Decree No.21 of Hebei Provincial People's Government [2165438]
Measures for the Implementation of Work-related Injury Insurance in Hebei Province was adopted at the 99th executive meeting of the provincial government on February 28, 211, and is hereby promulgated and shall come into force as of March 28, 212.
Acting Governor Zhang
December 31, 211
Measures for the Implementation of Industrial Injury Insurance in Hebei Province
Chapter I General Principles
First
In order to ensure that employees who suffer from accidents or occupational diseases at work get medical treatment and economic compensation, and promote industrial injury prevention and vocational rehabilitation, according to the Social Insurance Law of People's Republic of China (PRC) and the Regulations on Industrial Injury Insurance of the State Council (hereinafter referred to as "Regulations on Industrial Injury Insurance"),
second
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) within the administrative area of this province shall participate in industrial injury insurance in accordance with the provisions of the Regulations and these Measures.
the employer shall pay work-related injury insurance premiums for all employees or workers (hereinafter referred to as workers), and their workers have the right to enjoy work-related injury insurance benefits in accordance with the regulations and these measures.
article 3 the social insurance administrative department of the people's government at or above the county level shall be responsible for the work-related injury insurance within its administrative area.
the social insurance agency (hereinafter referred to as the agency) established by the social insurance administrative department according to the relevant regulations of the State Council and the provincial government specifically undertakes the work-related injury insurance affairs.
Article 4 The provincial social insurance administrative department shall solicit the opinions of trade union organizations and representatives of employers when formulating policies and relevant standards for industrial injury insurance.
article 5 the employing unit shall establish a responsibility system for production safety and occupational disease prevention, and take measures to prevent the occurrence of industrial accidents and avoid and reduce occupational hazards.
chapter ii industrial injury insurance fund
article 6 the industrial injury insurance fund shall be co-ordinated by the whole province. Specific measures shall be formulated by the provincial social insurance administrative department in conjunction with the provincial finance department, and implemented after being approved by the provincial people's government.
article 7
the rate of work-related injury insurance premium that the employer should pay shall be determined by the agency of the provincial social insurance administrative department (hereinafter referred to as the provincial agency) according to the corresponding rate grade of the industry to which the employer belongs, the use of work-related injury insurance premium by the employer, the incidence of work-related injury and other factors.
article 8
the employer shall declare and pay work-related injury insurance premiums based on the total wages of all employees in the previous year. Industries that fail to declare and pay work-related injury insurance premiums according to the total wages of all employees in the previous year shall be handled in accordance with the relevant provisions of the state and this province.
if the number of employees participating in work-related injury insurance changes, the employer shall report the changed employee list and related information to the agency within 5 days.
article 9
the employer shall report the amount of work-related injury insurance premium payable to the agency on a monthly basis, and the agency shall immediately review it. If the audit cannot be conducted immediately due to special circumstances, the audit shall be completed within 3 days from the date of receiving the payment declaration materials. The employer shall pay the industrial injury insurance premium in full in cash within 5 days after the audit by the agency.
if the employer fails to declare the amount of work-related injury insurance premiums that should be paid according to the regulations, the agency will temporarily determine the amount that should be paid according to 11% of the amount paid by the unit last month; If there is no payment amount last month, the agency shall temporarily determine the amount of payment according to the operation of the unit and the number of employees. After the employer completes the declaration procedures and pays the work-related injury insurance premium according to the approved amount, the agency shall settle the account according to the regulations.
article 1 work-related injury insurance premiums shall be collected by the agency in accordance with the relevant provisions of the state and this province.
when collecting work-related injury insurance premiums, the agency shall issue a charging voucher uniformly printed by the provincial finance department.
Article 11 The industrial injury insurance fund shall be used for the following items:
(1) Medical expenses and rehabilitation expenses for treating industrial injuries;
(2) food allowance for hospitalization;
(3) transportation and accommodation expenses required on the way to areas outside the city with districts;
(4) the cost of installing and configuring assistive devices for the disabled;
(5) the living nursing expenses of the injured workers who can't take care of themselves as confirmed by the labor ability appraisal committee;
(6) One-time disability allowance and monthly disability allowance for disabled employees of Grade I to IV;
(7) One-time medical subsidy for work-related injuries that should be enjoyed when the labor and employment contracts are terminated or dissolved;
(8) Funeral allowance, dependent relatives' pension and one-time work-related death allowance received by the survivors of employees who died at work;
(9) industrial injury prevention fee;
(1) Investigation fee for work-related injury identification;
(11) labor ability appraisal fee;
(12) Other items paid by the industrial injury insurance fund as stipulated by laws, regulations and rules.
the expenditure of the investigation fee for work-related injury identification shall be proposed by the provincial social insurance administrative department jointly with the provincial finance department, and implemented after being submitted to the provincial people's government for approval.
the extraction ratio, use and management of work-related injury prevention fees shall be implemented in accordance with the relevant regulations formulated by the national and provincial social insurance administrative departments in conjunction with the provincial finance, health and safety production supervision and management departments.
Article 12
Provincial agencies should set aside 1% of the total industrial injury insurance premiums collected by the whole province in that year as industrial injury insurance reserves before the end of the year to pay industrial injury insurance benefits for major accidents. The industrial injury insurance reserve can be carried forward year by year, but the total amount shall not exceed 3% of the total industrial injury insurance fund.
the use of industrial injury insurance reserves must be approved by the provincial people's government.
Chapter III Identification of Work-related Injuries
Article 13
The employing unit shall, within 3 days from the date when an employee is injured by an accident or diagnosed and identified as an occupational disease according to the Law of People's Republic of China (PRC) on the Prevention and Control of Occupational Diseases, apply to the social insurance administrative department of the city divided into districts or the social insurance administrative department of the county (city, district) entrusted by it. Due to traffic accidents, disappearance, accidental injuries caused by business trips, etc., it is temporarily impossible to apply for work-related injury identification within the prescribed time limit. With the consent of the municipal social insurance administrative department with districts, the application time limit may be appropriately extended, but the extension time shall not exceed 3 months.
if the employer fails to apply for work-related injury identification in accordance with the provisions of the preceding paragraph, employees or their close relatives or trade unions may directly apply for work-related injury identification to the social insurance administrative department of the city divided into districts where the employer is located or the social insurance administrative department of the county (city, district) entrusted by it within one year from the date of accident injury or occupational disease diagnosis and identification.
if there is a dispute between the employee and the employer due to labor and personnel relations, the time for handling the dispute according to legal procedures is not included in the application time limit for work-related injury identification.
Article 14 The following materials shall be submitted when applying for work-related injury identification:
(1) An application form for work-related injury identification;
(2) a copy of the labor and employment contract or other materials that prove the existence of labor and personnel relations (including factual labor and personnel relations) between employees and employers;
(3) industrial injury diagnosis certificate issued by medical institution, occupational disease diagnosis certificate issued by occupational disease diagnosis institution or occupational disease diagnosis and appraisal certificate issued by appraisal institution.
under any of the following circumstances, relevant certification materials shall be submitted separately after the social insurance administrative department accepts the application for work-related injury identification, and the time required to obtain the certification materials shall not be included in the time limit for work-related injury identification:
(1) If violence is committed due to the performance of duties, relevant certificates of public security organs, rulings of people's courts or other valid certificates shall be submitted;
(2) Where an application for work-related injury identification is filed due to a traffic accident or an urban rail transit, passenger ferry or train accident, relevant legal documents issued by the traffic management, transportation, railway and other departments of the public security organ or the judicial organ and organizations authorized by laws and administrative regulations shall be submitted;
(3) if you are injured due to work during the period of going out to work, submit the certificate of the public security organ or other certificates; If the whereabouts of the accident is unknown, it is determined that the person died at work, and a certificate of death declared by the people's court shall be submitted;
(4) If he dies within 48 hours due to sudden illness or ineffective rescue during working hours and post, he shall submit the rescue and death certificate of the medical institution;
(5) safeguarding national interests and public interests in activities such as emergency rescue and disaster relief, and submitting valid certificates;
(6) If disabled soldiers, who was disabled due to war or work, relapsed after going to the employer, he shall submit the disabled soldiers Certificate, the certificate issued by the local civil affairs department and the diagnosis certificate of the recurrence of the old injury in the medical institution;
(7) in other special circumstances, relevant certification materials shall be provided according to the provisions of relevant laws, regulations and rules.
Article 15
After receiving the application for ascertainment of a work-related injury, the social insurance administrative department shall immediately review the materials submitted by the employer, employees or their close relatives and trade unions (hereinafter referred to as the applicant). If the materials are complete, a decision on acceptance or rejection shall be made immediately within 15 days at the latest. If the materials are incomplete, it shall inform all the materials that need to be corrected in writing at one time, and make a decision on acceptance or rejection within 15 days after receiving the corrected materials at the latest.
if the social insurance administrative department decides to accept the application for work-related injury identification, it shall issue a "Decision on Acceptance of Work-related Injury Identification Application" to the applicant. If it decides not to accept the application, it shall issue a "Decision on Not Accepting the Application for Work-related Injury Identification" to the applicant.
Article 16
When the social insurance administrative department accepts an application for work-related injury identification submitted by employees or their close relatives or trade unions, if the employer needs to submit relevant materials, it shall notify the employer, and the employer shall submit it within 15 days. If the employer fails to submit it on time, the social insurance administrative department may make a work-related injury determination according to the materials provided by the employees or their close relatives or trade unions.
Article 17 If the social insurance administrative department needs to investigate and verify the relevant information after accepting the application for work-related injury identification, it shall assign two or more staff members to investigate and verify it.
Article 18
The administrative department of social insurance shall make a work-related injury determination decision within 6 days from the date of accepting the application for work-related injury determination, and within 2 days from the date of making the work-related injury determination decision, send the work-related injury determination decision or not to make the work-related injury determination decision to the employees or their close relatives and the employer, and send a copy to the agency.
the administrative department of social insurance shall issue a work-related injury certificate for employees who are identified as work-related injuries or regarded as work-related injuries. The work-related injury certificate shall be kept by the employee himself.
Article 19 The work-related injury insurance premium collected by the provincial agency shall be handled by the provincial social insurance administrative department.
chapter iv labor ability appraisal
article 2 provinces and cities divided into districts shall set up labor ability appraisal committees in accordance with the relevant provisions of the regulations, specifically to undertake the following work ability appraisal and confirmation and related matters (hereinafter referred to as labor ability appraisal):
(1) determination of disability grade;
(2) evaluation of nursing dependence grade;
(3) confirmation of work-related death during shutdown with pay, deferred shutdown with pay and shutdown with pay;
(4) Confirmation of the installation and configuration of assistive devices for the disabled;
(5) confirmation that work-related injuries directly lead to diseases;
(6) confirmation of work-related injury recurrence;
(7) Confirm the possibility of rehabilitation;
(8) Identification of dependent relatives who have completely lost their ability to work;
(9) other labor ability appraisal work as stipulated by the state and this province.
the office of the labor ability appraisal Committee is located in the social insurance administrative department at the same level, and is specifically responsible for the daily work of the labor ability appraisal Committee and the organization of labor ability appraisal.
Article 21
If an employee is injured by an accident or is diagnosed or identified as an occupational disease according to the Law of People's Republic of China (PRC) on the Prevention and Control of Occupational Diseases, and receives treatment during the period of suspension with pay, he shall apply for labor ability appraisal within 6 days from the expiration of the period of suspension with pay.
Article 22
The employer, the injured employee or their close relatives shall apply to the municipal labor ability appraisal committee with districts (the provincial agency shall apply to the provincial labor ability appraisal committee if it collects work-related injury insurance premium), and submit the following materials:
(1) Application Form for Labor Ability Appraisal;
(2) determination of work-related injuries;
(3) Medical information such as medical records, diagnosis certificates and checklists issued by medical institutions.
if an injured worker directly causes other diseases due to work-related injuries, he shall apply for confirmation when applying for labor ability appraisal, and submit the certificates of relevant medical institutions.
article 23
if the employing units and workers injured at work or their close relatives who apply for labor ability appraisal are dissatisfied with the appraisal conclusion, they shall, within 15 days from the date of receiving the appraisal conclusion, submit an application for re-appraisal to the provincial labor ability appraisal Committee and submit the initial appraisal conclusion.
The labor ability appraisal committee that made the preliminary appraisal shall hand over the relevant materials to the provincial labor ability appraisal committee.
article 24 the labor ability appraisal Committee shall make an appraisal conclusion within 6 days from the date of receiving the appraisal application materials.
if the injury of an employee at work is complicated or the treatment involves multiple medical and health professions, the appraisal period may be appropriately extended, but the extension time shall not exceed 3 days.
Article 25
One year after the conclusion of labor ability appraisal is made, if the injured worker or his close relatives, the employing unit or the agency think that the disability of the injured worker has changed, they may apply to the local municipal or provincial labor ability appraisal committee for re-appraisal. If the disability level changes after the review, the regular treatment in the treatment of work-related injuries shall be adjusted in accordance with the relevant provisions of this province.
Article 26
If the employer pays the work-related injury insurance premium according to law, the expenses required for the initial labor ability appraisal shall be paid by the work-related injury insurance fund; If the employer fails to pay the work-related injury insurance premium according to law, it shall be paid by the employer. If the employer fails to pay the work-related injury insurance premium and the initial labor ability appraisal fee, it shall be paid in advance by the work-related injury insurance fund. If the applicant applies for re-appraisal or re-appraisal, it shall pay the appraisal fee in advance. If the conclusion of re-appraisal or re-appraisal is consistent with the original appraisal conclusion, the appraisal fee shall be borne by the applicant; If the re-appraisal or review conclusion is inconsistent with the original appraisal conclusion, the appraisal fee shall be paid by the industrial injury insurance fund.
Chapter V Treatment of Work-related Injury Insurance
Article 27 If an injured worker needs to stop work for treatment, the original salary and welfare benefits will remain unchanged during the period of suspension with pay, and the unit will pay him monthly.
paid downtime is generally not more than 12 months. Workers injured at work are seriously injured or have special circumstances. Confirmed by the municipal or provincial labor ability appraisal committee with districts, the period of shutdown with pay may be appropriately extended, but the extension time shall not exceed 12 months. Workers with work-related injuries stop their original treatment and enjoy disability treatment in accordance with the Regulations and these Measures. 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.
during the paid shutdown period, the employer shall not terminate or dissolve the labor and personnel relationship with the employees who are injured at work. Workers with work-related injuries can't take care of themselves during the paid shutdown period, and the employer shall assign special personnel to take care of them. With the consent of the injured workers or their close relatives, the employer may also pay the nursing fee according to the average monthly salary of one worker in the previous year.
article 28 the work-related injury and food subsidies for hospitalized workers with work-related injuries, as well as the transportation and accommodation expenses for medical treatment outside the city divided into districts, which are certified by medical institutions and reported to the agency for approval, shall be paid by the work-related injury insurance fund.
the payment standards for food subsidies, transportation expenses and accommodation expenses specified in the preceding paragraph shall be formulated by the provincial social insurance administrative department in conjunction with the provincial finance department and implemented after being submitted to the provincial people's government for approval.
Article 29 The medical expenses of employees with work-related injuries shall be paid by the employer first.