(1) medical expenses. The expenses for work-related injury treatment must conform to 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.
(2) Hospitalization food allowance. 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.
(3) Transportation and accommodation expenses for medical treatment in different places. Medical institutions issue certificates and report them to the agency for approval. If the injured workers go to the outside of the overall planning area for medical treatment, the required transportation, accommodation and expenses shall be reimbursed by the unit according to the standard of employees' business trip.
(4) Rehabilitation expenses. The expenses for rehabilitation treatment of 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 provisions of the third paragraph of this article, such as the Catalogue of Work-related Injury Insurance Diagnosis and Treatment Items, the Catalogue of Work-related Injury Insurance Drugs and the Standards for Hospitalization Services of Work-related Injury Insurance.
(5) Expenses for assistive devices. Workers with work-related injuries may install artificial limbs, orthotics, artificial eyes, dentures and wheelchairs and other auxiliary 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.
(6) wages during the paid period of shutdown. If an employee suffers from an accident or occupational disease at work and needs to be suspended from work to receive work-related injury medical treatment, the original salary and welfare benefits will remain unchanged during the paid suspension, and the unit where he works will pay him monthly.
(7) Living nursing expenses. Workers with work-related injuries can't take care of themselves and need nursing during paid shutdown. ..
1. Does the medical compensation for work-related injuries include medical insurance reimbursement expenses?
Medical expenses are reimbursement expenses, not compensation. However, the benefits that can be enjoyed at present will be paid in full when applying for the review of work-related injury benefits. Industrial injury compensation includes company payment and social security payment. After the results of labor ability appraisal are issued, employees should apply to the social security center for a review of work-related injury benefits, and issue work-related injury benefits after approval. The social security fund needs to submit: a copy of the work-related injury and occupational disease certificate; Certificate of labor ability appraisal or medical terminal appraisal form; List of medical invoices and total hospitalization expenses; Copies of outpatient medical records and discharge summary; Transfer to account; A copy of your ID card. The wages paid by the unit shall be paid monthly. If there is a disability, it shall be paid in consultation with the unit when the labor relationship is terminated. Workers and units that have disputes over compensation for work-related injuries may apply for labor arbitration to safeguard their rights.
Two, the medical expenses of work-related injuries are generally paid by the work-related injury insurance fund.
1. Medical expenses for work-related injuries are generally paid by the work-related injury insurance fund. If the employer fails to pay the work-related injury insurance as required, it shall be paid by the employer. If the employer fails to pay, it shall pay in advance from the industrial injury insurance fund and be repaid by the employer. If the work-related injury is caused by a third person, and the third person fails to pay the medical expenses for the work-related injury or cannot identify the third person, the work-related injury insurance fund shall pay in advance. After the industrial injury insurance fund is paid in advance, it has the right to recover from the third party. Generally, the unit manager carries the required information to the social security agency for reimbursement, or directly settles the account when leaving the hospital. The specific handling procedures shall be implemented in accordance with local policies.
2 units to participate in work-related injury insurance, work-related injury treatment costs are all paid by the work-related injury insurance fund. According to the Regulations on Work-related Injury Insurance, 100% will be paid for those who meet the three types of work-related injuries. Even if the unit has no responsibility to pay the medical expenses, the expenses are paid by the industrial injury insurance fund. As for the actual amount of reimbursement from the work-related injury fund, it is up to them to review, that is to say, whether or not to reimburse and how much to reimburse is up to the work-related injury insurance fund.
Three, more than the scope of reimbursement of work-related injury medical expenses borne by the individual.
1. According to the relevant provisions of the Social Insurance Law and the Regulations on Work-related Injury Insurance, the medical expenses for work-related injuries should conform to 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, which are commonly referred to as the "three catalogues". Only those that meet the "three catalogues" belong to the scope of legal protection. The employer's insurance is paid by the fund, and the uninsured is paid by the unit.
2. Generally speaking, the medical needs of workers with work-related injuries have been fully considered when the "three catalogues" are formulated, and there is basically no problem in ensuring the recovery of workers with work-related injuries. Social insurance has a very important concept and principle, which guarantees the basics. Therefore, it is impossible for all workers with work-related injuries to live in luxury wards, and there are standards for using imported advanced drugs. You can live in a high-end ward, but some individuals who exceed the standard have no reason to bear it for you. Otherwise, injured workers use expensive drugs, live in wards and hospitals, and do not plan to come out, which unit can afford it. The medical expenses outside the "three catalogues" shall be borne by the individual. Any dispute can be settled by the local labor arbitration committee.
Legal basis:
Notice of the Ministry of Health on Doing a Good Job in the Implementation of Tort Liability Law
Two, strengthen management, standardize medical behavior
(a) standardize medical behavior, ensure the quality and safety of medical care. Health administrative departments at all levels and medical institutions at all levels should, in accordance with the provisions of the Tort Liability Law, combine the actual situation of the region and the unit, sort out the existing working system, formulate and implement various systems of medical quality and safety management, and especially pay special attention to the implementation of the core system of medical quality and safety. Medical institutions and their medical staff should carry out medical work in strict accordance with relevant laws, administrative regulations, rules, clinical diagnosis and treatment guidelines and technical operation specifications, effectively improve medical quality and ensure medical safety. Once medical damage occurs, medical institutions should immediately take active and effective treatment measures to minimize the damage to patients. For every medical injury, we should be highly responsible for the people's right to life and health, find out the problems and implement rectification.
(two) to strengthen the management of clinical use of drugs, disinfectants, blood and medical devices, and reduce the damage to patients. Medical institutions shall, in accordance with the Drug Administration Law, the Blood Donation Law, the Regulations on the Supervision and Administration of Medical Devices, the Interim Provisions on the Administration of Pharmaceutical Affairs in Medical Institutions, the Standards for the Safety Management of Clinical Use of Medical Devices (for Trial Implementation) and the Measures for the Administration of Disinfection, do a good job in the management of the clinical use of drugs, disinfectants, blood and medical devices, standardize the procurement procedures, and strictly implement the acceptance system and storage system. Suspected to be caused by the defects of drugs, disinfectants and medical devices, or the input of unqualified blood that does not meet the standards and requirements stipulated by the state, both doctors and patients shall seal up the on-site items in accordance with relevant regulations, so as to find out the facts and clarify the responsibilities.
(three) do a good job of communication between doctors and patients to protect the rights and interests of patients. Medical institutions shall, in accordance with the requirements of the Tort Liability Law, improve the communication system between doctors and patients, improve the communication content between doctors and patients, and improve the communication ability of medical staff. Improve the relevant system of informed consent, earnestly fulfill the obligation of explanation, and timely and accurately explain the illness and medical measures to patients and their families according to law; If surgery, special examination and special treatment are needed, the patient or his close relatives shall be informed of the medical risks and alternative medical plans in time and obtain their written consent.
Patients or their close relatives do not cooperate with medical institutions to meet the diagnosis and treatment standards, medical institutions and their medical staff should fully inform their risks and the relevant provisions of Article 60 of the Tort Liability Law, and record them truthfully in the medical records. It is necessary to further improve the examination and approval procedures for taking medical measures in an emergency. If the opinions of patients or their close relatives cannot be obtained in emergency situations such as rescuing dying patients, corresponding medical measures shall be implemented in strict accordance with relevant procedures and with the approval of the person in charge of the medical institution or the authorized person in charge.
(four) standardize the writing of medical records and do a good job in medical record management. Medical institutions and their medical staff shall, in accordance with the regulations on the management of medical institutions' medical records and the basic norms for medical record writing, standardize the writing and properly keep medical records, take effective measures to prevent the loss of medical records, and shall not forge, tamper with or destroy medical records; If patients and their families request to consult and copy relevant medical records, medical institutions shall provide them.