Work-related injury claim process

I. Work-related injury reporting procedures

This procedure can only be handled if the employer has already handled work-related injury insurance for the workers in the work-related injury insurance institution.

The unit shall submit the work-related injury identification report to the local labor administrative department within 15 days from the date of work-related injury accident or occupational disease diagnosis.

Second, the work-related injury identification procedures

It is a procedure and the first step for social insurance agencies to investigate work-related (death) accidents and determine whether they belong to work-related injuries. However, if the employer recognizes the work-related injury in writing and fails to apply for work-related injury insurance, it may not be handled according to this procedure.

Pay attention to two work-related injuries: if the unit does not mention work-related injuries, the injured person must apply to the labor department within one year from the date of the accident. After investigation and identification, the social security agency shall notify the unit and the injured person in writing.

Three. Work-related injury identification procedure

Work-related injury identification refers to the behavior of the labor appraisal committee at or above the county level to evaluate the disability level of the employees who apply for work-related injury identification on the basis of work-related injury identification (that is, after completing the work-related injury identification procedure). In a broad sense, industrial injury appraisal includes labor ability appraisal and disability grade appraisal. In a narrow sense, industrial injury appraisal refers to disability grade appraisal.

Four. Procedures for negotiating compensation

After the work-related injury appraisal, the compensation amount can be calculated according to the appraisal standard. 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.

Verb (abbreviation of verb) labor arbitration procedure

If no settlement can be reached through consultation with the employer, arbitration proceedings may be initiated in accordance with labor arbitration laws and regulations.

Court proceedings of intransitive verbs

If you are dissatisfied 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.

Seven. executive program

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 enforce it.

Eight. Complaint procedure

If you are dissatisfied with the effective judgment, you can apply to start the retrial procedure, but this is generally difficult.

Legal basis: Article 20 of the Regulations on Work-related Injury Insurance The administrative department of social insurance shall make a decision on work-related injury identification within 60 days from the date of accepting the application for work-related injury identification, and notify the employees who apply for work-related injury identification or their close relatives and the units where the employees work.

The administrative department of social insurance shall, within 15 days, make a work-related injury determination decision on the application with clear facts and clear rights and obligations.

If it is necessary to make a work-related injury determination decision according to the conclusion of the judicial organ or the relevant administrative department, the time limit for making a work-related injury determination decision shall be suspended during the period when the judicial organ or the relevant administrative department has not yet made a conclusion.

If the staff of the social insurance administrative department has an interest in the applicant for work-related injury identification, they should withdraw.