Regulation on Work-Related Injury Insurance (2010 Revision)

Regulation on Work-Related Injury Insurance (2010 Revision) Regulation on Work-Related Injury Insurance (Promulgated by Order No.375 of the State Council of the People's Republic of China on April 27, 2003, amended according to the Decision of the State Council on Amending the Regulation on Work-Related Injury Insurance on December 20, 2010) Chapter I General Provisions Article 1 This Regulation is formulated to guaranteeing the employees who are injured from accidents arising from work or who suffer from occupational diseases to obtain medical care and economic compensation, promoting the prevention and occupational recovery from work-related injuries, and dispersing the work-related injury risks of employers. Article 2 Enterprises, public institutions, social organizations, private non-enterprise entities, foundations, law firms, accounting firms, and other organizations as well as individual industrial and commercial households hiring laborers (hereinafter referred to as “employers”) within the territory of the People's Republic of China shall, in accordance with this Regulation, purchase work-related injury insurance, paying work-related injury insurance premiums for all their employees or hired laborers (hereinafter referred to as “employees”). Employees of enterprises, public institutions, social organizations, private non-enterprise entities, foundations, law firms, and other organizations as well as laborers hired by individual industrial and commercial households within the territory of the People's Republic of China shall have the right to enjoy the work-related injury insurance benefits in accordance with this Regulation. Article 3 The work-related injury insurance premiums shall be collected and paid in accordance with the provisions in the “ Interim Regulation on the Collection and Payment of Social Insurance Premiums ” regarding the collection and payment of basic pension insurance premiums, basic medical insurance premiums, and unemployment insurance premiums. Article 4 The employers shall announce the relevant information on buying work-related injury insurance within the scope of the entity. The employers and the employees shall abide by the relevant laws and regulations on safe production and prevention and treatment of occupational diseases, implement the rules and standards on safety and health care, prevent work-related injury accidents, avoid and reduce harms from occupational diseases. When an employees from a work-related injury, the employers shall take measure to have the injured employee cured in time. Article 5 The social insurance administrative department under the State Council shall be responsible for the work of nationwide work-related injury insurances. The social insurance administrative department of each local people's government at or above the county level shall be responsible for the work of work-related injury insurance within its own jurisdiction. The social insurance handling institutions (hereinafter referred to as handling institutions) established by the social insurance administrative department under the State Council in accordance with the relevant provisions shall specifically undertake the affairs in respect of work-related injury insurances. Article 6 the social insurance administrative department and other departments shall, if formulating policies or standards concerning work-related injury insurances, solicit opinions from the representatives of the trade union organizations and employers. Chapter II Work-Related Injury Insurance Fund Article 7 The work-related injury insurance fund shall be composed of the work-related injury insurance premiums paid by the employers, the interest on the work-related injury insurance fund and other funds legally included in the work-related injury insurance fund. Article 8 The rate of the work-related injury insurance premiums shall be determined in compliance with the principles of basing collection on expenditure and balancing the income and expenditure. The state shall determine differential premium rates for different industries in light of their respective likelihood of work-related injuries, and set forth a number of different premium rates for each industry in light of the use of the work-related injury insurance premiums, occurrence rate of work-related injuries, etc. The differential premium rates for different industries and the different premium rates within each industry shall be decided by the social insurance administrative department under the State Council, and be subject to the approval of the State Council before promulgation and implementation. The handling institution in a region subject to overall planning shall, in light of the information on the employers' use of work-related injury insurance premiums and the occurrence rate of work-related injuries, etc., apply the corresponding grade of premium rate for the industry to determine the premium rate of the employers. Article 9 The social insurance administrative department under the State Council shall have regular knowledge of the revenue and expenditures of the work-related injury insurance funds in all overall planning areas throughout the country, and shall put forward a timely plan for adjustment of the differential premium rates for different industries and the different premium rates within each industry, which shall be subject to the approval of the State Council before promulgation and implementation. Article 10 The employers shall pay work-related injury insurance premiums on time, and individual employees do not have to pay the work-related injury insurance premiums. The amount of work-related injury insurance premiums paid by the employers shall be the product of multiplying the total amount of wages of the employees in the employers by the premiums rate of the employers. For any industry which has difficulty in paying work-related injury insurance premiums on the basis of the total wages, the specific methods for paying work-related injury insurance premiums shall be prescribed by the social insurance administrative department under the State Council. Article 11 Work-related injury insurance funds shall be gradually managed under provincial overall planning. For trans-regional industries and industries with large production mobility, the employers may buy work-related injury insurances in region subject to overall planning by a relatively concentrative means. The specific measures shall be formulated by the social insurance administrative department under the State Council jointly with the competent departments of the relevant industries. Article 12 Work-related injury insurance funds shall be deposited into a designated financial account of social security fund, and shall be used to pay work-related injury insurance benefits, work ability appraisal fees, fees for publicity and training with respect to work-related injury prevention and other fees as prescribed in this Regulation, as well as other expenses used for work-related injury insurance as prescribed in laws and regulations. The social insurance administrative department under the State Council shall, jointly with the departments of public finance, health administration, production safety supervision and administration, etc. under the State Council, formulate specific measures for the drawing ratio, use and administration of work-related injury prevention fees. No entity or individual may use work-related injury insurance funds to make investment operations, build or rebuild office places, or grant bonuses, or misappropriate such funds for other purposes. Article 13 A certain proportion of reserve among the work-related injury insurance fund shall be remained for the paying of the treatment of work-related injury insurances on major accidents in the regions subject to overall planning; if the reserve is not enough to pay the said treatment, the people's government of the region subject to overall planning shall pay the remaining sum. The specific proportion of the reserve among the total amount of the fund and the measures on using the reserve shall be provided for by the people's government of the province, autonomous region, or municipality directly under the Central Government. Chapter III Determination of Work-Related Injuries Article 14 A employees shall be ascertained to have suffered from work-related injury if: 1.he is injured from an accident within the working hours and the working place due to his work; 2.he is injured from an accident within the working place before or after the working hours for doing preparatory or finishing work related to his job; 3.he suffers from violence or other unexpected injury within the working hours and working place due to implementation of his duties; 4.he suffers from an occupational disease; 5.his whereabouts are unknown due to his injury or accident during his trip for performing his duties; 6.he is injured in traffic accident for which he is not principally responsible or in an urban rail transit, passenger ferry or train accident on his way to or back from work; 7.other circumstances provided for in laws and administrative regulations under which work-related injuries shall be ascertained. Article 15 An employee shall be regarded to have suffered from the work-related injury if: 1.during the working hours and on the post, he dies from a sudden disease or dies within 48 hours due to ineffective rescue; 2.he is injured when dealing with an emergency or providing disaster relief or in other activity for maintaining the state benefits or public benefits; or 3.he served in the army and became disabled due to war or duties, and has obtained the certificate of revolutionary disabled armyman, but recrudesces from the past injury after working in the employing entity. Where an employee is under the circumstance in Item (a) or (b) of the preceding paragraph, he may enjoy the treatment of work-related injury insurances in accordance with the relevant provisions of the present regulation; where an employee is under the circumstance in Item (c) of the preceding paragraph, he may enjoy the treatment of work-related injury insurances other than the lump-sum disability subsidy in accordance with the relevant provisions in the present regulation. Article 16 An employee who conforms to the provisions of Article 14 or Article 15 of this Regulation shall neither be determined nor be regarded to have suffered a work-related injury if: 1. He intentionally commits a crime; 2. He is under the influence of alcohol or drugs; or 3. He injures himself or commits suicide. Article 17 where an employee is injured from an accident or is diagnosed or assessed in accordance with the Law on Prevention and Treatment of Occupational Diseases to have an occupational disease, the employers shall, within 30 days as of the day when the accident injury is occurred or when he is diagnosed or assessed to have contracted the occupational disease, file an application for ascertainment of the work-related injury to the social insurance administrative department in the region subject to overall planning. Under special circumstances, the time limit for application may be properly extended, subject to the approval of the social insurance administrative department. Where an employers fails to file an application for ascertainment of a work-related injury in accordance with the preceding paragraph, the worker who suffered from the injury or his close relative, or the trade union organization may, within one year as of the day when the accident injury is occurred or when the employee is diagnosed or assessed to have the occupational disease, directly file the application for ascertainment of the work-related injury to the social insurance administrative department of the region subject to overall planning where the employers is located. The matter for which the work-related injuries shall be ascertained by the social insurance administrative department at the provincial level as provided for in Paragraph 1 of the present article, shall be handled by the social insurance administrative department at the level of city divided into districts at the locality of the employers in compliance with the principle of territory. Where an employers fails to file an application for ascertainment of a work-related injury within the time limit provided for in Paragraph 1 of the present article, the expenses for the treatment of the injury, etc. during this period, which conform to the present regulation, shall be borne by the employers. Article 18 Whoever files an application for ascertainment of a work-related injury shall submit the following documents: 1. the application form for ascertainment of the work-related injury; 2. the documents proving the existence of the labor relation (including de facto labor relation) with the employers; and 3.the certificate of medical diagnosis or the certificate of diagnosis of the occupational disease (or the assessment report on diagnosis of the occupational disease). The application form for ascertainment of a work-related injury shall include such basic information as the time, place, reason of the accident, and extent of the employee's injury, etc.. Where the applicant for ascertainment of a work-related injury fails to provide complete documents, the social insurance administrative department shall notify the application in writing in one time of all the documents needed to be supplemented for the ascertainment of the work-related injury. The social insurance administrative department shall accept the application after the applicant has supplemented the documents as required by the written notification. Article 19 The social insurance administrative department may, after accepting an application for ascertainment of a work-related injury, investigate and verify the accident injury upon the needs in examination, while the employers, the employees, the trade union organization, the medical treatment institution and other relevant departments shall provide assistance. The occupational disease shall be diagnosed and the diagnosis dispute shall be assessed in accordance with the relevant provisions in the Law on Prevention and Treatment of Occupational Diseases . With respect to the certificate of diagnosis of the occupational disease or the assessment report on diagnosis of the occupational disease which is obtained in accordance with the law, the social insurance administrative department for labor security shall no longer investigate or verify it. Where an employee or his relative believes that an injury is work-related, while the employer does not believe so, the latter shall bear the burden of proof. Article 20 The social insurance administrative department shall, within 60 days upon acceptance of an application for determination of a work-related injury, make a decision on determination of the work-related injury and notify the em......