Recently, the People's Government of Hubei Province promulgated the newly revised Measures for the Implementation of Industrial Injury Insurance in Hubei Province (hereinafter referred to as the "new measures"). Compared with the 2003 Measures for the Implementation of Industrial Injury Insurance in Hubei Province (hereinafter referred to as the original measures), the new measures have changed greatly in the scope of application, identification of industrial injuries and treatment standards. Explain the key terms as follows:
1. Scope of application: bring institutions into industrial injury insurance.
One of the highlights of Jiang Triangle's interpretation of the new "Measures" is to incorporate public institutions into the current industrial injury insurance system, expand the coverage of industrial injury insurance, and cancel the "dual track system" between public institutions and enterprises in the field of industrial injury insurance.
Related terms:
Article 2 Scope of Application Enterprises, institutions, social organizations, private non-enterprise units, foundations, law firms, accounting firms and other organizations within the administrative region of this province and individual industrial and commercial households with employees (hereinafter referred to as employers) shall participate in work-related injury insurance for all employees or employees (hereinafter referred to as employees) of their own units and pay work-related injury insurance premiums.
Fifty-second measures for the protection of civil servants and managers in the administrative area of this province with reference to the civil service law shall be formulated separately by the provincial people's government according to the relevant provisions of the state.
Second, the time limit for work-related injury identification: it can be extended under special circumstances.
Interpretation of 1 Different from the original "Measures" and "Draft for Comment", it is deleted that "if the application for work-related injury identification exceeds the application time limit stipulated in the Regulations, the social insurance administrative department will no longer accept it" and revised to "In case of special reasons such as force majeure, the application time limit can be extended by 60 days with the consent of the social insurance administrative department."
2. Article 7 of "Provisions of the Supreme People's Court on Several Issues Concerning the Trial of Administrative Cases of Work-related Injury Insurance" stipulates that "if the application period for work-related injury identification is exceeded due to reasons not belonging to employees or their close relatives, the delayed time shall not be included in the application period for work-related injury identification ..." Accordingly, the social insurance administrative department shall review the reasons for the overdue application and shall not refuse to accept it.
Related terms:
Article 13 During the application period, if an employee is injured by an accident or diagnosed and identified as an occupational disease according to the provisions of the Law on the Prevention and Control of Occupational Diseases, the unit to which he belongs shall, within 30 days from the date of the accident injury or the date of diagnosis and identification as an occupational disease, apply to the social insurance administrative department in the overall planning area for the identification of work-related injuries. In case of force majeure and other special reasons, with the consent of the administrative department of social insurance, the application time limit can be extended by 60 days.
If the employing unit fails to apply for work-related injury identification in accordance with the provisions of the first paragraph, the workers with work-related injuries or their close relatives and trade unions may directly apply to the social insurance administrative department of the co-ordination area where the employing unit is located within 1 year from the date of accident injury or the date of diagnosis and identification as an occupational disease.
If the employer fails to submit an application for work-related injury identification within the time limit specified in the first paragraph, the employer shall bear the relevant expenses such as the treatment of work-related injuries that meet the requirements during this period.
Three. Jurisdiction over the determination of work-related injuries in different places of employment: the place where the employer is registered or the place where it produces and operates.
interpret
1. Units participating in industrial injury insurance shall be under the jurisdiction of the insured place; Those who have not participated in work-related injury insurance shall be under the jurisdiction of the place where the unit is registered.
2. For those who have not participated in industrial injury insurance, it should be noted that the regulations in other places are different, such as the industrial injury insurance policies in Anhui, Jiangxi and Guangdong, which stipulate that this situation is under the jurisdiction of the place of business.
Related terms:
Article 15 If the place where the work-related injury is recognized is not in the same overall planning area as the place where the employer is registered and the place where the work-related injury is operated, the employer, the workers with work-related injuries or their close relatives and trade unions shall apply to the social insurance administrative department where the insured person is located for work-related injury recognition; If the employer does not participate in work-related injury insurance, it shall apply to the social insurance administrative department where the unit is registered for work-related injury identification.
Four, adjust the one-time Medicaid standard paid by the social security fund.
The original Measures and the new Measures are 5th gear 18 months, 22 months, 6th gear 16 months, 7th gear 14 months, 12 months and 8th gear 12 months. Grade 9, 10 month, 8 months, 10 grade, 8 months, 6 months.
(Note: Based on the average monthly salary of employees in the overall planning area in the previous year)
Related terms:
Article 15 If the place where the work-related injury is recognized is not in the same overall planning area as the place where the employer is registered and the place where the work-related injury is operated, the employer, the workers with work-related injuries or their close relatives and trade unions shall apply to the social insurance administrative department where the insured person is located for work-related injury recognition; If the employer does not participate in work-related injury insurance, it shall apply to the social insurance administrative department where the unit is registered for work-related injury identification.
Verb (abbreviation of verb) paid downtime: determined by the employer according to the diagnosis certificate and classification catalogue.
interpret
1. The new "Measures" deleted the original "Measures" in which "the time for stopping work with pay is proposed by the agreed medical institution according to the diagnosis conclusion, reported to the Municipal Labor Ability Appraisal Committee or its dispatched institution for confirmation, and notified to the employer and the injured employee."
2. At present, the period of shutdown with pay is determined according to the Interim Measures for the Administration of Shutdown with Pay for Workers with Injury in Hubei Province (E 'renshefa [2010] No.53), that is, it is determined by the employing unit according to the diagnosis certificate issued by designated hospitals or medical institutions and the Classified Catalogue of Workers with Injury in Hubei Province.
Related terms:
Article 27. If an employee is injured at work during the period of unpaid leave, and the injury is relatively stable after treatment, which will affect his working ability, or if his unpaid leave expires (including the extension period confirmed by the labor ability appraisal Committee), the injured employee or his unit shall promptly apply to the labor ability appraisal Committee for labor ability appraisal.
Compensation for work-related injuries caused by the third party's infringement of intransitive verbs: In addition to medical expenses, social security funds can also be required to pay work-related injury insurance benefits.
interpret
Compared with the original "Measures", the new "Measures" have made great changes in the concurrence of third party tort liability. The revised part of the new "Measures" is consistent with the "Provisions of the Supreme People's Court on Several Issues Concerning the Trial of Administrative Cases of Work-related Injury Insurance" (Fa Shi [2065438+04] No.9): In addition to medical expenses, workers still have the right to ask social insurance agencies to pay work-related injury insurance benefits.
Related terms:
Article 39 A work-related injury caused by a third party's concurrent tort liability, if the third party fails to pay the medical expenses for the work-related injury or cannot identify the third party, the work-related injury insurance fund shall pay it in advance. After the industrial injury insurance fund is paid in advance, it has the right to recover from the third party.
If an employee suffers work-related injuries due to the reasons of a third party, the injured employee or his close relatives may claim civil compensation in accordance with relevant regulations. The agency shall not refuse to pay the treatment of work-related injury insurance on the grounds that the injured employee or his close relatives bring a civil lawsuit against the third party, except for the medical expenses already paid by the third party.
Seven. Compensation for work-related injuries caused by third-party infringement: In addition to medical expenses, social security funds can also be required to pay work-related injury insurance benefits.
interpret
Compared with the original "Measures", the new "Measures" have made great changes in the concurrence of third party tort liability. The revised part of the new "Measures" is consistent with the "Provisions of the Supreme People's Court on Several Issues Concerning the Trial of Administrative Cases of Work-related Injury Insurance" (Fa Shi [2065438+04] No.9): In addition to medical expenses, workers still have the right to ask social insurance agencies to pay work-related injury insurance benefits.
Related terms:
Article 39 A work-related injury caused by a third party's concurrent tort liability, if the third party fails to pay the medical expenses for the work-related injury or cannot identify the third party, the work-related injury insurance fund shall pay it in advance. After the industrial injury insurance fund is paid in advance, it has the right to recover from the third party.
If an employee suffers work-related injuries due to the reasons of a third party, the injured employee or his close relatives may claim civil compensation in accordance with relevant regulations. The agency shall not refuse to pay the treatment of work-related injury insurance on the grounds that the injured employee or his close relatives bring a civil lawsuit against the third party, except for the medical expenses already paid by the third party.