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Regulation on Work-Related Injury Insurances [Revised]
工伤保险条例 [已被修订]
【法宝引证码】
 
  
  
Regulation on Work-Related Injury Insurances
Decree No. 375 of the State Council of the People's Republic of China
The "Regulation on Work-Related Injury Insurances", which was deliberated and adopted at the 5th executive meeting of the State Council on April 16, 2003, is hereby promulgated, and shall come into force on January 1, 2004.
Wen Jiabao, Premier
April 27, 2003

 

中华人民共和国国务院令
(第375号)


《工伤保险条例》已经2003年4月16日国务院第5次常务会议讨论通过,现予公布,自2004年1月1日起施行。
总理 温家宝
二00三年四月二十七日
工伤保险条例
Chapter I General Provisions
 

第一章 总则


Article 1 The present regulation is enacted with a view to guaranteeing the workers who are injured from accidents arising from work or who suffer from occupational diseases to obtain medical care and economic compensation, promoting the prevention and occupational recovery from work-related injuries, and dispersing the work-related injury risks of employing entities.
   第一条 为了保障因工作遭受事故伤害或者患职业病的职工获得医疗救治和经济补偿,促进工伤预防和职业康复,分散用人单位的工伤风险,制定本条例。
Article 2 The various enterprises and individual industrial and commercial households hiring employees (hereinafter referred to as employing entities) inside the territory of the People's Republic of China shall, in accordance with the present regulation, buy work-related injury insurances, that is, pay work-related injury insurance premiums for all their workers or employees (hereinafter uniformly referred to as workers).
All workers of various enterprises and all employees of various individual industrial and commercial households inside the territory of the People's Republic of China shall, in accordance with the present regulation, have the right to enjoy the treatment of work-related injury insurances.
The specific procedures and implementing measures for individual industrial and commercial households hiring employees to buy work-related injury insurances shall be provided for by the people's government of the province, autonomous region or municipality directly under the Central Government.
   第二条 中华人民共和国境内的各类企业、有雇工的个体工商户(以下称用人单位)应当依照本条例规定参加工伤保险,为本单位全部职工或者雇工(以下称职工)缴纳工伤保险费。
中华人民共和国境内的各类企业的职工和个体工商户的雇工,均有依照本条例的规定享受工伤保险待遇的权利。
有雇工的个体工商户参加工伤保险的具体步骤和实施办法,由省、自治区、直辖市人民政府规定。
Article 3 The work-related injury insurance premiums shall be collected and paid in accordance with the provisions in the "Interim Regulation on the Collection and Payment of Social Insurance Premiums" regarding the collection and payment of basic pension insurance premiums, basic medical insurance premiums, and unemployment insurance premiums.
   第三条 工伤保险费的征缴按照《社会保险费征缴暂行条例》关于基本养老保险费、基本医疗保险费、失业保险费的征缴规定执行。
Article 4 An employing entity shall announce the relevant information on buying work-related injury insurances within the scope of the entity.
The employing entities and the workers shall abide by the relevant laws and regulations on safe production and prevention and treatment of occupational diseases, implement the rules and standards on safety and health care, prevent work-related injury accidents, avoid and reduce harms from occupational diseases.
When a worker suffers from a work-related injury, the employing entity shall take measures to have the injured worker cured in time.
   第四条 用人单位应当将参加工伤保险的有关情况在本单位内公示。
用人单位和职工应当遵守有关安全生产和职业病防治的法律法规,执行安全卫生规程和标准,预防工伤事故发生,避免和减少职业病危害。
职工发生工伤时,用人单位应当采取措施使工伤职工得到及时救治。
Article 5 The administrative department for labor security under the State Council shall be responsible for the work of nationwide work-related injury insurances.
The administrative department for labor security of each local people's government at or above the county level shall be responsible for the work of work-related injury insurances within its own jurisdiction.
The social insurance handling institutions (hereinafter referred to as handling institutions) established by the administrative department for labor security under the State Council in accordance with the relevant provisions shall specifically undertake the affairs in respect of work-related injury insurances.
   第五条 国务院劳动保障行政部门负责全国的工伤保险工作。
县级以上地方各级人民政府劳动保障行政部门负责本行政区域内的工伤保险工作。
劳动保障行政部门按照国务院有关规定设立的社会保险经办机构(以下称经办机构)具体承办工伤保险事务。
Article 6 The administrative department for labor security and other departments shall, if formulating policies or standards concerning work-related injury insurances, solicit opinions from the representatives of the trade union organizations and employing entities.
   第六条 劳动保障行政部门等部门制定工伤保险的政策、标准,应当征求工会组织、用人单位代表的意见。
Chapter II Work-Related Injury Insurance Fund
 

第二章 工伤保险基金


Article 7 The work-related injury insurance fund shall be composed of the work-related injury insurance premiums paid by the employing entities, the interest on the work-related injury insurance fund and other funds legally included in the work-related injury insurance fund.
   第七条 工伤保险基金由用人单位缴纳的工伤保险费、工伤保险基金的利息和依法纳入工伤保险基金的其他资金构成。
Article 8 The rate of the work-related injury insurance premiums shall be determined in compliance with the principles of basing collection on expenditure and balancing the income and expenditure.
The state shall determine the differential premium rates of different industries in light of their work-related injury risks, and set forth several grades of premium rates in each industry in light of the use of the work-related injury insurance premiums and the occurrence rate of work-related injuries, etc.. The industrial differential premium rates and the grades of the premium rates within each industry shall be formulated by the administrative department for labor security under the State Council jointly with the financial department, the administrative department for health, and the administrative department for supervision over safe production under the State Council, and be subject to approval by the State Council before promulgation and enforcement.
The handling institution in a region subject to overall planning shall, in light of the information on the employing entities' use of work-related injury insurance premiums and the occurrence rate of work-related injuries, etc., apply the corresponding grade of premium rate for the industry to determine the premium rate for the entity.
   第八条 工伤保险费根据以支定收、收支平衡的原则,确定费率。
国家根据不同行业的工伤风险程度确定行业的差别费率,并根据工伤保险费使用、工伤发生率等情况在每个行业内确定若干费率档次。行业差别费率及行业内费率档次由国务院劳动保障行政部门会同国务院财政部门、卫生行政部门、安全生产监督管理部门制定,报国务院批准后公布施行。
统筹地区经办机构根据用人单位工伤保险费使用、工伤发生率等情况,适用所属行业内相应的费率档次确定单位缴费费率。
Article 9 The administrative department for labor security under the State Council shall regularly know about the information on the income and expenditure of the work-related injury insurance funds in all regions subject to overall planning around the country, and shall, jointly with the financial department, the administrative department for health and the administrative department for supervision over safe production under the State Council, timely render the proposal on adjustment of the industrial differential premium rates and the grades of premium rates for the industry, which shall be submitted to the State Council for approval before promulgation and enforcement.
   第九条 国务院劳动保障行政部门应当定期了解全国各统筹地区工伤保险基金收支情况,及时会同国务院财政部门、卫生行政部门、安全生产监督管理部门提出调整行业差别费率及行业内费率档次的方案,报国务院批准后公布施行。
Article 10 The employing entities shall pay work-related injury insurance premiums on time, and individual workers do not have to pay the work-related injury insurance premiums.
The amount of work-related injury insurance premiums paid by an employing entity shall be the product of multiplying the total amount of wages of the workers in this entity by the premium rate of this entity.
   第十条 用人单位应当按时缴纳工伤保险费。职工个人不缴纳工伤保险费。
用人单位缴纳工伤保险费的数额为本单位职工工资总额乘以单位缴费费率之积。
Article 11 The work-related injury insurance fund shall be subject to overall planning in municipalities directly under the Central Government and cities divided into districts, while the overall planning levels of other regions shall be determined by the people's government of the province or autonomous region.
For trans-regional industries and industries with large production mobility, the employing entities may buy work-related injury insurances in region subject to overall planning by a relatively concentrative means. The specific measures shall be formulated by the administrative department for labor security under the State Council jointly with the competent departments of the relevant industries.
   第十一条 工伤保险基金在直辖市和设区的市实行全市统筹,其他地区的统筹层次由省、自治区人民政府确定。
跨地区、生产流动性较大的行业,可以采取相对集中的方式异地参加统筹地区的工伤保险。具体办法由国务院劳动保障行政部门会同有关行业的主管部门制定。
Article 12 The work-related injury insurance fund shall be deposited in the special fiscal account of social security fund, and be used to pay the treatment of work-related injury insurances provided for in the present regulation, the work capability assessment and other expenses provided for in laws and regulations to be used for work-related injury insurances. No entity or individual shall use the work-related injury insurance fund for investment operations, build or rebuild office places, to grant bonuses, or to misappropriate such fund for other purposes.
   第十二条 工伤保险基金存入社会保障基金财政专户,用于本条例规定的工伤保险待遇、劳动能力鉴定以及法律、法规规定的用于工伤保险的其他费用的支付。任何单位或者个人不得将工伤保险基金用于投资运营、兴建或者改建办公场所、发放奖金,或者挪作其他用途。
Article 13 A certain proportion of reserve among the work-related injury insurance fund shall be remained for the payment of the treatment of work-related injury insurances on major accidents in the regions subject to overall planning; if the reserve is not enough to pay the said treatment, the people's government of the region subject to overall planning shall pay the remaining sum. The specific proportion of the reserve among the total amount of the fund and the measures on using the reserve shall be provided for by the people's government of the province, autonomous region, or municipality directly under the Central Government.
   第十三条 工伤保险基金应当留有一定比例的储备金,用于统筹地区重大事故的工伤保险待遇支付;储备金不足支付的,由统筹地区的人民政府垫付。储备金占基金总额的具体比例和储备金的使用办法,由省、自治区、直辖市人民政府规定。
Chapter III Ascertainment of Work-Related Injuries
 

第三章 工伤认定


Article 14 A worker shall be ascertained to have suffered from work-related injury if:
   第十四条 职工有下列情形之一的,应当认定为工伤:
(a) he is injured from an accident within the working hours and the working place due to his work;
 (一)在工作时间和工作场所内,因工作原因受到事故伤害的;
(b) he is injured from an accident within the working place before or after the working hours for doing preparatory or finishing work related to his job;
 (二)工作时间前后在工作场所内,从事与工作有关的预备性或者收尾性工作受到事故伤害的;
(c) he suffers from violence or other unexpected injury within the working hours and working place due to implementation of his duties;
 (三)在工作时间和工作场所内,因履行工作职责受到暴力等意外伤害的;
(d) he suffers from an occupational disease;
 (四)患职业病的;
(e) his whereabouts are unknown due to his injury or accident during his trip for performing his duties;
 (五)因工外出期间,由于工作原因受到伤害或者发生事故下落不明的;
(f) he is injured from a motor vehicle accident on his way to or back from work; or
 (六)在上下班途中,受到机动车事故伤害的;
(g) other circumstances provided for in laws and administrative regulations under which work-related injuries shall be ascertained.
 (七)法律、行政法规规定应当认定为工伤的其他情形。
Article 15 A worker shall be regarded to have suffered from the work-related injury if:
   第十五条 职工有下列情形之一的,视同工伤:
(a) during the working hours and on the post, he dies from a sudden disease or dies within 48 hours due to ineffective rescue;
 (一)在工作时间和工作岗位,突发疾病死亡或者在48小时之内经抢救无效死亡的;
(b) he is injured when dealing with an emergency or providing disaster relief or in other activity for maintaining the state benefits or public benefits; or
 (二)在抢险救灾等维护国家利益、公共利益活动中受到伤害的;
(c) he served in the army and became disabled due to war or duties, and has obtained the certificate of revolutionary disabled armyman, but recrudesces from the past injury after working in the employing entity.
Where a worker is under the circumstance in Item (a) or (b) of the preceding paragraph, he may enjoy the treatment of work-related injury insurances in accordance with the relevant provisions of the present regulation; where a worker is under the circumstance in Item (c) of the preceding paragraph, he may enjoy the treatment of work-related injury insurances other than the lump-sum disability subsidy in accordance with the relevant provisions in the present regulation.
 (三)职工原在军队服役,因战、因公负伤致残,已取得革命伤残军人证,到用人单位后旧伤复发的。
职工有前款第(一)项、第(二)项情形的,按照本条例的有关规定享受工伤保险待遇;职工有前款第(三)项情形的,按照本条例的有关规定享受除一次性伤残补助金以外的工伤保险待遇。
Article 16 A worker shall neither be ascertained nor be regarded to have suffered from the work-related injury if:
   第十六条 职工有下列情形之一的,不得认定为工伤或者视同工伤:
(a) he is injured or dies for committing a crime or violating the public security order;
 (一)因犯罪或者违反治安管理伤亡的;
(b) he dies from being drunk; or
 (二)醉酒导致伤亡的;
(c) he injures himself or commits suicide.
 (三)自残或者自杀的。
Article 17 Where a worker is injured from an accident or is diagnosed or assessed in accordance with the Law on Prevention and Treatment of Occupational Diseases to have an occupational disease, the employing entity shall, within 30 days as of the day when the accident injury is occurred or when he is diagnosed or assessed to have contracted the occupational disease, file an application for ascertainment of the work-related injury to the administrative department for labor security in the region subject to overall planning. Under special circumstances, the time limit for application may be properly extended, subject to the approval of the administrative department for labor security.
Where an employing entity fails to file an application for ascertainment of a work-related injury in accordance with the preceding paragraph, the worker who suffered from the injury or his lineal relative, or the trade union organization may, within one year as of the day when the accident injury is occurred or when the worker is diagnosed or assessed to have the occupational disease, directly file the application for ascertainment of the work-related injury to the administrative department for labor security of the region subject to overall planning where the employing entity is located.
The matters for which the work-related injuries shall be ascertained by the administrative department for labor security at the provincial level as provided for in Paragraph 1 of the present article, shall be handled by the administrative department for labor security at the level of city divided into districts at the locality of the employing entity in compliance with the principle of territory.
Where an employing entity fails to file an application for ascertainment of a work-related injury within the time limit provided for in Paragraph 1 of the present article, the expenses for the treatment of the injury, etc. during this period, which conform to the present regulation, shall be borne by the employing entity.
   第十七条 职工发生事故伤害或者按照职业病防治法规定被诊断、鉴定为职业病,所在单位应当自事故伤害发生之日或者被诊断、鉴定为职业病之日起30日内,向统筹地区劳动保障行政部门提出工伤认定申请。遇有特殊情况,经报劳动保障行政部门同意,申请时限可以适当延长。
用人单位未按前款规定提出工伤认定申请的,工伤职工或者其直系亲属、工会组织在事故伤害发生之日或者被诊断、鉴定为职业病之日起1年内,可以直接向用人单位所在地统筹地区劳动保障行政部门提出工伤认定申请。
按照本条第一款规定应当由省级劳动保障行政部门进行工伤认定的事项,根据属地原则由用人单位所在地的设区的市级劳动保障行政部门办理。
用人单位未在本条第一款规定的时限内提交工伤认定申请,在此期间发生符合本条例规定的工伤待遇等有关费用由该用人单位负担。
Article 18 Whoever files an application for ascertainment of a work-related injury shall submit the following documents:
   第十八条 提出工伤认定申请应当提交下列材料:
(a) the application form for ascertainment of the work-related injury;
 (一)工伤认定申请表;
(b) the documents proving the existence of the labor relation (including de facto labor relation) with the employing entity; and
 (二)与用人单位存在劳动关系(包括事实劳动关系)的证明材料;
(c) the certificate of medical diagnosis or the certificate of diagnosis of the occupational disease (or the assessment report on diagnosis of the occupational disease).
The application form for ascertainment of a work-related injury shall include such basic information as the time, place, reason of the accident, and extent of the worker's injury, etc..
Where the applicant for ascertainment of a work-related injury fails to provide complete documents, the administrative department for labor security shall notify the applicant in writing in one time of all the documents needed to be supplemented for the ascertainment of the work-related injury. The administrative department for labor security shall accept the application after the applicant has supplemented the documents as required by the written notification.
 (三)医疗诊断证明或者职业病诊断证明书(或者职业病诊断鉴定书)。
工伤认定申请表应当包括事故发生的时间、地点、原因以及职工伤害程度等基本情况。
工伤认定申请人提供材料不完整的,劳动保障行政部门应当一次性书面告知工伤认定申请人需要补正的全部材料。申请人按照书面告知要求补正材料后,劳动保障行政部门应当受理。
Article 19 The administrative department for labor security may, after accepting an application for ascertainment of a work-related injury, investigate and verify the accident injury upon the needs in examination, while the employing entity, the workers, the trade union organization, the medical treatment institution and other relevant departments shall provide assistance. The occupational disease shall be diagnosed and the diagnosis dispute shall be assessed in accordance with the relevant provisions in the Law on Prevention and Treatment of Occupational Diseases. With respect to the certificate of diagnosis of the occupational disease or the assessment report on diagnosis of the occupational disease which is obtained in accordance with the law, the administrative department for labor security shall no longer investigate or verify it.
Where a worker or his lineal relative believes that an injury is work-related, while the employing entity does not believe so, the latter shall bear the burden of proof.
   第十九条 劳动保障行政部门受理工伤认定申请后,根据审核需要可以对事故伤害进行调查核实,用人单位、职工、工会组织、医疗机构以及有关部门应当予以协助。职业病诊断和诊断争议的鉴定,依照职业病防治法的有关规定执行。对依法取得职业病诊断证明书或者职业病诊断鉴定书的,劳动保障行政部门不再进行调查核实。
职工或者其直系亲属认为是工伤,用人单位不认为是工伤的,由用人单位承担举证责任。
Article 20 The administrative department for labor security shall, within 60 days as of day when it accepts the application for ascertainment of a work-related injury, make a decision on ascertaining the work-related injury, and notify the worker who applies for ascertainment of the work-related injury or his lineal relative and the worker's entity in writing.
Where a functionary of the administrative department for labor security has an interest in the applicant for ascertainment of a work-related injury, he shall withdraw.
   第二十条 劳动保障行政部门应当自受理工伤认定申请之日起60日内作出工伤认定的决定,并书面通知申请工伤认定的职工或者其直系亲属和该职工所在单位。
劳动保障行政部门工作人员与工伤认定申请人有利害关系的,应当回避。
Chapter IV Work Capability Assessment
 

第四章 劳动能力鉴定


Article 21 Where a worker who suffered from a work-related injury becomes disabled and his work capability is impacted after he has been cured to be comparatively stable with his injury, his work capability shall be assessed.
......
   第二十一条 职工发生工伤,经治疗伤情相对稳定后存在残疾、影响劳动能力的,应当进行劳动能力鉴定。
......



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