Social security payment process after the completion of work-related injury appraisal

Work-related injury social security reimbursement process is as follows:

1. The insured or their families bring relevant information and apply to the local social security bureau;

2, the staff investigation to verify the applicant's materials, whether the materials are complete, whether it meets the statutory acceptance form;

3. Within 60 days after acceptance, it shall be delivered to the insured or his family by the staff after investigation and verification. If the application materials are incomplete and do not conform to the statutory form, it shall inform the applicant in writing on the spot or within 15 working days before accepting it.

First, how to apply for social security compensation after a work-related injury is identified

1, depending on whether there is any problem with the identification level. If you are dissatisfied with or have doubts about the appraisal conclusion (level), you may apply to the Provincial Labor Ability Appraisal Committee for a second appraisal conclusion within 15 days after receiving the appraisal conclusion.

2. After the work-related injury appraisal, the compensation amount can be calculated according to the appraisal standard. Compensation for work-related injuries includes:

Medical expenses, wages during shutdown, hospital food subsidies, nursing expenses, transportation expenses, accommodation expenses, one-time disability subsidies, one-time employment and medical subsidies, etc. If the unit has invested in industrial injury insurance, it shall be paid directly by the national industrial injury insurance institution according to the standard. If there is no insurance (especially in industrial injury insurance institutions), it shall be settled through consultation with the employer according to the standards.

3. If no settlement can be reached through consultation with the employer, arbitration proceedings can be initiated according to labor arbitration laws and regulations.

If you are not satisfied with the labor arbitration, you can bring a lawsuit to the court for settlement. Anyone who refuses to accept the judgment of the court of first instance may appeal to the court of second instance according to law.

5. After the arbitration or judgment comes into effect, if the employer fails to pay the compensation fee, it may apply to the executive board of the court for enforcement according to the effective legal documents, and the court will execute it. Article 17 of the Regulations on Work-related Injury Insurance, if an employee suffers an accident injury or is diagnosed and identified as an occupational disease in accordance with 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 work-related injury identification. Under special circumstances, with the consent of the administrative department of social insurance, the application time limit may be appropriately extended. If the employing unit fails to apply for work-related injury identification in accordance with the provisions of the preceding paragraph, the employees with work-related injuries or their close relatives and trade unions may directly apply for work-related injury identification to the social insurance administrative department where the employing unit is located within 1 year from the date of the accident injury or the date of being diagnosed as an occupational disease. In accordance with the provisions of the first paragraph of this article, matters that should be identified by the provincial social insurance administrative department shall be handled by the municipal social insurance administrative department located in the district where the employer is located in accordance with the principle of territoriality. If the employer fails to file an application for work-related injury identification within the time limit specified in the first paragraph of this article, the employer shall bear the relevant expenses such as work-related injury treatment in accordance with the provisions of these regulations during this period.

Second, what should I do if I refuse to accept the conclusion of disability level after injury identification?

(1) The injured workers are not satisfied with the conclusion of disability grade, and the correct way should be through the bottom-up review procedure to ensure the fairness and rationality of the appraisal work.

Namely:

Workers who are dissatisfied with the conclusion of disability appraisal made by the Municipal Labor Appraisal Committee may apply to the Provincial Labor Appraisal Committee for re-appraisal, and the appraisal conclusion made by the Provincial Labor Appraisal Committee is final.

(2) Workers injured at work are not satisfied with the conclusion of disability grade and cannot bring an administrative lawsuit for the following reasons:

First, the Administrative Reconsideration Law clearly stipulates that this situation does not belong to the scope of administrative reconsideration, and naturally administrative proceedings cannot be conducted.

After the promulgation of the Administrative Procedure Law of the People's Republic of China, the Ministry of Labor and Social Security issued the Measures for Administrative Reconsideration of Labor and Social Security on June 23rd. 1999 165438 stipulates:

A citizen, a legal person or any other organization may not apply for administrative reconsideration if it refuses to accept the conclusion of the disability grade appraisal made by the labor appraisal committee (see Article 5).

In other words, citizens and legal persons are dissatisfied with the level of labor ability appraisal, and there is no legal basis for bringing legal proceedings or accepting cases by the court.

Second, judging from the nature of the organization and work of the labor appraisal committee, it is not a specific administrative act.

Therefore, the appraisal of disability grade is carried out according to the national disability evaluation standard. The Labor Appraisal Committee is a fictitious organization that the local government coordinates labor, health and trade unions to support this cause, and the work of the Labor Appraisal Institute is specifically organized and implemented.

The identification of disability grade and nursing dependence is a technical conclusion made by the medical expert group according to the injury of the injured workers. It is largely a technical and career work, rather than a specific administrative act.

According to relevant regulations, employees identified as work-related injuries generally need to apply for compensation from the social security department. The salary standard has a great relationship with the employee assessment results. The general first-class industrial injury standard can get 24 months of economic compensation.

I hope the above content can help you. Please consult a professional lawyer if you have any other questions.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Article 38 According to the regulations of the state, various expenses incurred due to work-related injuries can be paid from the work-related injury insurance fund. Such as rehabilitation and medical expenses, meals, transportation, accommodation and so on.