工傷保險(xiǎn)條例(英文)

Work-related Injury Insurance Regulations國(guó)務(wù)院令第375號(hào)（Promulgated by the State Council on 27 April 2003 and effective as of 1 January 2004.）頒布日期：20030427 實(shí)施日期：20040101 頒布單位：國(guó)務(wù)院PART ONEGENERAL PROVISIONSArticle 1These Regulations are formulated in order to guarantee availability of medical treatment and economic compensation to staff and workers that 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 2All types of enterprises and sole traders that hire workers （Employer（s） shall participate in work-related injury insurance and pay work-related injury insurance premiums for all of the staff and workers or hired workers in their work unit （Employee（s） in accordance with the provisions hereof.The Employees of all types of enterprises and the hired workers of sole traders in the Peoples Republic of China shall have the right to enjoy the benefits of work-related injury insurance in accordance with the provisions hereof.The specific steps and implementing procedures for participation of sole traders that hire workers in work-related injury insurance shall be stipulated by the peoples governments of provinces， autonomous regions and municipalities directly under the central government.Article 3Collection and payment of work-related injury insurance premiums 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 4An Employer shall announce within the work unit the relevant details of its participation in work-related injury insurance.An Employer and its Employees shall abide by the laws and regulations regarding safe production and prevention and treatment of occupational diseases， implement safety and health regulations and standards， prevent occurrence of work-related injury accidents and avoid and mitigate the harms of occupational diseases.If an Employee suffers from work-related injury， the Employer shall adopt measures to ensure that such Employee receives timely rescue and treatment.Article 5The administrative department of labour security of the State Council shall be in charge of the work of work-related injury insurance throughout the country.The administrative departments of labour security of all levels of local peoples governments at the county level and above shall be in charge of work-related injury insurance work within their respective administrative areas.The social insurance agencies established by the administrative departments of labour security in accordance with relevant provisions of the State Council （Agency/Agencies） shall undertake the practical affairs of work-related injury insurance.Article 6Administrative departments of labour security and other departments shall seek the opinion of trade unions and representatives of Employers when formulating policies and standards for work-related injury insurance.PART TWOWORK-RELATED INJURY INSURANCE FUNDSArticle 7Work-related injury insurance funds shall be composed of work-related injury insurance premiums paid by Employers， interest on work-related injury insurance funds and other funds paid into the work-related injury insurance funds in accordance with law.Article 8The premium rate for work-related injury insurance shall be determined on the principles that receipt be determined on the basis of payment and that receipt and payment be balanced.The State shall determine premium rate differentials between industries according to the degree of risks of work-related injuries in different industries， and shall determine several tiers of premium rates within each industry according to circumstances such as the use of work-related injury insurance 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 security of the State Council in conjunction with the finance department， health administrative department and safe production regulatory department of the State Council， and shall be promulgated and implemented upon approval by the State Council. The Agency for a pooling region shall determine the work unit payable premium rate for an Employer on the basis of such circumstances such as use of work-related injury insurance premiums and frequency of occurrence of work-related injuries of the Employer， and the corresponding premium rate tier applicable to the industry to which the Employer belongs.Article 9The administrative department of labour security of the State Council shall periodically obtain the details of receipt and payment of work-related injury insurance funds of all pooling regions throughout the country， and shall propose adjustment to the inter-industry premium rate differentials and the intra-industry premium rate tiers in a timely manner and in conjunction with the finance department， health administrative department and safe production regulatory department of the State Council. Such adjustment shall be promulgated and implemented upon approval by the State Council.Article 10Employers shall pay work-related injury insurance premiums on time. Employees shall not pay work-related injury insurance premiums themselves.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 unit and the work unit payable premium rate.Article 11Work-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 regions shall be determined by the peoples government of the province or autonomous region.An inter-region industry or an industry with a relatively high level of production mobility may participate from another region in work-related injury insurance in a pooling region by adopting a method of relative concentration. The specific procedures shall be formulated by the administrative department of labour security of the State Council in conjunction with the department in charge of the relevant industry.Article 12Work-related injury insurance funds shall be deposited into a dedicated finance account for social security funds for benefits of work-related injury insurance， assessment of work capability and payment of other expenses for work-related injury insurance stipulated herein. No work unit or individual may use the work-related injury insurance funds for investment and operation， construction or renovation of office site， distribution of bonuses， or divert such funds to other uses.Article 13A certain ratio of work-related injury insurance funds shall be maintained as reserves for payment of work-related injury insurance benefits in the event of major accidents in the pooling region. In case of a shortage of reserves， the peoples government of the pooling region shall advance 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 the peoples governments of provinces， autonomous regions or municipalities directly under the central government.PART THREEDETERMINATION OF WORK-RELATED INJURYArticle 14An Employee shall be determined as having a work-related injury if：1. he is injured in an accident at work during working hours in the workplace； 2. he is injured in an accident while engaging in preparatory or finishing-up work related to work before or after working hours in the workplace；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 accident， during work-related travel；6. he is injured in a motor vehicle accident while going to or returning from work； or7. he is in other circumstances that shall be determined as work-related injury according to the provisions of laws and administrative regulations.Article 15An 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 interests such as emergency rescue and disaster relief； or3. he is injured and disabled in war or on duty while in military service and has obtained a revolutionary injured and disabled soldier certificate， and suffers from a relapse of the old injury while being employed by the Employer.Where an Employee is in the circumstance of Item （1） or （2） of the preceding paragraph， he shall be entitled to work-related injury insurance benefits in accordance with the relevant provisions hereof. Where an Employee is in the circumstance of Item （3） of the preceding paragraph， he shall be entitled to work-related injury insurance benefits other than the lump sum disability allowance in accordance with the relevant provisions hereof.Article 16An 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 violation of public security administration；2. he is injured or he dies as a result of intoxication； or3. he inflicts harm on himself or commits suicide.Article 17If an Employee is injured in an accident or diagnosed or certified 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 administrative department of labour security of the relevant pooling region within 30 days of the date of occurrence of the accidental injury or the date of diagnosis or certification of the occupational disease. In special circumstances， the time limit for application may， subject to the consent of the administrative department of labour security， be extended as appropriate.If the Employer fails to file an application for determination of work-related injury pursuant to the preceding paragraph， the Employee with work-related injury， his directly-related family members or the trade union may directly file an application for determination of work-related injury to the administrative department of labour security of the pooling region in 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 required under the first paragraph of this Article to be conducted by the administrative department of labour security at the provincial level shall be handled by the administrative department of labour security of a municipality having districts in which the Employer is located according to the principle of jurisdiction.If the Employer fails to file an application for determination of work-related injury within the time limit prescribed in the first paragraph of this Article， the relevant expenses such as the work-relatedinjury benefits that comply with the provisions hereof arising during this period shall be borne by the Employer. Article 18When filing an application for determination of work-related injury， 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 （including de facto labour relationship）； and3. a certificate of medical diagnosis or a certificate of diagnosis of occupational disease （or an assessment of diagnosis of occupational disease）。The application for determination of work-related injury shall include the basic details of the accident such as the time and place of occurrence， the cause of the accident and the degree of injury to the Employee.If the materials provided by the applicant for determination of work-related injury are incomplete， the administrative department of labour security shall notify the applicant of all the materials that need to be supplemented in a one-time written notice. After the applicant has supplemented the materials as required by the written notice， the administrative department of labour security shall accept the application.Article 19After the administrative department of labour security has accepted an application for determination of work-related injury， it may investigate and verify the accident and injury as required in examining and verifying the application， and the Employer， Employee， trade union， medical institution and other relevant departments shall provide assistance. Assessment of diagnosis of occupational disease and diagnosis dispute shall be handled in accordance with the relevant provisions of the Prevention and Treatment of Occupational Diseases Law. The administrative department of labour security shall not carry out further investigation or verification on certificates of diagnosis of occupational disease or assessment of diagnosis of occupational disease that are obtained in accordance with the law.Where an injury is considered as work-related by the Employee or his directly-related family members but not by the Employer， the burden of proof shall be borne by the Employer.Article 20The administrative department of labour security shall render a decision on determination of work-related injury within 60 days of the date of acceptance of the application for determination of work-related injury， and shall notify the Employee applying for determination of work-related injury or his directly-related family members and his work unit in writing.Where the personnel of the administrative department of labour security has a material interest in the applicant for determination of work-related injury， he shall withdraw from the case.PART FOURASSESSMENT OF WORK CAPABILITYArticle 21If an Employee suffers from a work-related injury and he is in stable condition after treatment but has disability or his work capability is affected， the Employee shall undergo an assessment of work capability.Article 22An assessment of work capability is an assessment of the degree of impairment in work functions and the ability to self-care.Impairment in work functions is classified into ten disability classes， from class one， the most severe， to class ten， the mildest.Impairment in the ability to self-care is classified into three classes： total self-care disability， substantial self-care disability and partial self-care disability.Standards for assessment of work capability shall be formulated by the administrative department of labour security of the State Council in conjunction with the health administrative department and other departments of the State Council.Article 23Applications for assessment of work capability shall be filed by the Employer， the Employee with work-related injury or his directly-related family members to the assessment of work capability committee of a municipality having districts， and the decision on determination of work-related injury and the information relevant to the medical treatment of the work-related injury of the Employee shall be provided. Article 24The assessment of work capability committee of provinces， autonomous regions， municipalities directly under the central government and municipalities having districts shall be composed of representatives of the administrative department of labour security， personnel administrative department， health administrative department， trade unions， Agencies and Employers 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 medical or health profession；2. possessing the relevant knowledge for assessment of work capability； and3. having good professional conduct.Article 25After the assessment of work capability committee of a municipality 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 shall provide an assessment opinion. The assessment of work capability committee 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 necessary， it may entrust a qualified medical institution to assist in the relevant diagnosis.The assessment of work capability committee of the municipality having districts shall render an assessment of work capability conclusion within 60 days of the date of receipt of the application for assessment of work capability. The time limit for rendering an assessment of work capability conclusion may be extended for 30 days if necessary. The assessment of work capability conclusion shall be served in a timely manner on the work unit and individual that applies for assessment.Article 26If the work unit or individual that applies fo