[Guozun Law Firm] Administrative Confirmation and Evidence Determination in Work-Related Injury Accidents: Revealing the Core Elements for Determining Work-Related Injury

The Key Role of Administrative Confirmation in the Determination of Work-Related Injury Accidents

Standards for Determining Work-Related Injury Accidents

Traffic accident or accidental injury: An employee is injured in a traffic accident for which he or she does not bear the principal responsibility, or is injured in an accident involving urban rail transit, a passenger ferry, or a train.

Other statutory circumstances: Other circumstances that shall be determined as work-related injury according to laws and administrative regulations.

Analysis of the Work-Related Injury Determination Process

Application stage: The employee or his or her employer, close relatives, and others submit a work-related injury application to the social insurance administrative department.

Confirmation stage: The social insurance administrative department confirms the nature of the work-related injury according to the application materials.

Nature and Process of Work-Related Injury Determination

Administrative confirmation act: The labor administrative department, based on legal authorization, characterizes whether an employee’s accidental injury belongs to a work-related injury.

Specific administrative act: The results include work-related injury, non-work-related injury, deemed work-related injury, and not deemed work-related injury.

Determination process:

Investigation and evidence collection: Investigate the course of the accident, fix the evidence, and investigate witnesses.

Filling in the application form: Fill in the Application Form for Work-Related Injury Determination.

Review and verification: The social insurance administrative department reviews the application materials and, where necessary, conducts investigation and verification.

Appraisal: The Labor Capacity Appraisal Committee appraises matters related to the work-related injury.

Decision notification: The social insurance administrative department makes the decision on work-related injury determination and notifies the applicant and the employer.

How to Determine Work-Related Injury

Key Points of Work-Related Injury Appraisal

Appraisal conditions: After the employee is determined to have suffered a work-related injury, appraisal is conducted after medical treatment ends or after the relevant period expires.

Appraisal scope: Includes labor capacity appraisal, suspension from work with pay period, nursing level, configuration of disability assistive devices, and so on.

Basis for Work-Related Injury Determination

Working time, place, and cause: The employee suffers accidental injury during working time, at the workplace, because of work reasons, or while performing duties.

Occupational disease determination standard: Meets the standards for determination of occupational disease.

Accidents on the way to and from work: Consider relevant accidents occurring while the employee is commuting to and from work.

Specific Steps in the Work-Related Injury Determination Process

Application for Work-Related Injury Determination

Applicant: The injured employee or the employer.

Application materials: Including proof of labor relationship, medical diagnosis certificate, and so on.

Investigation of Work-Related Injury Determination

Social insurance administrative department: Conducts investigation and verification of the accidental injury.

Making a decision: The social insurance administrative department makes the decision on work-related injury determination and notifies the applicant and the employer.

Scope of Work-Related Injury and Its Determination Standards

Scope of Work-Related Injury

Within working time and workplace: Suffering accidental injury because of work reasons.

Before and after working time: Suffering accidental injury while engaging in preparatory or finishing work related to the job.

Performing work duties: Suffering violent or other accidental injury due to performing work duties.

Suffering from an occupational disease.

During a period of work-related travel.

Standards for Determining Work-Related Injury

Work-related reason: Suffering accidental injury or occupational disease because of work reasons or work-related activities.

Performing tasks: Performing the daily production or work tasks of the employer or temporary tasks assigned by the person in charge.

Related to the employer: Engaging in scientific experiments, inventions and creations, or technological improvements related to the employer.

Exposure to occupational harmful factors: Contact with occupational harmful factors in the working environment resulting in occupational disease.

Definition of Work-Related Injury Accidents and Legal Analysis

Legal analysis

Definition of work-related injury: Injury suffered by an employee in production labor or in work.

Compensation standard: Corresponding compensation is given according to the injury condition.

Definition of work-related injury accident

Occupational activity injury: Injury from adverse factors and occupational disease injury suffered by a worker while engaging in occupational activities or activities related to occupational activities.

International conventions: The 1921 Convention and the 1964 Convention both emphasize that compensation for work-related injury should include occupational diseases and commuting traffic accidents.

How to Effectively Prove Work-Related Injury

Legal basis

Article 18 of the Regulation on Work-Related Injury Insurance: When applying for work-related injury determination, it is necessary to submit the application form for work-related injury determination, proof of labor relationship, medical diagnosis certificate, and so on.

Social insurance administrative department: The employee or his or her employer, close relatives, and others submit a work-related injury application to the social insurance administrative institution.

Supporting materials

Identity certificate: The employee’s own identity card or other valid identity document.

Work-related injury accident report: A detailed description of the process, time, place, and injury circumstances of the work-related injury accident.

Medical proof: Including emergency records, hospitalization certificate, diagnosis certificate, and so on, to prove the fact and extent of the employee’s injury.

Hospital proof

Appraisal: First go to the labor bureau for appraisal to determine the disability grade, corresponding to the relevant compensation standard.

Work-related injury determination: Go to the labor bureau at the place where the work-related injury accident occurred to determine the work-related injury, and then conduct disability appraisal.

Legal effect: The appraisal made by that institution has legal effect and serves as the basis for requesting enjoyment of work-related injury insurance benefits.