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Interpretation of Industrial Injury Insurance Policy in Zhengzhou City from 2065438 to 2009
Industrial injury insurance is an important branch of social insurance. Industrial injury insurance is a social security system that provides material assistance to workers who suffer from accidents or occupational diseases due to work reasons. The object of industrial injury insurance is the professional population. Once these people are injured, the impact on individuals, families and even society is often far greater than the accident itself, which is an important cause of labor disputes. The industrial injury insurance system in our city has undergone a transformation from "enterprise insurance" in the planned economy period to "social insurance" in the market economy period, and has made remarkable achievements in recent years.

First, prevention of work-related injury insurance comes first

20 10 The newly revised Regulations on Industrial Injury Insurance emphasizes the trinity principle of industrial injury prevention, industrial injury compensation and industrial injury rehabilitation. Prevention of work-related injuries can reduce the occurrence of work-related injuries, ensure the safety and health of workers, disperse enterprise risks, strengthen safety responsibilities, reduce the expenditure of work-related injury insurance funds and the loss of social material wealth, and reduce social costs. With the progress of society, we should reduce the occurrence of industrial accidents and occupational diseases from the source and strengthen the construction of industrial injury prevention system. At present, there are two main measures to prevent work-related injuries in our city.

On the one hand, it is the preventive measures of the rate mechanism, which means that the purpose of prevention is achieved by adjusting the rate when collecting work-related injury insurance premiums. Article 34 of the Social Insurance Law and Article 8 of the Regulations on Work-related Injury Insurance stipulate that the state determines the industry differential rates according to the degree of work-related injury risks in different industries, and determines the rate grades according to the use of work-related injury insurance funds and the incidence of work-related injuries. The social insurance agency shall determine the employer's payment rate according to the employer's use of work-related injury insurance funds, the incidence of work-related injuries and the level of industry rates. Among the five social insurances, only industrial injury insurance has this rate mechanism.

The rate mechanism consists of two parts: (1) According to the working environment faced by different industries, the possible risk of casualties and the degree of occupational hazards, different payment ratios are determined, which is called differential rate. Such as finance, securities and other industries with low industrial injury risk, the industrial injury insurance rate is 0.5%, the manufacturing industrial injury insurance rate is 1%, and the mining industrial injury insurance rate is 2%. (2) On the basis of differential rates, according to the enterprise's safety production situation and work-related injury expenses in a certain period of time, on the basis of evaluation, the enterprise's rates are periodically floated, which is called floating rates. Differential rates are "entry rates"; The floating rate is directly linked to the industrial accident rate of enterprises, which can be changed through the subjective efforts of enterprises. The more accidents an enterprise has in the last year, the more it will pay in the next year, which reflects the economic leverage of the floating rate. Its purpose is to promote enterprises to do a good job in safety production and reduce accidents.

On the other hand, using the industrial injury insurance fund is a preventive measure. It refers to extracting a certain proportion of work-related injury prevention expenses from the work-related injury insurance fund and taking educational, technical and economic measures to improve the awareness of work-related injury prevention of employers and employees, promote enterprises to strengthen safety production, improve the safety and health status of employees, and reduce the occurrence of work-related accidents and occupational diseases. Our city has a special budget for work-related injury prevention every year, and enterprises can apply for financial support for work-related injury prevention projects.

Second, compensation for work-related injuries and timely assistance.

Industrial injury compensation is the treatment of industrial injury insurance that workers can get. Industrial injury insurance is a social insurance treatment system to implement industrial injury compensation and protect the legitimate rights and interests of industrial injury workers, and it is the core content of industrial injury insurance system.

After a work-related injury accident occurs and is recognized as a work-related injury, the treatment enjoyed by employees can be roughly divided into three categories according to the content. The first category is medical treatment, the second category is economic compensation, and the third category is long-term treatment of living security. The medical treatment period should include four aspects: medical treatment for work-related injuries, food subsidies for hospitalization, transportation and accommodation for medical treatment in different places, and treatment during shutdown with pay; The so-called economic compensation benefits are one-time industrial injury insurance benefits, including one-time disability benefits, one-time industrial injury medical benefits and one-time employment benefits, one-time work death benefits and funeral benefits; The long-term benefits of living security include disability allowance, living care fee, pension for supporting relatives and the cost of configuring assistive devices. Disability allowance refers to the living security benefits paid by social insurance agencies or employers on a monthly basis when employees with work-related injuries completely or mostly lose their ability to work. The so-called "long-term" refers to the monthly payment until the recipients lose their eligibility.

According to the treatment of industrial injury insurance, the payment items are divided into two categories. One kind is the items paid by the employer, including the wages and benefits of the employees with work-related injuries during the paid shutdown; Workers with Grade 5 or 6 disabilities receive disability allowance every month; A one-time disability employment subsidy that should be received when the labor contract is terminated or dissolved. The other category is the items paid by the industrial injury insurance fund, including: medical expenses; Rehabilitation expenses for work-related injuries; Labor ability appraisal fee; Industrial injury prevention fee; Treatment of work-related injuries: food subsidies during hospitalization; Transportation and accommodation expenses for medical treatment outside the overall planning area; One-time disability allowance; A one-time medical subsidy that should be received when terminating or dissolving labor relations; Disability allowance received by employees with one to four work-related injuries on a monthly basis; Life care expenses; Cost of auxiliary equipment; Pension for dependent relatives; One-time work death grant and funeral grant.

Third, rehabilitation of work-related injuries and smoothing of scars.

Work-related injury rehabilitation covers a wide range of contents, including professional and technical work such as work-related injury disability prevention, medical rehabilitation, vocational rehabilitation and rehabilitation AIDS configuration, as well as social work such as work-related injury rehabilitation policy, rehabilitation standard formulation and work-related injury rehabilitation management. As far as the development level of industrial injury rehabilitation in China is concerned, the work carried out by industrial injury rehabilitation institutions mainly focuses on the medical rehabilitation of industrial injuries and the configuration of rehabilitation AIDS.

The scope of work-related injury rehabilitation in Zhengzhou City is implemented according to the "Work-related Injury Rehabilitation Service Standard (Trial)" issued by the former Ministry of Labor and Social Security. The specific types of industrial injuries include: craniocerebral injury, persistent vegetative state, spinal cord injury, peripheral nerve injury, fracture, amputation, hand injury, joint and soft tissue injury, burns, etc.

The rehabilitation object of work-related injury refers to the workers who have participated in the local social work-related injury insurance according to law, still retain the social work-related injury insurance relationship and meet the relevant provisions of work-related injury insurance in the overall planning area, are disabled or cause physical dysfunction due to work-related injuries (including occupational diseases), and need necessary rehabilitation examination or rehabilitation treatment after they have rehabilitation value, their injuries are relatively stable or the medical treatment period for work-related injuries expires.