Understanding Work-Related Injury （and Your Benefits)

As a foreign employee in China, it’s essential to understand your rights regarding work injury insurance. This system is designed to protect workers who sustain injuries during their employment. In this article, we will clarify what constitutes a work-related injury, outline the benefits provided by work injury insurance, and explain how to protect your rights if your employer fails to pay for this insurance.

What Is Considered a Work Injury?

According to Chinese law, a work injury is defined as any injury that occurs “in the workplace during working hours due to work” (the “three work” threshold). While "in the workplace" and "during working hours" can be easily identified, whether the injury is due to work can be a tricky question. According to the Supreme Court, any injury that happens at the workplace during working hours shall be identified as a work-related injury UNLESS proven otherwise by the employer or the social insurance department.

However, some injuries that occur outside the workplace and/or outside working hours can also be classified as work-related injuries. For example:

1. Commute Incidents: The most common case is a traffic incident during commute. An employee’s injury resulting from such an incident shall be classified as a work-related injury unless the traffic police identify that the employee bears major or all responsibility. It's important to note that the incident must occur during the commute, which means traveling between workplace and home or other reasonable living places (such as to a grocery store or picking up children).

2. Sudden Illness: According to the Work Injury Insurance Regulations, if an employee dies due to a sudden illness while at work or within 48 hours of being treated without success,     it is considered a work-related injury. "Sudden illness"   includes various diseases and does not require a connection to work. Common examples include heart attacks, strokes, and myocardial infarctions. The 48-hour timeframe starts from the initial diagnosis by a medical institution. If an employee suffers a sudden illness while on duty but only dies 48 hours later after unsuccessful resuscitation, this does not qualify as a work-related injury.

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What Does Not Qualify as a Work Injury?

Certain situations are explicitly excluded from being categorized as work injuries:

1. Off-Duty Injuries: If you are injured while engaging in personal activities during work hours, such as playing sports or running personal errands, this is not considered a work injury. For instance, if you are injured during a lunch break while playing basketball with friends, it won't qualify for compensation.

2. Self-Inflicted Injuries: Injuries that you intentionally inflict upon yourself are not eligible for compensation. For example, if you injure yourself while trying to demonstrate a risky stunt to coworkers, this would not be covered.

3. Injuries from Alcohol or Drugs: The law excludes injuries or fatalities resulting from intoxication from being classified as work injuries. This is primarily due to laws that prohibit working or driving under the influence. Thus, various accidents caused by losing control due to intoxication cannot be treated as work injuries. However, if there is no causal relationship between the employee's intoxication and the injury, and if the injury meets the legal criteria for work injuries, it may still be recognized as such.

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Benefits Under Work Injury Insurance

If your injury qualifies under work injury insurance, you are entitled to various benefits, including:

1. Medical Expenses: Coverage for medical treatment related to your work injury, including hospital stays, surgeries, physical therapy, and rehabilitation. 

2. Lost Wages: Compensation for lost wages during recovery is also provided. This is calculated based on the employee's average salary during the recovery period.

3. Disability Compensation: If the injury results in a permanent disability, the assessment of a worker’s degree of disability follows ten basic degrees, with Degree 1 being the most severe. Degree 1 to 4 indicate that the employee no longer has any ability to work; Degree 5 and 6 signify that an employee has lost most of their ability to work, while workers with Degree 7 to 10 injuries are classified as partially disabled. Based on the level of disability, the employee will be entitled to:

   • A one-time disability benefit.

   • If employment ends, a one-time medical treatment benefit and a one-time disability employment benefit.

The amount of one-time compensation varies according to the degree of disability; the higher the disability degree, the greater the compensation amount.

Let's look at this hypo: Consider John, a diligent employee at a company in China who sustains an injury at work, incurring 10,000 RMB in medical bills. The social insurance center classifies John's injury as work-related and determines it caused a degree 10 disability. Since John's employer provided social insurance, the following benefits apply:

1. John’s medical bills are covered.

2. He receives compensation for lost wages.

3. He qualifies for a one-time disability benefit (equal to seven months of his salary).

If John's employment ends, he is entitled to:

4. A one-time medical treatment benefit (equal to two months' average salary in his city).

5. A one-time disability employment benefit (equal to three months' average salary in his city).

What to Do If Your Employer Has Not Paid for Work Injury Insurance

Your employer is obligated to pay social insurance for you, which includes work-related insurance.

If you discover that your employer has not paid the required work injury insurance premiums, here are steps you can take to protect your rights:

1. Gather Evidence: Collect documents that prove your employment, such as your employment contract, pay stubs, and any correspondence with your employer regarding insurance. Keeping detailed records of workplace incidents and communications is crucial.

2. Consult Legal Advice: Reach out to a legal professional who specializes in labor law in China to provide you with detailed guidance on your options and rights, including whether to pursue compensation or report your employer.

3. File a Complaint: You can file a complaint with the local labor authority. Provide them with the evidence you've gathered to support your claim. The local labor bureau is responsible for enforcing labor laws and can investigate your employer’s non-compliance.

4. Consider Mediation or Legal Action: If the issue remains unresolved, mediation services can be sought through labor dispute resolution organizations. If necessary, you may pursue legal action against your employer to recover compensation or to compel them to fulfill their obligations regarding insurance payments.

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Understanding the nuances of work injury insurance in China is crucial for all foreign workers. By knowing what constitutes a work injury, the benefits you are entitled to, and how to act if your employer fails to fulfill their obligations, you can better protect your rights and ensure a safer work environment. Stay informed and proactive about your rights to ensure that you are adequately protected while working in China! Feel free to share this information with fellow workers to help them understand their rights as well!

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