Are social security and work-related injuries together?

Legal analysis: if an employee is injured in the course of work, it should first be recognized as a work-related injury. After identification, all work-related injuries and medical expenses are paid by work-related injury insurance, and medical insurance cannot be used. Medical insurance is used to treat employees' diseases or non-work-related injuries. If it is not recognized as a work-related injury, or it is not recognized as a work-related injury, it can only be reimbursed through medical insurance.

1. According to the provisions of the Social Insurance Law, basic medical insurance and industrial injury insurance are different types of insurance. Industrial injury insurance is to ensure that employees get economic compensation and medical treatment after accidents or occupational diseases at work. Basic medical insurance is the basic medical expenses to protect employees from non-work-related injuries or illnesses.

2. According to the Regulations on Work-related Injury Insurance, if an employee is injured by an accident at work, the unit shall report the work-related injury identification to the local labor administrative department within 1 month. If it is identified as a work-related injury, the ability to work will be identified after the injury is stable, and the corresponding work-related injury treatment will be enjoyed according to the assessed disability level. To sum up, medical insurance and industrial injury insurance are two different kinds of insurance. If it is a work-related injury, all medical expenses will be borne by work-related injury insurance, so medical insurance cannot be used. If it is not recognized as a work-related injury, or it is not recognized as a work-related injury, it can only be reimbursed through medical insurance. Therefore, medical insurance and industrial injury insurance cannot be reimbursed at the same time.

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

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.

Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.