Regulations for Work-related Injury Insurance (Revised)

Article 2: Enterprises, public institutions, associations, private non-corporate entities, foundations, law firms, accounting firms and other such organisations in the People's Republic of China, as well as family proprietorships in the People's Republic of China that employ workers (Employers) shall enrol in work-related injury insurance in accordance herewith and pay work-related injury insurance premiums for all of their employees or workers (Employees).

All employees of enterprises, institutions, associations, private non-corporate entities, foundations, law firms, accounting firms and other such organisations and workers of individual proprietorships in the People's Republic of China are eligible for work-related injury insurance benefits in accordance herewith.

Article 3: The collection and payment of work-related injury insurance premiums shall be handled in accordance with the provisions on the assessment and payment of basic old-age insurance premiums, basic medical insurance premiums and unemployment insurance premiums of the Tentative Regulations for the Collection and Payment of Social Insurance Premiums.

Article 4: An Employer shall display relevant information on its enrolment in work-related injury insurance on its premises.

Employers and their Employees shall abide by laws and regulations on work safety and the prevention of occupational diseases, implement safety and hygiene procedures and standards, take precautions against the occurrence of accidents that cause work-related injuries and avoid and minimise hazards that lead to occupational diseases.

When an Employee sustains a work-related injury, the Employer shall take measures to ensure that the Employee who sustained the work-related injury (the Injured Employee) receives immediate care.

Article 5: The State Council's social insurance administrative department shall be responsible for work-related injury insurance work nationwide.

The social insurance administrative departments of local people's governments at every level from the county level and above shall be responsible for work-related injury insurance work in their respective jurisdictions.

The social insurance agency (Agency) established by a social insurance administrative department in accordance with relevant State Council provisions shall be responsible for the handling of specific work-related injury insurance matters.

Article 6: When a social insurance administrative department or other such department formulates work-related injury insurance policies and standards, it shall seek the opinions of representatives of labour unions and Employers.

Part Two: Work-related injury insurance fund

Article 7: A work-related injury insurance fund shall comprise the work-related injury insurance premiums paid by Employers, interest accruing on the work-related injury insurance fund and other funds included in the work-related injury insurance fund in accordance with the law.

Article 8: The rate for work-related injury insurance premiums shall be determined based on the principle of the premiums collected ensuring the expenditures and the principle of a balanced premiums and expenditures.

The state shall determine different premium rates for different industries based on their different degrees of work-related injury risk, and, based on the use of work-related injury insurance premiums, rate of occurrence of work-related injuries, etc., determine a number of premium rate tiers within each industry. The different premium rates among industries and the premium rate tiers within industries shall be determined by the State Council's social insurance administrative department, and shall be published and implemented after approval by the State Council.

The Agency of a pooling region shall, based on the use of work-related injury insurance premiums by Employers, their rates of occurrence of work-related injuries, etc., determine the rates of the premiums payable by them by applying the relevant premium rate tier in their industries.

Article 9: The State Council's social insurance administrative department shall keep itself apprised on a regular basis of the income and expenditures of the work-related injury insurance funds of the pooling regions nationwide, and propose plans for the adjustment of the different premium rates among industries and the premium rate tiers within industries in a timely manner, which shall be published and implemented after approval by the State Council.

Article 10: Employers shall punctually pay work-related injury insurance premiums. Employees do not themselves pay work-related injury insurance premiums.

The amount of the work-related injury insurance premium paid by an Employer shall be the product derived by multiplying its total payroll by its premium rate.

For industries in which the payment of work-related injury insurance premiums based on total payroll is difficult, their specific methods of paying work-related injury insurance premiums shall be specified by the State Council's social insurance administrative department.

Article 11: Provincial-level pooling shall progressively be implemented for work-related injury insurance funds.

Industries that cross regions and those in which there is a relatively high degree of work mobility may, in a relatively centralised manner, enrol in the work-related injury insurance of a pooling region outside its home region. The specific measures therefor shall be formulated by the State Council's social insurance administrative department together with the departments in charge of the relevant industries.

Article 12: A work-related injury insurance fund shall be deposited into a dedicated financial account for the social security fund and used for the payment of expenses such as the work-related injury insurance benefits specified herein, assessments of work capacity, publicity for and training on the prevention of work-related injuries, etc. as well as other work-related injury insurance expenses specified in laws and regulations.

The specific measures for the percentage to be allocated to, and the use and administration of, moneys for work-related injury prevention shall be specified by the State Council's social insurance administrative department together with departments such as the State Council's finance, health administrative and work safety regulatory departments.

No entity or individual may use the work-related injury insurance fund for investing in the operation, construction or alteration of office premises or the payment of bonuses, or divert it for other purposes.

Article 13: A certain percentage of the work-related injury insurance fund shall be retained in a reserve to be used for the payment of work-related injury insurance benefits in the event of a major accident in the pooling region; and if the funds in the reserve are insufficient to cover the same, the moneys shall be advanced by the people's government of the pooling region. The specific percentage of the total fund to be accounted for by the reserve and the measures for using the reserve shall be specified by the people's government of the province, autonomous region or municipality directly under the central government.

Part Three: Determination of work-related injuries

Article 14: An Employee shall be determined as having sustained a work-related injury if:

(1) he/she is injured in an accident during working hours, on work premises due to a work-related reason;

(2) he/she is injured in an accident before or after working hours, on work premises while doing preparatory or wrapping up tasks for his/her work;

(3) he/she sustains an injury as a result of an unexpected matter such as violence during working hours, on work premises in connection with the performance of his/her work duties;

(4) he/she contracts an occupational disease;

(5) while in the field for work reasons, he/she sustains an injury due to a work-related reason or is involved in an accident and goes missing;

(6) while on his/her way to or from work, he/she sustains an injury in a traffic accident for which he/she does not bear the main responsibility, or in an urban rail transport, ferry or train accident; or

(7) another circumstance as specified in laws or administrative regulations where a work-related injury should be recognised arises.

Article 15: An Employee shall be considered to have sustained a work-related injury if:

(1) he/she suffers a sudden illness and dies during working hours while on the job or within 48 hours after efforts to save him/her prove ineffectual;

(2) he/she is injured in the course of activities to safeguard state interests or the public interest, such as in helping in a disaster or relief work; or

(3) he/she, in the past while doing military service, sustained an injury in battle or while in the service of the public, resulting in a disability, in consequence of which he/she secured a certificate of a disabled revolutionary soldier, and while with his/her employer the old injury recurs.

If the circumstance set forth in Item (1) or (2) of the preceding paragraph applies to an Employee, he/she shall be entitled to work-related injury insurance benefits in accordance with relevant provisions of these Regulations; or if the circumstance set forth in Item (3) of the preceding paragraph applies to him/her, he/she shall be entitled to work-related injury insurance benefits, other than the lump sum disability supplement, in accordance with relevant provisions of these Regulations.

Article 16: An Employee who satisfies any of the provisions of Article 14 or 15 hereof shall not be determined as having sustained a work-related injury or be considered as having sustained a work-related injury if:

(1) he/she was willfully committing a criminal offence;

(2) he/she was under the influence of alcohol or a narcotic; or

(3) he/she deliberately injured himself/herself or committed suicide.

Article 17: If an Employee is injured in an accident or if, pursuant to regulations on the prevention and treatment of occupational diseases, he/she is diagnosed or assessed as having contracted an occupational disease, his/her Employer shall submit an application for determination of a work-related injury to the social insurance administrative department of the pooling region within 30 days from the date of the occurrence of the accident that caused the injury or of the diagnosis or assessment of the occupational disease. In special circumstances, with the consent of the social insurance administrative department, the deadline for the application may be suitably extended.

If the Employer fails to submit the work-related injury determination application in accordance with the preceding paragraph, the Injured Employee or a close family member thereof or the labour union may directly submit an application for determination of a work-related injury to the social insurance administrative department of the pooling region where the Employer is located within one year from the date of the occurrence of the accident that caused the injury or of the diagnosis or assessment of the occupational disease.

If, pursuant to the first paragraph of this Article, the determination of a work-related injury ought to be carried out by the provincial-level social insurance administrative department, matters shall be handled by the social insurance administrative department at the level of city (divided into districts) where the Employer is located in accordance with the territoriality principle.

If an Employer fails to submit an application for determination of a work-related injury by the deadline set forth in the first paragraph of this Article, the relevant costs, such as work-related injury benefits that comply with the provisions of these Regulations that arise during such period shall be borne by the Employer.

Article 18: When submitting an application for determination of a work-related injury, the following materials shall be provided:

(1) an application for determination of a work-related injury;

(2) materials evidensing the existence of the employment relationship (including a de facto employment relationship) with the Employer; and

(3) proof of the medical diagnosis or an occupational disease diagnosis certificate (or written occupational disease diagnosis assessment).

The work-related injury determination application shall include basic particulars such as the date on which, and the place where the accident occurred, the reason it occurred and the extent to which the Employee was injured.

If the materials submitted by the applicant for work-related injury determination are incomplete, the social insurance administrative department shall inform on one occasion such applicant in writing of all of the missing materials. Once the applicant has provided the missing materials as required in the written notice, the social insurance administrative department shall accept the application.

Article 19: Once it has accepted the work-related injury determination application, the social insurance administrative department may, for review reasons, conduct an investigation and verification of the injury sustained in the accident, and the Employer, Employee, labour union, medical institution and relevant departments shall assist it. The diagnosis of occupational diseases and assessments for disputes over diagnoses shall be handled in accordance with relevant provisions of the Law on the Prevention and Treatment of Occupational Diseases. Where an occupational disease diagnosis certificate or written occupational disease diagnosis assessment has been secured in accordance with the law, the social insurance administrative department will not conduct an investigation and verification.

Where an Employee or a close family member thereof claims that an injury is work-related and the Employer claims otherwise, the Employer shall bear the burden of proof.

Article 20: The social insurance administrative department shall render its decision on the work-related injury determination and notify the Employee or his/her close family member who applied for the work-related injury determination and his/her Employer in writing within 60 days from the date on which it accepted the work-related injury determination application.

With respect to an application for determination of a work-related injury of which the facts are clear and the rights and obligations connected therewith unambiguous, the social insurance administrative department shall render its decision on the work-related injury determination within 15 days.

Where the rendering of a work-related injury determination is dependent on the conclusions of the judicial authority or of a relevant competent administrative department, the time limit for rendering of the decision shall be suspended while the conclusions from the judicial authority or relevant competent administrative department are pending.

If a member of the working personnel of the social insurance administrative department has an immediate interest in the work-related injury determination applicant, he/she shall recuse himself/herself.

Part Four: Assessments of work capacity

Article 21: When an Employee sustains a work-related injury and, after his/her injury is relatively stabilised following treatment, he/she is disabled, and this affects his/her work capacity, an assessment of his/her work capacity shall be carried out.

Article 22: The term “assessment of work capacity” means a grading assessment of the degree to which work function is impaired and the degree to which the ability to take care of oneself is impaired.

Impairment of work function is divided into 10 levels of disability, the most serious being level 1 and the least serious being level 10.

Impairment of the ability to take care of oneself is divided into three levels: completely unable to take care of oneself, largely unable to take care of oneself and partially unable to take care of oneself.

The criteria for assessments of work capacity shall be formulated by the State Council's social insurance administrative department together with departments such as the State Council's health administrative department.

Article 23: An application for an assessment of work capacity shall be submitted, together with the decision on the work-related injury determination and relevant information on the Employee's treatment for the work-related injury, by the Employer and the Injured Employee or a close family member thereof to the work capacity assessment committee at the level of city (divided into districts).

Article 24: The work capacity assessment committee of a province, autonomous region, municipality directly under the central government or city (divided into districts) shall comprise representatives of the social insurance administrative department, health administrative department, labour union and Agency of the province, autonomous region, municipality directly under the central government or city (divided into districts) respectively, as well as Employers' representatives.

A work capacity assessment committee shall establish a database of medical and health experts. Professional medical and health personnel included in the database of experts shall satisfy the following conditions:

(1) having senior professional qualifications for medical or health positions;

(2) having the relevant knowledge for assessments of work capacity; and

(3) having good professional ethics.

Article 25: Once the work capacity assessment committee at the level of city (divided into districts) receives a work capacity assessment application, it shall randomly select three or five relevant experts from the medical and health expert database established by it to constitute a panel of experts, and such panel shall submit its assessment findings. The work capacity assessment committee at the level of city (divided into districts) shall render its conclusion on the assessment of the Injured Employee's work capacity based on the assessment findings of the panel of experts. When necessary, it may appoint a qualified medical institution to assist in carrying out the relevant diagnosis.

The work capacity assessment committee at the level of city (divided into districts) shall render its conclusion on the assessment of work capacity within 60 days from the date of receipt of the work capacity assessment application; when necessary, such period may be extended for up to 30 days. The work capacity assessment conclusions shall be served on the entity and individual that applied for the assessment in a timely manner.

Article 26: If an entity or individual that applied for an assessment is dissatisfied with the assessment conclusions rendered by the work capacity assessment committee at the level of city (divided into districts), it/he/she may submit an application for a further assessment to the work capacity assessment committee of the province, autonomous region or municipality directly under the central government within 15 days from the date of receipt of the assessment conclusions. The assessment conclusions rendered by the work capacity assessment committee of the province, autonomous region or municipality directly under the central government shall be final.

Article 27: Assessments of work capacity shall be objective and impartial. If a member of the work capacity assessment committee or an expert involved in an assessment has an immediate interest in a concerned party, he/she shall recuse himself/herself.

Article 28: If an Injured Employee or a close family member thereof and, his/her Employer or the Agency is, within one year from the date on which the work capacity assessment conclusions were rendered, of the opinion that there has been a change in the disability, he/she/it may apply for a reassessment of work capacity.

Article 29: The time period for a further assessment or reassessment conducted by a work capacity assessment committee in accordance with Article 26 or 28 hereof shall be handled in accordance with the second paragraph of Article 25 hereof.

Part Five: Work-related injury insurance benefits

Article 30: An Employee who is injured in an accident at work or contracts an occupational disease and receives treatment therefor shall be entitled to work-related injury medical treatment benefits.

When an Employee seeks medical treatment for a work-related injury, he/she shall do so at a medical institution with which a service agreement has been executed. In an emergency, he/she may first seek emergency treatment at a nearby medical institution.

If the charges required for the treatment of a work-related injury comply with the catalogue of diagnostic and treatment items covered by work-related injury insurance, the catalogue of drugs covered by work-related injury insurance and/or the standards for hospitalisation services covered by work-related injury insurance, they shall be paid from the work-related injury insurance fund. The catalogue of diagnostic and treatment items covered by work-related injury insurance, the catalogue of drugs covered by work-related injury insurance and the standards for hospitalisation services covered by work-related injury insurance shall be specified by the State Council's social insurance administrative department together with departments such as the State Council's health administrative department or food and drug regulatory department.

The meal allowance of an Employee hospitalised for treatment of a work-related injury, as well as the transport, food and accommodation expenses of an Injured Employee who seeks medical treatment outside the pooling region, if a supporting document is issued in respect thereof by the medical institution and the Agency gives its consent, shall be paid from the work-related injury insurance fund. The specific rate at which payment is to be made from the fund shall be specified by the people's government of the pooling region.

An Injured Employee who seeks treatment for an illness not triggered by his/her work-related injury shall not be eligible for work-related injury medical benefits in respect thereof, rather, the matter shall be handled in accordance with the Measures on Basic Medical Insurance.

The charges incurred by an Injured Employee for work-related injury rehabilitation received at a medical institution with which a service agreement has been executed shall, if they satisfy provisions, be paid from the work-related injury insurance fund.

Article 31: If an administrative review or an administrative action is instituted after a social insurance administrative department has rendered a decision recognising a work-related injury, the medical expenses for the treatment of the Injured Employee's work-related injury shall not be suspended while the administrative review or administrative action is pending.

Article 32: If needed for his/her day-to-day activities or for the purpose of seeking employment and confirmed by the work capacity assessment committee, an Injured Employee may be fitted with an artificial limb, orthopedic instrument, artificial eye or artificial tooth, or supplied with a wheelchair or other such disability aid, and the expenses therefor shall be paid from the work-related injury insurance fund at the rate specified by the state.

Article 33: If an Employee who is injured in an accident at work or has contracted an occupational disease needs to stop working for a time to receive medical treatment for the work-related injury, his/her original wage and benefits shall not change during the rest-with-pay period (Paid Leave Period), and shall be paid on a monthly basis by his/her Employer.

In general, the Paid Leave Period shall not exceed 12 months. Where the injury is serious or the circumstances special, the period may be appropriately extended, subject to confirmation by the work capacity assessment committee at the level of city (divided into districts), provided that such extension does not exceed 12 months. Once an Injured Employee's level of disability has been determined, the original benefits shall cease to be paid to him/her and he/she shall be entitled to disability benefits in accordance with relevant provisions of this Part. If an Injured Employee still needs treatment after the expiration of his/her Paid Leave Period, he/she shall continue to receive work-related injury medical treatment benefits.

If an Injured Employee who cannot take care of himself/herself requires nursing care during his/her Paid Leave Period, his/her Employer shall be responsible therefor.

Article 34: If an Injured Employee has had his/her level of disability determined and it is confirmed by the work capacity assessment committee that he/she requires daily care, the daily care fees shall be paid from the work-related injury insurance fund on a monthly basis.

Payment of the daily care fee shall vary depending on whether the Injured Employee is entirely unable to take care of himself/herself, largely unable to take care of himself/herself or partially unable to take care of himself/herself. The rates therefor shall be 50%, 40% and 30%, respectively, of the average monthly wage of employees in the pooling region during the preceding year.

Article 35: If an Employee disabled as a result of work is assessed as having sustained a level 1 to level 4 disability, his/her employment relationship shall be maintained, he/she shall withdraw from his/her job and be entitled to the following benefits:

(1) payment of a lump sum disability supplement from the work-related injury insurance fund based on the level of his/her disability; the rates therefor shall be as follows: the equivalent of his/her wage for 27 months for a level 1 disability, the equivalent of his/her wage for 25 months for a level 2 disability, the equivalent of his/her wage for 23 months for a level 3 disability and the equivalent of his/her wage for 21 months for a level 4 disability;

(2) payment of a monthly disability allowance from the work-related injury insurance fund at the following rates: 90% of his/her wage for a level 1 disability, 85% of his/her wage for a level 2 disability, 80% of his/her wage for a level 3 disability and 75% of his/her wage for a level 4 disability; if the actual amount of the disability allowance is less than the local minimum wage rate, the work-related injury insurance fund shall make up the difference; and

(3) once the Injured Employee reaches the retirement age and carries out retirement procedures, he/she shall cease to be paid the disability allowance and shall, instead, receive basic old-age insurance benefits in accordance with relevant state regulations. If the basic old-age insurance benefits are less than the disability allowance, the work-related injury insurance fund shall make up the difference.

When an Employee disabled as a result of work is assessed as having sustained a level 1 to level 4 disability, his/her Employer and the Employee himself/herself shall pay basic medical insurance premiums based on the disability allowance as the benchmark figure.

Article 36: If an Employee disabled as a result of work is assessed as having sustained a level 5 or level 6 disability, he/she shall be entitled to the following benefits:

(1) payment of a lump sum disability supplement from the work-related injury insurance fund based on the level of his/her disability; the rates therefor shall be as follows: the equivalent of his/her wage for 18 months for a level 5 disability and the equivalent of his/her wage for 16 months for a level 6 disability; and

(2) maintenance of his/her employment relationship with his/her Employer, with his/her Employer arranging suitable work for him/her; if arrangement of such work is difficult, his/her Employer shall pay him/her a monthly disability allowance at the following rates: 70% of his/her wage for a level 5 disability or 60% of his/her wage for a level 6 disability, and his/her Employer shall pay the various social insurance premiums payable for him/her in accordance with provisions. If the actual amount of the disability allowance is less than the local minimum wage rate, the Employer shall make up the difference.

If proposed by the Injured Employee himself/herself, he/she may terminate or end his/her employment relationship with his/her Employer, and he/she shall be paid a lump sum work-related injury medical treatment supplement from the work-related injury insurance fund and a lump sum disabled employment supplement by his/her Employer. The specific rates for such supplements shall be specified by the people's government of the province, autonomous region or municipality directly under the central government.

Article 37: If an Employee disabled as a result of work is assessed as having sustained a level 7 to level 10 disability, he/she shall be entitled to the following benefits:

(1) payment of a lump sum disability supplement from the work-related injury insurance fund based on the level of his/her disability; the rates therefor shall be as follows: the equivalent of his/her wage for 13 months for a level 7 disability, the equivalent of his/her wage for 11 months for a level 8 disability, the equivalent of his/her wage for 9 months for a level 9 disability and the equivalent of his/her wage for 7 months for a level 10 disability; and

(2) if the term of his/her employment or engagement contract expires and the contract ends or if the Employee himself/herself proposes termination of his/her employment or engagement contract, he/she shall be paid a lump sum work-related injury medical treatment supplement from the work-related injury insurance fund and a lump sum disabled employment supplement by his/her Employer. The specific rates for such supplements shall be specified by the people's government of the province, autonomous region or municipality directly under the central government.

Article 38: If an Injured Employee's work-related injury recurs and it is confirmed that he/she requires treatment, he/she shall be entitled to the work-related injury benefits set forth in Articles 30, 32 and 33 hereof.

Article 39: If an Employee dies as a result of work, his/her close family members shall, in accordance with the following provisions, receive a funeral allowance, dependent family members' benefits and a lump sum work-related death supplement from the work-related injury insurance fund:

(1) the funeral allowance shall be equivalent to six months of the average monthly wage of employees in the pooling region during the preceding year;

(2) the dependent family members' benefits shall be paid at a certain percentage of the Employee's wage to those of his/her family members to whom he/she provided the main source of their livelihoods before his/her death and who have no work capacity; the rates therefor shall be as follows: 40% per month for a spouse, 30% per month per person for other family members, and the foregoing plus an additional 10% per month per person for the elderly left alone or orphans; the total of the benefits determined for all of the dependent family members shall not be greater than the Employee's wage before his/her death; the specific scope of dependent family members shall be specified by the State Council's social insurance administrative department; and

(3) the rate for the lump sum work-related death supplement shall be the equivalent of 20 times the per capita disposable income of urban residents nationwide during the preceding year.

If a disabled Employee dies as a result of his/her work-related injury during his/her Paid Leave Period, his/her close family members shall be entitled to the benefits set forth in the first paragraph of this Article.

If a level 1 to level 4 disabled Employee dies after the expiration of his/her Paid Leave Period, his/her close family members shall be entitled to the benefits set forth in Items (1) and (2) of the first paragraph of this Article.

Article 40: The disability allowance, dependent family members' benefits and daily care fee shall be revised at appropriate times by the social insurance administrative department of a pooling region based on changes in the average wage and living expenses of Employees. The measures for making such revisions shall be specified by the people's government of the province, autonomous region or municipality directly under the central government.

Article 41: If an Employee goes missing while in the field for work reasons due to an accident or while helping in a disaster or doing relief work, his/her wage shall continue to be paid for three months from the month in which the accident occurred. Payment of his/her wage shall cease from the fourth month and, instead, his/her dependent family members shall be paid dependent family members' benefits from the work-related injury insurance fund on a monthly basis. In hardship cases, 50% of the lump sum work-related death supplement may be paid in advance. If an Employee is declared dead by a people's court, matters shall be handled in accordance with the provisions on the work-related deaths of Employees of Article 39 hereof.

Article 42: An Injured Employee shall cease to be eligible for work-related injury insurance benefits if:

(1) the conditions entitling him/her to the benefits cease to apply to him/her;

(2) he/she refuses to submit to an assessment of his/her work capacity; or

(3) he/she refuses to undergo treatment.

Article 43: If an Employer is divided, merged or transferred, its successor shall assume the work-related injury insurance liability of the former Employer. If the former Employer had enrolled in work-related injury insurance, the successor shall carry out the procedures for registering the change in work-related injury insurance with the local Agency.

If the operation of an Employer is contracted out, the work-related injury insurance liability shall be assumed by the entity with which the Employees have their employment relationships.

If an Employee is injured in a work-related injury accident while seconded to another entity, the work-related injury insurance liability shall be borne by his/her original Employer. However, the original Employer and the entity to which the Employee was seconded may agree upon a compensation method.

When an enterprise goes bankrupt, the costs of work-related injury insurance benefits payable by the entity shall be allocated in accordance with the law during the bankruptcy liquidation.

Article 44: If an Employee is posted abroad to work and, in accordance with the laws of the country or region where he/she is posted, he/she is required to enrol in the local work-related injury insurance, he/she shall do so and his/her work-related injury insurance relationship in China shall be suspended. If he/she cannot enrol in the local work-related injury insurance, his/her work-related injury insurance relationship in China shall not be suspended.

Article 45: If an Employee sustains a further work-related injury and, in accordance with provisions, he/she is entitled to the disability allowance, he/she shall receive the disability allowance benefits for his/her newly-determined disability level.

Part Six: Oversight

Article 46: An Agency undertakes specific work-related injury insurance matters and shall perform the following duties:

(1) collecting work-related injury insurance premiums in accordance with the provisions of the people's government of the province, autonomous region or municipality directly under the central government;

(2) verifying the payroll and the number of Employees of Employers, carrying out work-related injury insurance registration and being responsible for keeping records on the payment of premiums by Employers and the receiving of work-related injury insurance benefits by Employees;

(3) conducting surveys of, and keeping statistics on, work-related injury insurance;

(4) managing the expenditures from the work-related injury insurance fund in accordance with provisions;

(5) determining work-related injury insurance benefits in accordance with provisions; and

(6) providing consulting services to Injured Employees and their close family members free of charge.

Article 47: An Agency shall execute service agreements with medical institutions and disability aid supply organisations on the basis of equality and negotiations, and shall publish the list of the medical institutions and disability aid supply organisations with which it has executed such service agreements. The specific measures therefor shall be formulated by the State Council's social insurance administrative department together with departments such as the State Council's heath administrative department and civil affairs department.

Article 48: An Agency shall verify the use of medical expenses, rehabilitation expenses and disability aid expenses of Injured Employees based on the agreements and relevant state catalogues and rates, and punctually settle the expenses in full.

Article 49: An Agency shall publish information on the receipts and expenditures of the work-related injury insurance fund on a regular basis, and submit recommendations to the social insurance administrative department on the revision of rates in a timely manner.

Article 50: Social insurance administrative departments and Agencies shall regularly listen to the opinions of Injured Employees, medical institutions, disability aid supply organisations and the public at large on improving work-related injury insurance work.

Article 51: A social insurance administrative department shall conduct monitoring inspections of the collection and payment of work-related injury insurance premiums and payments from the work-related injury insurance fund in accordance with the law.

The finance department and audit department shall monitor the receipts, expenditures and management of the work-related injury insurance fund in accordance with the law.

Article 52: Any organisation or individual has the right to report violations of work-related injury insurance laws. The social insurance administrative department shall promptly investigate such reports, handle the matter in accordance with provisions and maintain the confidentiality of persons who make such reports.

Article 53: Labour unions shall, in accordance with the law, safeguard the lawful rights and interests of Injured Employees and monitor the work-related injury insurance work of Employers.

Article 54: If a dispute over work-related injury benefits arises between an Employee and his/her Employer, it shall be handled in accordance with provisions on the handling of labour disputes.

Article 55: An entity or individual may apply for administrative review in accordance with the law or institute an administrative action in a people's court in accordance with the law if:

(1) an Employee or a close family member thereof or his/her Employer that applied for determination of a work-related injury is dissatisfied with a decision not to accept such application;

(2) an Employee or a close family member thereof or his/her Employer that applied for determination of a work-related injury is dissatisfied with the conclusions of the determination of the work-related injury;

(3) an Employer is dissatisfied with its premium rate determined by the Agency;

(4) a medical institution or disability aid supply organisation that has executed a service agreement is of the opinion that the Agency has failed to perform the relevant service agreement or provisions; or

(5) an Injured Employee or his/her close family member objects to the work-related injury insurance benefits determined by the Agency.

Part Seven: Legal liability

Article 56: If an entity or individual violates Article 12 hereof by diverting funds from the work-related injury insurance fund and the same constitutes a criminal offence, it/he/she shall be criminally prosecuted in accordance with the law. If a criminal offence is not constituted, he/she/it shall be sanctioned or given disciplinary sanctions in accordance with the law. The diverted funds shall be recovered by the social insurance administrative department and returned to the work-related injury insurance fund. Any confiscated illegal income shall be paid into the national treasury in accordance with the law.

Article 57: If any of the following circumstances applies to a member of the working personnel of a social insurance administrative department, he/she shall be sanctioned in accordance with the law; and if the circumstances are serious, constituting a criminal offence, he/she shall be criminally prosecuted in accordance with the law:

(1) he/she does not accept an application for determination of a work-related injury without a valid reason or, through fraudulent means, determines someone not satisfying work-related injury conditions as being an Employee who has sustained a work-related injury;

(2) he/she fails to duly keep the evidentiary materials for an application for determination of a work-related injury, resulting in the relevant evidence being lost; or

(3) he/she accepts property from a concerned party.

Article 58: If an Agency commits any of the acts set forth below, the social insurance administrative department shall order it to rectify the matter and impose disciplinary sanctions on the supervisors in charge and other responsible persons in accordance with the law; if the circumstances are serious, constituting a criminal offence, it shall be criminally prosecuted; if such act causes a concerned party to incur an economic loss, the Agency shall be liable for compensation in accordance with the law:

(1) it fails to keep records on the payment of premiums by Employers and the receiving of work-related injury insurance benefits by Employees in accordance with provisions;

(2) it fails to determine work-related injury insurance benefits in accordance with provisions; or

(3) it accepts property from a concerned party.

Article 59: If a medical institution or disability aid supply organisation fails to provide services in accordance with the service agreement, the Agency may terminate the service agreement.

If an Agency fails to punctually settle charges in full, the social insurance administrative department shall order it to rectify the matter, and the medical institution or disability aid supply organisation may terminate the service agreement.

Article 60: If an Employer, Injured Employee or a close family member thereof obtains work-related injury insurance benefits by fraud, or a medical institution or disability aid supply organisation obtains expenditures from the work-related injury insurance fund by fraud, the social insurance administrative department shall order it/him/her to return the same and fine it/him/her not less than two times and not more than five times the amount fraudulently obtained. If the circumstances are serious, constituting a criminal offence, it/he/she shall be criminally prosecuted in accordance with the law.

Article 61: If any of the circumstances set forth below apply to an organisation or individual that engages in the assessment of work capacity, the social insurance administrative department shall order it/him/her to rectify the matter and fine it/him/her not less than Rmb2,000 and not more than Rmb10,000; if the circumstances are serious, constituting a criminal offence, it/he/she shall be criminally prosecuted in accordance with the law:

(1) it/he/she provides fraudulent assessment findings;

(2) it/he/she provides a fraudulent proof of diagnosis; or

(3) it/he/she accepts property from a concerned party.

Article 62: If, pursuant to, an Employer is required to enrol in work-related injury insurance but fails to do so, the social insurance administrative department shall order it to enrol within a specified period of time, pay the outstanding work-related injury insurance premiums and charge it a late payment fine at the daily rate of 0.05% commencing from the date the premiums were owed. If the Employer still fails to pay, the social insurance administrative department shall fine it not less than the equivalent of and not more than three times the outstanding amount.

If an Employer that is required to enrol in work-related injury insurance pursuant to these Regulations fails to do so and its Employee sustains a work-related injury, the Employer shall pay the costs based on the work-related injury insurance benefit items and at the rates specified in these Regulations.

Once the Employer enrols in work-related injury insurance and pays the outstanding premiums and late payment fine, the work-related injury insurance fund and Employer shall pay the new costs that arise in accordance with these Regulations.

Article 63: If an Employer violates Article 19 hereof by refusing to assist the social insurance administrative department in investigating and verifying an accident, the social insurance administrative department shall order it to rectify the matter and fine it not less than Rmb2,000 and not more than Rmb20,000.

Part Eight: Supplementary provisions

Article 64: For the purposes of these Regulations, the term “total payroll” means the total labour compensation directly paid by an Employer to all of its Employees.

For the purposes of these Regulations, the term “his/her wage” or “Employee's wage” means the Injured Employee's average wage, on the basis of which premiums are paid, for the 12 months before he/she sustained the injury in an accident at work or contracted an occupational disease. If his/her wage is more than 300% of the average wage of Employees in the pooling region, it shall be calculated at 300% of the average wage of Employees in the pooling region. If his/her wage is less than 60% of the average wage of Employees in the pooling region, it shall be calculated at 60% of the average wage of Employees in the pooling region.

Article 65: If a civil servant or a member of the working personnel of a public institution or association that is administered with reference to the Civil Servants Law is injured in an accident at work or contracts an occupational disease, the costs shall be paid by the entity with which he/she serves. The specific measures therefor shall be specified by the State Council's social insurance administrative department together with the State Council's finance department.

Article 66: If an Employee of an entity that does not have a business licence or that failed to carry out registration or record filing procedures in accordance with the law or of an entity that has had its business licence revoked or had its registration or record filing cancelled in accordance with the law sustains an injury in an accident or contracts an occupational disease, the entity shall pay the disabled Employee or the close family members of the deceased Employee a lump sum compensation, and the rate of such compensation may not be less than the work-related injury insurance benefits specified in these Regulations. An Employer may not use child workers. If an Employer uses a child worker and such use results in the disability or death of the child worker, the entity shall pay the child worker or the child worker's close family members a lump sum compensation, and the rate of such compensation may not be less than the work-related injury insurance benefits specified in these Regulations. The specific measures therefor shall be specified by the State Council's social insurance administrative department.

In the event of a dispute between a disabled Employee or the close family members of a deceased Employee as mentioned in the preceding paragraph and the entity over the amount of the compensation, or of a dispute between a child worker or the close family members of a child worker as mentioned in the preceding paragraph and the entity over the amount of the compensation, it shall be handled in accordance with relevant provisions on the handling of labour disputes.

Article 67: These Regulations shall be effective as of January 1 2004. If the determination of the work-related injury of an Employee who sustained an injury in an accident or contracted an occupational disease before the implementation hereof has not been completed, matters shall be handled in accordance with these Regulations.