Reimbursement process for secondary surgery costs of work-related injuries

1. The employer or the employee himself comes to the Industrial Injury Section of the Municipal Social Insurance Center to get and fill out the "Application for Second Hospitalization of Work Injured Employee" in duplicate and stamp the official seal of the unit;

2. The employer or the employee himself goes to the fixed-point hospital to fill in the history and medical treatment of the injured employee and the fixed-point medical treatment puts forward the opinion of the second hospitalization and seals the official seal of the hospital;

3. Hospital seal;

3, the employer or the employee himself or herself will be sent to the municipal social insurance center of the Industrial Injury Section for the record seal, the employer and the municipal social insurance center of the Industrial Injury Section to hold a copy of the reimbursement of medical expenses for verification.

Second, the declaration materials:

1, by the municipal social insurance center injury section of the filing of the "second hospitalization of injured workers application filing form" a

2, filled out and stamped with the official seal of the unit of the "application for treatment of work-related injuries," a form (form in the social security bureau online download or come to the municipal social insurance center, the injury section to get);

3, the certificate of work-related injuries The original and a copy;

4, the injured worker's original ID card and a copy;

5, the original invoice of medical expenses of designated medical institutions;

6, the list of costs (including the list of outpatient invoices or inpatient invoices, in the hospital payment window to print, the specifics can be consulted with the hospital);

7, the original outpatient medical records and copies A;

8, a hospitalized case (hospitalization invoices provided, in the hospital copy and stamped with a special hospital seal, the use of steel plates and other special materials, but also to provide the certificate of conformity of the materials used or instructions and stamped with a special hospital seal);

9, diagnosis of the original and a copy of the certificate.

Three, for the institution

1, the employer to participate in the district (county) social security sub-centers;

2, individuals to the streets, towns (townships) community affairs service centers or districts (counties) social security sub-centers.

Four, the application conditions

1, the employee by the district, county human resources and social security bureau recognized as a work-related injuries (recognized as an old work-related injuries) personnel;

2, the employer to pay the required work-related injuries insurance premiums;

3, work-related injuries to employees in the month of the accident has been to participate in the city's social insurance, and pay the social insurance premiums in accordance with the provisions of the city.

Legal basis:

Article 30 of the Regulations on Work-Related Injury Insurance

Work-injured workers, due to the needs of daily life or employment, can be fitted with assistive devices such as prosthetic limbs, orthopaedic appliances, false eyes, false teeth, and wheelchairs, as confirmed by the Labor Ability Appraisal Committee; and the necessary expenses shall be paid from the Work-Related Injury Insurance Fund in accordance with the state's prescribed standards. The required expenses shall be paid from the Work Injury Insurance Fund in accordance with the standards stipulated by the State.

Article 21 of the Regulations on Work-Related Injury Insurance

When an employee is injured at work, and there is a disability that affects his or her ability to work after the injury has been relatively stabilized by treatment, he or she shall have his or her ability to work appraised.

Article 22 of the Regulations on Work-Related Injury Insurance

Labor capacity appraisal refers to the appraisal of the degree of impairment of labor function and the degree of impairment of self-care in life.

Labor functional impairment is divided into ten disability grades, with the heaviest being grade one and the lightest being grade ten.

There are three levels of impairment of self-care: totally unable to take care of oneself, mostly unable to take care of oneself and partially unable to take care of oneself.

The criteria for the appraisal of labor capacity are formulated by the State Council's administrative department of social insurance in conjunction with the State Council's administrative department of health and other departments.

Article 23 of the Regulations on Work-Related Injury Insurance

The appraisal of labor capacity shall be made by the employer, the injured employee or the close relatives of the injured employee to the municipal Labor Capacity Appraisal Committee of the district, and the decision on the determination of the work-related injury and the relevant information on the medical treatment of the employee's work-related injury shall be provided.