How to reimburse social security industrial injury insurance?

Social security work-related injury insurance needs to follow the steps of seeking medical treatment, applying for work-related injury identification, applying for labor ability appraisal and applying for work-related injury insurance benefits. When putting forward the work-related injury identification, it is necessary to submit the application form for work-related injury identification, the existence of labor relations with the employer and other supporting materials.

First, how to reimburse social security work-related injury insurance?

When a work-related injury occurs, the work-related injury reimbursement can be made according to the following steps:

1, see a doctor

The medical treatment of work-related injuries should follow the social security regulations. Generally, only designated medical institutions can reimburse. In case of emergency, you can go to the nearest medical institution. Feel free to go to some private hospitals or non-designated hospitals, and industrial injury insurance will not matter.

For some occupational diseases or suspected occupational diseases, employers need to send employees to medical institutions established by provincial health administrative departments for diagnosis. Because of medical conditions need to be transferred to other cities for medical treatment, it needs to be put forward by the current medical institutions, and then approved by the municipal social insurance agency.

As an employer, it is required to report the accident to the relevant social security department on the first working day after the accident, and issue a work-related accident report to the social security agency within seven working days after the accident and put it on record.

2. Apply for work-related injury identification.

If an employee is injured by an accident or is diagnosed or identified as an occupational disease, the unit to which he belongs shall apply to the Social Security Bureau for work-related injury identification within 30 days. If the employer fails to apply for work-related injury identification in accordance with the regulations, the employee or his relatives or trade union may directly apply for work-related injury identification within one year.

If you take part in work-related injury insurance, but the employer fails to submit an application for work-related injury identification within the specified time, then as long as the injured employee meets the requirements of work-related injury insurance, all relevant expenses will be borne by the employer.

3, labor ability appraisal

The employee has a work-related injury and the injury is stable after treatment. If there is a disability or affects their working ability, they need to be appraised. The specific appraisal method requires employers, employees with work-related injuries or their close relatives to submit an application for labor ability appraisal to the labor ability appraisal committee, and submit a decision on work-related injury identification and relevant information on medical treatment for employees with work-related injuries, including cases, diagnosis certificates and corresponding inspection reports of employees with work-related injuries.

4. Apply for work-related injury insurance benefits

After the work-related injury is identified, the employer will generally apply for medical treatment of work-related injury insurance for the workers with the relevant materials such as the Decision on Work-related Injury Identification. Industrial injury insurance benefits generally include medical expenses for work-related injuries, food subsidies for hospitalization, transportation and accommodation expenses for medical treatment in different places, etc.

After the appraisal of labor ability, the level of disability is assessed, and the unit can apply for work-related injury and disability treatment for employees with work-related injuries with the "Appraisal of Labor Ability" and other related materials.

Second, what materials should be submitted to make a request for work-related injury identification?

When applying for work-related injury identification, the following materials shall be submitted:

(a) the application form for work-related injury identification;

(two) the existence of labor relations with the employer (including factual labor relations);

(3) Medical diagnosis certificate or occupational disease diagnosis certificate (or occupational disease diagnosis certificate).

The application form for ascertainment of a work-related injury shall include basic information such as the time, place and cause of the accident and the degree of injury of the employees.

If the materials provided by the applicant for work-related injury identification are incomplete, the social insurance administrative department shall inform the applicant in writing of all the materials that need to be supplemented at one time. The administrative department of social insurance shall accept the corrected materials after the applicant has been informed in writing.

Units need to fulfill the obligations of paying social security such as work-related injury insurance for employees. For employees who have already paid work-related injury insurance, if they are injured in the course of work and are recognized as work-related injuries, they can enjoy the corresponding work-related injury insurance benefits. For employees with work-related injuries, if the unit dismisses, compensation or compensation may be required.