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Implementation Procedures of Shanghai Municipality on the Industrial Injury Insurance

Chapter I General Provisions

Article 1 (Basis)

These Procedures are formulated in accordance with the State Council¡¯s¡°Regulation on the Industrial Injury Insurance¡±and in the light of the actual circumstances of this Municipality.

Article 2 (Application Scope)

These Procedures apply to the enterprises, institutions, state organs, mass organizations, private non-enterprise units, and self-employed workers having employees (hereinafter jointly referred to as employer-units) and all their employees in the administrative area of this Municipality.

Article 3 (Administration of the Collection and Payment)

The collection and payment of the premium of industrial injury insurance shall be implemented according to the relevant provisions of the State Council¡¯s¡°Interim Regulations on the Collection and Payment of the Premium of Social Insurance¡±, and¡°Provisions of Shanghai Municipality on the Collection and Payment of the Premium of Social Insurance for Urban Employees¡±.

Article 4 (Publication and Treatment and Cure)

The employer-units shall make known the relevant contents of joining the industrial injury insurance in the units.

In case that an employee suffers industrial injury, the employer-unit shall take measures to ensure that the industrially injured person (hereinafter referred to as injured person) receives timely treatment and cure.

Article 5 (Administrative Department)

The Shanghai Municipal Labor and Social Security Bureau (hereinafter referred to as the SMLSSB) is the competent administrative department of the industrial injury insurance in this Municipality, and shall be responsible for the centralized administration of the industrial injury insurance in this Municipality.

The district/county labor and social security bureaus (hereinafter jointly referred to as district/county administrative departments of labor security) shall be responsible for the routine administration of the industrial injury insurance in their own administrative areas.

The municipal and district/county industrial injury insurance handling agencies (hereinafter referred to as the handling agencies) shall be responsible for the specific business of industrial injury insurance.

Article 6 (Supervision)

When the SMLSSB and other departments work out the policy and standard on the industrial injury insurance, they shall solicit the opinions of the representatives from the trade unions and the employer-units.

The trade union shall safeguard the legitimate rights and interests of the injured persons according to law, and exercise supervision over the employer-units¡¯work of industrial injury insurance.

Chapter II Fund of Industrial Injury Insurance

Article 7 (Source of Fund)

The fund of industrial injury insurance shall be made up by the premium of industrial injury insurance paid by the employer-units, the interest of the fund of industrial injury insurance and other money that can be included into the fund of industrial injury insurance according to law.

In case that the fund of industrial injury insurance is not enough to pay off the benefit of industrial injury insurance for serious accidents, the municipal finance shall pay for it temporarily.

Article 8 (Principle of Payment)

The employer-units shall pay the premium of industrial injury insurance on time. The employee personally does not pay the premium of industrial injury insurance.

The rate of the premium of industrial injury insurance shall be decided according to the principle of¡°outlay determines the amount to be collected, the balance of income and outlay shall be kept¡±.

Article 9 (Base of Payment)

The base for the employer-unit to pay the premium of industrial injury insurance shall be decided according to the base that the unit pays the premium of endowment insurance for urban employees or the premium of social insurance for employees of small towns.

Article 10 (Rate)

The employer-unit shall pay the basic rate of the premium of industrial injury insurance, and the basic rate shall be unified as 0.5 % of the base of payment.

The employer-unit with the occurrence of industrial injury shall, according to provisions, adopt floating rate on the basis of the basic rate.

The floating rate shall be determined according to the employer-unit¡¯s use of the industrial injury insurance premium and the rate of the occurrence of industrial injury. The floating rate shall be classified under 5 grades, and the difference between each grade shall be 0.5 % of the base of payment, The highest rate after up-floating (the basic rate plus floating rate) shall be no more than 3% of the base of payment, while the lowest rate after down-floating by grades in turn shall be no less than the basic rate. The floating rate shall be checked and determined once a year.

The detailed procedures of the floating of the rate of the premium of industrial injury insurance shall be worked out by the SMLSSB jointly with the departments of finance, public health and production safety supervision, etc., and shall be implemented after being approved by the Municipal People¡¯s Government.

Article 11 (Payment Scope)

The fund of industrial injury insurance shall be used for the benefit of industrial injury insurance and the appraisal of labor ability provided in these Procedures, and the payment of other fees for industrial injury insurance provided by laws and regulations.

Article 12 (Administration and Supervision of the Fund)

The fund of industrial injury insurance adopts the principle of overall planning by this Municipality, setting up special account, and special money for special use. No unit or individual person shall use the money without authorization.

The SMLSSB shall exercise supervision and inspection over the payment of the premium of industrial injury insurance and the payment of the fund of industrial injury insurance according to law.

The municipal finance and audit departments shall exercise supervision over the collection, payment and management of the fund of industrial injury insurance according to law.

Article 13 (Expense of a Handling Agency)

The handling agency¡¯s funds needed for carrying out industrial injury insurance shall be checked and ratified by the finance department, and be brought into the budget management.

Chapter III Identification of Industrial Injury

Article 14 (Scope of Identification of Industrial Injury)

With any one of the following situations, the employee shall be identified as suffering from industrial injury:

1. Injured by accident due to some cause incidental to his/her work within working hours and inside the working place;

2. Injured by accident due to the preparatory or tail-in work relevant to the job before or after working hours and inside the working place;

3. Accidentally injured by violence, etc. due to the performance of his duty within working hours and inside the working place;

4. Suffering from industrial diseases;

5. Injured during a business trip or become missing by occurrence of an incident due to some cause incidental to his/her work,;

6. Injured in motor vehicle accident on the way to or from work; and

7. Other situations that laws and administrative regulations provide that shall be identified as industrial injury.

Article 15 (Scope of Injury Treated as Industrial Injury)

With any one of the following situations, the employee¡¯s injury shall be treated as industrial injury:

1. Died within working hours and on the job post due to sudden disease or died within 48 hours upon emergency rescue of the disease;

2. Injured in activities to protect national or public interests such as rescue and disaster relief, etc.; and

3. Recurrence of old wounds at the employer-unit of the employee who once served in the army and was injured due to war or job and was awarded the Certificate of Revolutionary Disabled Army-man.

The employee with the situation provided in Item 1, Item 2 of the preceding Clause shall enjoy the benefit of the industrial injury insurance according to relevant provisions of these Procedures; the employee with the situation provided in Item 3 of the preceding Clause shall, according to the relevant provisions of these Procedures, enjoy the benefit of industrial injury insurance except the one-time subsidy for the injured and disabled in a lump sum.

Article 16 (Exclusion of Industrial Injury)

With any one of the following situations, the employee¡¯s injury shall not be affirmed or be treated as industrial injury:

1. Injured or died due to law-breaking or violating regulations of public order;

2. Injured or died due to alcoholism; and

3. Self-injury or suicide.

Article 17 (Application for Identification)

In case that the employee suffers accidental injury or is diagnosed or appraised as industrial disease according to the provisions in the¡°Law of Prevention and Treatment of Industrial Disease¡±, the employer-unit shall, within 30 days upon the accidental injury or the diagnose or appraisal of the industrial disease, apply to the district/county administrative department of labor security of its locality for the identification of industrial injury. In special cases and with the approval of the district/county administrative department of labor security, the time limit of the application may be properly prolonged.

In case that the employer-unit does not apply for the identification of industrial injury according to the provisions of the preceding clause, the employee or his/her direct relatives or the trade union may, within one year upon the accidental injury or the diagnose or appraisal of the industrial disease, apply directly to the district/county administrative department of labor security of its locality for the identification of industrial injury.

In case that the employer-unit does not apply for the identification of industrial injury within the time limit provided in Clause 1 of this Article, the fees relevant to the benefit of industrial injury provided in these Procedures incurred during the period shall be born by the employer-unit.

Article 18 (Application Materials for Identification of Industrial Injury)

The following materials shall be submitted for the application for the identification of industrial injury:

1. Application form of identification of industrial injury;

2. Materials that prove the existence of labor relationship with the employer-unit (including de facto labor relationship); and

3. Certificate of medical diagnose or certificate of industrial disease diagnose (or certificate of appraisal of the diagnose of industrial disease).

The application form shall include the basic information such as the time, place and cause of the occurrence of the accident, and degree of the employee¡¯s injury, etc.

The submission of the application for identification of industrial injury may include the existing evidence materials of the employer-unit, relevant administrative organs or the people¡¯s court in addition to the materials required by the provisions of the preceding clause of this Article.

Article 19 (Acceptance and Handling)

In case that the applicant for the identification of industrial injury applies for the identification of industrial injury within the time limit provided in these Procedures and with complete application materials, the district/county administrative department of labor security shall issue the notice of acceptance and handling within 10 working days upon receiving the application for identification of industrial injury. In case that the conditions of acceptance and handling have not been met, the district/county administrative department of labor security shall not accept and handle, and shall inform the applicant for identification of industrial injury in writing.

In case that the applicant for the identification of industrial injury applies for the identification of industrial injury within the time limit provided in these Procedures but with incomplete application materials, the district/county administrative department of labor security shall, within 10 working days upon receiving the application for identification of industrial injury, notify for once only the applicant for identification of industrial injury in writing of all the materials needed to be added and corrected. In case that the applicant adds and corrects the materials within 30 days in compliance with the requirements, the district/county administrative department of labor security shall accept and handle it.

Article 20 (Investigation, Checking and Burden of Proof)

Upon the acceptance and handling of the application for identification of industrial injury, the district/county administrative department of labor security may investigate and check the accidental injury according to the need of examination and verification, and the employer-unit, employee, trade union, medical institute, and relevant departments shall cooperate. The appraisal of the diagnose of industrial disease and the dispute over the diagnose shall be handled according to relevant provisions in the¡°Law of Prevention and Treatment of Industrial disease¡±. In case that the certificate of industrial disease diagnose or the appraisal of industrial disease diagnose is legally obtained, the district/county administrative department of labor security need not investigate and check again.

In the identification of industrial injury by the district/county administrative department of labor security, if the employee or his/her direct relatives consider it to be an industrial injury while the employer-unit considers it not to be, the employer-unit shall bear the burden of proof.

Article 21 (Procedures of Identification)

The district/county administrative department of labor security shall make a decision on the identification of industrial injury within 60 days upon receiving the application for identification of industrial injury, and send the decision on the identification of industrial injury to the employee who applies for the identification of industrial injury, or to his/her direct relatives, or the unit the employee works in.

During the identification of industrial injury, and in case that the departments of safety production supervision, public security, public health, and civil affairs, etc. have not yet made a conclusion on the corresponding accident, and the conclusion may affect the identification of the industrial injury, the procedure of the identification of the industrial injury may be suspended.

Article 22 (Items to be Recorded in the Decision of an Industrial Injury Identification)

The following items shall be recorded in the decision of industrial injury identification:

1. The basic information of the employer-unit and the industrially injured person;

2. The part of body injured, the time of the accident and the time of diagnose and treatment, or the name of the industrial disease, the course of being injured and its verification, and the basic situation of the medical treatment and diagnostic conclusion;

3. Basis of being identified as industrial injury, considered as industrial injury, or identified as not belonging to industrial injury, and not considered as industrial injury;

4. Conclusion of the identification;

5. The department and time limit of applying for administrative reconsideration in case that the decision of identification is not accepted; and

6. The time that the decision of identification is made.

The decision on the identification of industrial injury shall be stamped with the special seal for the identification of industrial injury by the administrative department of labor security.

Article 23 (Obligation of Informing)

The district/county administrative department of labor security shall, at the time of serving the decision on the identification of industrial injury to the employee who applies for the identification of industrial injury, or his/her direct relative and the unit he/she works in, inform them in writing of the application procedures for the appraisal of labor ability.

Chapter IV Appraisal of Labor Ability

Article 24 (Appraisal of Labor Ability)

In case that the industrial injury causes disability to the employee when the injury is relatively stable after medical treatment, and thus affects the employee¡¯s labor ability, the labor ability concerning the handicap grades of labor function and the handicap grades of taking care of himself/herself in daily life shall be appraised.

The handicap of labor function shall be categorized into 10 grades, and the handicap to take care of himself/herself in daily life into 3 grades.

The standard of the appraisal of labor ability shall be implemented according to relevant provisions of the State.

Article 25 (Appraisal Organization)

The municipal, and district/county appraisal committees of labor ability (hereinafter referred to as the appraisal committees) shall be formed by departments of labor and social security, personnel, public health, etc. at the same level, and the representatives from the trade union, handling agency and the representatives from the employer-unit. The office of the municipal, and district/county appraisal committees shall be placed at the administrative departments of labor security at the same level to be responsible for the routine work of the appraisal committees.

The municipal appraisal center of labor ability shall, entrusted by the municipal appraisal committee, be responsible for the specific work of the appraisal of the labor ability of industrial disease sufferers, and the re-appraisal of injured persons.

The district/county appraisal committee shall be responsible for the appraisal of the labor ability of injured persons in its own administrative area.

The appraisal committee shall establish a bank of medical and public health specialists according to law, and perform the appraisal of labor ability.

Article 26 (Application Materials for Appraisal of Labor Ability)

The application for the appraisal of labor ability of the injured person may be submitted to the appraisal committee by the employer-unit, the injured person or his/her direct relatives.

In case of submitting an application for the appraisal of labor ability, the following materials shall be submitted:

1. Fully filled application form of labor ability appraisal;

2. Decision on the identification of industrial injury; and

3. Relevant materials about the diagnose and treatment of industrial injury issued by the medical institution designated in the medical insurance contract.

Article 27 (Procedures of Appraisal)

The appraisal committee shall organize a group of specialists according to law upon receiving the application for the appraisal of labor ability, and the appraisal opinion shall be put forward by the group of specialists. The appraisal committee shall, according to the appraisal opinion of the group of specialists, draw the conclusion of the appraisal of labor ability of the injured person within 60 days upon receiving the application for the appraisal of labor ability. In case of necessity, the time limit of drawing the conclusion of the appraisal of labor ability may prolong 30 days. The conclusion of the appraisal of labor ability shall be served to the employer-unit, the injured person or his/her direct relatives who have applied for the appraisal of labor ability in time.

At the time of the serving of the conclusion of the appraisal of labor ability, the appraisal committee shall inform in writing the employer-unit, the injured person or his/her direct relatives of how to go through the formalities of enjoying the benefit of industrial injury insurance, and provide the application form for the benefit of industrial injury insurance.

Article 28 (Re-appraisal)

In case the employer-unit, the injured person or his/her direct relatives who have applied for the appraisal of labor ability do not agree with the conclusion of the appraisal of labor ability or the conclusion of the appraisal of industrial disease, they may apply to the municipal appraisal committee for a re-appraisal within 15 days upon receiving the appraisal conclusion.

In case of the application for the re-appraisal due to disagreeing with the conclusion of the appraisal of industrial disease, the municipal appraisal committee shall organize another group of specialists to do the re-appraisal.

The conclusion of the re-appraisal made by the municipal appraisal committee shall be the final conclusion.

Article 29 (Appraisal of Re-examination)

One year after the date that the conclusion of the appraisal of labor ability is made, and in case that the injured person or his/her direct relatives, the employer-unit or the handling agency believes that there is a change in the injury or handicap, an application for the appraisal of re-examination of labor ability may be raised.

Article 30 (Appraisal Expenses)

The expenses for the first appraisal of labor ability of the injured person shall be paid by the fund of industrial injury insurance.

Where the employer-unit, the injured person or his/her direct relatives apply for re-appraisal or appraisal of re-examination, if the conclusion of the re-appraisal maintains the original conclusion, or if there is no change in the conclusion of the re-examination, the appraisal expenses shall be born by the employer-unit, or the injured person, or his/her direct relatives who have applied for the re-appraisal or appraisal of re-examination; in case that the conclusion on the re-appraisal or appraisal of re-examination differs from the original, the appraisal expenses shall be born by the fund of industrial injury insurance.

Chapter V Benefit of Industrial Injury Insurance

Article 31 (Principle of Medical Treatment)

The injured person who receives medical treatment because of accidental injury or the suffering of industrial disease due to his/her work enjoys the benefit of the medical treatment of industrial injury.

The injured person shall go to a medical institution or the medical institution for industrial disease in this Municipality designated in the medical insurance contract for the treatment of industrial injury; in case of emergency, he/she may go to the nearby medical institution for first aid, and when the injury becomes stable, he/she shall be timely transferred to the medical institution designated in the medical insurance contract for further treatment. In case of a necessity to be transferred to another province or city, the injured person shall go through relevant formalities with the handling agency.

Article 32 (Benefit of Medical Treatment)

The medical expenses needed for the treatment of the industrial injury shall comply with the State and this Municipality¡¯s catalogue of medical treatment items of industrial injury insurance, the catalogue of medicine of industrial injury insurance, and the standard of hospitalization service of the industrial injury insurance. The medical expenses for industrial injury with the exception of the part of expenses that shall be born by the fund of medical insurance according to the provisions of this Municipality, shall be born by the fund of industrial injury insurance.

This Municipality¡¯s catalogue of medical treatment items of industrial injury insurance, the catalogue of medicine of industrial injury insurance, and the standard of hospitalization service of the industrial injury insurance shall be implemented in accordance with this Municipality¡¯s provisions relating to the scopes of medical treatment items, the scope of the use of medicines, and the scope of facilities of medical service, etc. of the basic medical insurance.

In case that the injured person goes to hospital for diseases not caused by the industrial injury, the medical expense needed shall not be listed into the payment scope of the fund of industrial injury insurance.

Article 33 (Standard of the Expense for Meals in Hospital, Traveling, Boarding and Lodging)

In case that the injured person is hospitalized for the treatment of industrial injury, the employer-unit shall pay the food allowance of hospitalization, which is 70% of the unit¡¯s standard of food allowance for business trips, and in case of being approved to be transferred to another province or city for medical treatment, the expense needed for traveling, boarding and lodging shall be reimbursed according to the standard of business trips of the unit¡¯s employees.

Article 34 (Auxiliary Appliances)

In case the injured person needs for daily life or employment, and with the affirmation of the appraisal committee, he/she may fix artificial limbs, orthopedic apparatus, artificial eyes, teeth and equip auxiliary appliances like wheelchairs, etc., the expense needed shall be paid from the fund of industrial injury insurance according to the standard and items of auxiliary appliances provided by the State and this Municipality.

Article 35 (Benefit During the Period of Rest with Pay)

In case that the employee suffers accidental injury or industrial disease due to a cause incidental to his work and needs a period of rest for medical treatment of industrial injury, the original salary (wage) and social welfare shall remain the same to be paid to him/her as before, and shall be paid by the employer-unit monthly during the period of rest with pay.

Generally, the period of rest with pay shall not exceed 12 months. In case of serious injury or special situation, the period may be appropriately lengthened with the affirmation of the appraisal committee, however, the lengthening shall not exceed 12 months. After the appraisal of the injury grade, the original benefit of the injured person shall be suspended and he/she shall begin to enjoy the injury and handicap benefit according to relevant provisions of these Procedures. If the injured person needs further medical treatment after the termination of the period of rest with pay, he /she may continue to enjoy the benefit of medical treatment of industrial injury.

In case that the injured person who lacks the ability of self care in daily life needs care and nursing during the period of rest with pay, the employer-unit shall be responsible therefor.

Article 36 (Benefit of Care and Nursing for Daily Life)

In case that the injured person has been appraised for the grade of injury and handicap and with the confirmation of the appraisal committee that he/she needs care and nursing for daily life, the expenses for the care and nursing shall be paid monthly from the fund of industrial injury insurance.

The expenses for the care and nursing shall be paid according to 3 different grades, i.e., total inability of self care and nursing, most part inability of self care and nursing, and partial inability of self care and nursing. The standard of payment shall respectively be 50%, 40% and 30% of the monthly average salary (wage) of the employees in this Municipality in the preceding year.

Article 37 (Benefit for Handicap Grade 1 to 4)

In case of being appraised as Injury and Handicap Grade 1 to 4 due to industrial injury, the injured person may be laid-off with the labor relationship kept and enjoy the following benefit:

1. The fund of industrial injury insurance pays the lump sum injury and handicap grant-in-aid (GIA). The GIA is 24 months¡¯salary (wage) that the injured person receives the preceding month of the injury and according to which he/she pays the social security for Injury and Handicap Grade 1, 22 months¡¯salary (wage) for Injury and Handicap Grade 2, 20 months¡¯salary (wage) for Injury and Handicap Grade 3, and 18 months¡¯salary (wage) for Injury and Handicap Grade 4;

2. Injury and handicap subsidy is drawn monthly from the fund of industrial injury insurance. The subsidy shall be 90% of the salary (wage) that the injured person receives the preceding month of the injury and according to which he/she pays the social security for Injury and Handicap Grade 1, 85% for Injury and Handicap Grade 2, 80% for Injury and Handicap Grade 3, and 75% for Injury and Handicap Grade 4.

3. After the injured person has gone through the formalities of drawing monthly old age pension, the subsidy for injury and handicap shall be suspended, and the injured person may enjoy the benefit of endowment insurance. In case that the basic old age pension is less than the subsidy for injury and handicap, the difference shall be covered by the fund of industrial injury insurance. In case that the injured person reaches the legal retirement age, but does not meet the conditions of drawing monthly old age pension, the fund of industrial injury insurance shall continue the payment of subsidy for injury and handicap; and

4. The employer-unit and the injured person who join this Municipality¡¯s basic medical care insurance shall, on the basis of the subsidy for injury and handicap, pay the premium of basic medical care insurance monthly, and enjoy the benefit of basic medical care insurance. The injured person shall, after reaching the legal retirement age, continue the enjoyment of the benefit of basic medical care insurance.

Article 38 (Benefit for Handicap Grade 5 and 6)

In case of being appraised as Injury and Handicap Grade 5 and 6 due to industrial injury, the injured person may enjoy the following benefit:

1. The fund of industrial injury insurance pays the lump sum GIA. The GIA is 16 months¡¯salary (wage) that the injured person receives the preceding month of the injury, and according to which he/she pays the social security for Injury and Handicap Grade 5, and 14 months¡¯salary (wage) for Injury and Handicap Grade 6; and

2. Where the labor relationship with the employer-unit is kept, the employer-unit shall assign him/her an appropriate job. In case that it is difficult to assign an appropriate job, the employer-unit shall pay monthly the injury and handicap subsidy. The subsidy for Injury and Handicap Grade 5 shall be 70% of the salary (wage) that the injured person receives the preceding month of the injury and according to which he/she pays the social security, and 60% for Injury and Handicap Grade 6. The employer-unit and the injured person shall continue the payment of the premium of every item of social insurance according to the provisions. In case that the injury and handicap subsidy is less than the standard of the minimum monthly salary (wage) of the employees in this Municipality, the difference shall be covered by the employer-unit.

If put forward by the injured person him/herself, he/she may dissolve or terminate the labor relationship with the employer-unit, and in this case, the employer-unit shall pay the lump sum subsidy for medical treatment of the industrial injury and that for re-employment of the injured and handicapped. The sum total of the 2 subsidies for Injury and Handicap Grade 5 is 30 months average salary (wage) of the employees in this Municipality in the preceding year; and 25 months for Injury and Handicap Grade 6.

In case that the labor relationship is terminated due to the retirement or death of the injured person, the benefit provided in Clause 2 of this Article shall not be enjoyed.

Article 39 (Benefit for Handicap Grade 7 to 10)

In case of being appraised as Injury and Handicap Grade 7 to 10, the injured person may enjoy the following benefit:

1. The fund of industrial injury insurance shall pay the lump sum GIA. The GIA is 12 months¡¯salary (wage) that the injured person receives the preceding month of the injury and according to which he/she pays the social security for Injury and Handicap Grade 7; 10 months¡¯salary (wage) for Injury and Handicap Grade 8; 8 months¡¯salary (wage)for Injury and Handicap Grade 9; and 6 months¡¯salary (wage) for Injury and Handicap Grade 10; and

2. In case that the labor contract is terminated due to expiration, or dissolved due to the proposal of the injured person him/herself, the employer-unit shall pay the lump sum subsidy for medical treatment of the industrial injury and that for re-employment of the injured and handicapped. The sum total of the 2 subsidies for Injury and Handicap Grade 7 is 20 months average salary (wage) of the employees in this Municipality in the preceding year; 15 months for Injury and Handicap Grade 8; 10 months for Injury and Handicap Grade 9; and 5 months for Injury and Handicap Grade 10.

In case that the labor relationship is terminated due to retirement or death of the injured person, the benefit provided in Item 2, Clause 1 of this Article shall not be enjoyed.

Article 40 (Relapse of Industrial Injury)

In case of relapse of the industrial injury and with the affirmation of the appraisal committee that medical treatment is needed, the injured person may enjoy the benefit of industrial injury insurance provided in Article 31 to Article 36 of these Procedures.

The injured person, who has dissolved or terminated the labor relationship with the employer-unit, and receives the lump sum subsidy for medical treatment of the industrial injury and that for re-employment of the injured and handicapped, shall no longer enjoy the benefit provided in Article 31 to Article 36 of these Procedures.

Article 41 (Benefit for Work-related Death)

In case of the employee¡¯s death was work-related, his/her direct relatives may draw from the fund of industrial injury insurance the funeral subsidy, the compensation for the dependent relatives of the deceased, and the lump sum grant-in-aid for the work-related death:

1. The funeral subsidy is 6 months average salary (wage) of the employees in this Municipality of the preceding year of the employee¡¯s work-related death;

2. The compensation to the dependant relatives of the deceased shall, according to a certain proportion of the salary (wage) the employee received the month before his/her work-related death and according to which he/she pays the social security, be paid to the relatives without labor ability and depends chiefly on him/her for living. Among them, the spouse receives 40% monthly, and other relatives 30% monthly, and for the aged widow/widower, or orphan, a monthly 10% shall be added on the basis of the above standard. The sum total of the compensation verified and rectified for all the dependent relatives shall not be more than the employee¡¯s salary (wage) of the month prior to his/her work-related death; and

3. The standard of the lump sum grant-in-aid for the work-related death shall be 50 months average salary (wage) of the employees in this Municipality of the year prior to the employee¡¯s work-related death.

In case that the injured person dies during the period of rest with salary (wage), his/her direct relatives may enjoy the benefit provided in Clause 1 of this Article.

In case that the injured person of Injury and Handicap Grade 1 to 4 dies after the expiration of the period of rest with salary (wage), his/her direct relatives may enjoy the benefit provided in Item 1 and Item 2 of Clause 1 of this Article; among them, for the one who dies after drawing monthly pension, and if the funeral subsidy that the fund of endowment insurance pays to his/her direct relatives is lower than the standard provided in Item 1 of Clause 1 of this Article, the difference shall be covered by the fund of industrial injury insurance.

The scope of the dependent relatives shall be implemented according to relevant provisions of the State.

Article 42 (Special Provision on Salary (Wage) According to Which One Pays Social Security)

In case that the salary (wage) according to which one pays the social security and which the injured receives before the injury or the deceased received before the work-related death provided in Item 1 and Item 2 of Clause 1 of Article 37, Item 1 of Clause 1 of Article 38, Item 1 of Clause 1 of Article 39 and Item 2 of Clause 1 of Article 41 of these Procedures is lower than the standard of the monthly average salary (wage) of the employees in this Municipality of the preceding year, the salary (wage) shall be adjusted according to the standard of the monthly average salary (wage) of the employees in this Municipality of the year prior to the injury of the injured or the work-related death of the deceased.

Article 43 (Adjustment of Benefits)

The standard of the injury and handicap subsidy, compensation to the dependent relatives of the deceased and the care and nursing fee shall be timely adjusted by the SMLSSB according to the situations like the variation of the average salary (wage) of the employees in this Municipality and the CPI, etc. The procedures of the adjustment shall be worked out by the SMLSSB and be implemented with the approval of the Municipal People¡¯s Government.

Article 44 (Relationship with Other Compensations)

In case of the industrial injury caused by motor vehicle accident or by other infringement of civil rights by a third party, and the employer-unit or the fund of industrial injury insurance has paid in advance according to the benefit of industrial injury insurance provided in these Procedures, the injured person or his/her direct relatives shall pay back correspondingly after receiving the motor vehicle accident or civil compensation.

Article 45 (Benefit to Persons Suffer Accidents in Business Trip or Missing in Rescue and Disaster Relief)

In case that the employee suffers accident in business trip or missing in rescue and disaster relief, his/her salary (wage) shall be paid for the 3 months after the accident, and shall be suspended from the 4th month, while the compensation to the dependent relatives of the deceased shall be paid monthly according to the provisions stipulated in Item 2, Clause 1 of Article 41 of these Procedures. In case of living difficulty, 50% of the lump sum grant-in-aid for industrial death may be prepaid. In case that the People¡¯s Court declares the death of the employee, the case shall be handled according to the provisions in Article 41 of these Procedures.

Article 46 (Suspension of Benefits)

With one of the following situations, the benefit of industrial injury insurance to the injured person shall be suspended:

1. Lose the conditions of enjoying the benefit;

2. Refuse to accept the appraisal of labor ability;

3. Refuse medical treatment; and

4. Be sentenced imprisonment.

Article 47 (Determination of Duty for Insurance)

In case of the split-off, merger or transfer of the original employer-unit, the successor employer-unit shall bear the duty for industrial injury insurance of the original employer-unit.

In case of adopting the contracting business, the duty for industrial injury insurance shall be born by the unit with which the employee has the labor relationship.

In case that the employee is injured in industrial accident during the temporary transfer, the original employer-unit shall bear the duty for industrial injury insurance, however, the original employer-unit may reach a compensation agreement with the temporarily transferring employer-unit.

In case of the bankruptcy of the enterprise, the priority of payment in the bankrupt liquidation shall be the expense for the benefit of industrial injury insurance born by the bankrupt unit according to law.

Article 48 (Compensation Abroad)

In case that the employee is sent to work abroad, and the law of that country or region requires a buying of the local industrial injury insurance, he/she shall buy the local industrial injury insurance, while the home industrial injury insurance is suspended; in case that buying local industrial injury insurance is impossible, his/her home industrial injury insurance shall not be suspended, and he/she may enjoy the benefit of industrial injury insurance according to the provisions of these Procedures.

Article 49 (Procedures for Enjoying Benefits)

In case of an employee¡¯s work-related injury or death, the injured person or his/her direct relatives or the employer-unit shall go through the formalities for the benefit of industrial injury insurance with the handling agency, and provide the following corresponding materials:

1. Fully filled application form for the benefit of industrial injury insurance;

2. Receipt of paying the medical expenses of industrial injury;

3. Materials to prove the labor relationship between the injured person and the employer-unit that bears the liability of industrial injury;

4. The ID certificate of the person who enjoys the benefit and the certificate to prove the dependent relationship with the work-related deceased;

5. Materials to prove the missing or to declare the death; and

6. Other relevant materials.

The handling agency shall, within 30 days upon receiving the application for enjoying the benefit of industrial injury insurance, examine and verify the conditions for the injured person or his/her dependent relatives¡¯enjoyment of the benefit of industrial injury insurance. If the conditions are met, the handling agency shall decide after verification the standard of the benefit, and pay in full in time; if the conditions are not met, the handling agency shall inform the applicant in writing.

Chapter VI Special Provisions

Article 50 (Part-time Employees¡¯Payment of Premium)

The employer-unit that employs part-time employees shall include the payable premium of industrial injury insurance into the employees¡¯labor payment, and let the employee him/herself to pay the premium according to the base and rate of the payment of the premium of industrial injury insurance provided in these Provisions.

Article 51 (Part-time Employees¡¯Benefit of Industrial Injury)

If a part-time employee suffers work-related accidental injury or industrial disease, the labor relationship between the part-time employee and the employer-unit shall be handled according to the provisions in the¡°Regulations of Shanghai Municipality on the Labor Contract¡±, and the part-time employee may enjoy the following benefit of industrial injury insurance:

1. The benefit of industrial injury insurance paid from the fund of industrial injury insurance provided in these Procedures;

2. The employer-unit that bears the liability of industrial injury shall pay the benefit in the period of rest with salary (wage) with reference to the provisions in these Procedures, which shall not be lower than the standard of the minimum salary (wage) of the employees in this Municipality;

3. In case of a suffering of Injury and Handicap Grade 1 to 4, the employer-unit that bears the liability of industrial injury and the injured person shall, on the basis of the injury and handicap subsidy enjoyed, pay in lump sum the premium of the basic medical insurance up to the injured person¡¯s legal retirement age, and the benefit of the basic medical insurance may then be enjoyed; and

4. In case of a suffering of Injury and Handicap Grade 5 to 10, the employer-unit that bears the liability of industrial injury shall, according to the provisions in these Procedures, pay the lump sum subsidy for the treatment of industrial injury and that for the re-employment of the injured and the handicapped.

Article 52 (Benefit of Industrial Injury for Persons with Agreement Insurance)

In case that the employer-unit employs the person with agreement insurance with re-employment registration, the salary (wage) income of the person with agreement insurance shall not be included into the employer-unit¡¯s payment base of the premium of industrial injury insurance.

In case of industrial injury, the person with agreement insurance may, according to the provisions in these Procedures, enjoy the benefit of industrial injury insurance, however, the handling agency shall check and determine the employer-units¡¯floating rate of payment of the next year according to provision.

Article 53 (Benefit of Industrial Injury for Employees in Labor Organizations of Non-regular Employment)

The labor organization of non-regular employment shall pay the premium of industrial injury insurance with reference to the base and rate of payment provided in these Procedures. After the payment of premium of industrial injury insurance, if its employee who has registered with the labor security department according to provision suffers industrial injury, he/she may enjoy the benefit of industrial injury insurance paid from the fund of industrial injury insurance provided in these Procedures.

Chapter VII Legal Liability

Article 54 (Legal Liability of the Administrative Department of Labor Security)

With any one of the following situations, a staff member in the administrative department of labor security shall be given administrative sanction; and in a serious case that the wrongful act constitutes a crime, the wrongdoer shall be prosecuted for criminal liability as provided by law:

1. Do not accept and handle the application for the identification of industrial injury with no proper reason, or identify through fraud and deceit the person who does not fit the conditions of industrial injury as the injured person;

2. Do not properly keep the evidence materials for applying for the identification of industrial injury, and thus cause the damage and loss of relevant evidences; and

3. Accept money and/or property from the party concerned.

Article 55 (Legal Liability of Relevant Unit and Individual Person)

In case that any unit or individual person misappropriates the fund of industrial injury insurance in violation of provision, and the wrongful act constitutes a crime, the wrongdoer shall be prosecuted for criminal liability as provided by law; in case the wrongful act does not constitute a crime, administrative sanction or disciplinary sanction shall be given according to law. The misappropriated funds shall be recovered by the SMLSSB, and be re-deposited into the fund of industrial injury insurance.

In case that the handling agency does any one of the following acts, the SMLSSB shall order a rectification, and give disciplinary sanction to the person directly in charge and other liable person(s) according to law; in a serious case where the wrongful act constitutes a crime, the wrongdoer shall be prosecuted for criminal liability as provided by law; and in case financial losses to the party concerned is caused, the handling agency shall be liable for damages.

1. Do not follow the provision to keep the factual records of the employer-unit¡¯s payment of the premium and the injured person¡¯s enjoyment of the benefit of industrial injury insurance;

2. Do not follow the provision to check the benefit of industrial injury insurance; and

3. Accept money and/or property from the party concerned.

Article 56 (Legal Liability for Obtaining Money from the Fund Through Cheating)

In case that the employer-unit, or the injured person, or his/her direct relatives obtain the benefit of industrial injury insurance through cheating, or the medical institution or the auxiliary appliances fixing agency obtains the payment from the fund of industrial injury insurance through cheating, the SMLSSB shall order a payback within the time limit, and impose on them a fine of between no less than one time and no more than 3 times of the money cheated; and in a serious case where the wrongful act constitutes a crime, the wrongdoer shall be prosecuted for criminal liability as provided by law.

Article 57 (Legal Liability of Appraisal Organizations)

In case that the institution or individual person engaging in the appraisal of labor ability does any one of the following acts, the SMLSSB shall order a rectification, and impose a fine of between not less than 2,000 yuan and not more than 10,000 yuan; and in a serious case where the wrongful act constitutes a crime, the wrongdoer shall be prosecuted for criminal liability as provided by law:

1. Provide false appraisal opinions;

2. Provide false diagnose certificate; and

3. Accept money and/or property from the party concerned.

Article 58 (Provisions on Those Should be Insured But are Not Insured or Have Not Paid the Premium as Required)

In case that the employer-unit that should join the industrial injury insurance but has not, or has not paid the premium of industrial injury insurance as required, the administrative department of labor security shall order it to rectify, and handle the case according to relevant provisions in the¡°Interim Regulations on the Collection and Payment of the Premium of Social Insurance¡±made by the State Council, and the¡°Provisions of Shanghai Municipality on the Collection and Payment of the Premium of Social Insurance for Urban Employees¡±. In case that an employee in the employer-unit unit that has not join the industrial injury insurance or has not paid the premium of industrial injury insurance as required suffers industrial injury in that particular period, the benefit of industrial injury during that period shall be paid by the employer-unit according to the items and standard of the benefit of industrial injury insurance provided in these Procedures.

Article 59 (Resolving Dispute)

In case of a dispute between the injured person and the employer-unit over the benefit of industrial injury, the case shall be handled according to relevant provisions on labor dispute.

Article 60 (Administrative Reconsideration and Administrative Litigation)

In case that the employer-unit or the employee does not accept the specific administrative acts made by the administrative department of labor security or the handling agency according to the provisions in these Procedures, the party concerned may apply for administrative reconsideration or bring an administrative lawsuit.

Chapter VIII Supplementary Provisions

Article 61 (Special Provision on Application Scope)

In case that the State has otherwise provided on the industrial injury insurance for state organs, mass organizations, institutions and private non-enterprise units, adjustments shall be made according to such state provisions.

Article 62 (Provision on Employing Retired Persons)

In case that the retired person re-employed by the employer-unit suffers from industrial injury, the employer-unit shall pay his/her benefit of industrial injury insurance with reference to the provisions in these Procedures.

Article 63 (Provisions on Historically Injured Persons)

In case of the injured person who has suffered accidental injury or industrial disease before the implementation of these Procedures, and the employer-unit bears the responsibility of paying his/her benefit of industrial injury, the detailed measures concerning the transfer of the relevant benefit of industrial injury insurance to the payment from the fund of industrial injury insurance shall be separately worked out by the SMLSSB, and shall be implemented after the approval of the Municipal People¡¯s Government.

Before the implementation of the specific measures, the relevant benefit of the injured person provided in the preceding clause of this Article shall be continuously paid by the employer-unit according to the original measure.

Article 64 (Provisions on Out-of-town Employees)

In case that the out-of-town employee employed by the employer-unit of this Municipality suffers industrial injury, the case shall be handled according to relevant provisions on industrial injury in the¡°Interim Procedures of Shanghai Municipality on the Comprehensive Insurance for Out-of-town Employees¡±.

Article 65 (Provisions on Not Joining for the Time Being)

The employer-unit and the employee in this Municipality who has joined the rural social endowment insurance do not join the industrial injury insurance provided in these Procedures for the time being. In case the employee suffers industrial injury, the employer-unit shall pay his/her benefit of industrial injury insurance with reference to the provisions in these Procedures.

Article 66 (Effective Date)

These Procedures shall become effective on July 1, 2004.

Matters like the identification of industrial injury, appraisal of labor ability, and enjoyment of the benefit of industrial injury insurance, etc. in this Municipality shall be handled according to the provisions in these Procedures from January 1, 2004.