工伤保险条例(英文版)

工伤保险条例(英文版)
Regulation on Work-Related Injury Insurances
（Decree No. 375 of the State Council of the People's Republic of China）
The "Regulation on Work-Related Injury Insurances", which was deliberated and adopted at the 5th executive meeting of the State Council on April 16,
2003, is hereby promulgated, and shall come into force on January 1, 200
4.
Wen Jiabao, Premier
April 27, 2003
PART ONE GENERAL PROVISIONS
Article 1 These Regulations are formulated in order to guarantee availabi
lity of medical treatment and economic compensation to staff and workers t hat suffer from work-related accidental injury or occupational disease，
to promote prevention of work-related injury and vocational rehabilitation， and to distribute work-related injury risks of employers.
Article 2 All types of enterprises and sole traders that hire workers （Em ployer（s）） shall participate in work-related injury insurance and pay wo rk-related injury insurance premiums for all of the staff and workers o
r hired workers in their work unit （Employee（s）） in accordance with th
e provisions hereof. The Employees o
f all types of enterprises and the hired workers of sole tr aders in the People's Republic of China shall have the right to enjoy the benefits of work-related injury insurance in accordance with the provision s hereof.
The specific steps and implementing procedures for participation of sole t raders that hire workers in work-related injury insurance shall be stipula ted by the people's governments of provinces， autonomous regions and munic ipalities directly under the central government.
Article 3 Collection and payment of work-related injury insurance premium s shall be carried out in accordance with the provisions in the Collection and Payment of Social Insurance Premiums Tentative Regulations regarding collection and payment of basic old age insurance premiums， basic medical insurance premiums and unemployment insurance premiums.
Article 4 An Employer shall announce within the work unit the relevant de tails of its participation in work-related injury insurance.
An Employer and its Employees shall abide by the laws and regulations rega rding safe production and prevention and treatment of occupational disease s， implement safety and health regulations and standards， prevent occurre nce of work-related injury accidents and avoid and mitigate the harms of o ccupational diseases.
If an Employee suffers from work-related injury， the Employer shall adopt measures to ensure that such Employee receives timely rescue and treatmen t.
Article 5 The administrative department of labour security of the State C ouncil shall be in charge of the work of work-related injury insurance thr oughout the country.
The administrative departments of labour security of all levels of local p eople's governments at the county level and above shall be in charge of wo rk-related injury insurance work within their respective administrative ar eas.
The social insurance agencies established by the administrative department s of labour security in accordance with relevant provisions of the State C ouncil （Agency/Agencies） shall undertake the practical affairs of work-re lated injury insurance.
Article 6 Administrative departments of labour security and other departm ents shall seek the opinion of trade unions and representatives of Employe rs when formulating policies and standards for work-related injury insuran ce.
PART TWO WORK-RELATED INJURY INSURANCE FUNDS
Article 7 Work-related injury insurance funds shall be composed of work-r elated injury insurance premiums paid by Employers， interest on work-relat ed injury insurance funds and other funds paid into the work-related injur y insurance funds in accordance with law.
Article 8 The premium rate for work-related injury insurance shall be det ermined on the principles that receipt be determined on the basis of payme nt and that receipt and payment be balanced. The State shall determine premium rate differentials between industries ac cording to the degree of risks of work-related injuries in different indus tries， and shall determine several tiers of premium rates within each indu stry according to circumstances such as the use of work-related injury ins urance premiums and the frequency of occurrence of work-related injuries. Inter-industry premium rate differentials and intra-industry premium rate tiers shall be formulated by the administrative department of labour secur ity of the State Council in conjunction with the finance department， healt h administrative department and safe production regulatory department of t he State Council， and shall be promulgated and implemented upon approval b y the State Council.
The Agency for a pooling region shall determine the work unit payable prem ium rate for an Employer on the basis of such circumstances such as use of work-related injury insurance premiums and frequency of occurrence of wor k-related injuries of the Employer， and the corresponding premium rate tie r applicable to the industry to which the Employer belongs.
Article 9 The administrative department of labour security of the State C ouncil shall periodically obtain the details of receipt and payment of wor k-related injury insurance funds of all pooling regions throughout the cou ntry， and shall propose adjustment to the inter-industry premium rate diff erentials and the intra-industry premium rate tiers in a timely manner and in conjunction with the finance department， health administrative departm ent and safe production regulatory department of the State Council. Such a djustment shall be promulgated and implemented upon approval by the State Council.
Article 10 Employers shall pay work-related injury insurance premiums on time. Employees shall not pay work-related injury insurance premiums thems elves.
The amount of work-related injury insurance premium payable by an Employer shall be the product of the total payroll of the Employees of the work un it and the work unit payable premium rate.
Article 11 Work-related injury insurance funds in municipalities directly under the central government and municipalities having districts shall be pooled on a municipality-wide basis. The level of pooling in other region s shall be determined by the people's government of the province or auto nomous region.
An inter-region industry or an industry with a relatively high level of production mobility may participate from another region in work-related in jury insurance in a pooling region by adopting a method of relative concen tration. The specific procedures shall be formulated by the administrative department of labour security of the State Council in conjunction with th e department in charge of the relevant industry.
Article 12 Work-related injury insurance funds shall be deposited into a dedicated finance account for social security funds for benefits of work-r elated injury insurance， assessment of work capability and payment of othe r expenses for work-related injury insurance stipulated herein. No work un it or individual may use the work-related injury insurance funds for inv estment and operation， construction or renovation of office site， distr ibution of bonuses，or divert such funds to other uses. Article 13 A certain ratio of work-related injury insurance funds shall b e maintained as reserves for payment of work-related injury insurance bene fits in the event of major accidents in the pooling region. In case of a s hortage of reserves， the people's government of the pooling region shall a dvance the payment. The specific ratio of reserves to the total amount of funds and the procedures for the use of reserves shall be stipulated by th e people's governments of provinces， autonomous regions or municipalitie s directly under the central government.
PART THREE DETERMINATION OF WORK-RELATED INJURY
Article 14 An Employee shall be determined as having a work-related injur y if：
1. he is injured in an accident at work during working hours in the workpl ace；
2. he is injured in an accident while engaging in preparatory or finishi ng-up work related to work before or after working hours in the workplac e；
3. he is injured by violence or in other accident in his performance of job duties during working hours in the workplace；
4. he suffers from an occupational disease；
5. he is injured at work or his whereabouts became unknown in an acciden t， during work-related travel；
6. he is injured in a motor vehicle accident while going to or returning
from work； or
7. he is in other circumstances that shall be determined as work-related i njury according to the provisions of laws and administrative regulations.
Article 15 An Employee shall be deemed as having a work-related injury if：
1. he dies immediately or within 48 hours after emergency treatment for
a disease suddenly arising during working hours in the workplace；
2. he is injured in an act to protect national interests or public inter ests such as emergency rescue and disaster relief； or
3. he is injured and disabled in war or on duty while in military servic
e and has obtained a revolutionary injured and disabled soldier certificat e， and suffers from a relapse o
f the old injury while bein
g employed by th
e Employer.
Where an Employee is in the circumstance of Item （1）or （2） of the pr eceding paragraph， he shall be entitled to work-related injury insurance b enefits in accordance with the relevant provisions hereof. Where an Employ
ee is in the circumstance of Item （3） of the preceding paragraph， he sha ll be entitled to work-related injury insurance benefits other than the lu mp sum disability allowance in accordance with the relevant provisions her eof.
Article 16 An Employee shall not be determined or deemed as having work
-related injury if：1. he is injured or he dies as a result of commission of crime or viol ation of public security administration；
2. he is injured or he dies as a result of intoxication； or
3. he inflicts harm on himself or commits suicide.
Article 17 If an Employee is injured in an accident or diagnosed or c ertified as having occupational disease pursuant to the provisions of the Prevention and Treatment of Occupational Diseases Law， his work unit shall file an application for determination of work-related injury to the admin istrative department of labour security of the relevant pooling region wit hin 30 days of the date of occurrence of the accidental injury or the da te of diagnosis or certification of the occupational disease. In special circumstances， the time limit for application may， subject to the consen t of the administrative department of labour security， be extended as appr opriate.
If the Employer fails to file an application for determination of work-rel ated injury pursuant to the preceding paragraph， the Employee with work-re lated injury， his directly-related family members or the trade union m ay directly file an application for determination of work-related injury t o the administrative department of labour security of the pooling region i n which the Employer is located within one year of the date of occurrence of the accidental injury or the date of diagnosis or certification of the occupational disease.
Matters concerning the determination of work-related injury that is requir ed under the first paragraph of this Article to be conducted by the admini
strative department of labour security at the provincial level shall be ha ndled by the administrative department of labour security of a municipalit y having districts in which the Employer is located according to the princ iple of jurisdiction.
If the Employer fails to file an application for determination of work-rel ated injury within the time limit prescribed in the first paragraph of thi s Article， the relevant expenses such as the work-related injury benefits that comply with the provisions hereof arising during this period shall be borne by the Employer.
Article 18 When filing an application for determination of work-related i njury， the following materials shall be submitted：
1. an application for determination of work-related injury；
2. the evidential materials of labour relationship with the Employer （incl uding de facto labour relationship）； and
3. a certificate of medical diagnosis or a certificate of diagnosis of o ccupational disease （or an assessment of diagnosis of occupational diseas e）。

The application for determination of work-related injury shall include the basic details of the accident such as the time and place of occurrence， t he cause of the accident and the degree of injury to the Employee.
If the materials provided by the applicant for determination of work-relat ed injury are incomplete， the administrative department of labour security shall notify the applicant of all the materials that need to be supplemen ted in a one-time written notice. After the applicant has supplemented the materials as required by the written notice， the administrative departmen t of labour security shall accept the application.
Article 19 After the administrative department of labour security has acc epted an application for determination of work-related injury， it may inve stigate and verify the accident and injury as required in examining and ve rifying the application， and the Employer， Employee， trade union， medic al institution and other relevant departments shall provide assistance. As sessment of diagnosis of occupational disease and diagnosis dispute shall be handled in accordance with the relevant provisions of the Prevention an d Treatment of Occupational Diseases Law. The administrative department of labour security shall not carry out further investigation or verificati on on certificates of diagnosis of occupational disease or assessment of diagnosis of occupational disease that are obtained in accordance with th e law.
Where an injury is considered as work-related by the Employee or his dir ectly-related family members but not by the Employer， the burden of proof shall be borne by the Employer.
Article 20 The administrative department of labour security shall render a decision on determination of work-related injury within 60 days of the d ate of acceptance of the application for determination of work-related inj ury， and shall notify the Employee applying for determination of work-rela ted injury or his directly-related family members and his work unit in w riting.
Where the personnel of the administrative department of labour security ha s a material interest in the applicant for determination of work-related i njury， he shall withdraw from the case.
PART FOUR ASSESSMENT OF WORK CAPABILITY
Article 21 If an Employee suffers from a work-related injury and he is in stable condition after treatment but has disability or his work capabil ity is affected， the Employee shall undergo an assessment of work capabili ty.
Article 22 An assessment of work capability is an assessment of the degre e of impairment in work functions and the ability to self-care.
Impairment in work functions is classified into ten disability classes， fr om class one， the most severe， to class ten， the mildest.
Impairment in the ability to self-care is classified into three classes： t otal self-care disability， substantial self-care disability and partial se lf-care disability.
Standards for assessment of work capability shall be formulated by the adm inistrative department of labour security of the State Council in conjunct ion with the health administrative department and other departments of the State Council.
Article 23 Applications for assessment of work capability shall be filed by the Employer， the Employee with work-related injury or his directly-r elated family members to the assessment of work capability committee of a municipality having districts， and the decision on determination of work-r elated injury and the information relevant to the medical treatment of the work-related injury of the Employee shall be provided.
Article 24 The assessment of work capability committee of provinces， auto nomous regions， municipalities directly under the central government and m unicipalities having districts shall be composed of representatives of the administrative department of labour security， personnel administrative de partment， health administrative department， trade unions， Agencies and E mployers of provinces， autonomous regions， municipalities directly under the central government and municipalities having districts respectively.
The assessment of work capability committee shall set up a pool of medical and health experts. Medical and health professional technicians included in the expert pool shall satisfy the following conditions：
1. possessing the qualifications for a senior technical position in the me dical or health profession；
2. possessing the relevant knowledge for assessment of work capability； an d
3. having good professional conduct.
Article 25 After the assessment of work capability committee of a municip ality having districts has received an application for assessment of work capability， it shall select three or five relevant medical and health experts at random from its expert pool to form an expert panel， which shal l provide an assessment opinion. The assessment of work capability committ
ee of the municipality having districts shall render an assessment of work capability conclusion in regards to the Employee with work-related injury on the basis of the assessment opinion of the expert panel. Where necessa ry， it may entrust a qualified medical institution to assist in the releva nt diagnosis.
The assessment of work capability committee of the municipality having dis tricts shall render an assessment of work capability conclusion within 60 days of the date of receipt of the application for assessment of work capa bility. The time limit for rendering an assessment of work capability conc lusion may be extended for 30 days if necessary. The assessment of work ca pability conclusion shall be served in a timely manner on the work unit an d individual that applies for assessment.
Article 26 If the work unit or individual that applies for assessment i s dissatisfied with the assessment conclusion of the assessment of work ca pability committee of the municipality having districts， the work unit o r individual may， within 15 days of the date of receipt of the assessment conclusion， apply to the assessment of work capability committee of the p rovince， autonomous region or municipality directly under the central go vernment for a reassessment. The assessment of work capability conclusion of the assessment of work capability committee of the province， autonomous region or municipality directly under the central government shall be f inal.
Article 27 Assessment of work capability shall be objective and impartial. If any member of the assessment of work capability committee or expert participating in the assessment has a material interest in the party， he s hall withdraw from the assessment.
Article 28 If， within one year after an assessment of work capability con clusion is made， the Employee with work-related injury or his directly-r elated family members， his work unit or the Agency believes that there i s a change in the disability condition， he may apply for a review of the a ssessment of work capability.
PART FIVE
WORK-RELATED INJURY INSURANCE BENEFITS
Article 29 An Employee that receives treatment for work-related accidenta l injury or occupational disease shall be entitled to work-related injur y medical benefits.
An Employee shall seek medical treatment for work-related injury at a medi cal institution that has entered into a service agreement. In cases of eme rgency， the Employee may first seek emergency treatment at the nearest med ical institution.
If the costs required for treating the work-related injury fall within the treatment item catalogue， pharmaceutical catalogue and/or hospitalization service standard for work-related injury insurance， they shall be paid fr om work-related injury insurance funds. The treatment item catalogue， phar maceutical catalogue and hospitalization service standard for work-related injury insurance shall be stipulated by the administrative department of labour security of the State Council in conjunction with the health admini
strative department， the pharmaceutical regulatory department and other de partments of the State Council.
Where an Employee is hospitalized for treatment of work-related injury， hi s work unit shall pay an amount of meal allowance at 70% of the meal allow ance rate payable by the work unit for travel on duty. If the Employee wit
h work-related injury seeks medical treatment outside the pooling region w ith the referral certificate of a medical institution and the consent of t he Agency， the necessary travel and boarding expenses shall be reimbursed by his work unit according to the standard for travel on duty of Employees of the work unit.
An Employee with work-related injury shall not be entitled to work-related injury medical benefits for treatment of a disease not arising from work-related injury， and such treatment shall be handled in accordance with the procedures on basic medical insurance.
Where the costs of rehabilitative treatment of the Employee with work-rela ted injury at a medical institution that has entered into a service agreem ent satisfy the conditions in the third paragraph of this Article， they sh all be paid from work-related injury insurance funds.
Article 30 An Employee with work-related injury may， due to daily life o r employment needs and subject to the confirmation of assessment of work capability committee， wear artificial limbs， orthosis， artificial eyes a nd false teeth and equip himself with an aiding device such as wheelchair， and the necessary costs shall be paid from work-related injury insurance funds at the standards stipulated by the State. Article 31 If an Employee needs to suspend working in order to receive me dical treatment for work-related accidental injury or occupational disea se， his original wage and welfare benefits shall remain unchanged and paya ble monthly by his work unit during the suspension-of-work-with-pay perio d.
The suspension-of-work-with-pay period shall normally not exceed 12 months. If the injury is severe or the circumstances are exceptional， such peri od may， subject to confirmation by the assessment of work capability commi ttee of a municipality having districts， be extended as appropriate， but such extension may not be more than 12 months. After the disability class of the Employee with work-related injury is assessed， the original benefit s shall be terminated， and the Employee shall be entitled to the disabilit y benefits according to the relevant provisions of this Part. If the Emplo yee with work-related injury still needs medical treatment after the end o f the suspension-of-work-with-pay period， the Employee shall continue to e njoy work-related injury medical benefits.
If an Employee with work-related injury with self-care disability needs nu rsing care during the suspension-of-work-with-pay period， his work unit sh all be responsible for such needs.
Article 32 If an Employee with work-related injury has been assessed with respect to his disability class and confirmed by the assessment of work c apability committee as having need for living care， the fees for living ca re shall be paid monthly from work-related injury insurance funds.
Fees for living care shall be paid according to the three different classe
s of self-care disability， namely， total self-care disability， substanti al self-care disability and partial self-care disability， and the standard s shall be 50%， 40% or 30% of the average monthly wage of Employees in t he pooling region in the preceding year respectively.
Article 33 If an Employee with work-related disability is assessed as hav ing class one to class four disability， the labour relationship shall rema in， and the Employee shall withdraw from the work post and enjoy the follo wing benefits：
1. a disability allowance shall be paid from the work-related injury insur ance funds according to the disability class in a lump sum， and the standa rds are： for class one disability， the Employee's wages for 24 months； f or class two disability， the Employee's wages for 22 months； for class th ree disability， the Employee's wages for 20 months； and for class four di sability， the Employee's wages for 18 months；
2. a monthly disability subsidy shall be paid from the work-related injury insurance funds， and the standards are： for class one disability， 90% o f the Employee's wage； for class two disability， 85% of the Employee's wa ge； for class three disability， 80% of the Employee's wage； and for clas s four disability， 75% of the Employee's wage. If the actual amount of the disability subsidy is lower than the local minimum wage standard， the dif ference shall be made up from the work-related injury insurance funds； and
3. the disability subsidy shall be terminated once the Employee with work-related injury has reached retirement age and completed the retirement pro cedures， and the Employee shall then be entitled to basic old age insuranc e benefits. If the basic old age insurance benefits are lower than the dis ability subsidy， the difference shall be made up from the work-related inj ury insurance funds.
If an Employee with work-related disability is assessed as having class on e to class four disability， the Employer and the Employee shall pay the ba sic medical insurance premium on the basis of the disability subsidy.
Article 34 If an Employee with work-related disability is assessed as hav ing class five or class six disability， the Employee shall be entitled t o the following benefits：
1. a disability allowance shall be paid from work-related injury insurance funds according to the disability class in a lump sum， and the standards are： for class five disability， the Employee's wages for 16 months； and for class six disability， the Employee's wages for 14 months； and
2. his labour relationship with the Employer shall remain and the Employer shall arrange appropriate work for the Employee. Where it is difficult to arrange any work for the Employee， the Employer shall pay a monthly disab ility subsidy to the Employee， and the standards are： for class five disa bility， 70% of the Employee's wage and for class six disability， 60% of t he Employee's wage， and the Employer shall also pay as required on behalf of the Employee all the social insurance premiums payable by the Employee. If the actual amount of the disability subsidy is lower than the local mi nimum wage standard， the difference shall be made up by the Employer.
Upon request of the Employee with work-related injury， the labour relation ship between the Employee and the Employer may be dissolved or terminate d， and the Employer shall pay the work-related injury medical allowance an d a disability employment allowance in a lump sum. The specific standards shall be stipulated by the people's governments of provinces， autonomous r egions and municipalities directly under the central government.
Article 35 If an Employee with work-related disability is assessed as hav ing class seven to class ten disability， the Employee shall be entitled to the following benefits：
1. a disability allowance shall be paid from work-related injury insurance funds according to the disability class in a lump sum， and the standards are： for class seven disability， the Employee's wages for 12 months； for class eight disability， the Employee's wages for 10 months； for class ni ne disability， the Employee's wages for eight months； and for class ten d isability， the Employee's wages for six months； and
2. upon termination of the labour contract at the end of the term thereo
f，or upon dissolution of the labour contract at the request of the Empl oyee， the Employer shall pay the work-related injury medical allowance and disability employment allowance in a lump sum. The specific standards sha ll be stipulated by the people's governments of provinces， autonomous regi ons and municipalities directly under the central government.
Article 36 If an Employee suffers from a relapse of the work-related inju ry and is confirmed as in need of medical treatment， the Employee shall be entitled to the work-related injury benefits specified in Articles 29， 30 and 31 hereof.
Article 37 In the case of a work-related death of an Employee， the direct ly-related family members of the Employee shall receive a funeral allowanc e， bereavement payments for dependent family members and a lump sum work-r elated death allowance from work-related injury insurance funds in accorda nce with the following provisions：
1. the funeral allowance shall be six months' average monthly wage of the Employees in the pooling region in the preceding year；
2. bereavement payments for dependent family members shall be made at a ce rtain percentage of the Employee's wage to each of the family members of t he Employee that， before the Employee's death， was dependent on the Emplo yee for primary source of income and that has no work capability. The stan dards are： 40% per month for the spouse， 30% per person per month for oth er family members， with an additional 10% on the basis of the afore-mentio ned standards per person per month in the case of an elderly living alon
e or an orphan. The sum o
f the bereavement payments to all dependent fam ily members so determined shall not be higher than the wage of the Employe e before his work-related death. The specific scope of dependent family me mbers shall be specified by the administrative department of labour securi ty of the State Council； and
3. the standard for the lump sum work-related death allowance shall be 48 to 60 months' average monthly wage of the Employees in the pooling region in the preceding year. The specific standard shall be stipulated by the pe。