How to use the work injury insurance in the social security

How to use the work injury insurance in social security is as follows:

1. First, apply for the work injury recognition and get the decision of work injury recognition;

2. Then, reimbursement will be made to the social security agency by submitting the decision of work injury recognition, the bill of payment of medical expenses and other materials;

3. Then, it will be examined and approved by the social security agency;

4. Finally, the social security agency will pay the reimbursement to the applicant according to the amount of the reimbursement approved by the agency;

5. amount to pay the applicant the reimbursement.

The scope of work injury is as follows:

Work injury is an accidental injury or occupational disease suffered by an employee in the course of work due to work. According to the relevant provisions, an employee shall be recognized as injured at work if one of the following circumstances exists:

1. Injured by an accident during working hours and in the workplace due to work;

2. Injured by an accident before or after working hours in the workplace, while engaged in preparatory or finishing work related to work;

3. Injured by violence or other accidents during working hours or in the workplace while performing work duties;

4. Suffering from occupational disease;

5. Injured due to work-related injuries or unaccounted for accidents while away from work;

6. Injured in traffic accidents or accidents in urban railways, passenger ferries or trains while commuting to and from work for which the injured person is not primarily responsible;

7. Other cases that should be recognized as work-related injuries as stipulated by laws and administrative regulations.

Legal basis: Article 18 of the Regulations on Work-Related Injuries Insurance

The following materials shall be submitted to the application for the recognition of work-related injuries:

(1) application form for the recognition of work-related injuries;

(2) proof of existence of a labor relationship (including de facto labor relationship) with the employer;

(3) Certificate of medical diagnosis or certificate of diagnosis of occupational disease (or certificate of diagnosis of occupational disease).

The application form for the recognition of work-related injuries shall include basic information such as the time, place and cause of the accident as well as the extent of the employee's injuries.

If the applicant provides incomplete materials, the social insurance administrative department shall inform the applicant in writing of all the materials that need to be corrected. The applicant in accordance with the written notice of the requirement to correct the material, the social insurance administrative department shall accept.

Article 19

After accepting the application for the determination of work-related injuries, the administrative department of social insurance shall, according to the needs of the review, investigate and verify the accidental injuries, and the employer, employees, trade union organizations, medical institutions and relevant departments shall provide assistance. Diagnosis of occupational diseases and diagnosis of disputes in accordance with the relevant provisions of the law on the prevention and control of occupational diseases. The social insurance administrative department shall no longer conduct investigations and verifications for those who have obtained a certificate of diagnosis of occupational diseases or an appraisal of diagnosis of occupational diseases in accordance with the law.

If the employee or his close relatives believe that it is a work-related injury, and the employer does not believe that it is a work-related injury, the employer shall bear the burden of proof.