Legal analysis: Title: Application for Work-related Injury and Disability Appraisal xx Labor Ability Appraisal Committee: My name, ID number, xxxx is an employee of xxx (employing unit). Injured at work on x day, x month x year. After treatment and completion of medical treatment, please apply for labor ability appraisal. Please process it. Applicant (Signature): xxxx year x month x day Unit opinion: xxx unit stamp: x year x month x day

Legal basis: "Regulations on Work-related Injury Insurance" Article 20 The social insurance administrative department shall A decision on work-related injury identification shall be made within 60 days from the date of acceptance of the application for work-related injury identification, and the employee applying for work-related injury identification or his close relatives and the employee's unit shall be notified in writing. The social insurance administrative department shall make a decision on work-related injury identification within 15 days for applications with clear facts and clear rights and obligations. If the decision to identify a work-related injury needs to be based on the conclusion of the judicial authority or the relevant administrative department, the time limit for making the decision to identify the work-related injury shall be suspended while the judicial authority or the relevant administrative department has not made a conclusion. Staff members of the social insurance administrative department who have an interest in the applicant for work-related injury determination shall recuse themselves.