Implementation Measures For The Work Injury Insurance In Xi ' An City

Original Language Title: 西安市工伤保险实施办法

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(On May 13, 2004 Xian City Government 49th times Executive Conference considered through on May 24, 2004 Xian City Government makes 23rd, announced since on July 1, 2004 up purposes) first chapter General first article for guarantees for work suffered accident hurt or patient occupational of workers get medical treatment and economic compensation, dispersed employing units injury risk, promote safety, and injury prevention and career rehabilitation, according to State injury insurance Ordinance, and Shaanxi Province implementation injury insurance Ordinance approach
    And State regulations, combined with the city's actual, these measures are formulated.
    Article in the administrative area of the city of all kinds of enterprises and employees of individual businesses (hereinafter referred to as the employer) shall participate in work-related injury insurance for workers or employees of the unit (hereinafter employees) pay a fee for work-related injury insurance. Article III registration of industrial injury insurance insured workers ' real names, each year an audit.
    Employers to participate in work-related injury insurance should be about publicity in this unit.
    Employer and the employee shall comply with occupational safety and occupational-disease-prevention laws and regulations and implementation of safety and health regulations and standards, the prevention of occupational accidents, prevent and reduce occupational hazards.
    Workers injured by accident, the employer must implement injury medical treatment, to ensure that injured workers receive timely treatment.
    Fourth municipal labor and social security administrative departments are responsible for the city's workers ' compensation insurance.
    Municipalities and counties to set up work-related injury insurance agency (hereinafter referred to as the Agency) is undertaking work-related injury insurance matters.
    Capability approval of municipal Labor Committee in charge of the appraisal work of injured workers, the ability to work.
    Five levels of finance, personnel, administration, health, work safety supervision and management departments and organizations such as trade unions, the Federation should be cooperative administrative departments of labor security work injury insurance. Chapter II the work injury insurance fund collection and manage the sixth work injury insurance fund municipal social planning.
    Work-related injury insurance fees levied by the local tax authorities.
    Administrative departments of labor security and financial, auditing, administration in accordance with the work-related injury insurance provisions of the Ordinance and these rules, the oversight of payment and management of the work injury insurance fund.
    Seventh work injury insurance fund paid by employers of industrial injury insurance, industrial injury insurance fund's interest and other funds covered by work injury insurance fund according to law. Eighth the employer shall be paid in full and in a timely manner on a monthly industrial injury insurance. Employees do not pay workers ' compensation insurance costs.
    Work injury insurance fund according to the following provisions: (a) the amount employers pay industrial injury insurance premiums for the employees in this unit product monthly salary multiplied by the contribution rate for the last year.
    (B) the employers ' employees, last year, lower than the average monthly wage of employees 60%, 60% monthly wage of staff and workers of the previous year, to the city as a base; average wage of staff and workers ' average monthly salary of the previous year, higher than the city of 300%, to last year's average monthly wage of employees 300% in this city as a base excess employer stopped paying.
    (C) employees of individual businesses, workers ' monthly salary of the previous year as the base, to the payment of workers ' compensation insurance costs. Nineth work injury insurance fund according to fixed income, balanced principles to determine rates for industry differential rate and a floating rate. Different rates according to the standards set by the National Executive.
    Floating rate within the industry rate brackets, by the agency based on the employer's annual injury rate, work injury insurance and occupational diseases harm, in the context of national adjustments. When the Agency first determines the employer's contribution rate, based on the license of the employing unit or the scope of the license, according to the work-related injury insurance industry risk benchmark for industry categories in the classification of rates determined.
    Business is the formation of, and determined in accordance with high risk industries. Tenth Article injury insurance fund deposit social security fund revenue designed households, implemented payments two article line management, earmarks dedicated, and according to following project spending: (a) disability workers injury medical; (ii) a to four level injury workers disability allowance; (three) one-time disability grant; (four) life nursing fee; (five) funeral grant; (six) dependent relatives pension; (seven) one-time workers died grant; (eight) auxiliary apparatus acquisition fee; (nine) injury rehabilitation fee; (ten) injury vocational
    Labor appraisal fee; (11) other costs prescribed by laws and regulations. 11th work injury insurance, no relief.
    Employers of industrial injury insurance premium arrears, arrears paid from the work injury insurance fund workers ' compensation insurance before treatment of the injured worker and injuries occurred during the unpaid workers, its outstanding workers ' compensation insurance for the period of treatment by the employer in accordance with the work-related injury insurance regulations and the items and standards of payment as provided herein, compensation paid from the work injury insurance fund after filling. 12th municipal labor and social security administration departments should be extracted from the collection of the work injury insurance fund 10%, risk reserve for major accident work injury insurance benefits paid in the city.
    When reserves are insufficient to pay, the municipal finance advance.
    Chapter III work injury certification the 13th industrial injuries cognizance implement territorial management principles. After the accident employer, you should inform the agency within 24 hours. Work-related injury certification application should be made by the employer in the employee accident injury date or from the date of diagnosis of occupational disease in the 30th, to submit to the administrative departments of labor security.
    In special cases, the administrative departments of labor security, applicants may be appropriately extended.
    Employers not complying with the provisions of the preceding paragraph apply for industrial injury, injured workers or their immediate family members, trade unions in the accident date or within 1 year from the date of diagnosis of occupational disease, can be directly applied to the administrative departments of labor security work injury certification.
    Employer is not submitted within the time limits stipulated in work injury certification application, occurred during this period in accordance with the provisions relating to the treatment of work-related injuries such as costs, borne by the employer.
    Article 14th work injury cognizance application should be filled out the application form for work-related injury certification, and submit the following materials: (a) the injured employee's identity documents, and labor contract copy or labor relation with the employer (including labor relations of fact) documents, (ii) medical certificate after an injury in early diagnosis of calendar, medical records, diagnosis certificate or certificate of diagnosis of occupational disease.
    15th article belongs to following situation of should provides related proved material: (a) production accident class of injury, should submitted to handling institutions record records and employing units accident survey report; (ii) finds occupational Shi, should submitted engaged in toxic harmful jobs of original information (or health archives) and has occupational diagnosis right of medical institutions of records and occupational diagnosis testimonials; (three) for perform work duties by violence hurt of, should submitted police organ or Court of judgment or other effective proved; (Four) due to motor vehicle accident by hurt of, should submitted police traffic management sector of responsibility finds book or other effective of legal instruments and related proved; (five) for workers out during, due to work reasons by hurt of, should submitted police sector of proved or other proved; occurred accident unaccounted for needed finds for workers death of, should submitted Court declared death of judgement; (six) in work time and work post, burst disease death or in 48 hours within by rescue invalid death of,
    Should submitted medical institutions treatment information and death proved; (seven) in rescue relief, maintenance national interests, and public interests activities in the by hurt of, should submitted incident to County above Government about sector issued of proved; (eight) belongs to for public, and for war wounded disability of jobs, and demobilized soldiers, old injury recurrence of, should submitted revolution disability soldiers card and the labor capacity identification Committee made of old injury recurrence of identification proved.
    Due to special circumstances, unable to provide relevant supporting documents, shall be stated in writing. Work-related injury certification information provided by the applicant does not complete, administrative departments of labor security in writing shall, within 15 working days once told all work injury certification the applicant need to correct material.
    Applicants shall be informed within 30th of corrections all the materials.
    Applicant's application materials, belonging to the administrative departments of labor security and limitation of acceptance of the jurisdiction of labour and social security administrative departments shall accept, and issue a notice of acceptance.
    The 16th if the following situation occurs, administrative departments of labor security may be inadmissible, and send a rejection notice.
    (A) not meet application limitation provides of; (ii) by said hurt basic facts not clear, and material not full of; (three) not meet jurisdiction right provides or no written delegate agent relationship of; (four) party on hurt treatment to court filed litigation, court judgment by finds facts not in injury range of; (five) has by labor arbitration institutions arbitration and has implementation hurt treatment, or by labor arbitration mediation, both on hurt treatment reached agreement and has implementation of; (six) other and this approach provides inconsistent of situation. 17th after the administrative departments of labor security accepts applications for work injury certification, based on the audit will need to be able to investigate the accident verified. Employers, injured workers, trade union organizations, medical institutions and departments concerned shall assist in the investigation and give evidence. Administrative departments of labor security in accordance with the needs, commissioned to co-ordinate regional Labor and social security administration departments or related departments to carry out investigation to verify.
    Legally obtained the occupational disease certificate or certificate of diagnosis of occupational disease, labor and social security administration no longer carry out investigation to verify. Employees or their immediate family members considered to be work-related injury, the employer is not considered a work-related injury, the employer bears the burden of proof.
    Employer refused to the onus of proof, administrative departments of labor security in accordance with the injured employee shall make the ascertainment of evidence to provide conclusions.
    18th a labour and social security administrative departments shall accept an application for work-related injury certification within 60 days from the date of work-related injury certification decisions, and work-related injury certification within 15 working days from the date of the decision, work-related injury certification decision notice of injured workers (or their immediate family members) and the trade union organization, and copied to the work-related injury insurance agency.
    According to the statutory procedures deal with labor disputes of the time does not count injury within the identified time frame. Fourth chapter of work competency expertise 19th work competency expertise on implementation of national labour standards.
    Labor capacity identification main including following content: (a) labor function obstacles degree grade of identification; (ii) life themselves obstacles degree grade of identification; (three) shutdown left paid period extended of confirmed; (four) injury directly led to disease of confirmed; (five) configuration auxiliary apparatus of confirmed; (six) dependent relatives completely lost labor capacity of identification; (seven) legal, and regulations provides of other matters.
    The 20th employee injuries treated injuries after a relatively stable disabilities, affecting the ability to work, work identification should be carried out.
    Work identified by the employer, the injured employee or their immediate family members to apply to the Municipal Commission of work competency expertise, and provide the following information: (a) the administrative departments of labor security work-related injury certification results; (b) issued by the Occupational Health Department of medical diagnosis, medical information such as medical records and reports on the results.
    21st units or individuals applying for identification, to municipal labor refuses to accept the conclusions of the appraisal Committee, from the date of receipt of the expert's conclusion on 15th to the province the ability to work within Appraisal Committee to apply for recertification. 22nd injured workers and their relatives, the units or agencies since the 1 year after the date of conclusion, that people change, you can apply for work review and identification.
    Review conclusions unchanged, identification of costs borne by the applicant.
    Fifth chapter work injury insurance benefits the 23rd employee for a work-related injury treatment, suffering from occupational diseases, work-related injury medical treatment.
    Treatment of work-related injury medical institution shall sign a service agreement, when the urgency of the situation, you can go to the nearest medical institution for treatment.
    Comply with State requirements for treating work-related injuries injury insurance medical project directory, work injury insurance, medical, work injury insurance, hospital services standard, paid from the work injury insurance fund. Hospitalized injuries of workers by their units, food allowances on business units in accordance with the national standard of 70% to hospital food allowances. Treatment of injured workers need to field, certified by medical institutions, agency approval for the referral procedures.
    The necessary transport, food and accommodation costs are covered by the unit in accordance with the employees in this unit standard on business expenses.
    Injured workers in the treatment of work-related injury caused by disease, not entitled to work injury medical treatment, basic medical insurance, in accordance with this approach. 24th employee for work-related injury or occupational disease need to suspend access to health care, during the shutdown leaves pay period, the original wage benefits unchanged, by the units of the monthly payment.
    Injured worker assessment after grade, since the work appraisal Committee conclusions of the month, suspension of primary treatment, in accordance with the workers ' compensation insurance Ordinance and these rules, the relevant provisions of the enjoyment of disability benefits.
    Injured workers are required in shutdown leaves after expiration of the paid treatment, continue to work-related injury medical treatment.
    Unable to take care of injured workers in the work stoppage paid life care by the units responsible.
    Injured workers in the work stoppage period salary, the employer shall not discharge or termination of labor relations. 25th injured workers need to install, configure, assistive devices, by the occupational health services recommendation, confirmed by the labour assessment Committee, work-related assistive devices service installation and configuration.
    Its costs directly by the Agency and work-related assistive devices services settlement.
    26th employee work was identified as grade I to grade of disability disability, labor relations, quit jobs, 32nd, 33rd, in accordance with regulations of the work-related injury insurance regulations, since the work appraisal Committee conclusions of the month enjoy the benefits of disability.
    27th five to six injured workers a voluntary relationship with employer terminates the labor, by the employer to the city workers ' monthly salary of the previous year as the base, paid 24 months and 21 months respectively by the one-time injury medical benefit and disability employment 24 months and 21 months of a one-time grant.
    28th seven to ten injured workers have one of the following conditions, paid by the employer to employees one-time injury medical benefit and disability employment grant: (a) voluntary termination of labor relations I, (ii) the employer according to the 25th article of the Labour Code stipulates termination of labor relations and (iii) the expiration of labor contract termination of labor relations. One-time injury medical benefit and disability employment grant to dissolution or termination of labor relations, workers ' monthly salary of the previous year as the base.
    One-time injury medical benefit criteria are as follows: seven levels of 15 months, eight levels of 12 months, nine 9 months, ten 6 months one-time disabled employment subsidy standards for: seven for 15 months, eight to 12 months, nine 9 months, ten 6 month. 29th injured workers of less than 5 years from the legal retirement age, a one-time injury medical benefits and disability employment subsidy payments at the 1 per cent decline in 20% standard, away from the mandatory retirement age less than 1 year of 10% paid in full.
    Injured worker reaches retirement age or retirement formalities, does not enjoy a one-time injury medical benefit and disability employment grant.
    Article 30th injured worker injury recurrence, moved by the appointed medical institutions of work-related injuries and work competency expertise on the Committee recognize the need for treatment by the city, enjoying the way the 23rd, 24th, 25th, work-related injury insurance benefits provided for in article. 31st employee who died in the one-time death benefit standards, workers ' monthly salary of the previous year as the base, to the city, a one-time death grants to 48 months to 60 months.
    Meet injury insurance Ordinance 14th article subsection (a), and (ii), and (four), and (five), and (six), and (seven) items and 15th article subsection (a) items provides of, to 48 months of workers died grant; meet injury insurance Ordinance 14th article subsection (three) items, and 15th article subsection (ii) items provides of, to 54 months of workers died grant; was grant martyrs title of, to 60 months of workers died grant.
    32nd accidents and civil compensation (including traffic accidents), first by the civil compensation, the compensation amount is lower than the standards for the treatment of industrial injury insurance, the difference from the work injury insurance fund up.
    Article 33rd, revocation, dissolution or bankruptcy of the employer closing shall be from the date of notice in the 15th, notify the organizing bodies participating in liquidation according to law from the realization of assets revenue priority should be allocated in the treatment of work-related injury insurance fees paid by the employer, and in accordance with the relevant provisions of the State debts due to pay industrial injury insurance.
    Level of disability allowance to four injured workers, enjoy the dependent relative pension treatment and retired injured personnel, in line with the work injury insurance fund paid project work injury insurance benefits paid by the Agency.
    Not reached the statutory retirement age from five to ten injured workers, by the employer in accordance with the criteria set forth in the 27th and 28th of these measures, payment of the one-time injury medical benefit and disability employment grant and termination of work-related injury insurance.
    Sixth chapter supervision and management 34th article handling institutions specific hosted injury insurance Affairs, perform following duties: (a) verification employing units of payroll and workers number, handle injury insurance registration, and is responsible for save employing units payment and workers enjoy injury insurance treatment situation of records; (ii) for injury insurance of survey and statistics; (three) approved injury insurance treatment; (four) according to provides management injury insurance fund of spending; (five) regularly announced injury insurance fund of payments situation, timely adjustment rates;
    (Vi) provided free consulting services to injured workers or their immediate family members.
    Article 35th of the administrative departments of labor security in accordance with the work-related injury insurance levy and supervise and inspect the work injury insurance fund payments.
    Financial departments and audit institutions shall work injury insurance fund revenue and expenditure monitoring and management.
    Trade unions at all levels shall safeguard the legal rights of injured workers and supervision work of the employer's workers ' compensation insurance. The 36th article of any organization and individual violations of work injury insurance and right to report.
    Should report to the administrative departments of labor security investigations in a timely manner, in accordance with the provisions of, and the informer confidential.
    The 37th industrial workers and employers pay dispute, in accordance with the relevant regulations of the labor disputes.
    38th article has following case one of of, units and personal can law application administrative reconsideration; on reconsideration decided refuses to of, can law filed administrative litigation: (a) application injury finds of workers or its immediate family, and the workers where units on injury finds conclusion refuses to of; (ii) employing units on handling institutions determine of units payment rates refuses to of; (three) signed service agreement of medical institutions, and auxiliary apparatus configuration institutions think handling institutions not perform about agreement or provides of;
    (D) the injured employee or his or her immediate family on work injury insurance benefits approved by the Agency disagrees. 39th employing unit pursuant to this Regulation shall participate in work injury insurance and did not participate in, the administrative departments of labor security shall be ordered to correct.
    Employer does not participate in work-related injury insurance, employee injuries, by the employer in accordance with the provisions of these measures work-related injury insurance items and fees. The seventh chapter by-laws 40th the employing unit shall, from the date of implementation of this approach in the 30th, with licence or social insurance registration certificate and other relevant documents, the Agency declared for a work-related injury insurance matters.
    After the implementation of this approach the employer shall set up since its inception in the 30th, with such documents for a work-related injury insurance matters.
    41st before the implementation of these measures has been injured by accident or workers suffering from occupational diseases, work-related injury certification decisions already taken, no longer changes the treatment of work-related injuries and to pay channels, but the disability allowance, the care and maintenance of relative pension adjustment; industrial injury decision had yet been made, according to the work-related injury insurance regulations of the Ordinance and these rules.
                                                                                                                              42nd article of the rules take effect on July 1, 2004.