How to identify work-related injuries

I. Seven legal situations for determining work-related injuries

Two, as the three legal cases of work-related injuries

Three, the Supreme Court's judicial interpretation of four types of work-related injury cases

Four, the State Council Legislative Affairs Office reply can be identified as work-related injuries in three ways.

Five, the administrative court of the Supreme Court reply identified seven types of work-related injuries.

Six, Ministry of Human Resources and Social Security on the work-related injury that retirement age is divided into two situations.

According to the Regulations on Work-related Injury Insurance, the judicial interpretation of the Supreme Court, the reply from the Administrative Chamber of the Supreme Court, the relevant reply from the Legislative Affairs Office of the State Council and the latest Opinions on Implementing the Regulations on Work-related Injury Insurance issued by Ministry of Human Resources and Social Security, this paper summarizes 26 cases of work-related injury identification, and briefly prompts the main points of identification for reference in practice.

▌ 1. Seven legal situations for determining work-related injuries.

According to Article 14 of the Regulations on Work-related Injury Insurance, there are seven legal situations that should be recognized as work-related injuries:

(1) Being injured by an accident during working hours and in the workplace;

The core factor "work reason" in the "three jobs" is a sufficient condition for a work-related injury. "Working place" and "working hours" are more auxiliary factors to prove the working reasons, and also play a strengthening role in the working reasons. If the employer or the social insurance administrative department has no evidence to prove that the injuries suffered during working hours and workplaces are caused by non-work reasons, they are presumed to be work reasons and can also be identified as work-related injuries.

(two) before and after working hours, in the workplace, engaged in work-related preparatory work or finishing work and was injured by an accident;

The so-called "preparatory work" refers to the preparatory work related to work within a reasonable time before work. Such as transportation, material preparation, tool preparation, etc. The so-called "finishing work" refers to finishing the work-related finishing work within a reasonable time after work, such as cleaning, safe storage, cleaning tools and clothes.

(three) in the working hours and workplace, due to the performance of work duties by violence and other accidental injuries;

The identification point of "accidental injury caused by violence in performing work duties" includes two meanings. One is that some people fail to achieve unreasonable or illegal purposes because of their job duties, and they are violently injured to employees out of revenge; The other layer refers to the accidental injuries suffered by employees during working hours and workplaces due to the performance of their duties, such as earthquakes, factory fires, collapse of workshops and houses, and unsafe other facilities in the unit.

"Accidental injuries such as violence due to performance of work duties" refers to the causal relationship between violent injuries and performance of work duties.

(4) Suffering from occupational diseases;

Identification points Occupational diseases must be diseases caused by employees in their professional activities. If a person suffers from a certain disease specified in the Occupational Diseases Catalogue, but it is not caused by contact with dust, radioactive substances or other toxic and harmful substances in professional activities, but by the unit that produces toxic substances around his living environment, then his disease does not belong to the occupational diseases mentioned in the industrial injury insurance regulations.

The diagnosis of occupational diseases and the identification of diagnostic disputes shall be carried out in accordance with the relevant provisions of the Law on the Prevention and Control of Occupational Diseases. If an occupational disease diagnosis certificate or occupational disease diagnosis appraisal book is obtained according to law, the social insurance administrative department will no longer conduct investigation and verification, and can directly identify the work-related injury.

(5) Being injured at work or missing for work reasons;

The identification points include: 1, the period during which the employee is sung by the employer for work needs or engaged in activities related to job responsibilities outside the workplace; 2. The employee is assigned by the employer to go out for study or meeting; 3. During the period when employees go out for activities due to work needs.

Employees who are injured during their work due to personal activities unrelated to their work or assigned by the employer to go out for study or meetings cannot be considered as work-related injuries.

Employees who go abroad for work reasons, who have a fixed residence and a clear schedule of work and rest, should be regarded as working normally in the local area.

If an employee has an accident while going out to work, the employee should be paid within 3 months from the month of the accident and stop paying wages from the fourth month. The industrial injury insurance fund shall pay the pension for dependent relatives on a monthly basis. Life is difficult, you can advance 50% of the one-time work death subsidy. If an employee is declared dead by the people's court, it shall be handled in accordance with the provisions of Article 39 of these regulations on the death of an employee due to work.

(six) on the way to work, I was injured by a traffic accident or an urban rail transit, passenger ferry or train accident for which I was not primarily responsible;

Identification points include: 1, reasonable commuting and living routes, and frequent residence and dormitory within a reasonable time; 2. A reasonable route to and from work and the residence of spouse, parents and children within a reasonable time; 3. Engage in activities required for daily work and life, and commute at a reasonable time and route; 4. Go to work through other reasonable routes within a reasonable time;

Accidents that are not my main responsibility include traffic accidents that are not my main responsibility and urban rail transit, passenger ferry and train accidents that are not my main responsibility.

"Traffic accident" refers to the incident that causes personal injury or property loss due to the fault or accident of the vehicle on the road as stipulated in Article 119 of the Road Traffic Safety Law. "Vehicle" refers to motor vehicles and non-motor vehicles; "Road" refers to highways, urban roads and places where social motor vehicles are allowed to pass, including squares, public parking lots and other places for the public to pass.

(seven) other circumstances that should be recognized as work-related injuries as stipulated by laws and administrative regulations.

▌ II. Three legal situations regarded as work-related injuries

According to Article 15 of the Regulations on Industrial Injury Insurance, there are three situations that are regarded as industrial injuries:

(a) died of sudden illness during working hours and jobs or died within 48 hours after being rescued;

Identification points "sudden illness" includes various diseases and is not required to be related to work. The starting time of "48 hours" is based on the initial diagnosis time of medical institutions as the starting time of sudden diseases.

Note: Although the employee suddenly fell ill during working hours and work, but died after 48 hours of rescue, it is not regarded as a work-related injury.

(2) Safeguarding national interests and public interests in emergency rescue and disaster relief activities;

Key points of identification This item only lists the situations of emergency rescue and disaster relief, but any similar emergency rescue and disaster relief behavior should be identified as an act of safeguarding national interests and public interests. Those who are injured in activities to safeguard national interests and public interests do not need to meet working hours, working places, working reasons and other factors.

(3) An employee who once served in the army and was disabled due to war or work has obtained a revolutionary disabled soldier's certificate, and his old injury recurs after going to the employing unit.

The key points of identification are that employees who have obtained the revolutionary disabled soldier's certificate have a recurrence of old injuries in the employer, and they no longer enjoy a one-time disability subsidy, but they can enjoy other work-related injury insurance benefits.

▌ Three or four judicial interpretations of work-related injury identification

According to Article 4 of the Provisions of the Supreme People's Court on Several Issues Concerning the Trial of Administrative Cases of Work-related Injury Insurance, the following four situations can be identified as work-related injuries:

(a) the employer or the administrative department of social insurance has no evidence to prove that employees are injured during working hours and workplaces;

(2) Employees are injured when they participate in activities organized by the employing unit or are assigned by the employing unit to participate in activities organized by other units;

(3) During working hours, employees travel to and from several reasonable areas between workplaces related to their job responsibilities and are injured due to work;

(four) other injuries suffered during working hours and within a reasonable range due to the performance of work duties.

The State Council Legislative Affairs Office has considered four or three situations that can be identified as work-related injuries in the relevant reply.

(1) The Legislative Affairs Office of the State Council letter [2005] No.315, "Request for Instructions on whether an employee is injured by a motor vehicle on the way off work in violation of the internal regulations of the enterprise", holds that as long as the injury suffered by an employee conforms to the situation of "being injured by a motor vehicle on the way to and from work" as stipulated in Item (6) of Article 14 of the Regulations on Industrial Injury Insurance, it should be recognized as an industrial injury.

(II) The Legislative Affairs Office of the State Council's Reply to the Request for Instructions on the Application of Item 6 of Article 14 of the Regulations on Work-related Injury Insurance issued by the Legislative Affairs Office of the Anhui Provincial Government (Letter [2008] No.375) holds that Li's going from the dormitory to his parents' home belongs to "on the way to and from work" as stipulated in Item 6 of Article 14 of the Regulations on Work-related Injury Insurance, which is a work-related injury.

(III) The reply of the Legislative Affairs Office of the State Council to "Request for Instructions on Whether Employees Participate in Sports Activities Organized by Units Can Be Recognized as Work-related Injuries" (Guo Fa Mi Han [2005] No.311No.) holds that as the work arrangement of the unit, if employees are injured in sports training activities, it shall be in accordance with the provisions of the first paragraph of Article 14 of the Regulations on Work-related Injury Insurance.

▌ Seven cases identified as work-related injuries in the relevant reply of the Supreme People's Court Administrative Court.

(1) "Reply of the Supreme People's Court Administrative Trial Chamber on whether there is a labor relationship between retirees and their current work units and whether the industrial injury insurance regulations are applicable when they are injured during work" ([2007] Hanghezi No.6) holds that according to Articles 2 and 6 1 of the Industrial Injury Insurance Regulations, retirees are employed by their current work units, and the current work units have paid industrial injury insurance premiums for them.

(II) The Reply of the Supreme People's Court Administrative Court on whether employees who are injured by others while studying abroad should be regarded as work-related injuries ([2007] Hanghezi No.9) holds that employees who are injured by others during the study period arranged by the learning unit should be regarded as work-related injuries.

(III) The Reply of the Supreme People's Court Administrative Trial Court on whether the casualties of drivers employed by the actual owners of vehicles operated by other units can be regarded as work-related injuries ([2006] Hang He ZiNo. 17) holds that if vehicles purchased by individuals are operated in the name of affiliated units, the drivers employed by them have formed a factual labor relationship with affiliated units, and if there are casualties in vehicle operation, the Labor Law and the Regulations on Work-related Injury Insurance shall apply. (Note from Li Yingchun: According to the reply of the Supreme People's Court No.2013, if a vehicle purchased by an individual is attached to another unit and operated in the name of the attached unit, the driver employed by it and the attached unit do not have the basic characteristics of labor relations, so it is not appropriate to assume that it has formed a factual labor relationship. )

(IV) the Supreme People's Court's Summary of the Symposium on Several Issues Concerning the Trial of Administrative Cases Related to Low Temperature Rain, Snow and Freezing Disasters (Fa Fa [2008]139) holds that during the low temperature rain, snow and freezing disasters, employers strive to restore transportation, communication, power supply, water supply, drainage, gas supply, road repair, and ensure food, drinking water and fuel in order to safeguard national interests and social public interests.

(V) The Request of the Supreme People's Court Administrative Trial Court on How to Apply the Law to the Death of State Organs ([2009] Hanghezi No.2) holds that Wang Kui, a driver temporarily employed by Dongfanghong Police Station of Dongshan Branch of Hegang Public Security Bureau, did not participate in work-related injury insurance, was not a regular policeman, and died of sudden illness in his unit, and it should be determined by hegang Labor and Social Security Bureau according to the Regulations on Work-related Injury Insurance whether it belongs to the standard of work-related injury and work-related injury treatment. The relevant work-related injury treatment expenses shall be paid by the employer.

(VI) The Reply of the Supreme People's Court Administrative Trial Court on whether the Regulations on Work-related Injury Insurance are applicable to migrant farmers over the statutory retirement age ([20 10]No. 10) holds that if migrant farmers over the statutory retirement age are injured or killed during working hours or at work, the relevant provisions of the Regulations on Work-related Injury Insurance shall be applied for work-related injury identification.

(VII) The reply of the the Supreme People's Court Administrative Trial Court on whether the death of an employee during a business trip should be regarded as a work-related injury ([20 10] Hang He Zi No.236) holds that if the cause of death of an employee during a business trip is unknown and the evidence provided by the employer or the social security department cannot exclude the non-work-related cause of death, it should be regarded as a work-related injury according to the provisions of Item (5) of Article 14 and Paragraph 2 of Article 19 of the Labor Law of People's Republic of China (PRC).

Six, Ministry of Human Resources and Social Security's latest regulations on retirement age are divided into two situations.

2065438+On March 28th, 2006, Ministry of Human Resources and Social Security made new provisions on the identification of work-related injuries of people who have reached retirement age in Opinions on Several Issues Concerning the Implementation of the Regulations on Work-related Injury Insurance (II), stipulating that the identification of work-related injuries can be divided into two situations:

(a) to reach or exceed the statutory retirement age, but did not go through the retirement formalities or enjoy the basic old-age insurance benefits for urban workers according to law, and continue to be injured by accidents or suffer from occupational diseases during the work of the original employer, the employer shall bear the responsibility of industrial injury insurance according to law.

(II) If an employer recruits a person who reaches or exceeds the statutory retirement age or has received the basic old-age insurance benefits for urban workers, and during the recruitment period, he is injured by an accident or suffers from occupational diseases due to work reasons, and the employer has paid work-related injury insurance premiums for him according to the project, the Regulations on Work-related Injury Insurance shall apply.