I believe that we will not be unfamiliar with the word work-related injury insurance. This is what the unit must pay for its employees, so that if an accident occurs, it can be guaranteed to a certain extent. So, what are the treatment provisions of work-related injury insurance? The following will explain the relevant content for you, for your reference and learning, hoping to help you.
What treatment regulation does industrial injury insurance have
Regulations on industrial injury insurance
Chapter V industrial injury insurance benefits
Article 30 employees who suffer from accident injuries or occupational diseases due to their work shall enjoy the medical treatment for work-related injuries.
Employees shall seek medical treatment in the medical institution that has signed the service agreement for treatment of work-related injury. In case of emergency, they can first go to the nearest medical institution for first aid.
If the expenses required for the treatment of work-related injuries meet the list of diagnosis and treatment items of industrial injury insurance, the catalogue of drugs for industrial injury insurance, and the hospitalization service standards of industrial injury insurance, they shall be paid from the industrial injury insurance fund. The catalogue of diagnosis and treatment items of work-related injury insurance, the catalogue of drugs for work-related injury insurance, and the standards for in-patient service of work-related injury insurance shall be formulated by the social insurance administrative department of the State Council in conjunction with the health administrative department and the food and drug administration department under the State Council.
The board allowance for the employees who are hospitalized for work-related injuries, as well as the transportation and accommodation expenses required by the injured workers to seek medical treatment outside the overall planning area shall be paid from the industrial injury insurance fund, and the specific payment standards of the fund shall be stipulated by the people's Government of the overall planning area.
Industrial injury workers who treat diseases not caused by work-related injuries do not enjoy medical treatment for work-related injuries and shall be treated according to the basic medical insurance measures.
The expenses for the rehabilitation of work-related injuries conducted by the injured workers to the medical institutions that have signed the service agreement shall be paid from the industrial injury insurance fund if they meet the requirements.
Article 31 in the event of administrative reconsideration or litigation after the decision of the social insurance administrative department to determine the work-related injury, the payment of medical expenses for the treatment of work-related injury shall not be stopped during the period of administrative reconsideration and administrative litigation.
Article 32 for the needs of daily life or employment, the injured workers may install artificial limbs, orthoses, artificial eyes, dentures, wheelchairs and other auxiliary devices upon confirmation by the labor capacity appraisal committee, and the expenses required shall be paid from the industrial injury insurance fund according to the standards set by the state.
Article 33 If an employee needs to suspend work for work-related injury medical treatment due to accident injury or occupational disease at work, the original wages and benefits shall remain unchanged during the period of suspension and pay by the unit to which he belongs on a monthly basis.
Generally speaking, the period of leave for work stoppage shall not exceed 12 months. If the injury is serious or in special circumstances, it may be extended appropriately after confirmation by the municipal labor capacity appraisal committee with districts, but the extension shall not exceed 12 months. After the assessment of the disability level of the injured workers, the original treatment shall be stopped and the disabled treatment shall be enjoyed in accordance with the relevant provisions of this chapter. If the injured workers still need treatment after the period of suspension of work and pay, they shall continue to enjoy the medical treatment for industrial injury.
If the injured workers who can't take care of themselves in the period of shutdown and pay leave, they shall be responsible by their units.
Article 34 If an injured worker has assessed the disability level and is confirmed by the labor capacity appraisal committee to need life care, he shall pay the living nursing fee from the industrial injury insurance fund on a monthly basis.
The living and nursing expenses are paid according to three different levels: totally unable to take care of themselves, most of them can't take care of themselves or part of their lives can't take care of themselves. The standard is 50%, 40% or 30% of the average monthly wage of employees in the planned area in the previous year.
Article 35 If an employee is identified as grade I to IV disability due to work-related disability, he / she shall retain his / her labor relationship, withdraw from his / her post and enjoy the following benefits:
（1） A one-time disability subsidy is paid from the industrial injury insurance fund according to the level of disability. The standard is: 27 months' salary for the first level disability, 25 months' salary for the second level disability, 23 months' salary for the third level disability, and 21 months' salary for the fourth level disability;
（2） From the industrial injury insurance fund, disability allowance shall be paid on a monthly basis. The standard is as follows: 90% of the salary for the first level disability, 85% for the second level disability, 80% for the third level disability, and 75% for the fourth level disability. If the actual amount of disability allowance is lower than the local minimum wage standard, the difference shall be made up by the industrial injury insurance fund;
（3） After the injured workers reach the retirement age and go through the retirement procedures, they shall stop paying disability allowance and enjoy the basic pension insurance benefits according to the relevant provisions of the state. If the basic endowment insurance benefits are lower than the disability allowance, the difference shall be made up by the work injury insurance fund.
If an employee is identified as grade I to grade IV disability due to work-related disability, the employer and the employee shall pay the basic medical insurance premium based on the disability allowance.
Article 36 an employee who has been identified as grade 5 or grade 6 disability due to work-related disability shall enjoy the following benefits:
（1） From the industrial injury insurance fund, a one-time disability subsidy is paid according to the disability level. The standard is: 18 months' personal salary for five-level disability, and 16 months' salary for six-level disability;
（2） The employer shall retain the labor relationship with the employer, and the employer shall arrange appropriate work. If it is difficult to arrange work, the employer shall pay disability allowance on a monthly basis. The standard is as follows: 70% of the salary for the fifth level disability, 60% for the sixth level disability, and the employer shall pay the social insurance premium payable for him in accordance with the regulations. If the actual amount of disability allowance is lower than the local minimum wage standard, the employer shall make up the difference.
According to the proposal of the injured employee himself, the employee may terminate or terminate the labor relationship with the employer, and the employer shall pay the one-time medical subsidy for industrial injury and the employer shall pay the one-time disability employment subsidy. The specific standards for the one-time medical subsidy for work-related injury and the one-time disability employment subsidy shall be formulated by the people's governments of provinces, autonomous regions and municipalities directly under the central government.
Article 37 an employee whose work-related disability is identified as grade 7 to grade 10 shall enjoy the following benefits:
（1） From the industrial injury insurance fund, a one-time disability subsidy is paid according to the disability level. The standard is: 13 months' personal salary for 7-level disability, 11 months' salary for 8-level disability, 9-month salary for 9-level disability, and 7-month salary for 10-level disability;
（2） If the labor or employment contract is terminated at the expiration of the term, or the employee himself proposes to terminate the labor or employment contract, the one-time industrial injury medical subsidy shall be paid by the industrial injury insurance fund, and the one-time disability employment subsidy shall be paid by the employer. The specific standards for the one-time medical subsidy for work-related injury and the one-time disability employment subsidy shall be formulated by the people's governments of provinces, autonomous regions and municipalities directly under the central government.
Article 38 employees who have suffered from a recurrence of work-related injury and are confirmed to need treatment shall enjoy the treatment of work-related injury as 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-off work-related death subsidies from the industrial injury insurance fund in accordance with the following provisions:
（1） The funeral subsidy is the average monthly wage of the staff and workers in the overall planning area for 6 months in the previous year;
（2） The pension for supporting relatives shall be paid to the relatives who have provided the main source of income and have no ability to work before their death according to a certain proportion of their own wages. The criteria are as follows: spouse 40% per month, other relatives 30% per month, orphans or orphans each month increase by 10% on the basis of the above criteria. The sum of the approved pension for each dependent relative shall not be higher than the salary of the employee who died at work. The specific scope of supporting relatives shall be prescribed by the social insurance administrative department of the State Council;
（3） The standard of one-time work death subsidy is 20 times of the per capita disposable income of urban residents in China last year.
If a disabled employee dies due to work-related injury during the period of suspension of work with pay, his close relatives shall enjoy the treatment prescribed in the first paragraph of this article.
If a disabled worker of grade one to four dies after the expiration of the period of suspension of work with pay, his near relatives may enjoy the treatment prescribed in items (1) and (2) of the first paragraph of this article.
Article 40 disability allowance, pension for supporting relatives and living and nursing expenses shall be timely adjusted by the social insurance administrative department of the overall planning area according to the changes in the average wages and living expenses of the staff and workers. The measures for adjustment shall be formulated by the people's governments of provinces, autonomous regions and municipalities directly under the central government.
Article 41 If an employee has an accident during his / her absence from work or his / her whereabouts are unknown in the course of emergency rescue and disaster relief, his / her wages shall be paid within three months from the month of the accident, and the wages shall be suspended from the fourth month. The pension for the dependent relatives shall be paid by the industrial injury insurance fund on a monthly basis. Those who have difficulties in life can advance 50% of the one-time work-related death allowance. If an employee is declared dead by the people's court, it shall be dealt with in accordance with the provisions of Article 39 of these regulations.
Article 42 If an injured worker is in any of the following circumstances, he shall cease to enjoy the benefits of industrial injury insurance:
（1） Losing the conditions for enjoying treatment;
（2） Refusing to accept the appraisal of labor capacity;
（3） Refused treatment.
Article 43 in case of division, merger or transfer of the employing unit, the successor unit shall bear the liability of the original employer for the work-related injury insurance; if the original employer has already participated in the work-related injury insurance, the successor unit shall go through the change registration of the industrial injury insurance with the local agency.
If the employer implements contract operation, the liability 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 period of secondment, the original employer shall bear the liability for industrial injury insurance, but the former employer and the secondment unit may agree on compensation measures.
If an enterprise goes bankrupt, it shall allocate the industrial injury insurance benefits that should be paid by the unit during the bankruptcy liquidation.
Article 44 If an employee is dispatched to work abroad and is required to participate in the local work-related injury insurance according to the laws of the country or region to which he / she is dispatched, he / she shall participate in the local work-related injury insurance, and his / her domestic work-related injury insurance relationship shall be terminated if he / she is unable to participate in the local work-related injury insurance.
Article 45 If an employee is required to enjoy disability allowance in accordance with the provisions in case of another industrial injury, he shall be entitled to disability allowance according to the newly determined disability level.
Through the above explanation, we can understand that the work-related injury insurance is carried out according to the provisions of the national law. The above are the relevant contents sorted out by the small edition for you. Thank you for your reading.