Full text of the detailed rules for the implementation of the industrial injury insurance regulations in Fujian Province in 2020 (with compensation standards)

General rule

Article 1 These Measures are formulated in accordance with the Regulations of the State Council on Work-related Injury Insurance and the actual situation of this province.

Article 2 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 industrial injury insurance in accordance with the Regulations on Industrial Injury Insurance and these Measures, and pay industrial injury insurance premiums for all employees or employees (hereinafter referred to as employees).

Employees within the administrative region of this province shall enjoy the treatment of work-related injury insurance in accordance with the Regulations on Work-related Injury Insurance and these Measures.

Article 3 The social insurance administrative department of the local 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 established by the administrative department of social insurance (hereinafter referred to as the agency) specifically undertakes work-related injury insurance affairs.

Article 4 The financial and auditing departments shall supervise the revenue and expenditure management of the industrial injury insurance fund according to law.

Local tax authorities are responsible for collecting work-related injury insurance premiums.

Health, construction and production safety supervision and management departments shall, within the scope of their respective duties, assist the social insurance administrative departments to do a good job in work-related injury insurance.

Chapter II Industrial Injury Insurance Fund

Fifth industrial injury insurance funds in the city divided into districts to implement the city-wide overall planning and provincial adjustment system, and gradually implement provincial overall planning.

Article 6 The handling agency shall determine the unit payment rate according to the industry differential rate and intra-industry rate grade stipulated by the state, and according to the use of work-related injury insurance premiums and the incidence of work-related injuries by the employer.

The amount of work-related injury insurance premium paid by the employer is the product of the total wages of employees multiplied by the unit payment rate.

Article 7 The rate of industrial injury insurance shall be subject to a floating system. The administrative department of social insurance in the overall planning area shall, jointly with relevant departments, formulate floating measures according to the use of work-related injury insurance premiums by employers, the incidence of work-related injuries, the degree of occupational hazards and the necessary risk reserve. And solicit the opinions of trade union organizations and representatives of employers, and report to the people's government of the overall planning area for approval before implementation.

The agency shall determine the floating grade of the employer's rate according to the floating method of the industrial injury insurance rate.

Article 8 If it is difficult for an employer to pay work-related injury insurance premiums according to the total wages, the specific collection method of work-related injury insurance premiums shall be implemented in accordance with the relevant provisions of the state and this province.

Article 9 The employing unit shall pay the work-related injury insurance premium in accordance with the regulations, and submit the personnel list and the detailed list of personnel increase and decrease to the agency in time.

The effective date of insurance is the day after the employer submits the personnel information table and personnel change list.

Article 10 The industrial injury insurance fund shall be used for the payment of industrial injury insurance benefits, labor ability appraisal, publicity and training of industrial injury prevention and other industrial injury insurance expenses as stipulated in the Regulations on Industrial Injury Insurance and these Measures.

The provincial social insurance administrative department shall, jointly with the provincial finance, health and safety production supervision and management departments, formulate specific implementation rules for our province according to the proportion, use and management measures of work-related injury prevention expenses stipulated by the state.

The management service funds required by the agency and the funds for the investigation and verification of work-related injury identification by the social insurance administrative department shall be included in the financial budget of the overall planning area (including the provincial level) according to the actual work needs.

To guide the province to carry out the publicity and training expenses required for prevention, and make overall arrangements from the provincial financial budget to the special business funds of industrial injury insurance of the provincial social insurance administrative department every year.

Industrial injury insurance funds are all included in the financial accounts of social security funds, and two lines of revenue and expenditure management are implemented.

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.

Eleventh overall planning areas to implement the system of industrial injury insurance reserve. When collecting work-related injury insurance premiums as a whole, the reserve fund shall be raised at a level of not less than one month. The balance of the industrial injury insurance fund over the years was partially incorporated into the reserve.

Reserve in the event of a major work-related injury accident or the current work-related injury insurance fund is insufficient, the agency shall apply and use it after being approved by the administrative department of social insurance and the financial department of the overall planning area.

Twelfth the establishment of provincial industrial injury insurance swap system. The city divided into districts pays the industrial injury insurance adjustment fund at 3% of the total amount of industrial injury insurance every year. Work-related injury insurance swap funds shall be managed by special financial accounts, which shall be used to pay subsidies for work-related injury insurance benefits of major work-related injuries in cities divided into districts, subsidies for income and expenditure gap of work-related injury insurance funds, and provincial-level labor ability appraisal. The use and management of provincial industrial injury insurance transfers shall be implemented in accordance with the Measures for the Administration of Provincial Industrial Injury Insurance Transfers in Fujian Province.

Need to adjust the provincial industrial injury insurance subsidies, by the districts of the city social insurance administrative department and the financial department to apply, after the approval of the provincial social insurance administrative department and the financial department allocated.

Provincial labor ability appraisal and other expenses required by the provincial social insurance administrative department to apply, the Provincial Department of Finance for approval and disbursement.

Chapter III Identification of Work-related Injury

Article 13 Where an employing unit, an employee with a work-related injury or his close relatives or a trade union organization acts as an applicant for work-related injury identification according to law, it shall file an application for work-related injury identification or deemed work-related injury identification with the social insurance administrative department of the county (city, district) entrusted by the city where the employing unit is located, and the social insurance administrative department shall accept it according to law and make a decision on work-related injury identification.

The social insurance administrative department of a city divided into districts may entrust the social insurance administrative department of a county (city, district) to undertake the specific work of work-related injury identification.

Article 14 The administrative department of social insurance shall establish a rapid working mechanism for the identification of work-related injuries. The administrative department of social insurance shall make a decision on work-related injury identification within 15 days for the application for work-related injury identification with clear facts and clear rights and obligations.

Fifteenth when applying for work-related injury identification, the applicant shall submit the application materials in accordance with the provisions of Article eighteenth of the Regulations on Work-related Injury Insurance.

Sixteenth in the process of work-related injury identification, the applicant claims that the following work-related injuries have occurred or have been identified as work-related injuries, and shall submit the corresponding certification materials:

(a) in the working hours and workplace, due to the performance of duties by violence and other accidental injuries, should be submitted to the public security department certificate or other valid proof;

(two) during the period of going out to work, if you are injured or have an accident, you should submit a certificate issued by the public security department or other valid certificates;

(3) On the way to and from work, if I am injured due to a traffic accident for which I am not primarily responsible, or an urban rail transit, passenger ferry or train accident, I shall submit an accident liability certificate issued by the public security traffic management department or a valid certificate issued by the relevant department;

(4) In case of sudden illness or death within 48 hours after being rescued, a death certificate of sudden illness or a rescue certificate issued by a medical institution shall be submitted;

(five) to safeguard national interests and public interests in emergency rescue and disaster relief activities, and to submit valid certificates to the people's governments at or above the county level or the relevant departments;

(6) If the old injuries of retired soldiers who are disabled due to war or on duty recur, they shall submit the Certificate of Disabled Revolutionary Soldiers and the confirmation of the labor ability appraisal institution on the recurrence of the old injuries.

Seventeenth social insurance administrative departments found that the accepted cases of work-related injury identification do not meet the statutory acceptance conditions, it shall decide to reject the application for work-related injury identification.

Eighteenth construction enterprises, mining enterprises and other employers contract out the project (business) or management rights to organizations or natural persons who do not have the qualification of employment subject. If employees employed by such organizations or natural persons are injured by accidents or suffer from occupational diseases at work, the employer shall be the employer in the identification of work-related injuries.

Chapter IV Appraisal of Labor Ability

Nineteenth provinces and cities divided into districts shall set up labor ability appraisal committees, and provincial labor ability appraisal committees shall formulate labor ability appraisal rules. Provincial and municipal labor ability appraisal committees conduct labor ability appraisal in accordance with national and provincial labor ability appraisal methods (rules).

Article 20 The employing unit, employees with work-related injuries or their close relatives shall submit an application for labor ability appraisal to the municipal labor ability appraisal committee with districts, and submit the work-related injury identification decision, diagnosis certificate, inspection results, medical records and other materials.

Twenty-first labor ability appraisal fees shall be paid as a whole from the industrial injury insurance fees collected in the current year.

The employer shall participate in the work-related injury insurance and not participate in the work-related injury insurance, and the labor ability appraisal fee of the injured employee shall be paid by the employer. The specific charging standards shall be formulated by the competent price department and the financial department of the provincial people's government.

Chapter V Work-related Injury Insurance Benefits

Twenty-second employers, employees or their close relatives shall submit relevant materials in accordance with the provisions when going through the formalities for payment of work-related injury insurance benefits to the agency.

The agency shall inform the required materials at one time. If the materials are complete, it shall be handled within 30 days.

Article 23 Where an employing unit or a close relative of an employee who has died at work goes through the formalities of enjoying the pension for supporting relatives, it shall submit to the agency the household registration book and resident identity card of the dependent, the certificate of close relationship issued by the public security department where the household registration is located, and the certificate of economic status of the dependent issued by the subdistrict office and the township (town) people's government.

In any of the following circumstances, the corresponding materials shall be submitted separately:

(a) the dependents are elderly and orphans, and valid certificates issued by the neighborhood offices and township (town) people's governments shall be submitted;

(two) the dependents belong to adoptive parents, adopted children or close relatives, and the household registration book can not prove it, and submit a notarial certificate;

(three) if the dependent has completely lost the ability to work, submit the appraisal conclusion of the labor ability appraisal institution.

Article 24 The employer shall not terminate or dissolve the labor (employment) relationship with a worker during the period of suspension with pay, unless the worker voluntarily proposes to terminate or dissolve the labor (employment) relationship according to law.

Article 25. The certificate issued by the hospital food allowance and medical institutions for workers with work-related injuries shall be submitted to the agency for examination and approval. The transportation and accommodation expenses required for medical treatment for workers with work-related injuries outside the overall planning area shall be paid from the work-related injury insurance fund, and the specific standards for fund payment shall be stipulated by the people's government of the overall planning area.

Twenty-sixth workers work-related disability, one of the following circumstances, the industrial injury insurance fund to pay a one-time work-related injury medical subsidies, the employer to pay a one-time disability employment subsidies:

(1) If the injured worker is identified as a level 5 or level 6 disability, I voluntarily propose to terminate or terminate the labor (employment) relationship with the employer in writing;

(2) If the employee is identified as disabled at level 7 to level 10, the labor (employment) contract expires, the employer terminates the labor (employment) relationship and does not renew the labor (employment) contract, or the injured employee himself voluntarily terminates the labor (employment) contract in writing;

(three) the employer terminates the labor (employment) relationship according to the provisions of Article 36 and Article 39 of the Labor Contract Law of People's Republic of China (PRC);

Employees who receive a one-time work-related injury medical subsidy or a one-time disability employment subsidy shall sign a written agreement with the employer and the local agency to terminate the work-related injury insurance relationship and no longer enjoy the treatment of work-related injury insurance.

Twenty-seventh five to ten levels of work-related injuries, one-time work-related injury medical subsidies and disability employment subsidies are calculated separately. The standard is calculated according to the difference between the average life expectancy of the population last published in the overall planning area and the age when the labor relationship is dissolved or terminated, and the difference between the average monthly salary of employees in the overall planning area in the previous year when the labor relationship is dissolved or terminated:

(1) One-time medical subsidy for work-related injuries: level 5, paid for 0.7 months every full year; Level 6, issued for 0.6 months every full year; Level 7, 0.4 months for each full year; Grade 8, 0.3 months for each full year; Grade 9, 0.2 months for each full year; 10, 0. 1 month, every full year. Less than one year counts as one year.

If the one-time work-related injury medical subsidy for employees with five to six levels of work-related injuries is less than 15 months, it will be paid according to 15 months; If the one-time work-related injury medical subsidy for employees with seven to eight work-related injuries is less than 10 month, it will be paid according to 10 month; If the one-time work-related injury medical subsidy for nine-level workers is less than 5 months, it will be paid in 5 months; If the one-time work-related injury medical subsidy for workers with ten-level work-related injuries is less than 3 months, it will be paid in 3 months.

For employees suffering from occupational diseases, the one-time medical subsidy for work-related injuries will be increased by 30% on the basis of the above standards.

(2) One-time disability employment subsidy: level 5, paid for 0.7 months every full year; Level 6, issued for 0.6 months every full year; Level 7, 0.4 months for each full year; Grade 8, 0.3 months for each full year; Grade 9, 0.2 months for each full year; 10, 0. 1 month, every full year. Less than one year counts as one year.

If the one-time disability employment subsidy for employees with five to six levels of work-related injuries is less than 15 months, it will be paid according to 15 months; If the one-time disability employment subsidy for employees with seven to eight levels of work-related injuries is less than 10 month, it will be paid according to 10 month; If the one-time disability employment subsidy for nine-level injured workers is less than 5 months, it will be paid in 5 months; If the one-time disability employment subsidy for ten-level injured workers is less than 3 months, it will be paid in 3 months.

For employees suffering from occupational diseases, the one-time disability employment subsidy will be increased by 30% on the basis of the above standards.

Twenty-eighth employees where the employer fails to pay work-related injury insurance premiums according to law, the employer shall pay work-related injury insurance benefits. If the employer does not pay, it shall pay in advance from the industrial injury insurance fund. The industrial injury insurance benefits paid in advance from the industrial injury insurance fund shall be repaid by the employer. If the employer fails to repay the loan within the time limit, the social insurance agency may recover the compensation according to law.

Article 29 If a work-related injury is caused by a third person, and the third person fails to pay the medical expenses for the work-related injury or cannot identify the third person, the work-related injury insurance fund shall pay in advance. After the industrial injury insurance fund is paid in advance, it shall claim compensation from the third party according to law.

Article 30 The disability allowance, the pension for dependent relatives and the living care fee shall be adjusted once a year by the administrative department of social insurance in the overall planning area according to the changes in the average salary and living expenses of employees in the overall planning area, and the opinions of the representatives of the trade unions and employers shall be solicited and reported to the people's government in the overall planning area for approval before implementation. The people's government of the overall planning area shall announce the adjustment results to the society.

Article 31 Where an employer terminates due to bankruptcy, dissolution or other reasons, it shall pay off the unpaid work-related injury insurance premiums to the social insurance premium collection agency in accordance with the law when liquidating its property.

Chapter VI Supplementary Provisions

Thirty-second institutions belonging to the financial allocation (excluding participation in public management) shall participate in work-related injury insurance in the overall planning area, and in the first year of organization and implementation, they shall pay work-related injury insurance premiums according to 0.5% of the total wages of their employees, and the required funds shall be included in the financial budget at the same level; If its staff members have accidents or occupational diseases due to work during the period of 2011from the date of promulgation of these measures, they shall enjoy the treatment of industrial injury insurance in accordance with the Regulations on Industrial Injury Insurance and these measures. Those who have participated in the overall work-related injury medical expenses or work-related injury insurance shall be paid by the work-related injury fund, and those who have not participated in the overall work-related injury medical expenses or work-related injury insurance shall be paid by the employer.

Article 33 Work-related injury insurance for civil servants, institutions managed according to the Civil Service Law and social group work personnel shall be implemented in accordance with relevant state regulations.

Article 34 These Measures shall come into force as of the date of promulgation. The Measures for Implementing the Regulations on Work-related Injury Insurance in Fujian Province (Min Zheng [2004]12) promulgated by the provincial government on April 30, 2004 shall be abolished at the same time. 20 111June1From the date of promulgation of these measures, the one-time medical subsidy for work-related injuries that should be paid by the work-related injury insurance fund and the one-time disability employment subsidy that should be paid by the employer shall be implemented with reference to these measures.