What steps does Dongguan Huangjiang industrial injury go to social security for reimbursement?

(1) Conditions for applying for reimbursement

Employers and their employees, urban individual industrial and commercial households and their employees, and flexible employees participate in medical insurance according to regulations 1 month.

1. Identification of work-related injuries: (1) Injured by accidents during working hours and workplaces; (two) before and after working hours in the workplace to engage in work-related preparatory work or finishing work was injured by an accident; (3) Accidental injuries such as violence are caused during working hours and workplaces due to the performance of work duties; (4) Suffering from occupational diseases; (five) when going out to work, he is injured or his whereabouts are unknown due to work reasons; (six) injured by a motor vehicle accident on the way to and from work; (seven) other circumstances that should be recognized as work-related injuries as stipulated by laws and administrative regulations.

2. It is regarded as a work-related injury: (1) sudden illness or death within 48 hours after being rescued; (2) Being injured in activities such as emergency rescue and disaster relief to safeguard national interests and public interests; (3) Employees who were disabled in the army because of war or work have obtained revolutionary disabled servicemen's certificates, and their old injuries have recurred after going to the employing unit.

(2) Time limit for claim

Work-related injury identification: generally, the work-related injury identification decision is made within 15 days from the date of accepting the application for work-related injury identification; Under special circumstances, it shall not exceed the prescribed time limit of 60 days.

Appraisal of labor ability: make a conclusion of labor ability appraisal within 60 days from the date of appraisal (the time limit for making appraisal conclusion can be extended by 30 days if necessary).

Time limit for reimbursement: if the audit materials are complete, it will be settled within 15 working days from the date of processing.

(3) the required materials

Work-related injury identification data:

(1) Original application form for work-related injury identification; (2) A copy of the certification materials for the existence of labor relations (including factual labor relations) with the employer (the original is for future reference);

(3) Copy of medical diagnosis certificate or occupational disease diagnosis certificate (or occupational disease diagnosis certificate) (original for future reference); At the same time, according to the needs of industrial injury identification, the applicant shall submit the following materials:

(4) A copy of the employee's identity certificate (original for future reference);

(5) Relevant circumstantial evidence, such as attendance proof materials, witness testimony, witness identification materials or on-site records, photos, oral records, etc. ;

(6) Relevant diagnosis and treatment materials, such as medical records, CT and X-ray inspection reports;

(7) A copy of the responsibility confirmation letter for traffic accidents or urban rail transit, passenger ferry and train accidents (original for future reference) and the original sketch map of the accident site. For example: submit a copy of road traffic accident responsibility confirmation for road traffic accidents;

(8) If criminal injury is involved, submit a copy of the certification materials of the local public security organ (the original is for future reference);

(9) A copy of the registration materials of the unit or enterprise as a legal person (the employer has not participated in work-related injury insurance in this city) (the original is for future reference);

(10) Other materials that need to be submitted for work-related injury identification (see Notice of Submission of Materials for Work-related Injury Identification for details).

Labor ability appraisal data:

1, the original application form for labor ability appraisal in Dongguan; 2, "Dongguan city labor ability appraisal notice" original;

3, inductrial injury worker must provide a copy of the work injury certificate (original for future reference); 4. Original and photocopy of the appraiser's ID card;

5. Copies and originals of all relevant medical materials (medical records, diagnosis certificates, discharge summaries, inspection results, relevant X-rays, CT, MR films, etc.). );

6. 1 photo of my recent 4R injury; 7, other information, according to the actual appraisal situation, such as entrusted appraisal shall submit a power of attorney, etc.

Work-related injury reimbursement information:

1, file form for settlement of medical expenses for work-related injuries; 2. Work-related injury certificate (filed); 3. Appraisal of Dongguan Labor Ability Appraisal Committee;

4. Copy of the injured employee's ID card (original for future reference) and 1 one-inch photo; 5. Effective disease diagnosis certificate;

6. Receipt (invoice) and detailed list of medical expenses for work-related injuries issued by the agreement institution; 7. Copies of relevant physical examination reports and discharge summary;

8, outpatient treatment, need to submit a copy of outpatient medical records, social insurance prescription;

9. If rehabilitation equipment needs to be installed, submit a copy of the appraisal certificate of Dongguan Labor Ability Appraisal Committee or the Approval Form for Rehabilitation Equipment and the Invoice for Rehabilitation Equipment Assembly issued by the rehabilitation equipment assembly organization;

10, the bank account information of the treatment recipient (unit or injured employee or immediate family member); 1 1, commercial insurance or civil compensation results;

12. Other information required to receive relief funds.

Application for compensation for work-related injury insurance:

(1) grade 1- 10, failing to reach grade or giving up disability assessment.

1, industrial injury compensation treatment file table; 2. Work injury certificate (stub);

3. Appraisal letter of Dongguan Labor Ability Appraisal Committee (1 to 10 and unqualified); Statement on waiver of disability assessment (waiver of disability assessment);

4, inductrial injury worker's ID card copy (original for future reference); 5. 1 inch photo; 6. 4R color photos of disability (not required for those who give up disability assessment);

7. Bank account information of welfare recipients (generally employees with work-related injuries); 8. Other information needed for treatment.

(2) For work-related injuries, materials shall be prepared in accordance with the Materials to be Prepared by the Relatives of Workers who Died at Work to Apply for Work-related Injury Insurance Compensation (see Annex):

1, application form for industrial injury rehabilitation in Dongguan; 2. Copy of work-related injury certificate; 3. Copy of employee ID card;

4. Copies of certification materials of other applicants and relevant entrustment certification materials; 5. A copy of the hospitalization medical record or discharge summary after the industrial injury;

6. A copy of a valid medical institution's disease diagnosis certificate or occupational disease diagnosis certificate; 7 copies of relevant inspection results; 8. Other relevant materials.

(4) Handling procedures

Bring all the information to the local social security bureau's handling window.