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Work-Related Injury Insurance Aids For Configuration Management

Original Language Title: 工伤保险辅助器具配置管理办法

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  Chapter I General provisions article in order to standardize the work-related injury insurance AIDS for configuration management, maintain the legal rights of injured workers, according to the work-related injury insurance Ordinance, these measures are formulated.

Second injured workers because of daily life or employment needs, identified by the work Committee confirmed that configure prostheses, orthoses, artificial eye, dentures and assistive devices such as wheelchairs, these measures shall apply. III human resources and social security administrative departments are responsible for work-related injury insurance supervision and management of AIDS for configuration.

Home, health and family planning administrative departments responsible within the scope of their respective duties, such as work-related injury insurance supervision and management work related to assistive devices configured.

The social insurance agency (hereinafter referred to as the Agency) is responsible for applying to take work-related injury insurance AIDS for configuration service aid Assembly bodies and medical institutions (hereinafter referred to as AIDS for configuration of industrial injury insurance agency) agreement, and paid in accordance with the provisions of the nuclear configuration costs.

Fourth city divided into districts (including municipalities, municipal districts, counties) of work competency expertise Committee (hereinafter referred to as labour assessment Committee) is responsible for the work-related injury insurance auxiliary appliances configuration confirmation work.

The fifth province, autonomous region, municipality directly under the administration of human resources and Social Security Department is responsible for the development of work-related injury insurance AIDS for configuration assessment methodology.

Agency in accordance with the assessment approach and signed a service agreement with assistive devices configuration of industrial injury insurance agency and publicize AIDS for configuration of industrial injury insurance institutions have signed service agreement (hereinafter referred to as the treaty bodies) list.

The sixth section according to socio-economic development of the Department of human resources and social security levels, injured workers and employment needs of daily life, and organizations to develop national industrial injury insurance assistive devices configuration directory, determine the configuration item content, scope, such as minimum age, and adjust.

Human resources and social security administrative departments of provinces, autonomous regions and municipalities can be combined with the local area, the configuration item identified in the list of countries on the basis of developing provincial assistive devices configuration directory of industrial injury insurance, increasing AIDS for configuration items, and configure the maximum limit determined the region's assistive and other specific criteria. Second chapter confirmed and configuration program seventh article injury workers think need configuration auxiliary apparatus of, can to labor capacity identification Committee proposed auxiliary apparatus configuration confirmed application, and submitted following material: (a) injury finds decided book original and copies, or other confirmed injury of file; (ii) identity card or social security card, effective identity proved original and copies; (three) effective of diagnosis proved, and according to medical institutions records management about provides copy or copy of check, and

Complete medical history materials such as inspection report.

Injured worker himself due to physical causes, such as applicants, their close relatives or employers for application. Eighth work competency expertise on the Committee received assistive devices after you configure the application, and shall promptly review materials are not complete, shall within 5 working days from the date of receipt of the application in writing to inform all applicants need to supplement materials materials shall, within 60 days from the date of receipt of the application to confirm conclusions.

More complicated injuries, involving health care professional, confirm that conclusion can be extended to 30th.

Nineth work competency expertise on the Committee of experts shall be equipped with auxiliary equipment configuration expert, engaged in auxiliary appliances configuration confirmation work. Labour assessment Committee shall be based on the configured application material, randomly from the database 3 or 5 experts expert group, site configuration up on injured workers confirmed.

Expert group includes at least 1 support equipment configuration in expert, 2 injured worker injury-related experts. Tenth Group of experts according to the injured worker injury, according to the work-related injury insurance AIDS for configuration directory of relevant provisions proposed are confirmed to be configured.

When experts disagree, determined in accordance with the principle of majority opinion of the expert group. Labour assessment Committee configuration under the expert group recognized AIDS confirm that conclusion.

Among them, confirm the configuration should confirm the configuration set forth reasons, basis and assistive information such as name and recognizes that is not configured, it shall explain the reasons that are not configured.

11th work competency expertise on the Committee shall confirm confirm conclusions conclusion date of the 20th served on injured workers and their employers, and copied to the Agency.

12th article injury workers received be configuration of confirmed conclusion Hou, timely to handling institutions for registration, handling institutions to injury workers issued configuration costs nuclear pay notification single, and told following matters: (a) injury workers should to agreement institutions for configuration; (ii) confirmed configuration of auxiliary apparatus highest paid limit and minimum using years; (three) injury workers configuration auxiliary apparatus Super directory or beyond limit part of costs, injury insurance fund not paid.

13th injured workers can configure cost certified notice, select a Protocol mechanism to configure assistive.

Treaty bodies should be under service agreements with the Agency, provide configuration services for injured workers, injured workers and truthfully record information, configuration information, the maximum payment limit, minimum age and the actual configuration fees configuration services.

Configuration service provided for in the preceding paragraph after the record signed by the injured employee, retained by the injured worker and the treaty bodies, respectively. 14th Protocol bodies or injured workers and agencies in settlement configuration costs, it shall issue a configuration service logs.

Agencies after the verification, shall be in accordance with the work-related injury insurance provides timely payment of costs related to assistive devices configuration directory.

15th injured workers to configure assistive devices cost including installation, maintenance, training and other expenses paid from the work injury insurance fund according to regulations.

The Agency agrees, injured workers to co-ordinate regional treaty bodies other than the configuration of assistive transport, accommodation costs, in line with the provisions of the human resources and social security administrative departments, from the work injury insurance fund.

16th AIDS reaches minimum use period, the injured workers could be in line with the provisions of the human resources and social security administrative departments to request replacement.

Injured worker due to injury changes, need to replace main components or configure a new assistive devices, make application to the labour assessment Committee and confirmed, costs paid from the work injury insurance fund allocation.

Chapter III management and supervision article 17th assistive devices configuration experts shall meet one of the following conditions: (a) has the health in the senior professional and technical qualifications of the position, (ii) has a prosthetic engineer or orthosis professional qualification; (c) assistive devices configuration expertise for more than 5 years.

Assistive devices configuration expert should have a good professional ethics.

18th assistive devices configured to specific conditions of work injury insurance by provinces, autonomous regions and municipalities directly under the human resources and social security administrative departments for home, health and family planning administrative departments.                                                                                                                                                                                         

19th agencies and work injury insurance assistive devices configured signed service agreement, shall include the following information:

(A) the managing institutions and agreements institution name, basic information such as the legal representative or principal responsible person; (b) term of service agreement, (c) configuration services; (d) configuration costs; (v) configuration management requirements; (f) breach of contract and dispute processing; (VII) laws, regulations, other matters should be incorporated into service agreements. 20th to configure assistive devices shall comply with the relevant national standards or trade standards.

Standard products or materials, such as assistive devices in front of the Assembly should be authorized by the national product quality inspection report issued by quality inspection agency, labeling products manufacturer, make, model, material, function, date of production, use and warranty issues. 21st the treaty bodies should establish injured worker configuration service files, and saved to the service at least two years from the date of the expiration.

Agency service records can be configured on the conduct of inspections, and as a basis for settlement configuration costs.

22nd agencies shall establish assistive devices to configure callback system, tracking AIDS for Assembly quality and service, and check the results as a basis for evaluation of the treaty bodies.

23rd the work injury insurance assistive devices configured for breaches of national AIDS for configuration management service standards, against the legal rights of injured workers, the home, health and family planning administrative departments in the context of their supervisory duties according to law.

24th under any of the following circumstances, the Agency withhold configuration costs: (a) without work competency expertise on the Committee acknowledges, to configure assistive; (b) in a non-treaty bodies to configure assistive; (c) configure assistive directory or beyond the limit section; (d) the replacement of the contravention of assistive devices.

25th the injured employee or his close relatives think agencies failing to pay fee for assistive devices configuration, or agencies agencies fail to implement the agreement, may apply for administrative reconsideration or bring an administrative suit.

Fourth chapter legal liability within the body of the 26th Manager management accept the party's property and nuclear in the cost allocation process, the human resources and social security administrative departments shall be ordered to correct to the direct responsible person in charge and other direct liable persons shall be given administrative sanctions in serious cases, constitute a crime, criminal responsibility shall be investigated according to law.

27th article engaged in injury insurance auxiliary apparatus configuration confirmed work of organization or personal has following case one of of, by human resources social security administrative sector ordered corrected, at 2000 Yuan above 10,000 yuan following of fine; plot serious, constitute crime of, law held criminal: (a) provides false confirmed views of; (ii) provides false diagnosis proved or records of; (three) received party property of.

28th servicing of the treaty bodies in accordance with the service agreement, the agencies may terminate the service agreement, and in accordance with the service agreement to hold corresponding responsibilities.

Operator configuration costs is not settled in full and on time, the human resources and social security administrative departments shall be ordered to correct; the treaty bodies may terminate the service agreement.

29th employers, injured workers or their close relatives in obtaining work injury insurance benefits, assistive devices Assembly cheat work injury insurance fund expenditures of institutions, medical institutions, in accordance with the provisions of the regulations of the work-related injury insurance 60th, the human resources and social security administrative departments is ordered to return, fined not more than the amount defrauded more than twice times 5 times; serious enough to constitute a crime, criminal responsibility shall be investigated according to law.

The fifth chapter supplementary articles article 30th employer fails to participate in work-related injury insurance, injured workers need to configure assistive devices, in accordance with the relevant provisions of the measures implemented, and configure the costs paid by the employer. 31st article this way come into force April 1, 2016.