How to reimburse social security industrial injury insurance?

Social security work-related injury insurance needs to follow the steps of seeking medical treatment, applying for work-related injury identification, applying for labor ability appraisal and applying for work-related injury insurance benefits. When putting forward the work-related injury identification, it is necessary to submit the application form for work-related injury identification, the existence of labor relations with the employer and other supporting materials.

First, how to reimburse social security work-related injury insurance?

When a work-related injury occurs, you can reimburse the work-related injury expenses according to the following steps:

1, see a doctor

The medical treatment of work-related injuries should follow the social security regulations. Generally, only designated medical institutions can reimburse. In case of emergency, you can go to the nearest medical institution for treatment. If you go to some private hospitals or non-designated hospitals at will, industrial injury insurance will be ignored.

For some occupational diseases or suspected occupational diseases, employers need to send employees to medical institutions established by provincial health administrative departments for diagnosis. If it is necessary to transfer to other cities for medical treatment due to medical conditions, it must be put forward by the current medical institution and then approved by the municipal social insurance agency.

As an employer, it must report the accident to the relevant social security department on the first working day after the accident, and issue a work-related accident report to the social security institution within seven working days after the accident and put it on record.

2. Apply for work-related injury identification.

If an employee is injured due to an accident or is diagnosed or identified as an occupational disease, the unit to which he belongs shall apply to the Social Security Bureau for work-related injury identification within 30 days. If the employer fails to apply for work-related injury identification as required, the employee or his relatives or trade union may directly apply for work-related injury identification within one year.

If you have participated in work-related injury insurance, but the employer fails to submit an application for work-related injury identification within the specified time, all relevant expenses will be borne by the employer as long as the injured employee meets the work-related injury insurance regulations.

3, labor ability appraisal

When employees suffer work-related injuries, the injuries are stable after treatment. If he/she has a disability or affects his/her working ability, he/she needs to evaluate his/her working ability. The specific appraisal method requires employers, employees with work-related injuries or their close relatives to submit an application for labor ability appraisal to the labor ability appraisal committee, and submit the work-related injury identification decision and relevant materials for medical treatment of employees with work-related injuries, including the cases, diagnosis certificates and corresponding inspection reports of employees with work-related injuries.

4. Apply for work-related injury insurance benefits

After the work-related injury is identified, the employer will generally apply for medical treatment of work-related injury insurance for employees with relevant materials such as the work-related injury identification decision. The treatment of work-related injury insurance generally includes medical expenses for work-related injuries, food subsidies for hospitalization, transportation and accommodation expenses for medical treatment in different places, etc.

After the appraisal of labor ability, the level of disability is assessed, and the unit can apply for work-related injury and disability treatment for employees with work-related injuries with the "Appraisal of Labor Ability" and other related materials.

Second, what materials should be submitted when making a request for work-related injury identification?

The following materials shall be submitted to apply for work-related injury identification:

Application form for work-related injury identification;

(two) the existence of labor relations with the employer (including factual labor relations);

(3) Medical diagnosis certificate or occupational disease diagnosis certificate (or occupational disease diagnosis certificate).

The application form for work-related injury identification shall include the time, place and cause of the accident, as well as the degree of injury of employees and other basic information.

If the materials provided by the applicant for work-related injury identification are incomplete, the social insurance administrative department shall inform the applicant in writing of all the materials that need to be supplemented at one time. The administrative department of social insurance shall accept the corrected materials after the applicant has been informed in writing.

Units need to fulfill their obligations to pay social security such as work-related injury insurance for employees. For employees who have paid work-related injury insurance, if they are injured in the course of work and are recognized as work-related injuries, they can enjoy the corresponding work-related injury insurance benefits. For employees who are injured at work, if the unit dismisses, they may need to pay compensation or compensation.