Case Sharing on Work-Related Injury Recognition (2), by the Occupational Disease Prevention and Control Task Force of the Occupational Disease Prevention and Control Institute

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Case introduction: In April 2015, Sun, an employee of Company A, brought a diagnosis certificate issued in February 2015 by the occupational disease prevention and control team at the local occupational disease prevention and treatment hospital to the local Human Resources and Social Security Bureau to apply for recognition of his work-related injury. After receiving the application, the Work Injury Insurance Section of the Municipal Human Resources and Social Security Bureau examined it. 　　 Upon investigation, it was found that the occupational disease diagnosis certificate held by Sun contained three violations of the regulations: first, the name of his condition in the diagnostic documents was listed as moderate occupational hearing loss ； Second, there is only one doctor’s signature on the diagnosis certificate ； Third, the entity that uses the official seal is not the Municipal Occupational Disease Prevention and Control Hospital, but the Municipal Occupational Disease Prevention and Control Task Force. 　 　After consideration, the Municipal Human Resources and Social Security Bureau decided not to recognize Sun’s application as an occupational injury. Sun then submitted that he had suffered an accident at work, which was the cause of his moderate hearing loss, and used this as a reason to file another application for work-related injury recognition. Staff from the Work-related Injury Insurance Department of the Municipal Human Resources and Social Security Bureau went to Company A, where Sun worked, to conduct an investigation to determine whether Sun had suffered any accidents at work. They reviewed Sun’s medical records and organized expert consultations; as a result, it was ruled out that Sun suffered from explosive deafness caused by pressure waves or shock waves, as well as any traumatic hearing loss resulting from non-external forces. Subsequently, the Municipal Human Resources and Social Security Bureau issued another decision determining that Sun’s moderate hearing impairment did not constitute a work-related injury. 　　After receiving the notice stating that his injury was not recognized as a work-related injury, Sun applied for administrative reconsideration to the Provincial Department of Human Resources and Social Security. Following the review of this application, the department upheld the decision made by the Municipal Department of Human Resources and Social Security, concluding that Sun’s injury was not considered a work-related injury. Points of dispute: First, whether moderate occupational hearing loss constitutes an occupational disease ； 　　Second, whether the signatures of the internal departments of the occupational disease prevention and control hospital can serve as a substitute for the hospital’s official seal designated for diagnosing occupational diseases, and whether they possess legal validity for making such diagnoses. Case Analysis Sun believes that, first, his occupational moderate hearing loss was caused by noise exposure at the workplace (the diagnosis clearly states that the occupational moderate hearing loss was resulting from noise during work) ； Secondly, the occupational disease diagnosis certificate is issued by qualified and legitimate physicians from occupational disease diagnosis institutions, and is stamped with the seal of the occupational disease prevention and control task force, which adds to its authority. Therefore, his occupational moderate hearing loss is undoubtedly an occupational disease and should rightfully be recognized as a work-related injury. 　　The Municipal Human Resources and Social Security Bureau stated: First, regarding the issue of occupational diseases. Firstly, the \"Classification and Catalogue of Occupational Diseases\" (Document No. Guo Wei Ji Bing Fa 48), issued in December 2013 by the **National Health and Family Planning Commission, the Ministry of Human Resources and Social Security, the State Administration of Work Safety, and the All-China Federation of Trade Unions, included noise-induced deafness and blast-induced deafness under the category of occupational ear, nose, throat, and oral diseases. The “Diagnostic Criteria for Occupational Hearing Loss” (GBZ49-2002) stipulate that mild hearing loss is defined as a hearing level of 26–40 dB ； Moderate hearing impairment corresponds to a hearing level of 41–55 dB ； Severe hearing impairment with hearing levels of 56–70 dB ； The hearing level in noise-induced deafness is 71–90 dB. The standard specifies that moderate hearing impairment does not fall under noise-induced deafness or blast-induced deafness. 　　Second, regarding the diagnosis of occupational diseases. The Law on the Prevention and Control of Occupational Diseases stipulates that medical and health institutions wishing to conduct diagnoses of occupational diseases must obtain approval from the health administrative departments of the provinces, autonomous regions, and municipalities directly under the Central Government. Medical institutions responsible for the diagnosis of occupational diseases shall meet the following conditions: (1) Hold a \"Medical Institution Practice License\" ； (II) Possess medical and health professionals competent for carrying out occupational disease diagnoses ； (III) Possess instruments and equipment appropriate for conducting diagnoses ； (IV) It has a sound management system for the diagnosis of occupational diseases. Medical and health institutions responsible for the diagnosis of occupational diseases shall organize a collective diagnosis by three or more practicing physicians qualified for such diagnoses when conducting such diagnoses. The certificate of occupational disease diagnosis shall be jointly signed by the physicians involved in the diagnosis, and approved and stamped by the medical institution responsible for the diagnosis of occupational diseases. In light of this, the diagnostic documents held by Sun, which bear a physician’s signature and the special diagnostic seal for occupational diseases issued by a non-occupational disease prevention and control institution, do not comply with the legal requirements for diagnosing occupational diseases; therefore, the human resources and social security authorities should declare the diagnostic certificate held by Sun to be invalid. 　　Third, regarding the issue of moderate hearing impairment caused by accident injuries. Work-related injuries generally include suffering from occupational accidents or contracting occupational diseases. An occupational accident injury is defined as damage to human tissues that occurs in an area related to occupational activities, as a result of sudden natural or human-induced harmful factors; such injuries are characterized by their sudden onset. Based on the medical records indicating moderate hearing impairment provided by Sun himself, as well as considering the cause of his hearing loss and the location of the damage to his ears, expert diagnoses and on-site investigations at his workplace ruled out the possibility of explosive deafness resulting from pressure waves or shock waves, as well as traumatic hearing loss caused by external force injuries. Therefore, it can be ruled out that Sun’s moderate hearing impairment was caused by a sudden accident. 　　 In conclusion, the Human Resources and Social Security Bureau issued decisions denying recognition of the work-related injuries in both cases: the first time, on the grounds that Sun suffered from a occupational disease resulting in moderate hearing loss, and the second time, on the grounds that the moderate hearing loss was caused by an accident.