in accordance with the provisions of Articles 32 and 33 of the Regulations on Work-related Injury Insurance, and enjoy disability treatment from the month following the conclusion made by the Labor Ability Appraisal Committee.
Twenty-seventh grade five to six injured workers voluntarily terminate the labor relationship with the employer, and the employer shall pay a one-time medical subsidy for work-related injuries for 24 months and 2 1 month and a one-time disability employment subsidy for 24 months and 2 1 month respectively according to the average monthly salary of employees in this city in the previous year.
Twenty-eighth seven to ten injured workers in any of the following circumstances, the employer shall pay a one-time work-related injury medical subsidies and disability employment subsidies to employees:
(1) I voluntarily terminate the labor relationship;
(two) the employer terminates the labor relationship according to the provisions of Article 25 of the Labor Law;
(3) When the labor contract expires, the labor relationship is terminated.
One-time medical subsidies for work-related injuries and disability employment subsidies are based on the average monthly salary of employees in this city in the previous year when the labor relationship is dissolved or terminated. The standards of one-time medical subsidy for work-related injuries are: level 7 15 months, level 8 12 months, level 9 months and level 10 6 months respectively; The one-time disability employment subsidy standard is: level 7 15 months, level 8 12 months, level 9 months and level 10 6 months.
Twenty-ninth injured workers who are less than five years away from the statutory retirement age shall be given a one-time medical subsidy for work-related injuries and a disability employment subsidy at the rate of 20% for each reduction of 1 year, and 1 0% for those who are less than1year. Workers with work-related injuries who have reached retirement age or gone through retirement procedures do not enjoy one-time work-related injury medical subsidies and disability employment subsidies.
Thirtieth workers with work-related injuries have a relapse, which is proposed by the designated medical institutions for work-related injuries and confirmed by the Municipal Labor Ability Appraisal Committee as needing treatment, and they can enjoy the treatment of work-related injury insurance stipulated in Articles 23, 24 and 25 of these Measures.
Thirty-first workers died of work-related subsidies standards, based on the average monthly salary of workers in this city in the previous year, a one-time payment of 48 months to 60 months of work-related subsidies. In line with the provisions of Item (1), (2), (4), (5), (6) and (7) of Article 14 of the Regulations on Work-related Injury Insurance and Item (1) of Article 15 of the Regulations, the work-related injury death subsidy will be paid for 48 months; In accordance with the provisions of Article 14 (3) and Article 15 (2) of the Regulations on Work-related Injury Insurance, a 54-month work-related injury death grant will be issued; Those who are awarded the title of martyr will be given a 60-month work death subsidy.
Thirty-second industrial accidents have civil compensation (including traffic accidents), according to the civil compensation first, the amount of compensation is lower than the treatment standard of industrial injury insurance, and the difference is made up by the industrial injury insurance fund.
Article 33 Where an employing unit goes bankrupt, cancels, dissolves or closes down, it shall, within 15 days from the date of announcement, notify the handling institution in writing to participate in asset liquidation, give priority to the industrial injury insurance benefits that the employing unit should pay according to law, and pay off the unpaid industrial injury insurance premiums in accordance with relevant state regulations.
Workers with work-related injuries who receive one to four levels of disability allowance, workers with work-related injuries and retirees with work-related injuries who enjoy pension benefits for dependent relatives are eligible for work-related injury insurance benefits paid by the work-related injury insurance fund, and shall be paid by the agency.
Workers with work-related injuries who have not reached the statutory retirement age of Grade 5 to Grade 10 shall be paid a one-time work-related injury medical subsidy and disability employment subsidy by the employing unit in accordance with the standards stipulated in Articles 27 and 28 of these Measures, and the relationship of work-related injury insurance shall be terminated. Thirty-fourth agencies specifically undertake work-related injury insurance affairs and perform the following duties:
(a) to verify the total wages of the employer and the number of employees, handle the registration of industrial injury insurance, and be responsible for keeping the records of the employer's payment and the employees' enjoyment of industrial injury insurance benefits;
(two) to carry out the investigation and statistics of industrial injury insurance;
(three) approved industrial injury insurance benefits;
(four) in accordance with the provisions of the management of industrial injury insurance fund expenditure;
(five) regularly publish the income and expenditure of the industrial injury insurance fund and adjust the rate in time;
(six) to provide free consulting services for employees or their immediate family members.
Article 35 The administrative department of labor security shall supervise and inspect the collection of work-related injury insurance premiums and the payment of work-related injury insurance funds according to law.
The financial department and the auditing organ shall supervise the income and expenditure and management of the industrial injury insurance fund according to law.
Trade union organizations at all levels shall safeguard the legitimate rights and interests of workers at work-related injuries according to law and supervise the work-related injury insurance of employers.
Article 36 Any organization or individual has the right to report illegal acts related to industrial injury insurance. The administrative department of labor and social security shall promptly investigate the report, handle it in accordance with the provisions, and keep the informant confidential.
Thirty-seventh workers and employers in the treatment of work-related injuries disputes, in accordance with the relevant provisions of the handling of labor disputes.
Thirty-eighth in any of the following circumstances, units and individuals may apply for administrative reconsideration according to law; If he refuses to accept the reconsideration decision, he may bring an administrative lawsuit according to law:
(a) the employee who applied for the work-related injury identification or his immediate family members and the unit where the employee works are dissatisfied with the conclusion of the work-related injury identification;
(two) the employer refuses to accept the unit payment rate determined by the agency;
(three) the medical institutions and auxiliary equipment allocation institutions that signed the service agreement think that the agency has not fulfilled the relevant agreements or regulations;
(four) employees or their immediate family members have objections to the treatment of work-related injury insurance approved by the agency.
Thirty-ninth employers in accordance with the provisions of these measures should participate in work-related injury insurance but did not participate, the administrative department of labor security shall order it to make corrections within a time limit. If the employer fails to participate in work-related injury insurance and the employee suffers from work-related injuries, the employer shall pay the fees in accordance with the treatment items and standards of work-related injury insurance stipulated in these Measures. Fortieth the employer shall, within 30 days from the date of implementation of these Measures, apply for work-related injury insurance at the agency with business license or social insurance registration certificate and other relevant documents. The employing unit established after the implementation of these Measures shall, within 30 days from the date of establishment, apply for work-related injury insurance with the above-mentioned relevant documents.
Article 41 Before the implementation of these Measures, if an employee who has been injured by an accident or suffered from an occupational disease has made a decision on the determination of work-related injury, his work-related injury treatment and payment channels will no longer change, but he will participate in the adjustment of disability allowance, living care expenses and pension for dependent relatives in this Municipality; If the decision on work-related injury identification has not been made, it shall be implemented in accordance with the Regulations on Work-related Injury Insurance and these Measures.
Article 42 These Measures shall come into force as of July 6, 2004.