【Case】For work-related injury recognition, please check here!

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1.jpg Today, we have compiled 5 real cases of work-related injury recognition for everyone to study and learn from, to help them understand the process of determining work-related injuries. 1. Can an injury sustained by an employee during another fall while hospitalized for a work-related injury be considered a work-related injury? Facts of the case: Hu is an employee of a company. On May 31, 2014, Hu suffered a head injury while at work, and it was later recognized as an occupational injury in accordance with the law. On December 14, 2014, Hu accidentally fell while under hospital treatment, resulting in a ruptured spleen. Afterward, Hu submitted another application for work-related injury recognition to the local social insurance administration, claiming that he had fallen and been injured while hospitalized due to a work-related injury. After conducting an investigation and verification, the local social insurance administration department, in accordance with Article 14 of the Regulations on Work-related Injury Insurance, decided not to recognize Hu’s injury as a work-related injury. Hu disagreed and filed an administrative reconsideration request with the local people’s court, which, in accordance with the law, upheld the decision made by the social insurance administration department to deny Hu the status of an employee injured at work. Comment: Article 14 of the Regulations on Work-related Injury Insurance stipulates that \"employees who suffer accidental injuries at work due to work reasons while within working hours and at the workplace\" ； Or, in the event of being injured due to work reasons or going missing as a result of an accident while on a business trip, it shall be considered an occupational injury. In this case, although Hu was hospitalized due to a work-related injury, the period of his hospitalization was neither during working hours nor at the workplace; he also did not engage in any work-related activities, and the accidental fall was not caused by work-related reasons. Therefore, it does not meet the conditions stipulated in Article 14 of the Regulations on Work-Related Injury Insurance. In summary, the local social insurance administration department’s decision not to recognize Hu as having suffered a work-related injury is in accordance with the law. 2. Can an injury sustained by an employee while walking home from work, caused by rebar struck by a passing vehicle, be classified as a work-related injury? Case details: Wang is an employee of a certain company. At around 11:45 on July 22, 2013, while walking home from work, Wang was hit by a van driven by someone else, which collided with a construction barrier and injured Wang. The accident handling department of the local traffic police force issued a certificate stating: “...Upon on-site inspection, it was found that this section of road is closed due to construction.” The small passenger vehicle hit a steel bar with construction wires attached to it, injuring Wang who was walking by. The case was then transferred to the local police station for handling. ”The police station issued a certificate stating: “At 11:45 on July 22, 2013, our station received a call referred by the 122 emergency service stating: … This incident was a civil dispute, and it was advised that the matter be resolved through negotiation.” ”Afterward, Wang submitted an application for work-related injury recognition to the local social insurance administration department. After conducting an investigation and verification, the local social insurance administration authority, in accordance with Article 14, Item (6) of the Regulations on Work-related Injury Insurance, decided not to recognize Wang’s injury as a work-related injury. Wang disagreed and filed an administrative lawsuit with the local people’s court. After reviewing the case, the court upheld the decision made by the social insurance administration department to deny Wang the status of an employee injured at work. Comment: Article 14, Paragraph (6) of the Regulations on Work-related Injury Insurance stipulates that \"if an employee is injured in a traffic accident, or an accident involving urban rail transit, passenger ferries, or trains, while on his or her way to or from work, and the employee is not primarily at fault for such accident, it shall be recognized as a work-related injury.\" In this case, although Wang was injured in an accident while on his way home from work, that accident was not recognized as a traffic accident by the traffic management authorities, and it does not fall under the statutory circumstances that would warrant it to be classified as a work-related injury. In summary, the local social insurance administration department’s decision not to recognize Wang’s injury as a work-related injury is in accordance with legal provisions. The parties may apply to the local people’s court for civil compensation in accordance with the law. 3. Is an injury sustained during a team-building activity organized by the employer considered an occupational injury? Case details: Huang is a teacher at a middle school. On April 20, 2014, while participating in a field trip organized by his workplace, Huang fell and got injured during an outdoor training activity; he was diagnosed with a lumbar muscle strain and a fracture of the lumbar vertebrae. Afterward, Huang submitted an application for work-related injury recognition to the local social insurance administration department. After accepting the case, the local social insurance administration department sent a notice requiring evidence submission to the middle school where Huang worked. The school responded by acknowledging the details of Huang’s injury but stating that it was not related to his work and therefore did not constitute an occupational injury. After conducting an investigation and verification, the local social insurance administration department determined that Huang’s injury constituted a work-related injury in accordance with Article 14, Item (5) of the Regulations on Work-Related Injury Insurance. Comment: Article 14, Paragraph (5) of the Regulations on Work-related Injury Insurance stipulates that \"if an employee is injured due to work reasons or goes missing in an accident while on a business trip, it shall be recognized as a work-related injury.\" In this case, Huang was injured while participating in a team-building training organized by his employer; since it was a work-related activity, it should be considered an injury sustained while on a work assignment due to work reasons. In summary, the local social insurance administration department’s decision to classify Huang’s injury as a work-related injury is in compliance with legal provisions. 4. Can an employee’s injury sustained due to personal reasons during working hours be classified as a work-related injury? Case details: Zhang is an employee of a branch of an insurance company. In November 2013, while visiting a friend at another branch office, Zhang had a dispute with Feng, an employee of that branch. During the pushing and shoving, Feng injured Zhang’s left eye. The local police station stated in the interrogation record: “The dispute arose between the two parties for personal reasons.” Afterward, Zhang submitted an application for work-related injury recognition to the local social insurance administration department. After conducting an investigation, the department decided, in accordance with Article 14, Paragraph 3 of the Regulations on Work-Related Injury Insurance, not to recognize Zhang’s injury as a work-related injury. Zhang was not satisfied and filed an administrative lawsuit with the local people’s court. After reviewing the case, the court upheld the decision made by the social insurance administration department to deny Zhang the status of an employee injured at work. Comment: Article 14, Paragraph (3) of the Regulations on Work-related Injury Insurance stipulates that \"incidents such as injuries caused by violence that occur to employees while they are at work and within the workplace while performing their job duties shall be recognized as work-related injuries.\" The focus of this case is determining whether an employee suffered an injury as a result of performing their job duties during working hours and at the workplace. Based on evidence such as the police interrogation records of Zhang and Feng, witness testimony, and the settlement agreement for the case, it can be shown that although Zhang had a conflict with Feng during working hours and suffered physical injuries, those injuries are not directly related to his job duties; therefore, they should not be considered work-related injuries. In summary, the local social insurance administration department’s decision not to recognize Zhang’s injury as a work-related injury is in accordance with legal provisions. 5. Can an employee’s injury sustained in a traffic accident on the way to work due to drunkenness, where the employee is not primarily at fault, be classified as a work-related injury? Case: Tan is an employee of a property management company. At around 20:00 on August 5, 2014, Tan was hit by a motor vehicle driven by Zhao while crossing the road on his way to work for a night shift; he died despite efforts to save him. Tests showed that Tan’s blood ethanol level was as high as 370mg/100ml, indicating a state of severe intoxication. The local public security traffic police department determined in the \"Road Traffic Accident Determination Report\" that Tan lost the ability to recognize and control himself due to intoxication, while Zhao failed to pay attention to the road conditions because of driving too fast; therefore, it was concluded that both parties were equally responsible for this traffic accident. Afterward, Tan’s family filed an application for work-related injury recognition with the local social insurance administration. After conducting an investigation, the local social insurance administration, in accordance with Article 16, Paragraph 2 of the Regulations on Work-Related Injury Insurance, decided not to recognize Tan’s injury as a work-related injury. Tan’s relatives were not satisfied and filed an administrative lawsuit with the local people’s court, arguing that Tan had suffered an accident on his way to work for which he was not primarily responsible. After reviewing the case, the court upheld the decision made by the social insurance administration department to deny Tan the status of an employee injured at work. Comment: Article 16 of the Regulations on Work-related Injury Insurance stipulates that \"if an employee meets the requirements of Articles 14 and 15 of these regulations but is under the influence of alcohol, such injury shall not be recognized as a work-related injury or treated as one.\" In this case, Tan was involved in a traffic accident on his way to work for which he was not primarily at fault. Although this meets the requirements of Article 14, Item (6) of the Regulations on Work-related Injury Insurance, he was under the influence of alcohol at the time of the accident, so it should not be classified as a work-related injury. In summary, the local social insurance administration department’s decision not to recognize Tan’s injury as a work-related injury is in accordance with legal provisions. Source: China Work-Related Injury Insurance