The written format of the Application for Extension of Paid Shutdown is the same as that of the Application for Paid Shutdown. The main content is to write down the reasons for the extension. Because the condition has not improved, it is required to postpone the work stoppage with pay and submit the diagnosis certificate issued by the doctor who went to the hospital to the unit.

The specific format of the application form is shown in the following figure, including name, gender, ID number, injured part, injury time, clinical diagnosis, telephone number, name of the company, contact person, injury situation of the injured part and application reason. Finally, sign, write down the year and month and hand it over to the human resources department of the unit.

Extended data

According to the provisions of the management measures, employees of enterprises who need to stop working and receive treatment due to work-related injuries or occupational diseases will be left without pay. The period of shutdown with pay refers to the period when employees who are injured at work or suffer from occupational diseases stop working and receive treatment, and continue to enjoy the original wages and benefits.

According to the diagnosis certificate confirmed by the work-related injury medical service institution, the enterprise determines the work-related injury leave period according to the Catalogue of Work-related Injury Workers' Work-related Injury Leave Period. If multiple injured parts or different tissues and organs are injured, the longest shutdown period corresponding to the injured parts shall be determined.

If the location and degree of work-related injury are not listed in the Catalogue of Paid Shutdown in Beijing, the paid shutdown shall be determined by the time when the clinical cure or injury is relatively stable.

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