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Compensation standards for work-related injuries and deaths (2016)

2016-10-31View Original

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The standards for work-related injury compensation, also known as the standards for work-related injury benefits, refer to the categories of compensation and the corresponding standards that workers who have suffered work-related injuries or whose relatives have lost them to such injuries are entitled to under the law. If an employee of an employer suffers an industrial injury during a period when no work-related injury insurance coverage is in place, the employer shall pay the related expenses in accordance with the items and standards for work-related injury benefits specified in the Regulations on Work-Related Injury Insurance. Legal basis: Articles 35, 36, 37, and 39 of the Regulations on Work-related Injury Insurance. The standards for compensation – one-time disability benefits for grades 1 to 10 – are stipulated in Articles 35, 36, and 37 of the Regulations on Work-related Injury Insurance. When an employee is injured at work and is classified as having a disability from grade 1 to grade 10, the work-related injury insurance fund shall pay a one-time disability benefit, with the following rates: Grade 1 disability: the employee’s salary × 27; Grade 2 disability: the employee’s salary × 25; Grade 3 disability: the employee’s salary × 23; Grade 4 disability: the employee’s salary × 21; Grade 5 disability: the employee’s salary × 18; Grade 6 disability: the employee’s salary × 16; Grade 7 disability: the employee’s salary × 13; Grade 8 disability: the employee’s salary × 11; Grade 9 disability: the employee’s salary × 9; Grade 10 disability: the employee’s salary × 7. Compensation standards for disabilities from level 1 to 6 (paid on a monthly basis): In accordance with Articles 35 and 36 of the Regulations on Work-related Injury Insurance, employees who are disabled as a result of work and are classified as having disabilities from level 1 to 6 are entitled to receive a disability allowance on a monthly basis. The amounts are as follows: Level 1 disability: 90% of the employee’s own salary; Level 2 disability: 85% of the employee’s own salary; Level 3 disability: 80% of the employee’s own salary; Level 4 disability: 75% of the employee’s own salary; Level 5 disability: 70% of the employee’s own salary; Level 6 disability: 60% of the employee’s own salary. Notes: 1) Disability allowances for grades 1–4 are paid from the work-related injury insurance fund; if the actual amount is lower than the local minimum wage, the difference shall be covered by the work-related injury insurance fund. 2) Disability allowances for grades 5–6 are paid by the employer in cases where it is difficult to arrange work for the affected person; if the actual amount of such allowances is lower than the local minimum wage, the employer shall cover the difference. 3) Personal salary: refers to the average monthly contributory salary of the injured worker over the 12 months prior to suffering an accident at work or contracting an occupational disease. If an individual’s salary is 300% higher than the average salary of workers in the relevant area, the calculation will be based on 300% of that average salary; if an individual’s salary is 60% lower than the average salary of workers in that area, the calculation will be based on 60% of that average salary (the same applies hereafter). Compensation standards for grades 5 to 10: One-time medical benefits for work-related injuries and disability employment benefits. 1) One-time medical benefits for work-related injuries: Paid by the work injury insurance fund; 2) One-time disability employment benefits: Paid by the employer. The standards for these two types of benefits are determined based on the degree of disability. The Work Injury Insurance Regulations do not specify uniform standards, and it is up to the people’s governments of various provinces, autonomous regions, and municipalities directly under the Central Government to establish specific standards. It can be found in the provincial regulations or guidelines on work-related injury insurance. For example: In Guangdong Province, the standards for one-time medical benefits for work-related injuries and benefits for employment in case of disability are as follows. One-time medical benefit for work-related injuries: For grade 5 disability: the employee’s salary × 10; for grade 6 disability: the employee’s salary × 8; for grade 7 disability: the employee’s salary × 6; for grade 8 disability: the employee’s salary × 4; for grade 9 disability: the employee’s salary × 2; for grade 10 disability: the employee’s salary × 1. One-time disability employment allowance: Grade 5 disability: salary × 50; Grade 6 disability: salary × 40; Grade 7 disability: salary × 25; Grade 8 disability: salary × 15; Grade 9 disability: salary × 8; Grade 10 disability: salary × 4. Compensation standard 4: Wage during the period of suspension from work with pay. During this period, the original wage and benefits remain unchanged, and they are paid on a monthly basis by the employer. The period of suspension from work with pay generally does not exceed 12 months. In cases of severe injuries or special circumstances, as confirmed by the municipal labor capacity assessment committee at the district level, the period may be extended appropriately, but the extension shall not exceed 12 months. Note: In practice, the standard approach is to determine it based on the average salary over the 12 months prior to the work-related injury. Compensation standard 5: During the period of suspension from work with pay, employees who are injured at work and unable to take care of themselves require nursing care, which shall be provided by their employer. If the employer does not arrange for nursing care, the employer shall pay for it. The standard for compensation: Nursing care expenses after disability assessment – If an employee injured at work has been assigned a disability grade and it is determined by the Labor Ability Assessment Committee that they require nursing care, then nursing care expenses will be paid on a monthly basis from the work-related injury insurance fund. Complete inability to take care of oneself in daily life: average salary × 50%; partial inability to take care of oneself in daily life: average salary × 40%; limited inability to take care of oneself in daily life: average salary × 30%. The compensation standards include: meal allowances for hospitalization, transportation costs, and accommodation expenses. The meal allowances for employees who are hospitalized due to work-related injuries, as well as the transportation, accommodation, and other related expenses required when such employees seek treatment outside the designated area, are covered by the work injury insurance fund. The specific criteria for these payments are determined by the people’s government of the relevant area. 8. Compensation standards: Medical expenses required for treating work-related injuries that fall within the scope of the insurance coverage for work-related injuries, as listed in the catalog of treatment services, the catalog of medications covered by this insurance, and the standards for inpatient care under this insurance, shall be paid from the insurance fund for work-related injuries. Medical expenses that exceed the catalog and service standards must still be covered by either the injured worker or the employer. In practice, different approaches are adopted in various regions; in most areas, it is the employer who does not bear such costs. Compensation standard 9: Costs for work-related injury rehabilitation – The expenses incurred by workers with work-related injuries in undergoing rehabilitation at medical institutions with which service agreements have been established are, if they meet the relevant requirements, covered by the work-related injury insurance fund. The compensation standards include costs for assistive devices. Workers who have suffered work-related injuries and need such devices for their daily lives or employment can, upon confirmation by the labor capacity assessment committee, obtain prosthetics, orthotics, artificial eyes, dentures, and wheelchairs; the associated costs are covered by the work injury insurance fund in accordance with the **established standards. It should be noted that assistive devices should generally be limited to those necessary for assisting with daily life and productive work, and standard products available on the domestic market should be used. If an injured worker chooses a different model of product, the higher cost compared to the standard version must be paid out of pocket by the individual. Compensation standards: 11. Benefits for recurrence of work-related injuries – Workers who suffer a recurrence of a work-related injury and are found to need treatment are entitled to reimbursement for medical expenses related to the injury, costs for assistive devices, and wages during the period of suspension from work with pay. The standards for compensation in cases of death at work are determined in accordance with Article 39 of the Regulations on Work-related Injury Insurance. When an employee dies as a result of work-related injuries, their close relatives may receive a funeral subsidy, benefits for dependents, and a one-time death benefit from the work-related injury insurance fund, in accordance with the following provisions: 1. Funeral subsidy: Local average wage × 6; for example, the current local average wage in Beijing is 7,086 yuan, so the funeral subsidy amounts to 7,086 yuan × 6 = 42,516 yuan. 2. Pension for dependents: Paid at a certain percentage of the employee’s own salary to relatives who relied on the deceased employee for their main source of income and who have no working capacity. The standard is: 40% per month for spouses, 30% per month for other relatives; an additional 10% per month is added to the above standard for elderly people living alone or orphans. The total amount of pensions for all approved dependents should not exceed the salary of the employee who died from work-related reasons during his or her lifetime. Formula: Spouse: The deceased’s own salary × 40% (paid on a monthly basis); Other relatives: The deceased’s own salary × 30% (per person per month); Elderly people without family support or orphans: An additional 10% on top of the above rates. When calculating, the total amount of such pensions must be ≤ the employee’s monthly salary (calculated on a monthly basis). 3. One-time death benefit: The amount is 20 times the per capita disposable income of urban residents nationwide in the previous year. According to the latest statistics from the **Bureau of Statistics, the per capita disposable income of urban residents nationwide in 2015 was 31,195 yuan, an increase of 8.2% compared with the previous year. Therefore, the standard amount for the one-time death benefit in 2016 was 31,195 yuan × 20 = 623,900 yuan. As the Regulations on Work-related Injury Insurance are implemented uniformly across the country, regardless of whether a region is in the east or west or whether its economy is developed or underdeveloped, the national standard for the one-time death benefit in 2016 was 623,900 yuan. Note: The above standards are all derived from the latest provisions of the Work-related Injury Insurance Regulations as well as the most recent statistical data.

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