How to apply for work-related injury after an employee has a work-related injury?What should I do after the work-related injury is identified?When will the labor ability appraisal be done?How is the period of leave without pay determined?This article goes from the determination of work-related injuries to work-related injury arbitration compensation. The workers' compensation process is complex, and it is advisable to keep it in your collection.
OneTime to apply for work-related injury recognition:
Within 30 days from the date of the accident, the employer may apply for a work-related injury determinationIf the employer does not apply, the employee or his/her family may apply within one year from the date of the accident.
If the employee does not have an employment contract in hand, he or she needs to apply to the labor arbitration commission at the place where the employer is located or where he or she works, and the arbitration request confirms the existence of an employment relationship with the employer. After the arbitral award takes effect, the application for work-related injury determination can be made. If the employer is dissatisfied with the arbitral award and files a lawsuit with the people's court after the arbitral award is rendered, it can only apply for a determination of work-related injury after the conclusion of the first or second instance.
Therefore, if the worker does not have a labor contract in hand, the first thing is to be prepared for a protracted war. In confirming the labor relationship procedure, the employer generally adopts delaying tactics, because the employer does not pay social insurance to the employee, and all work-related injury benefits are borne by the employer. But rest assured, the end result is sure to be good. At the same time, the time is also reassuring to the employee, because the time for applying for arbitration to confirm the delay of the employment relationship is not counted in the one-year period of the application for work-related injury determination.
2. Where and what department to apply for work-related injury identification:
After the municipal social security agency pays social security premiums and the employees of the provincial organs and institutions have accidents, they shall submit an application for work-related injury recognition to the municipal human resources and social security departmentThose who pay social security premiums at the district or county social security agency shall submit an application for work-related injury recognition to the district or county human resources and social security department;If the employer fails to pay work-related injury insurance to the employee, it shall submit an application for work-related injury recognition to the human resources and social security department of the district or county where the employer is registeredIf the employer has not paid work-related injury insurance, and it is a non-local enterprise or the registration authority is the municipal market supervision and administration bureau, it shall submit an application for work-related injury recognition to the municipal human resources and social security department where the employer is located.
3. Materials to be submitted for applying for work-related injuries:
1. Work-related injury certificate (the Social Security Bureau has a standard sample);
2. A copy of the worker's ID card, and if submitted by the family, a copy of the relationship certificate and relevant ID card should also be submitted
3. If there is no labor contract, the arbitration award or the judgment of the people's court shall also be submitted
4. Inpatient medical records and diagnosis certificates
A certificate issued by more than one colleague or co-worker regarding the incident;
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FourthHow much time does the social security department have to make a decision on the determination of work-related injuries:
1. The social insurance administrative department shall make a decision on the determination of work-related injury within 60 days from the date of acceptance of the application for work-related injury determination, and issue a "Decision on Determination of Work-related Injury" or "Decision on Non-recognition of Work-related Injury".
2. The social insurance administrative department shall make a decision on the determination of work-related injury within 15 days from the date of acceptance of the application for work-related injury determination with clear facts and clear rights and obligations.
5. What to do if the social security department is not recognized or dissatisfied?
Apply for administrative reconsideration to the people** at the same level who made the decision or the higher-level authority that made the decision, or file an administrative lawsuit with the basic people's court where the social security institution is located within 6 months.
2. At this stage, the employer will also adopt delaying tactics. After the work-related injury determination is issued, the employer will file an administrative lawsuit with the people's court within the six-month deadline. After the court of first instance of administrative litigation makes a judgment, an appeal will be filed within the appeal period, and the work-related injury determination procedure will not be heard until the judgment of the second instance is rendered.
6. When and where to apply for labor ability appraisal?What should I do if I am not satisfied with the appraisal conclusion?Labor ability appraisal and evaluation standards
1. If a work-related injury determination has been made before discharge, the employer, the injured employee or his or her immediate family members shall submit an application to the Labor Ability Appraisal Committee of the city divided into districts within 30 days of the expiration of the employee's medical treatment term, and provide the relevant materials of the work-related injury determination decision and the employee's work-related injury medical treatment. If a work-related injury determination is made after discharge, an application for labor ability appraisal shall be submitted within 30 days after the work-related injury determination is made.
2. Materials to be submitted: labor appraisal application form (labor ability appraisal committee has a standard **), work-related injury identification decision, copy of the worker's ID card, the worker's hospitalization medical record, diagnosis certificate, physical and chemical test report, CT, X-ray and other diagnosis and treatment materials.
3. The time for labor ability appraisal is generally 60 days, and the labor ability appraisal committee needs to make an appraisal conclusion within 60 days from the date of receipt of the labor ability appraisal application.
4. If the injured employee or employer is not satisfied with the appraisal conclusion made by the municipal labor ability appraisal committee, it shall apply to the provincial labor ability appraisal committee for re-appraisal within 15 days from the date of receipt of the appraisal conclusion. The conclusion of the labor ability appraisal made by the provincial labor ability appraisal committee is the final conclusion.
5. The evaluation standard of labor ability is based on: "Disability Rating of Work-related Injuries and Occupational Diseases of Employees in Labor Ability Appraisal (GB T 16180 2014) and Appendix".
7. Determination of the period of suspension with pay:
1. At the same time as applying for labor ability appraisal, the Municipal Labor Ability Appraisal Committee is required to confirm the suspension period.
2. The length of the suspension period shall be confirmed in accordance with the classification catalogue of the suspension period issued by the local government.
3. During the period of suspension of work and salary, the original salary and benefits of the employee remain unchanged, and the salary of the original salary is what is the salary of the suspension period. The amount of monthly salary varies and is taken as an average. The salary during the suspension period shall be paid by the employer and has nothing to do with social security**.
8. Application for work-related injury benefits or work-related injury arbitration compensation:
1. If the employer pays social security for the employee, the employer will assist the employee in applying for work-related injury benefits from the social security, including one-time disability allowance, transportation expenses, room and board expenses, ** expenses, assistive device expenses, and calculation of nursing expenses.
2. If the worker terminates the labor relationship with the employer, he or she can also receive a one-time disability employment subsidy and a one-time medical subsidy for work-related injuries. The one-time disability employment subsidy shall be paid by the employer, and after the employer pays the one-time disability employment subsidy, it can apply for social security** to pay a one-time medical subsidy for work-related injuries.
3. If the employer fails to pay social security to the employee, all work-related injury benefits shall be paid by the employer. At this time, the employee can directly apply to the labor arbitration commission for work-related injury arbitration compensation, including a one-time disability subsidy, a one-time disability employment subsidy, a one-time medical subsidy for work-related injuries, and wages for the period of suspension of work. Of course, at this stage, the employer will still adopt delaying tactics, such as arbitration, first instance, second instance, and so on, and will implement the procedure after it is completed. In order to avoid a protracted battle between the employer, the employer may apply for property preservation at the labor arbitration stage or the first instance stage.
9. If the employer fails to pay the work-related injury insurance to the employee, can the employee or his family directly apply for arbitration to demand the employer to pay the work-related injury insurance benefits if the social security department has not recognized the work-related injury?
Nope!If the employer fails to pay work-related injury insurance to the employee, although the employer bears the responsibility, the arbitration or the people's court, as the adjudication body, does not have the ability to determine the level of work-related injury and the degree of dependence on nursing, and still needs the conclusion of the work-related injury determination of the social security department and the assessment of the disability level of the labor ability appraisal committee. Therefore, the employee also needs to apply to the social security department for work-related injury recognition before applying for arbitration compensation after the labor ability appraisal.