Article 2 Enterprises, institutions, social organizations, private non-enterprise units, foundations, law firms, accounting firms and other organizations and individual industrial and commercial households with employees (hereinafter referred to as employers) shall participate in work-related injury insurance in accordance with regulations and pay work-related injury insurance premiums for all employees or employees of their own units (hereinafter referred to as employees).
The employees of the employing unit have the right to enjoy work-related injury insurance benefits in accordance with the regulations.
Civil servants, public institutions managed according to the Civil Service Law and social group work personnel who suffer from accidents or occupational diseases due to their work shall be paid by their units. The specific implementation measures shall be formulated by the provincial administrative department of human resources and social security in conjunction with the provincial financial department in accordance with state regulations.
Third provincial human resources and social security administrative departments are responsible for the work of industrial injury insurance in the province. The administrative departments of human resources and social security at or above the county level shall be responsible for the work-related injury insurance within their respective administrative areas.
The social insurance agency affiliated to the administrative department of human resources and social security (hereinafter referred to as the agency) specifically undertakes work-related injury insurance affairs.
All levels of finance, civil affairs, health, public security, transportation, construction, industry and commerce, production safety supervision and management, trade unions and other relevant departments and organizations. , shall, in accordance with their respective responsibilities, assist the administrative departments of human resources and social security to do a good job in work-related injury insurance.
Article 4 The industrial injury insurance fund shall be co-ordinated by the cities divided into districts and the whole city, and gradually by the provincial level.
Article 5 The work-related injury insurance fund shall be raised according to the principle of fixed income by expenditure and balance of payments, and deposited in the financial special account of the social security fund for special purposes. No unit or individual may use the industrial injury insurance fund for investment, operation, construction or decoration of office space, bonus payment or other purposes.
Article 6 The collection and payment of work-related injury insurance premiums shall be carried out in accordance with the relevant provisions of the Social Insurance Law and the Provisional Regulations on the Collection and Payment of Social Insurance Fees.
The employer shall pay the work-related injury insurance premium on time. Individual employees do not pay work-related injury insurance premiums.
Article 7 The initial payment rate of the employing unit shall be determined according to the industry benchmark rate.
According to the collection and payment of work-related injury insurance premiums and the occurrence of work-related injuries in the previous year, the agency in the overall planning area can adjust the employer's contribution rate within the corresponding rate level of the industry.
Article 8 For the construction, catering, commerce and other industries that have difficulties in paying work-related injury insurance premiums according to the total wages of employees, the provincial human resources and social security administrative department shall, jointly with the provincial housing and urban-rural construction, industrial and commercial administrative departments, formulate insurance payment methods that are suitable for the characteristics of the industry according to the relevant provisions of the state.
Article 9 The work-related injury insurance reserve shall be drawn according to the proportion of 10% of the overall annual work-related injury insurance fund collection amount, and the accumulated balance of the reserve shall not exceed 30% of the work-related injury insurance fund collection amount of that year. The use of industrial injury insurance reserve shall be applied by the social insurance agency in the overall planning area, and shall be audited by the administrative department of human resources and social security and the financial department at the same level and reported to the people's government at the same level for approval. Once the reserve is used, the difference should be made up in time. If the reserve fund is insufficient to pay, it shall be paid in advance by the people's government of the overall planning area.
Article 10 The industrial injury insurance fund shall be used for the following expenses:
(a) medical expenses and rehabilitation expenses for the treatment of work-related injuries;
(two) confirm the cost of installation and configuration of auxiliary devices;
(3) Hospitalization food subsidy;
(four) to co-ordinate the transportation and accommodation expenses of medical treatment and auxiliary devices outside the region;
(five) life can not take care of themselves, confirmed by the labor ability appraisal committee of life care costs;
(6) One-time disability allowance and monthly disability allowance for disabled employees of Grade I to IV;
(seven) the one-time medical subsidy that should be enjoyed when the labor contract is terminated or dissolved;
(8) Funeral grants, dependent relatives' pensions and work-related death grants received by survivors of work-related deaths;
(nine) labor ability appraisal fee;
(ten) publicity, training and other expenses for work-related injury prevention;
(eleven) other work-related injury insurance fees stipulated by laws and regulations.
The specific implementation measures for the proportion, use and management of work-related injury prevention expenses shall be formulated by the provincial administrative department of human resources and social security in conjunction with the provincial departments of finance, health and safety production supervision and management in accordance with state regulations.
The standards for food subsidies for hospitalized workers with work-related injuries, transportation, accommodation and expenses for medical treatment in different places, and the standards for the allocation of assistive devices shall be formulated by the people's government of the overall planning area.
Eleventh work-related injuries, the following expenses paid by the employer in accordance with state regulations:
(a) wages and benefits during the treatment of work-related injuries;
(two) the monthly disability allowance for disabled employees of Grade 5 and Grade 6;
(3) One-time disability employment subsidy that should be enjoyed when the labor contract is terminated or dissolved.
Twelfth employers, employees or their close relatives, trade unions to apply for work-related injury identification, in accordance with the "Regulations" provisions of Article seventeenth of the time limit to co-ordinate the regional human resources and social security administrative departments. Among them, if the employer is unable to apply within the prescribed time limit due to force majeure factors such as traffic accidents, disappearance and accidental injuries during work, the application period may be appropriately extended with the consent of the administrative department of human resources and social security in the overall planning area, but the extension time shall not exceed 30 days.
If the employer fails to file an application for work-related injury identification within the prescribed time limit, the employer shall bear the relevant expenses such as work-related injury benefits that meet the requirements of the Regulations during this period.
Article 13 If an employee is injured by a traffic accident that is not his main responsibility or an urban rail transit, passenger ferry or train accident on his way to and from work, the applicant shall submit a certificate of accident responsibility issued by the public security traffic management department or other relevant departments.
Article 14 The administrative department of human resources and social security in the overall planning area shall make a decision of acceptance or rejection within 15 days from the date of receiving the application for work-related injury identification, and notify the applicant in writing. Among them, the rejection decision shall specify the reasons and factual basis for rejection, and inform the applicant of the time and manner of applying for administrative reconsideration or bringing an administrative lawsuit.
Fifteenth administrative departments of human resources and social security shall make a decision on work-related injury identification within 60 days from the date of accepting the application for work-related injury identification. For an application for work-related injury identification with clear facts and clear rights and obligations, a decision on work-related injury identification shall be made within 15 days.
If it is necessary to make a work-related injury determination decision according to the conclusion of the judicial organ or the relevant administrative department, the time limit for making a work-related injury determination decision shall be suspended during the period when the judicial organ or the relevant administrative department has not yet made a conclusion.
Sixteenth provinces and cities divided into districts shall, in accordance with the provisions of the "Regulations", set up a labor ability appraisal committee and set up an office of the labor ability appraisal committee, and the person in charge shall be responsible for the daily work and organization and management of the labor ability appraisal committee.
Seventeenth labor ability appraisal committee shall undertake the following tasks:
(1) Appraisal of the working ability of workers with work-related injuries;
(2) Confirmation of paid downtime;
(3) Confirm the configuration of assistive devices;
(four) confirmation of the recurrence of old injuries;
(5) Identification of the causal relationship between diseases and work-related injuries;
(six) identification of dependent relatives who have completely lost their ability to work;
(seven) identification of the degree of loss of working ability of employees due to illness or non-work-related disability;
(eight) other matters of labor ability appraisal as prescribed by laws and regulations.
Eighteenth labor ability appraisal committee shall establish a medical and health expert database. Medical and health professional and technical personnel included in the expert database are selected by the labor ability appraisal Committee. The medical and health expert database is adjusted once a year in principle.
Nineteenth labor ability appraisal fees shall be formulated by the provincial administrative department of human resources and social security in conjunction with the provincial finance and price departments.
Twentieth workers believe that there is a causal relationship between illness and work-related injuries, they can apply for confirmation when applying for labor ability appraisal.
Article 21 If an employee suffers from an accident or occupational disease at work and needs to be suspended from work to receive work-related injury medical treatment, the original salary and welfare benefits will remain unchanged during the paid suspension, and the unit where he works will pay him monthly.
During the paid shutdown period, the employer shall not terminate or terminate the labor relationship with the employees who have suffered work-related injuries, except under the circumstances prescribed by law.
Twenty-second employees who are disabled due to work are identified as one to four levels of disability, retain labor relations, quit their jobs, and enjoy disability allowance according to the level of disability. If the actual amount of disability allowance is lower than the local minimum wage, the industrial injury insurance fund will make up the difference.
Workers with work-related injuries who reach retirement age and go through retirement formalities will stop receiving disability allowance and enjoy basic old-age insurance benefits in accordance with relevant state regulations. If the basic old-age insurance benefits are lower than the disability allowance, the industrial injury insurance fund will make up the difference.
Article 23 Measures for adjusting the disability allowance, dependent relatives' pension and living nursing expenses of the first-class to fourth-class injured workers shall be formulated in a timely manner by the administrative department of human resources and social security of the province in conjunction with the financial department according to the changes in the average wage and living expenses of workers in the province.
Article 24 If an employee is identified as level 5 or level 6 disability due to work-related disability, and it is difficult for the employer to arrange work, during the period of receiving the disability allowance on a monthly basis, if the disability allowance for employees with work-related injuries is adjusted from level 1 to level 4, the disability allowance will be adjusted according to the adjustment time of the disability allowance for employees with work-related injuries from level 1 to level 4, and the specific standards will be increased accordingly according to 90% and 80% of the adjustment standards for the disability allowance for employees with work-related injuries at level 4 in the overall planning area. If the actual amount of disability allowance is lower than the local minimum wage, the employer shall make up the difference.
Article 25 If an injured worker is identified as a level 5 or level 6 disability, he/she may propose to dissolve or terminate the labor contract with the employing unit, and when dissolving or terminating the labor contract, he/she shall pay a one-time medical subsidy for work-related injuries for 22 months, 18 months and a one-time disability employment subsidy for 36 months and 30 months respectively according to the average monthly salary of employees in the last year in the overall planning area.
Workers with work-related injuries are identified as seven to ten levels of disability, and the labor contract expires, or the employees themselves propose to terminate the labor contract. Based on the average monthly salary of employees in the previous year when the labor contract is dissolved or terminated, the one-time work-related injury medical subsidy and one-time disability employment subsidy are paid. The specific standards of one-time medical subsidy for work-related injuries are: level 7 13 months, level 8 10 months, level 9 7 months and level 10 4 months; The specific criteria of the one-time employment subsidy for the disabled are: 20 months for grade 7, 0/6 months for grade 8/kloc, 0/2 months for grade 9/kloc and 8 months for grade 10.
If the employee is diagnosed as an occupational disease, the one-time medical subsidy for work-related injury will be increased by 50% on the basis of the above standards.
When the employee with work-related injury terminates or terminates the labor contract with the employer, if it is more than 5 years away from the statutory retirement age, the one-time work-related injury medical subsidy and one-time disability employment subsidy will be paid in full; If it is less than 5 years away from the statutory retirement age, the one-time disability employment subsidy will be reduced by 20% every year. If it is less than 1 year from the statutory retirement age, it will be paid at 10% of the total amount of one-time disability employment subsidy; Those who have reached the statutory retirement age or gone through retirement formalities according to regulations will not be granted one-time medical subsidies for work-related injuries and one-time employment subsidies for the disabled.
One-time work-related injury Medicaid and one-time disability employment subsidy funds, where the employer has participated in work-related injury insurance, the one-time work-related injury Medicaid shall be paid by the work-related injury insurance fund, and the one-time disability employment subsidy shall be paid by the employer; Did not participate in work-related injury insurance, one-time work-related injury medical subsidies and one-time disability employment subsidies, paid by the employer.
Article 26 The employing unit shall, at the time of termination or rescission of the labor contract or before going through the formalities of retirement or resignation, conduct occupational health examination on the employees exposed to occupational hazards, and inform the employees of the examination results. Those who are diagnosed with occupational diseases shall go through the procedures of work-related injury identification, labor ability appraisal and treatment verification, and enjoy work-related injury insurance benefits according to regulations.
Workers who are diagnosed with occupational diseases after retirement and resignation can enjoy medical treatment for work-related injuries in accordance with regulations. Life can not take care of themselves, according to the degree of nursing dependence confirmed by the labor ability appraisal Committee, pay the living nursing fee.
Twenty-seventh to apply for work-related injury insurance benefits, it shall submit the work-related injury identification decision, the conclusion of labor ability appraisal and the declaration form of work-related injury insurance benefits to the overall regional agency.
Article 28 If an employee dies at work, the qualification of his dependent relatives to enjoy pension benefits shall be verified according to the conditions when the employee dies at work.
Twenty-ninth employees of the employer who should participate in work-related injury insurance but did not participate in the work-related injury identification shall be paid by the employer in accordance with the work-related injury insurance treatment items and standards stipulated in the Regulations and these Measures. After the employer participates in work-related injury insurance and pays the work-related injury insurance premium and overdue fine that should be paid, the work-related injury insurance fund and the employer shall pay new fees in accordance with the provisions of the Regulations and these Measures.
If the employer fails to pay the industrial injury insurance premium in full and on time, the treatment of industrial injury insurance during the unpaid period shall be paid by the employer. After paying the work-related injury insurance premium and the overdue fine, the newly-increased work-related injury insurance premium shall be paid by the work-related injury insurance fund and the employing unit in accordance with the provisions of the Regulations and these Measures.
Thirtieth bankruptcy, closure, dissolution and revocation of enterprises identified as first-class to fourth-class work-related injuries and work-related deaths of employees to support relatives to enjoy the work-related injury insurance benefits continue to be paid according to the original standard. The required funds, the original enterprise has participated in work-related injury insurance, paid from the work-related injury insurance fund; Those who are not insured shall be reserved to the local average life expectancy (among them, if the dependent relatives of the workers who died at work are under 18 years old, they shall be reserved to 18 years old), and shall be paid to the agency in one lump sum at the time of asset liquidation.
Were identified as five to ten, according to the provisions of the payment of a one-time work-related injury medical subsidies and one-time disability employment subsidies. The required funds, the original enterprise has participated in work-related injury insurance, its one-time work-related injury medical subsidy is paid from the work-related injury insurance fund, and its one-time disability employment subsidy is allocated in one lump sum at the time of asset liquidation; Without insurance, the one-time medical subsidy for work-related injuries and one-time disability employment subsidy will be paid in one lump sum at the time of asset liquidation.
For the dependent relatives of bankrupt, closed, dissolved or revoked employees and those who died at work, all localities may refer to the first and second paragraphs of this article and the relevant provisions on solving the problem of old work-related injuries to raise funds to ensure their work-related injury treatment.
Article 31 These Measures shall come into force as of July 201year, and the Trial Measures for the Implementation of the Regulations on Work-related Injury Insurance in Shandong Province (Lu Fa [2003]107) shall be abolished at the same time.