Chapter I General Provisions

Article 1 These Measures are formulated in accordance with the Regulations of the State Council Municipality on Work-related Injury Insurance and the Measures for the Implementation of Work-related Injury Insurance in Liaoning Province, combined with the actual situation of our city, in order to ensure that workers with work-related injuries receive medical treatment and economic compensation, promote work-related injury prevention and vocational rehabilitation, safeguard the legitimate rights and interests of workers, and disperse the work-related injury risks of employers.

Article 2 All kinds of enterprises and individual industrial and commercial households with employees within the administrative area of our city (hereinafter referred to as employers) shall participate in work-related injury insurance in accordance with the Regulations of the State Council on Work-related Injury Insurance and the Measures for the Implementation of Work-related Injury Insurance in Liaoning Province, and pay work-related injury insurance premiums for all employees or employees of this unit (hereinafter referred to as employees).

Measures for coal mining enterprises to pay work-related injury insurance premiums shall be formulated separately.

If the employer fails to participate in work-related injury insurance, the employer shall pay the fees in accordance with the treatment items and standards of work-related injury insurance stipulated in these Measures.

If the employer fails to pay the work-related injury insurance premium, and the work-related injury insurance benefits of the employees have been paid by the work-related injury insurance fund before payment, the work-related injury insurance benefits of the employees during the unpaid period shall be paid by the employer and supplemented by the work-related injury insurance fund after payment. However, the expenses paid during the period shall be excluded from the date when the industrial accident occurs in the self-use unit to the date when the post-treatment is completed.

Article 3 The collection and payment of work-related injury insurance premiums shall be carried out in accordance with the Provisions of Liaoning Province on the Collection and Payment of Social Insurance Fees. ~24. Article 4 The employing unit shall publicize the relevant information about participating in industrial injury insurance within the unit.

Employers and workers shall abide by the laws and regulations on production safety and occupational disease prevention and control, implement safety and health regulations and standards, prevent work-related accidents, and avoid and reduce occupational hazards.

When an employee suffers from a work-related injury, the employing unit shall take measures to enable the employee to receive timely treatment.

Fifth city and county (District) administrative departments of labor security shall be responsible for the work-related injury insurance within their respective administrative areas, and the specific affairs shall be undertaken by social insurance agencies.

Chapter II Industrial Injury Insurance Fund

Article 6 The work-related injury insurance fund consists of the work-related injury insurance premium paid by the employer, the interest of the work-related injury insurance fund and other funds incorporated into the work-related injury insurance fund according to law.

Article 7 The rate of work-related injury insurance shall be determined according to the principle of fixed income by expenditure and balance of payments. The employing unit shall pay the industrial injury insurance premium according to the first, second and third industry benchmark payment rates determined by the social insurance agency according to the Benxi Industrial Injury Insurance Industry Risk Classification Benchmark Payment Rate Table.

(1) The benchmark payment rate for a class of industries with less risk is 0.8%.

(2) The benchmark contribution rate of the secondary industry with moderate risk is 1.5%.

(3) The benchmark contribution rate of three high-risk industries is 2.2%.

Article 8 If the employing unit belongs to Category I industries, no rate fluctuation shall be implemented.

If the employer belongs to two or three industries, the rate will fluctuate. The floating range of the rate is determined by the social insurance agency on the basis of the benchmark payment rate according to the use of work-related injury insurance premiums by the employer, the incidence of work-related injuries, the degree of occupational disease harm and other factors. The floating rate is based on the total amount paid by the employer's industrial injury insurance fund and floats once a year.

(1) If the total payment exceeds 200% of the total payment of the enterprise in the same period, the payment rate will rise to150% of the benchmark payment rate;

(2) If the total payment reaches 150%-200% of the total payment of the enterprise in the same period, the payment rate will rise to120% of the benchmark payment rate;

(3) If the total payment is 50%-30% of the total payment of the enterprise in the same period, the payment rate will be reduced to 80% of the benchmark payment rate;

(four) the total payment is less than 30% of the total payment of the enterprise in the same period, and the payment rate is reduced to 50% of the benchmark payment rate.

Article 9 The employing unit shall participate in the overall planning of industrial injury insurance in accordance with the following provisions:

(a) the employer shall, from the date of obtaining the industrial and commercial business license, go to the social insurance agency for the registration of work-related injury insurance, and its procedures and methods are consistent with those of pension and medical insurance.

(II) When handling the registration of work-related injury insurance, the employing unit shall fill in the list of employees participating in work-related injury insurance and register the insured employees. The insured employees shall register with the notice of work-related injury identification conclusion issued by the administrative department of labor and social security.

(3) Where the registered items of the employer's industrial injury insurance change, it shall, within 30 days from the date of change, apply to the social insurance agency for change or cancellation of the industrial injury insurance registration with relevant documents and materials.

Article 10 The industrial injury insurance fund shall be co-ordinated at the municipal level and deposited in the financial special account of the social security fund, which shall be used for industrial injury insurance benefits, labor ability appraisal, industrial injury identification investigation, industrial injury prevention, industrial injury worker management and other related expenses. According to the law. In addition to the treatment of work-related injury insurance, other expenses are controlled within 3% of the actual total collection of work-related injury insurance funds in the current year, and the expenditure budget is compiled and implemented after being reported to the municipal government for approval.

Eleventh according to the proportion of 50% of the balance of the industrial injury insurance fund in this Municipality, the reserve fund shall be retained from the industrial injury insurance fund to pay for the industrial injury insurance benefits of major accidents; If the reserve fund is insufficient to pay, it shall be paid by the autonomous region government as a whole. When the accumulated amount of the reserve reaches 50% of the income of the industrial injury insurance fund in the previous year, the rate of industrial injury insurance shall be adjusted to reduce the reserve ratio.

The specific measures for the use of reserves shall be formulated separately by the municipal government.

Chapter III Identification of Work-related Injury

Article 12 Employers, employees with work-related injuries or their immediate family members, and trade unions shall, in accordance with the Regulations of the State Council on Work-related Injury Insurance, the Measures for the Implementation of Work-related Injury Insurance in Liaoning Province and its relevant provisions, submit an application for work-related injury identification to the administrative department of labor security and submit the following materials:

(a) the application form for work-related injury identification;

(two) valid proof materials of the existence of labor relations (including factual labor relations) with the employer;

(3) Medical diagnosis certificate or occupational disease diagnosis certificate (or occupational disease diagnosis certificate).

(four) the identity certificate of the employees or their immediate family members;

(5) Other materials that need to be provided.

Thirteenth employees or their immediate family members think it is a work-related injury, and the employer does not think it is a work-related injury, and the employer shall bear the burden of proof. If the employer refuses to provide evidence within 0/5 days from the date of receiving the notice of proof from the administrative department of labor and social security, the administrative department of labor and social security may make a conclusion on work-related injury according to the evidence provided by the injured employee.

Article 14 After accepting the application for work-related injury identification, the administrative department of labor security may suspend the work-related injury identification under any of the following circumstances during the investigation and verification:

(a) due to laws, regulations, rules and other needs to consult the higher authorities;

(two) because of the unclear boundary between work-related injury and disease, there is a dispute that needs to be confirmed;

(three) due to other irresistible factors, it is difficult to make a conclusion of work-related injuries.

To suspend the work-related injury identification, it is necessary to serve the Notice of Suspension of Work-related Injury Identification to the employing unit, work-related injury employees or their immediate family members and trade unions that apply for work-related injury identification. To eliminate the factors that stop the work-related injury identification, the work-related injury identification should be resumed, and the work-related injury identification period should be calculated continuously before and after.

Article 15 If an employer has an industrial accident, the administrative department of labor and social security shall investigate and verify the industrial accident, and the administrative department of production safety supervision and administration shall provide assistance.

The administrative department of labor and social security shall send a copy of the conclusion of work-related injury identification to the administrative department of production safety supervision and management.

Article 16 After an employee is injured in an accident, the employing unit shall report to the social insurance agency within 24 hours, and under special circumstances, it shall not exceed 72 hours at the latest.

Chapter IV Appraisal of Labor Ability

Seventeenth labor ability appraisal refers to the level appraisal of the degree of labor dysfunction and self-care disorder.

Labor dysfunction is divided into ten levels of disability, the heaviest being 1 level, and the lightest being1level.

There are three levels of self-care obstacles: life can't take care of itself at all, most of life can't take care of itself, and some of life can't take care of itself.

The labor ability appraisal standards shall be implemented in accordance with the relevant provisions of the state.

Eighteenth labor ability appraisal by the employer, injured workers or their immediate family members to apply to the municipal labor ability appraisal committee, and provide the following materials:

(a) the application form for labor ability appraisal;

(2) Notice of the conclusion of work-related injury identification issued by the administrative department of labor security;

(3) All the real medical information of employees' work-related injuries, including medical records, disease records or occupational disease records, diagnosis certificates (or occupational disease diagnosis and identification) and other treatment materials;

(four) the identity certificate and photos of the employees;

(5) Other materials that need to be provided.

If the employer or employee refuses to accept the conclusion of work-related injury identification issued by the administrative department of labor and social security, and applies for administrative reconsideration or brings an administrative lawsuit, the Municipal Labor Ability Appraisal Committee may temporarily refuse to accept the application for labor ability appraisal.

Nineteenth city labor ability appraisal committee is composed of representatives of the municipal labor security administrative department, personnel administrative department, health administrative department, trade union organizations, agencies and employers, and its office is located in the municipal labor security administrative department.

The Municipal Labor Ability Appraisal Committee establishes a medical and health expert database. Medical and health professional and technical personnel included in the expert database shall meet the following conditions:

(a) with senior professional and technical positions in medicine and health;

(two) to master the relevant knowledge of labor ability appraisal;

(3) Having good professional ethics.

Chapter V Work-related Injury Insurance Benefits

Twentieth employees who suffer from accidents or occupational diseases due to work shall enjoy medical treatment for work-related injuries.

Workers with work-related injuries should seek medical treatment in medical institutions that have signed service agreements. In case of emergency, they can go to the nearest medical institution for first aid.

If the expenses required for work-related injury treatment meet the catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs and the hospitalization service standard of work-related injury insurance, they shall be paid from the work-related injury insurance fund. The catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs and the hospitalization service standard of work-related injury insurance shall be implemented in accordance with the relevant provisions of the state.

If an employee is hospitalized due to a work-related injury, the employer shall issue a hospital food subsidy according to 70% of the food subsidy standard for the business trip of the unit; Medical institutions shall issue certificates and report them to social insurance agencies for approval. If employees with work-related injuries go to the outside of this city for medical treatment, the required transportation and accommodation expenses shall be reimbursed by the employing unit according to the standards for employees' business trips.

Workers with work-related injuries who treat diseases caused by non-work-related injuries do not enjoy medical treatment for work-related injuries, and are treated according to the basic medical insurance method.

The expenses for rehabilitation treatment of injured workers in medical institutions that have signed service agreements shall be paid by the industrial injury insurance fund if they meet the provisions of the third paragraph of this article.

Article 21 If an injured worker needs to install artificial limbs, orthotics, artificial eyes, dentures or wheelchairs, he shall apply to a medical institution that has signed an agreement with the social insurance agency, and after the medical institution issues a diagnosis opinion and is confirmed by the Municipal Labor Ability Appraisal Committee, he shall install and configure it in the agreed medical institution or the auxiliary device configuration institution.

Auxiliary equipment installation, configuration standards and settlement methods, etc. In accordance with the relevant provisions of the state.

Article 22 If an employee suffers from an accident or occupational disease at work and needs to be suspended from work to receive medical treatment for work-related injuries, the original salary and welfare benefits will remain unchanged during the paid suspension, and the employer will pay them monthly.

The paid shutdown period generally does not exceed 12 months. Serious injury or special circumstances, confirmed by the Municipal Labor Ability Appraisal Committee, can be appropriately extended, but the extension time shall not exceed 12 months. Workers injured in work-related injuries shall stop their original treatment and enjoy disability treatment in accordance with the relevant provisions of these measures after being assessed for disability level. Workers with work-related injuries who still need treatment after the expiration of paid shutdown shall continue to enjoy medical treatment for work-related injuries.

The employer shall be responsible for the work-related injury workers who cannot take care of themselves during the paid shutdown period.

Twenty-third workers injured by the assessment of disability level and confirmed by the Municipal Labor Ability Appraisal Committee need life care, the work-related injury insurance fund pays monthly life care fees.

Life care fees are paid according to three different levels: life can't take care of itself completely, most life can't take care of itself and some life can't take care of itself. The standards are 50%, 40% and 30% of the average monthly salary of employees in this city in the previous year.

Twenty-fourth workers who are disabled due to work are identified as first-class to fourth-class disabled, retain labor relations, quit their jobs, and enjoy the following benefits:

(a) according to the level of disability from the industrial injury insurance fund to pay a one-time disability allowance. The standard is: 24 months' salary for first-class disability, 22 months' salary for second-class disability, 20 months' salary for third-class disability and 0/8 months' salary for fourth-class disability;

(2) Pay the disability allowance from the industrial injury insurance fund on a monthly basis. The standard is: 90% of my salary for first-degree disability, 85% for second-degree disability, 80% for third-degree disability and 75% for fourth-degree disability. If the actual amount of disability allowance is lower than the local minimum wage standard, the industrial injury insurance fund will make up the difference;

(3) After the workers with work-related injuries reach retirement age and go through retirement formalities, they will stop paying disability allowances and enjoy basic old-age insurance benefits instead, which will be adjusted with the basic old-age insurance benefits. If the approved basic old-age insurance benefits are lower than the disability allowance, the work-related injury insurance fund will make up the difference.

Before the implementation of the Regulations on Work-related Injury Insurance, disabled workers from Grade 1 to Grade 4 who have reached retirement age and gone through retirement formalities and originally enjoyed regular disability pension will be transferred to the basic old-age insurance fund according to the approved amount of the original treatment, and adjusted with the basic old-age insurance treatment.

Workers who are disabled due to work are identified as one to four levels of disability, and the basic medical insurance premium shall be paid by the employer and individual employees according to the prescribed proportion on the basis of disability allowance.

Twenty-fifth workers who are disabled due to work are identified as five or six disabled, and enjoy the following benefits:

(a) according to the level of disability from the industrial injury insurance fund to pay a one-time disability allowance. The standard is: my salary is level 5 disability 16 months, level 6 disability 14 months;

(two) to retain the labor relationship with the employer, and the employer shall arrange appropriate work. If it is difficult to arrange a job, the employer will pay a monthly disability allowance. The standard is: level 5 disability is 70% of my salary, level 6 disability is 60% of my salary, and the employer shall pay the social insurance premium that should be paid according to the regulations. If the actual amount of disability allowance is lower than the local minimum wage, the employer shall make up the difference.

Upon the employee's own proposal, the employee may terminate or terminate the labor relationship with the employer, and the employer shall pay the one-time work-related injury medical subsidy and disability employment subsidy, and terminate the work-related injury insurance relationship. The payment standard of one-time work-related injury medical subsidy is calculated according to the average monthly salary of employees in this city in the previous year, of which the fifth grade is 16 months and the sixth grade is 14 months; One-time disability employment subsidy is calculated according to the monthly salary of employees, and shall not be lower than the local minimum wage standard, of which grade five is 28 months and grade six is 24 months.

Twenty-sixth workers who are disabled due to work are identified as seven to ten disabled, and enjoy the following benefits:

(a) according to the level of disability from the industrial injury insurance fund to pay a one-time disability allowance. The criteria are: level 7 disability 12 months, level 8 disability 10 months, level 9 disability for 8 months and level 10 disability for 6 months;

(two) the expiration of the labor contract, or the employee himself proposed to terminate the labor contract, the employer shall pay a one-time work-related injury medical subsidy and disability employment subsidy, and terminate the work-related injury insurance relationship. The payment standard of medical subsidy for one-time work-related injury is calculated according to the average monthly salary of employees in this city in the previous year, in which grade seven is 12 months, grade eight is 10 months, grade nine is 8 months, and grade ten is 6 months; The payment standard of one-time disability employment subsidy shall be calculated according to the monthly salary of injured workers, and shall not be lower than the local minimum wage standard, in which grade 7 is 20 months, grade 8 is 16 months, grade 9 is 12 months, and grade 10 is 8 months.

Article 27. When the disabled employees with Grade 5 to Grade 10 dissolve or terminate the labor relationship with the employer, and the retirement age is less than 5 years, if the labor relationship is dissolved or terminated with the employer 4 years, 3 years, 2 years, 1 year in advance, the one-time disability employment subsidy will be reduced accordingly 1 month, 2 months, 3 months and 4 months.

Twenty-eighth workers with work-related injuries need treatment, they should apply to the agreed medical institutions for work-related injury treatment, and after the diagnosis certificate is issued and approved by the social insurance agency, they will be treated by the agreed medical institutions; If it is really necessary to go outside the city for medical treatment, it can only be transferred to other places for medical treatment after I propose, agree with the medical institution and approve the social insurance agency. The industrial injury insurance fund will not pay the expenses incurred in transferring to other places for medical treatment without approval.

Twenty-ninth workers died at work, their immediate family members in accordance with the following provisions from the industrial injury insurance fund to receive funeral subsidies, dependent relatives pension and one-time work-related death subsidies:

(a) the funeral subsidy is 6 months of the average monthly salary of employees in this Municipality in the previous year;

(2) The pension for supporting relatives shall be paid to the relatives who provided the main source of livelihood before the death of the employee and were unable to work because of work according to a certain proportion of the employee's salary. The standard is: spouse 40%, other relatives 30%, widowed elderly or orphans 10%. The total approved pension of dependent relatives should not be higher than the salary of employees who died at work. The qualification of supporting relatives of workers who died because of work to enjoy pension benefits shall be approved by social insurance agencies in accordance with the provisions on the scope of supporting relatives of workers who died because of work;

(three) the standard of one-time death allowance is 60 months, that is, the average monthly salary of employees in this city in the previous year.

If a disabled employee dies at work during the period of paid suspension, his immediate family members shall enjoy the treatment stipulated in the first paragraph of this article.

One to four disabled workers died after the expiration of the suspension of work with pay, and their immediate family members can enjoy the treatment stipulated in Items (1) and (2) of the first paragraph of this article, and enjoy the one-time relief paid by the employer in accordance with the relevant provisions of the province; If a person dies after going through the retirement formalities, he shall be paid from the endowment insurance fund according to the treatment he should enjoy if he dies not because of work. If the treatment paid by the endowment insurance fund is lower than that paid by the industrial injury insurance, the industrial injury insurance fund will make up the difference.

Thirtieth employees injured at work shall be paid by the employer or the industrial injury insurance fund according to the actual expenses.

Among them, the disability allowance, the pension for dependent relatives and the living care fee are proposed by the municipal labor and social security administrative department according to the changes of the average wage increase and living expenses of employees in this city, and implemented after being approved by the municipal government, and submitted to the provincial labor and social security administrative department for the record.

Thirty-first level to four disabled migrant workers, short-term employment workers injured, they should enjoy and need to pay the treatment of work-related injury insurance on a regular basis, can be implemented in two ways: one-time payment or long-term payment. If I file a one-time claim, I will terminate the industrial injury insurance relationship after dissolving or terminating the labor relationship with the employer and signing an agreement with the social insurance agency.

One to four disabled migrant workers and short-term workers with work-related injuries enjoy the treatment standard of work-related injury insurance that needs to be paid at one time and regularly. If the employer's production and business premises are in this city, the average annual salary of employees in this city shall be taken as the compensation base, and the first-class disability shall be 14 times of the compensation base; Secondary disability is 12 times of the compensation base; The third-degree disability is 10 times of the compensation base; Level 4 disability is 8 times of the compensation base; In case of work-related death, one-time compensation shall be paid according to 10 times of the compensation base.

Chapter VI Legal Liability

Article 32 Where an employer conceals the total wages or the number of employees, the administrative department of labor security shall order it to make corrections and impose a fine of not less than 0 times but not more than 3 times the total wages.

Employers, employees with work-related injuries or their immediate family members cheat work-related injury insurance benefits, and medical institutions and assistive devices configuration institutions cheat work-related injury insurance fund expenditures, which shall be ordered by the administrative department of labor security to be refunded, and a fine of 1 times or more and 3 times or less shall be imposed; If the circumstances are serious enough to constitute a crime, criminal responsibility shall be investigated according to law.

Thirty-third employers in accordance with the provisions of these measures should participate in work-related injury insurance and did not participate, the administrative department of labor security shall order it to make corrections within a time limit; Those who refuse to make corrections within the time limit shall be fined 1 10,000 yuan to 30,000 yuan.

Chapter VII Supplementary Provisions

Article 34 The term "employees" as mentioned in these Measures refers to employees who have various employment forms and employment terms (including factual labor relations) with the employing unit.

The term "total wages" as mentioned in these Measures refers to the total amount of labor remuneration paid directly by the employer to all employees of the unit.

The term "my salary" as mentioned in these Measures refers to the average monthly payment salary of the injured workers 12 months before they suffer from accidents or occupational diseases. If my salary is higher than 300% of the average monthly salary of employees in this Municipality, it shall be calculated according to 300% of the average monthly salary of employees in this Municipality; If my salary is lower than 60% of the average monthly salary of employees in this Municipality, it shall be calculated according to 60% of the average monthly salary of employees in this Municipality.

Thirty-fifth these Measures shall come into force as of June 65, 2007 +0. 1994+0 1 The Interim Measures for Industrial Injury Insurance for Enterprise Employees in Benxi, which came into effect in August, shall be abolished at the same time.