工伤保险条例 State Council, Work-related Injury Insurance Regulations

mployee 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； or

　　3. he inflicts harm on himself or commits suicide.

　　Article 17　If 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-related

injury benefits that comply with the provisions hereof arising during this period shall be borne by the Employer.

　　Article 18　When 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）； and

　　3. 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 19　After 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 20　The 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 FOUR　ASSESSMENT OF WORK CAPABILITY

　　Article 21　If 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 22　An 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 23　Applications for assessment of work capability shall be filed by the Employer， the Employee with work-related injury or his dire

ctly-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 24　The 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； and

　　3. having good professional conduct.

　　Article 25　After 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 26　If the work unit or individual that applies for assessment is dissatisfied with the assessment conclusion of the assessment of work capability committee of the municipality having districts， the work unit or individual may， within 15 days of the date of receipt of the assessment conclusion， apply to the assessment of work capability committee of the province， autonomous region or municipality directly under the central government for a reassessment. The assessment of work capability conclusion of the assessment of work capability committee of the province， autonomous region or municipality directly under the central government shall be final.

　　Article 27　Assessment of work capability shall be objective and impartial. If any member of the assessment of work capability committee or expert participating in the assessment has a material interest in the party， he shall withdraw from the assessment.

　　Article 28　If， within one year after an assessment of work capability conclusion is made， the Employee with work-related injury or his directly-related family members， his work unit or the Agency believes that there is a change in the disability condition， he may apply for a review of the assessment of work

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