Standards for the identification of the degree of disability caused by work-related injuries and occupational diseases (Trial)
Classification number L35301199221
Title The Ministry of Labor, the Ministry of Health, and the All-China Federation of Trade Unions issued the " Notice of "Standards for Appraisal of the Degree of Disability in Work-related Injuries and Occupational Diseases of Employees (Trial)"
Timeliness is valid
The promulgating unit, the Ministry of Labor, etc.
Date of promulgation 19920309
Implementation date 19920309
Expiration date
Content classification cadre insurance benefits
Document number Labor insurance word (1992) No. 6
The research results of the "Standards for Appraisal of the Degree of Disability in Work-related Injuries and Occupational Diseases of Employees (Trial)" have been passed through the appraisal review and are now issued for trial implementation.
The "Standards for Identification of the Degree of Disability of Work-related Injuries and Occupational Diseases of Employees (Trial)" are proposed in accordance with the national "Ten-Year Plan for National Economic and Social Development and the Outline of the Eighth Five-Year Plan"
The requirements for establishing and improving the social security system were researched and formulated by relevant experts organized by the Ministry of Labor and the Ministry of Health in order to meet the needs of the reform of the work-related injury insurance system. The degree of disability and loss of working ability of employees is divided into ten levels, of which levels one, two, three and four are complete loss of working ability; levels five and six are mostly loss of working ability; seven, eight and nine Level 10 means partial loss of working ability
. All provinces, autonomous regions, and municipalities directly under the Central Government are requested to pilot the reform of the work-related injury insurance system and carry out labor appraisal work in accordance with this standard, and pay attention to summarizing experience. This standard can be referred to when assessing the extent of an employee's loss of working ability due to illness or non-work-related injury.
If there are any problems during the trial implementation, please inform us in time so that we can make revisions and provide a basis for the formation of national standards.
1. This standard is formulated to adapt to the reform of the work-related injury insurance system, protect the legitimate rights and interests of employees, strengthen production safety, and safeguard the overall interests of the country
.
2. This standard applies to employees who have been certified as having work-related injuries by the local labor department, or who have the right to diagnose occupational diseases with the approval of the health administrative department
After a medical and health institution diagnoses an occupational disease, When the medical unit determines the end of medical treatment, it is necessary to conduct a disability medical examination and work ability appraisal.
3. This standard takes due consideration of the patient’s organ damage, dysfunction and dependence on medical treatment and nursing at the end of medical treatment.
The social impact caused by the disability is appropriately considered. Psychological factors influence the degree of disability.
1. Organ damage is a direct result of work-related injuries, but occupational diseases do not necessarily involve organ damage.
2． Functional impairment: The degree of functional impairment after a work-related injury is related to the location and severity of the organ defect, and organ dysfunction caused by occupational diseases is related to the severity of the disease. The determination of functional impairment should be based on the results of the medical examination at the end of the medical treatment and determined one by one according to the disability assessment objects. This standard explains and explains the definitions of some disability categories and the classification criteria for the resulting functional impairment in appendices A, C, E, G, and I.
3. Medical dependence refers to a person who is disabled due to injury or illness and is still unable to leave treatment when medical treatment ends.
4． Nursing dependence refers to those who are disabled due to injury or illness and need to rely on others to take care of themselves because they cannot take care of themselves. The scope of self-care in daily life mainly includes the following five items:
(1) Eating; (2) Turning over; (3) Urine and urination; (4) Dressing and washing; (5) Self-movement.
The degree of nursing dependence is divided into three levels:
a. Complete nursing dependence refers to those who require nursing care for all the above five items.
b. Most care dependence refers to those who need care for three of the above five items.
c. Partial care dependence refers to those who need care for one of the above five items.
5. Some special disabilities of psychological disorders do not cause medical dependence on the basis of organ defects or dysfunction, but they lead to psychological disorders that hinder or reduce the quality of life of the disabled. When assessing the disability, Due consideration should be given to these consequences.
4. Based on the above principles, the disability caused by work-related injuries and occupational diseases is divided into ten levels, which are listed in Table A.
Due to the complexity of disability types, some types can be graded from the most severe (level one) to the lightest (level ten) covering ten levels, and some types can be less than ten levels
, or empty level. Individual disabilities not listed in this standard can be evaluated according to the above principles and with reference to the corresponding grades in this standard.
5. This standard is divided into five parts based on different systems and organ disability categories. Each part contains the standard text (degree of disability caused by work-related injuries and occupational diseases
Grading table), supplementary parts (grading basis or judgment standard) and reference parts (instructions on the correct use of standards), as shown in Table B
. For ease of use, a graded series is attached.
Injuries other than internal medicine caused by occupational factors and included in the occupational disease list issued by the Ministry of Health will have a disability level at the end of medical treatment
According to Tables 1 to 4 The corresponding disability in the section is evaluated, among which the disability caused by occupational tumor surgery is evaluated with reference to the corresponding entry of the main damaged organ.
6. When using this standard, you should strictly follow the grading basis or judgment standard for various types of disability in the supplementary document, and follow the instructions for correct use of the standard in the reference document.
According to the injury standard The specific conditions of disability, the classification of this standard, and the appraisal of the degree of disability caused by work-related injuries and occupational diseases.
8. If the organ damaged by the work-related injury has a history of disability and disease, the assessment of the disability level will be based on the actual disability outcome at the end of the medical treatment
.
Table A: Classification table for the degree of disability caused by work-related injuries and occupational diseases
Levels
Basics of level classification
Level 1
Those whose organs are missing or their functions are completely lost, other organs cannot compensate, and require special medical dependence and complete nursing dependence to maintain life and basic living.
Level 2
Those with serious organ defects or malformations, severe dysfunction or complications requiring special medical care and extensive nursing care.
Level 3
Those with severe organ defects or malformations, severe functional impairment or comorbidities who require special medical treatment and partial nursing care.
Level 4
Those with serious organ defects or malformations, severe dysfunction or complications requiring special medical dependence, and who can take care of themselves.
Level 5
Most of the organs are defective or obviously deformed, there are serious functional impairments or complications, those who require general medical treatment and can take care of themselves.
Level 6
Most of the organs are defective or obviously deformed, have moderate dysfunction or complications, require general medical dependence, and can take care of themselves.
Level 7
Most of the organs are defective or deformed, have mild dysfunction or complications, require general medical dependence, and can take care of themselves.
Level 8
Partial organ defects, morphological abnormalities, mild dysfunction, medical dependence, and ability to take care of themselves.
Level 9
Those with partial organ defects, morphological abnormalities, mild functional impairment, no dependence on medical treatment, and able to take care of themselves.
Level 10
Those with partial organ defects, abnormal morphology, no functional impairment, no dependence on medical care, and able to take care of themselves.
Table 1 Criteria for identifying the degree of disability caused by employee work-related injuries and occupational diseases (part of neurology, neurosurgery, and psychiatry)
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Disability Category｜ One｜ Two｜ Three｜ Four｜ Five｜
-------｜-----｜-----｜------｜-----｜----｜
｜ ｜ ｜ ｜ ｜ ｜
Intellectual decline｜ Extremely severe｜ ｜ Severe｜ ｜ Moderate｜
｜ ｜ ｜ ｜ ｜｜
－－－－－－｜－－ －－－｜－－－－－｜－－－－－｜－－－－－｜－－－－｜
| >
| ｜ ｜Those with rational abilities｜Those who act in action｜Those who have strength｜ ｜
－－－－－－｜－－－－－｜－－－－－｜－－－－－｜－－－－ －| －－－－｜－－－－－｜－－－－－｜
Movement disorders｜ ｜ ｜ ｜ ｜ ｜
1. Limb paralysis ｜ Quadriplegic muscles ｜ Triplegic muscles ｜ 1. Paraplegic muscles｜1. Single limb paralysis｜1. Quadriplegia｜
(brain, spinal cord and |strength level 3 or |strength level 3 or |strength level 3 |muscle strength level 2 |muscle strength level 4｜
Nerve damage) ｜Triplegic muscles｜Hemiplegic muscles｜2. Hemiplegic muscles｜2. Both feet are intact｜2. Single limb paralysis｜
｜Strength level 2｜Strength level 2｜Strength level 3, |Muscle paralysis Muscle strength｜Strength level 3｜
｜｜｜Or both hands｜2 Level｜3. Hands｜
｜ ｜ ｜Muscle paralysis and muscle strength ｜3. Muscles of both hands｜Divided muscle paralysis｜
｜｜｜Level 3｜Paralyzed muscle strength 3｜Strength level 2｜
｜ ｜ ｜ ｜Level ｜4. Handyness |
Both feet are intact｜
｜ ｜ ｜ ｜ ｜Muscle strength｜
｜ ｜ ｜ ｜ ｜Level 3｜
｜ ｜ ｜ ｜ ｜｜
｜ ｜ ｜ ｜ ｜｜
2. Non-limb paralysis | Severe | Moderate | |
Movement disorders | | | －－－｜－－－－－｜－－－－－｜－－－－｜
A4 Personality Change
Personality is the sum of individual psychological characteristics, with obvious Consistency and constancy represent a person's consistent behavior tendencies
and constant response methods, which are a person's habitual behavior patterns. Generally speaking, personality refers to the psychological attributes that an individual gradually develops during the development process
It is generally believed that maturity is reached after the age of 18. It is a combination of innate quality and acquired environment
The 浵法楠. Early childhood, especially before the age of 6, has greater plasticity, and environment and education have a greater impact on it. However, once it matures and is finalized, it is more tenacious and stable and often remains lifelong. And not easy to change. Personality characteristics always
affect a person's adaptation to the environment and response to specific things, determine a person's unique behavior and way of thinking,
also include their understanding of themselves and attitude.
Personality abnormalities caused by innate qualities or acquired environmental factors during the development process of an individual are called personality disorders;
Organism disorders caused by work-related injuries or occupational poisoning factors affecting the brain Qualitative personality abnormalities are called personality changes.
Organic personality change, with significant and lasting changes in behavior patterns and interpersonal relationships as the main clinical manifestations, at least one of the following conditions:
a. Emotional instability, such as a sudden change in mood from normal to depression, anxiety, or irritability;
b. Repeated fits of rage or aggressive behavior that are clearly disproportionate to the triggering factors;
c. Reduced sense of social responsibility, irresponsible work, lack of trust in dealing with others; emotional indifference, lack of due concern for the things around you
and inability to maintain normal interpersonal relationships with others;
d. Hyperactive instincts, lack of self-control, obviously damaged ethics and moral concepts, lack of self-esteem and shame; self-centered, prone to impulsiveness, and reckless behavior;
e. Social adaptation function is significantly impaired.
A5 Epilepsy Diagnosis and Frequency Grading Standards
A5.1 Diagnosis of epilepsy: There must be a definite history of work-related injuries or occupational diseases, and it must be described or certified by a physician or other eyewitnesses,
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The electroencephalogram shows abnormality, which is divided into mild, moderate and severe grades according to the frequency of epileptic seizures and medication control.
A5.2 Frequency classification of epilepsy
a. Mild
Those who have various types of epileptic seizures that require systematic medication to control.
b. Moderate
Various types of epileptic seizures. After two years of systemic medication treatment, grand mal and psychomotor seizures occur on average once a month
or less than once per month. Petit mal seizures and other types of attacks occur less than once a week on average.
c. Severe epileptic seizures
Various types of epileptic seizures, after two years of systemic medication treatment, grand mal and psychomotor seizures occur more than once a month on average
Petit mal and other types of seizures More than once a week on average.
B1 Scope of application of this standard
This standard applies to patients who are disabled due to work-related injuries or occupational diseases, and have neurological or mental dysfunction, and who need to be identified at the end of medical treatment
Those who are disabled.
B5 Schizophrenia and bipolar disorder are endogenous mental illnesses, and their onset is mainly determined by the patient's own biological qualities.
Endogenous mental illness accompanying work-related injuries or occupational diseases should not be confused with mental illness directly caused by work-related injuries or occupational diseases.
Schizophrenia and bipolar disorder are not work-related injuries or occupational mental illnesses.
Table 2 Criteria for identifying the degree of disability caused by employee work-related injuries and occupational diseases (part of orthopedics, orthopedics, and burns departments)
----------------- ------- －－－－－－｜－－－－－－－－－｜－－－－－－－－－｜
｜1. Severe facial disfigurement｜ ｜Severe facial disfigurement｜
｜Concomitantly accompanied by one of the secondary disabilities in Table 2｜ ｜ ｜
｜A person with one of the second-level disabilities｜ ｜ ｜
｜2. Severe scars all over the body｜ ｜ ｜
Destruction of head and face, formation of spine and limbs｜ ｜ ｜
Appearance｜Loss of some functions of large joints｜ ｜ ｜
｜ | ｜ | －－－－－｜－－－－－－－－｜
｜ ｜ ｜ ｜
| |
| －－－｜－－－－－－－－－｜
｜Both amputation above the elbow joint｜Bilateral wrist amputation or｜1. One hand is amputated, the other |
| Complete loss of limb or function | Complete loss of function of both hands | Missing thumb of hand |
| Loss | Loss | 2. The thumbs and index fingers of both hands are missing｜
｜ ｜ ｜lost or the function is completely lost ｜
｜ ｜ ｜lost ｜
｜ ｜ ｜ 3. One side above the elbow amputation |
>｜ ｜ ｜ ｜
｜ ｜ ｜ ｜
｜ ｜ ｜ ｜
| /p>
｜ ｜ ｜ ｜
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D1 This standard only applies to employees who suffer from disability caused by injuries to the spine and limbs caused by work-related injuries and occupational diseases. This standard is not applicable to other congenital malformations or degenerative changes that occur with age, such as osteoarthritis, etc.
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D15 Facial foreign body pigmentation refers to the retention of various foreign bodies (including stones, iron particles, etc.) on the face caused by work-related injuries such as explosion injuries. , or there are still varying degrees of pigmentation after removing foreign bodies. However, it is difficult to accurately classify the amount and area of ??foreign body pigmentation on the face clinically. At the same time, it is more difficult to generalize about the psychological impact caused by factors such as gender and age. Considering that many complex situations may be encountered in actual work, this standard Facial foreign body pigmentation is divided into two levels: mild and severe, with more than 1/4 and 1/2 of the total facial area being the criteria for judging mild and severe respectively (see C2).
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Table 3 Criteria for identification of disability levels due to work-related injuries and occupational diseases (ophthalmology, otolaryngology, and stomatology)
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Disability Category｜ One｜ Two｜
－－－－－－－｜－－－－－－－－｜－－－－－－－－－｜
｜No or only light perception in both eyes | One or no light perception in one eye , ｜
｜Light perception but inaccurate light positioning｜Corrected vision in another eye｜
｜Or｜≤0.02 or visual field｜
｜ ｜≤
Eye injury and visual function｜ ｜ ｜
Obstacles ｜ ｜ ｜
｜ ｜ ｜
｜ ｜ ｜
|
| ------- －－－－－－｜
｜ ｜ ｜
Laryngogenic dyspnea｜ ｜ ｜
And dysphonia ｜ ｜ ｜
－－－－－－－－｜－－－－－－－－｜－－－－－－－－－｜
| ｜After esophageal atresia or resection|
Swallowing dysfunction｜｜Dependence on gastrostomy for feeding｜
－－－－－－－｜－－－－－－－－｜－－－－－－－－－－｜
Auricular defect｜ ｜ ｜
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Evaluation of visual impairment in E3 aphakia
Due to work-related injuries Or occupational diseases lead to lens removal, which in addition to causing visual impairment, also affects the patient's visual field and stereoscopic vision function respectively. Therefore, the calculation of the effective value of the central vision (after correction) of aphakic eyes is lower than that of normal phakic eyes. The method can be determined based on the number of aphakic eyes and the best correction of vision for aphakic eyes (including wearing glasses or contact lenses and inserting intraocular lenses), and then comparing the percentage of vision loss with normal phakic eyes. Degree of visual impairment in aphakia.
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E5 Diagnostic standards and calculation methods for hearing impairment
E5.1 Equipment and methods for hearing threshold measurement must comply with relevant national standards ; Audiometer (GB7341-87); Standard zero level for calibrating pure-tone audiometers (GB4854-84); Acoustics-Pure-tone air conduction hearing threshold measurement-for hearing protection (GB7583-87).
E5.2 When calculating the hearing thresholds of subjects over 30 years old, the age correction value should be deducted from the actual measurement, and the latter should be taken from the national standard GB7582-87, Acoustics - Air conduction hearing thresholds of normal people in otology Values ??in Appendix B in relation to age and gender.
E5.3 Calculation method for binaural hearing loss: the mean speech frequency air conduction hearing threshold of the better hearing ear is the mean value, and the sum is divided by 5, that is,
PTA (good ears) wishes Chu Chu? School Yu Tuan?
－－－－－－－－－－－－－－－－－dB.
5
If the cause of deafness in the worse hearing ear has nothing to do with work injury or occupation, it will not be included in the calculation, and the average speech frequency hearing threshold of the better hearing ear will be used as the criterion. When calibrating the average hearing threshold, the mantissa after the decimal point is rounded off to an integer. Age-corrected value of pure tone air conduction threshold (dB)
---------------------------
｜ Male
Age (years) |－－－－－－－－－－－－－－－－－－－－－－－
| Frequency (HZ) ｜ 500 ｜ 1000 ｜
－－－－－－－｜－－－－－－－－｜－－－－－｜－－－－－－｜
30 | ｜ | 1 | 1 |
40 | ｜
70 ｜ ｜ 10 ｜ 11 ｜
------------------------- －－
－－－－－－－－－－－－－－－－－－－－－－－－－－
女
----------------------------------- －－－｜－－－－－｜－－－－－－｜－－－－－－
1 ｜ 1 ｜ 1 ｜ 1
3 ｜ 2 ｜ 2 ｜ 3
7 ｜ 4 ｜ 4 ｜ 6
12 ｜ 6 ｜ 7 ｜ 11
19 ｜ 10 ｜ 11 ｜ 16
－－－－－－－－－－－－－－－－－－－－－－－－－－
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F1 This standard It is only applicable to the evaluation of the degree of disability caused by injuries to the eyes, ears, nose, throat, and oral cavity caused by employees' work-related injuries and occupational diseases. Non-work-related injuries and occupational facial diseases such as night blindness, color blindness, stereoblindness, otosclerosis, etc. are not applicable. standard.
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F2 Visual damage caused by employee work-related injuries and occupational diseases is not only eye damage or destruction, but also involves visual function disorders and related Damage to anatomical structures and functions such as eyelids. Therefore, the identification of visual impairment includes: (1) identification of the degree of damage or destruction to the anatomical structures and functions of the eyelids, eyeballs, orbits, etc.; (2) identification of the degree of impairment of visual function (visual acuity, visual field, stereoscopic vision, etc.).
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F6 The identification of eyes disabled due to non-work-related injuries can refer to Article 8 of the General Provisions for identification of both eyes. However, the clinical identification of work-related injuries to non-work-related disabled eyes may be complicated by a variety of situations, such as (1) work-related injuries to one or both eyes and work-related injuries to a single disabled eye on the basis of both disabled eyes; (2) work-related injuries to a single disabled eye, respectively. There are three possible situations: (1) work-related injuries to the disabled eye; (2) work-related injuries to the normal eye; (3) work-related injuries to the normal eye and the disabled eye at the same time.
In view of the above circumstances, the legitimate interests of the state, the collective and the individual should be taken into consideration when making the final assessment of the degree of disability caused by work-related injuries to non-work-related disabled eyes.
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F15 If an employee is diagnosed with functional visual impairment or deafness due to work-related injuries or occupational-related factors, corresponding special examination methods should be used to confirm the diagnosis. The patient will not be assessed as disabled until the organic vision and hearing loss are determined. Pseudo-deafness should also be ruled out first and then assessed as disabled.
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Table 4 Identification standards for the degree of disability caused by work-related injuries and occupational diseases (general surgery, thoracic surgery, and genitourinary surgery)
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Disability Category｜One｜Two |
－－－－－－－－｜－－－－－－－－－－｜－－－－－－－－－－－－－－｜
| Pneumonectomy on one side and chest |
｜ | Contour reconstruction, dyspnea |
Chest wall, trachea, bronchi | Difficulty level III |
Trachea, lungs | －－－－－－－－－｜
｜ ｜ ｜
Heart and blood vessels｜ ｜Cardiac insufficiency grade three｜
｜ ｜ ｜
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－－－－－－－－｜－－－－－－－－－－｜－－－－－－－－－－－－－｜
｜ ｜Esophagus Atresia or resection｜
Esophagus｜｜Afterwards, feeding depends on gastrostomy｜
｜ ｜Fistula｜
－－－－－－－｜－－ －－－－－－－－｜－－－－－－－－－－－－－｜
Stomach ｜ ｜ ｜
－－－－－－－ |－－－－－－－－－－｜－－－－－－－－－－－－－｜
| ｜ ｜
Small intestine| 3/4, not performed｜
｜More than 90% resection｜Reverse peristaltic anastomosis｜
－－－－－－－｜－－－－－－－－－－ ｜－－－－－－－－－－－－－－｜
｜ ｜ ｜
Colon｜ ｜ ｜
－－－－－ ---|-----------------------------------------------------------------------------------------------| 3/4 of the liver was removed, and there was ｜
｜ transplantation ｜severe impairment of conventional liver function ｜
｜ ｜harm ｜
Liver ｜ ｜2. Post-hepatic trauma |
| | Pulse hypertension triad or development |
| | Budd-Chiari syndrome |
| | Syndrome |
－－－－－－－｜－－－－－－－－－－｜－－－－－－－－－－－－－｜
｜ ｜ Biliary duct injury causing severe liver damage |
Biliary duct | Functional damage |
－－－－－－－－－－－－－－－－－－－－－－－ －－－－－－－－－－－
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Table 5 Standards for Identification of Employee Work-related Injuries and Occupational Disease Disability Degrees (Occupational Disease Internal Medicine Department)
——————————————————————————————————————————————————————
Disability Category｜ One｜ Two｜ Three｜ Four｜ Five｜
－－－－｜－－－｜－－－－－－－｜－－－－－－－｜ －－－－－｜－－－－－－－－｜
｜ ｜1． Severe lung function｜1. Pneumoconiosis stage III | | 1. Pneumoconiosis II ｜
｜ ｜Degree injury ｜2. Pneumoconiosis stage II | | Stage with lung function |
| |2. Dyspnea ｜With moderate lung function ｜ ｜Able to lighten
Severe impairment｜
｜｜Grade 4 or｜Severe impairment or respiration｜｜Injury or respiration｜
｜｜PaO2 4.1～｜Difficulty level 3｜｜Difficulty level 2 ｜
｜ ｜8kPa or Pa-｜3. Pneumoconiosis I and II｜｜2. Pneumoconiosis I ｜
｜ ｜CO2 7.9～ ｜Phase combined with activity｜｜Phase with lung function｜
｜ ｜6kPa ｜Pulmonary tuberculosis｜ ｜Moderate impairment of energy｜
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Lung diseases｜｜3. Pneumoconiosis stage III｜4. Radiation lung｜ ｜Injury or respiration｜
｜ ｜With moderate lung function｜Post-inflammatory bilobar lung｜ ｜Difficult level 3｜
｜ ｜Severe injury or respiration｜Fibrosis｜ ｜ ｜
｜ ｜Difficulty breathing level 3｜ ｜ ｜ ｜
｜ ｜4. Radiation lung｜ ｜ ｜ ｜
｜ ｜The two lobes after inflammation are characterized by ｜ ｜ ｜ ｜
｜ ｜Upper lung fibrosis｜ ｜ ｜ ｜
-- －－｜－－－｜－－－－－－－－｜－－－－－－－｜－－－－－｜－－－－－－－｜
｜ ｜Heart function Insufficiency｜III degree AV obstruction｜Sick sinus｜1. Mohs II ｜
｜ ｜Grade 3｜Stagnation｜Knot syndrome｜Type II degree atrial｜
Heart｜ ｜ ｜ ｜ (Requires installation｜Ventricular block｜
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｜ ｜ ｜ ｜A master of weapons) ｜2. Heart function |
| －｜－－－－－｜－－－－－－－－｜
｜ ｜1. Leukemia ｜Agranulocytosis ｜ ｜1. Mild aplasia｜
｜ ｜Severe aplasia｜symptom｜ ｜Obstructive anemia｜
｜ ｜Obstructive anemia｜ ｜ ｜Anemia｜
｜ ｜( Type Ⅰ, Ⅱ) | | | | 2. Platelets｜
Blood｜ ｜ ｜ ｜ ｜ ｜
｜ ｜ | p>
|