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Tibet Autonomous Region, The Implementation Of The Measures Of Work-Related Injury Insurance Ordinance

Original Language Title: 西藏自治区实施《工伤保险条例》办法

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Methodology of implementation of the Work injury Insurance Regulations in the Tibetan Autonomous Region

(Summit 15th ordinary meeting of the People's Government of the Tibetan Autonomous Region of 12 September 2012 to consider the adoption of Decree No. 113 of 13 September 2012 of the People's Government Order No. 113 of the Tibetan Autonomous Region of 1 November 2012.

Chapter I General

In order to guarantee medical treatment and economic compensation for workers who are victims of accidents or occupational illnesses, as well as those who knowingly suffer from work, to promote work injury prevention and occupational rehabilitation, to disperse the risk of work injury in their units, and to develop this approach in conjunction with the self-government area.

Article 2

The State organs within the administrative region of the self-government sector, the business units that are governed by the civil service law (hereinafter referred to as the user's unit) should pay for work injury insurance for workers and employees of the unit (hereinafter referred to as workers).

Employers have the right to work injury insurance under the law.

Article 3 should establish a system of responsibility for the safe production and occupational disease prevention, and take measures to prevent accidents, avoid and reduce occupational hazards.

Article IV. The Social Insurance Administration of the Autonomous Region is responsible for work injury insurance throughout the region.

The social security administration in the area (markets), districts (markets, districts) is responsible for work injury insurance in the present administration.

The Social Insurance Agency established by the Social Insurance Administration at all levels (hereinafter referred to as the Office of the Ombudsman) performs specific work injury insurance.

Article 5

Chapter II Work injury insurance fund

Article 6. The specific approach was developed by the Social Insurance Administration of the Autonomous Region with the financial sector and was implemented after the approval of the Government of the People of the Autonomous Region.

The work injury insurance fund is deposited with the financial specialties of the Social Security Fund, with two line managements for income and expenditure, with a dedicated section.

Article 7

(i) Employees' insurance contributions;

(ii) Lower-in-kind contributions for work injury insurance;

(iii) The interest of the work injury insurance fund in the bank;

(iv) Other funds of the Work injury Insurance Fund should be incorporated by law.

Article 8 The user unit shall pay the worker's injury insurance in full in accordance with the rate established under this scheme. Work injury insurance shall not be paid.

The amount of contributions is less than 60 per cent of the average annual salary of the full-fledged workers, reaching 60 per cent, up from 30 per cent and at 30 per cent.

Article 9 is difficult to calculate, directly according to the total wage, the construction, services, mines, etc., which pays premiums for work injury, in accordance with the relevant provisions of the State, the cost of the project, the size of the operation or the proportion of the total production. Specific calculations are developed by the Social Insurance Administration of the autonomous region with the relevant departments and implemented after the approval of the Government of the People's Republic of the Autonomous Region.

Article 10 Work injury insurance rates are determined in accordance with the categories of work and injury insurance published by the State, a smaller category of the risk industry, 0.5 per cent of the total salary of the employee and no buoyage; secondary-risk industries and three sectors with a high risk, the initial payment rate is 1 per cent and 2 per cent of the total salary of the employee, and the rate has been buoyed every two years.

The principle of buoyage at the work injury insurance rate is applied. On the basis of the industrial baseline payment rate, two files were buoyed: 120 per cent of the first buoys to the current industry benchmark rate, i.e., 1.2 per cent in the second sector and 2.4 per cent in the three sectors; 50 per cent in the second tranquill to the current industry benchmark rate, i.e. 1.5 per cent in the second sector, 3 per cent in the three sectors; 80 per cent of the buoy rate in the current sector, i.e. 0.8 per cent in the secondary sector, 1.6 per cent in the second buoy industry, or 0.5 per cent.

Article 11. The Autonomous Region Agency is responsible for the organization of adjustments to the full range of sub-sectors and three types of industrial utility units and injury insurance rates. At the end of each year, an integrated assessment was carried out based on the use of insurance premiums for work-related injury and the incidence of work-related injuries, based on sector-wide sub-category II, three categories of industrial agents, adjusted the rate of work injury insurance for the user unit and carried out thereafter.

In the event of a lack of security production in the user unit, a high rate of work injury and occupational illness, the use of work injury insurance exceeds 25 per cent of the total amount of the unit's contributions over two years, buoyed to the first file of the industrial benchmark rate; more than 50 per cent, the rate was buoyed to the second file of the industrial benchmark rate. The rate of safe production, accident and occupational illnesses in the user unit is low, with the cost of using a worker injury less than 25 per cent of the total amount of the unit's contribution for two years, buoyed to the first file of the industrial benchmark rate; without accident of work injury and occupational illness hazards, buoyed down to the second part of the industrial benchmark rate.

Article 12

(i) Medical costs and rehabilitation costs for treatment of work injuries;

(ii) Accommodation grant;

(iii) Accommodation fees for medical treatment other than integrated areas;

(iv) Requirements for the installation of disability support equipment;

(v) Life is not self-sustainable and the cost of living care, as confirmed by the Labour Capacity Identification Commission;

(vi) A one-time disability grant and a disability allowance paid by one to four-tier disabled workers in the month;

(vii) A one-time medical grant should be granted when the labour contract is terminated or removed;

(viii) Deaths due to work, whose survivors receive funeral benefits, pension benefits for relatives and death benefits;

(ix) Feasibility of labour capacity;

(x) Advocacy, training fees for work injury prevention;

(xi) Other costs for work injury insurance under laws, regulations.

Article 13 The Work injury Insurance Fund should retain a certain percentage of the reserves established by the self-government agencies, which were made up of 10 per cent of the total annual contributions by the full-area work injury insurance fund and are deposited with the funds of the Autonomous Region. The rolling balance of the reserve exceeds 50 per cent of the total contributions due to the Fund.

The reserve is used to cover the treatment of work-related injury insurance when a major accident occurs across the region or when the current work injury insurance fund is underfunded. The use of the reserve was made by the executing agency, which was approved by the social insurance administration and the financial sector. Inadequate use of the reserve is donated by financial advances in the self-government area. The reserves that have been extracted in the next year are used first to reimburse financial advances in the self-government area until funds are closed.

Chapter III

Article 14.

As a result of transportation accidents, disappearances, accidents during public departures and other conditions that may not be applied in accordance with the prescribed time frame, the social security administration agrees that the time period for application could be extended to a maximum of three months.

Labour disputes should be resolved in accordance with the law before the application for injury is determined by the dispute affecting work injury. The time to resolve labour disputes is not calculated within the time frame for the determination of the application by the work injury.

Article 15. Requests for work injury determination shall be submitted to:

(i) The determination of the application and the copy of the individual identification card;

(ii) A copy of a license of the operation of a person's unit or an institution's code (the worker or his close relatives, trade union organizations may not be provided);

(iii) Other material of proof of labour relations with the user unit, including de facto labour relations;

(iv) Medical diagnostic certificates or occupational illness diagnosis certificates (or occupational disease diagnostic certificates).

Article 16 is one of the following cases, and, in addition to the material provided under article 15 of this approach, the following relevant evidence should be submitted:

(i) Submission to public security authorities or to the People's Court of Justice of evidence or judgement as a result of unintended harm, such as violence, to fulfil their duties;

(ii) In the course of work, the death announcement of the People's Court is submitted to the People's Court for reasons of work being harmed or accidental misconduct;

(iii) In the course of the trip, a traffic accident or an urban orbit that is not the primary responsibility of himself or herself, a passenger ferry, fire accident injury, is submitted to the public security transport management for a traffic accident or related certificate;

(iv) Removal of old injuries from war, militarization, demobilization and reintegration of veterans, submitted to the Revolutionary Military Liquidation and the Labour Capacity Identification Commission;

(v) Be harmed in the maintenance of national interests, public interest activities, such as the hijacking of disaster, to be submitted to the Civil Affairs Department of the Government of the more people at the district level or to other relevant administrations, as required;

(vi) Deaths of sudden illnesses in working hours and in working hours or unavoidable deaths within 48 hours, which are submitted to rescue treatment records, medical photocopies and death certificates;

(vii) A heroic person who meets the conditions for the treatment of work injury insurance, submitted to the Government's civil affairs department or other relevant administrative authorities, as required.

The Social Insurance Administration, upon receipt of the applicant's employment injury determination, shall, within 15 days, review the submissions submitted by the applicant and provide incomplete information on the request and shall inform the applicant in writing of the full material that the applicant needs to be filled and that the decision to receive or be inadmissible should be taken.

The Social Insurance Administration is aware of the fact that the right obligation to determine the application for employment injury shall be determined by the worker's injury within 15 days of the date on which the application is considered. Facts or information are required to investigate verification and to make a decision on industrial injury determination within 60 days. The decision shall be taken with respect to the identification of work injury decisions or the non-confirmation of work injury decisions, which shall be delivered to the applicant and to the institution.

Article 18 of the Social Insurance Administration accepts the application for finding that a person's unit is required to submit the material that was not submitted late or that the person's unit does not consider it to be a worker's injury without paying the burden of proof, and the social security administration may make a decision of work injury in accordance with the evidence provided by the employee or its close relatives.

The applicant's determination that the worker's injury is inadmissible or is not determined by the worker's injury may apply for administrative review or administrative proceedings in accordance with the law.

Chapter IV

Article 19 The Commission has the following responsibilities:

(i) Level of identification of labour functional barriers (i.e., disability classification);

(ii) A hierarchy of living barriers;

(iii) Confirmation of the duration of the work stay and the extension of the duration of work leave;

(iv) Accreditation of a supporting tool;

(v) Recognition of the period of recovery and rehabilitation of work injury;

(vi) Confirmation of the link between sickness and work injury;

(vii) The extent to which the worker lost his or her labour capacity;

(viii) The extent to which workers are not affected by work disability or are deprived of their labour capacity.

The Office of the Labour Capacity Identification Commission is based in the same-tier social security administration and is responsible for the day-to-day work identified by the labour capacity.

Article 20

Health specialists should have the following conditions:

(i) To be eligible for corresponding hygienic technical functions;

(ii) Knowledge on the identification of labour capacities;

(iii) There is good occupational integrity.

The relationship between the labour capacity identifiers and the parties should be avoided.

Article 21 contains disability and impact on the labour capacity after the expiration of the employee's work injury or the relative stability of the employee's pay period, and shall be submitted to the Commission for the identification of a written application for the labour capacity at the location (commune) working capacity, by an agent or worker and his close family.

(i) Applicate the application for the level of work injury and disability;

(ii) Work injury determinations;

(iii) Applications for a copy of the identification of staff members and recent photographs;

(iv) Relevant information from health-care institutions such as diagnostic certificates, diagnosis and treatment;

(v) Working capacity identification of other information provided by the Commission.

The Commission shall, within five days of the date of receipt of the request for information, make a decision on the admissibility of the application for the identification of the labour capacity and inform the applicant in writing.

The applicant should be informed, on a one-time basis, of the incompleteness of the material and the reasons for the inadmissibility of the written notification of the applicant's need to fill the full material.

Article 23. The applicant's finding of the local (market) Labour Capacity Identification Commission is inconsistency and may submit a request for re-identification to the self-governing committee within 15 days of receipt of the findings. The finding of the labour capacity of the self-government zone is final.

After one year from the date of the conclusion of the identification of the labour capacity, the worker or his immediate family, the unit or the agency considered changes in the disability situation, may apply for a review of the labour capacity.

Article 24 Costs for work injury workers participating in work injury insurance are charged by the work injury insurance fund; unpaid work injury insurance or unpaid work injury insurance are paid by the user unit.

Upon request for re-identification or review, its findings were not changed and the costs were borne by the applicant. The cost of identification is paid by the work injury insurance fund for review by the agency.

Chapter V

Article 25 Employees are subject to accident injuries or occupational illnesses requiring suspension of their medical treatment, with no change in the treatment of their salary benefits during the suspension of work, which is paid by the unit in the month, and the unit shall not be removed or terminated.

The duration of unpaid work is generally not more than 12 months. Staff injury is serious or exceptional, and the Labour Capacity Identification Commission at the location (market) confirms that an appropriate extension may not exceed 12 months. Employers are granted disability treatment in accordance with the Regulations and the scheme. There is still a need for medical treatment after the expiry of the pay period.

The duration of work is not self-sustainable and exclusive care is vested by a user unit. With the consent of the employee or his close relatives, the user unit could pay the care fee in accordance with the average monthly salary standards of the self-government.

The medical costs required for treatment of work injury are met with the directory of the work-related medical treatment project, the directory of work injury insurance medicines, and the standards for hospitalization services for work injury insurance insurance.

Article 27 Employers' treatment work injury should be medically available in the form of a service agreement, and the situation may be dealt with as a matter of urgency in the case of near-medical institutions, subject to the stability of the injury or the subsequent transfer to the targeted medical institution. In the case of multiple medical institutions, the user units should be sent to the institution within 15 days from the date of injury to the employee.

Article 28 requires rehabilitation treatment, which shall be submitted by a worker, a person's unit or a targeted medical (rehabilitation), and with the confirmation by the Labour Capacity Identification Commission and approval by the social insurance agency, may be treated by a medical body that enters into a service agreement, in accordance with the required medical expenses.

Article 29 pays for food aid for workers inpatient care or during rehabilitation, travel accommodation fees are paid from the work injury insurance fund, with specific criteria being developed by the Social Insurance Administration of the Autonomous Region with the financial sector, followed by the approval of the Government of the People of the Autonomous Region.

Article 31 Staff members who work injury is due to their daily or employment needs shall be submitted by themselves, with the advice of the targeted medical body, which may be installed or repaired, replacements, correctives, vouchers, recuperation, dental and assembly chairs, begging, etc., and the cost of payment from the work injury insurance fund in accordance with the standards set forth in the national and autonomous areas.

Article 31 Staff members were identified as disability at the level to IV level, retaining labour relations, withdrawing from their jobs and enjoying the treatment of work injury. The worker does not apply for the processing of a disability pension procedure under the State's provisions, which is based on a number of disability benefits paid by a user unit and the employee of the work injury, as prescribed by the payment of basic old-age premiums and basic medical insurance expenses.

Retirement procedures, suspension of disability benefits, and access to basic old-age insurance benefits are available when workers at the level-IV level meet their retirements under the self-government area or receive maternity insurance benefits.

For workers at first to four levels, they are in accordance with the State's established conditions of retirement for work-related disability and the conditions for old-age insurance under the self-government area, which may be subject to retirement, suspension of disability benefits and access to basic pension insurance treatment. The basic old-age insurance treatment is less than the disability allowance and is filled by the work injury insurance fund. Other work injury insurance entitlements that are consistent with the provisions are paid by the work injury insurance fund.

The user units that have participated in the work injury insurance shall be liquidated in accordance with the law or licensed to perform the work injury insurance expenses for a period of 10 years for the employee at the first to four levels of the unit, in accordance with the per capita cost of the work injury of the employee.

Article 32 defines the worker as a result of the disability of grades 5 to 10, the expiry of the labour contract or the dismissal or termination of the labour relationship with the agent's unit and the payment of a lump-sum medical grant by the work injury insurance fund after the confirmation of the institution.

A one-time work injury medical benefits standard: average monthly salary for the full-time active workers, 523 months, 6-19 months, 7-14 months, 812 months, 9 months and 10 months.

A one-time disability employment grant criterion: average monthly salary for the full-fledged workers, 525 months, 621 months, 716 months, 813 months, 9 November, 10 seven months.

After the worker receives a one-time work injury medical grant and disability employment benefits, the work injury insurance relationship ceased to pay for work injury treatment.

In the event of termination or dismissal of labour relations between workers and employees, a lump-sum medical grant was paid in full for less than five years from the statutory retirement age and a one-time disability employment grant was paid at a rate of 20 per cent per year per year; less than 1 year was paid at full 10 per cent. Employees are not granted a lump-sum medical grant and disability employment benefits.

Article 33 Disability benefits, pension benefits for foster relatives, living care fees, and are provided by the Social Insurance Administration of the Autonomous Region and the same-level financial sector, in accordance with the average wages and changes in living costs of local workers, and adjusting programmes in due course and seeking advice from representatives of trade union organizations and user units to report to the Government of the People of the Autonomous Region.

In accordance with article 34, the user unit takes part in the work injury insurance and pays its work injury insurance benefits in full, from the date of the payment of the payment; the worker's unit shall interrupt the payment of the worker's injury insurance for more than one month and shall interrupt the treatment of the worker's work injury covered by the agent's unit; the person's repayment shall be subject to the payment of the worker's insurance for the period from the start of the month.

Article 35 Employees' units are subject to occupational hazards, and prior to the termination, removal of labour relations or the processing of retirement proceedings, they shall be inspected by medical institutions designated by the social insurance administration at the location and inform the employee of the results. If diagnosis, identification is an occupational disease, work injury may be determined and covered by the provision.

The user unit does not carry out a pre-employment health examination for the worker and terminates the labour relationship and has been identified for occupational illness in three years and is covered by the employee's unit.

Article XVI precludes the non-payment of medical expenses for serious workers at risk of injury, and in order to secure their lives, receive timely treatment, and workers or their close relatives may make requests for prior payment of medical expenses in accordance with the State's provisions, after the approval of the institution of the office, meet the first payment of the work injury insurance fund, from the work injury insurance fund.

Medical fees paid from the work injury insurance fund shall be reimbursed by the user unit. A person's unit is not reimbursed and is paid by a social insurance agency in accordance with the Social Insurance Fund's pioneer payment scheme.

Chapter VI Oversight management

Article 37 The Social Insurance Administration of the Self-Government Zone, in conjunction with the relevant departments, develops the health-care management approach for work injury insurance and occupational illness management, in accordance with the characteristics of accidents and occupational illnesses in the self-government area, and integrates the planning of medical institutions, rehabilitation institutions and support equipment-sharing institutions.

Article 338 of the Social Insurance Agency at all levels, in conjunction with the qualification medical institutions, rehabilitation agencies and supporting equipment configurations, concluded service agreements, including service targets, scope, quality, duration and lifting the terms of the agreement, cost clearance schemes, clear the responsibilities, rights and obligations of both parties and the timely publication of lists of medical institutions, rehabilitation agencies and supporting equipment-sharing institutions to society.

Article 39 of the Social Insurance Administration oversees the payment of work injury insurance funds by law.

The financial sector and the audit body are governed by law by the payments and management of the Work injury Insurance Fund.

Article 40

Trade union organizations maintain the legitimate rights and interests of workers and injured workers in accordance with the law and supervise the work injury insurance of the user unit.

Article 40. The user unit shall regularly disclose the participation of the unit in the work injury insurance and the payment of the worker injury insurance and shall be subject to the supervision of the employee.

Any organization or individual has the right to report on the offence of work injury insurance. The Social Insurance Administration should investigate reports in a timely manner, be treated in accordance with the provisions and kept confidential.

Article 43 punishes violations of the provisions of this scheme in accordance with the provisions of the Social Insurance Act and the Regulations.

Chapter VII

Article 44 The Modalities for the Implementation of the Tibetan Autonomous Region, enacted by the Government of the People of the Tibetan Autonomous Region on 19 November 2004, were also repealed. Work-related injury treatment prior to the operation of the method from 1 January to 1 January 2011 is implemented in accordance with the Regulations and this approach.