[Direct answer]Of course, treatment should be prioritized. Work-related injury identification is a post-event confirmation procedure that does not affect workers' timely access to medical treatment. Workers who need treatment due to accidental injuries should seek medical treatment immediately and keep the medical records and receipts. According to the "Regulations on Work-Related Injury Insurance", if workers suffer from work-related injuries and need to suspend work for treatment, their original salary and welfare benefits will remain unchanged during the period of suspension of work and payment of wages. After being identified as work-related injuries, eligible medical expenses will be paid from the work-related injury insurance fund. Expenses incurred before identification may be prepaid by workers or their employers, and will be reimbursed according to regulations after identification. Employers shall not hinder treatment or stop paying wages on the grounds of "not having been identified yet".
I. Problem Background and Typical Scenarios
After an employee is injured, the employer may say, "The work-related injury hasn't been identified yet. Don't go to the hospital first. Wait until the results come out before making a decision," or require the employee to pay for the treatment themselves and discuss the matter later. The employee may worry that delaying treatment will affect the recovery of the injury, and also worry that no one will take responsibility for the costs. In fact, the identification of work-related injuries and treatment are two parallel processes: treatment cannot be delayed, and the costs will ultimately be resolved according to the rules of work-related injury compensation. During this period, the employee's salary and benefits are also clearly protected.
II. Key points of dispute
First, the chronological relationship between treatment and identification. Second, the wage treatment during the period of suspension of work with pay. Third, the subject who bears the burden of medical expenses before and after identification. Fourth, the response to the unit's obstruction of treatment.
III. Professional analysis by Henglue Law Firm
The first level: Treatment is not affected by the determination of work-related injury. The determination of work-related injury is a post-event confirmation of whether the injury belongs to a work-related injury. Workers should receive treatment first after being injured; employers should take timely measures to ensure that injured workers receive prompt treatment. If the delay in treatment results in the aggravation of the injury, the responsible party shall bear the consequences. The second level: Work-related injury benefits during treatment suspension and salary continuation. If a worker suffers an accident-related injury at work and needs to suspend work for treatment, the original salary and welfare benefits shall remain unchanged during the period of work-related injury benefits, and the employer shall pay them monthly. The period of work-related injury benefits is generally no more than 12 months. In the case of serious injuries or special circumstances, it may be extended upon confirmation by the labor capacity appraisal committee of the city-level administrative area. The third level: Responsibility for medical expenses. Medical expenses required for work-related injury treatment that comply with the work-related injury insurance treatment item catalogue, drug catalogue, and hospitalization service standards shall be paid from the work-related injury insurance fund. If the employer has not participated in the insurance in accordance with the law, the employer shall pay according to the benefit standards. Before the determination conclusion is made, the expenses are usually paid in advance by the worker or the employer and the receipts are retained. After the determination, the expenses shall be settled in accordance with the regulations. Treatment should not be refused due to the incomplete procedures. The fourth level: Responding to employer's obstruction of treatment. If the employer refuses to pay medical expenses or suspends the payment of wages, the worker may file a complaint with the labor supervision department or apply for labor arbitration to claim the salary during the work-related injury benefits period and medical expenses. At the same time, fix the diagnosis certificates, hospitalization records, and payment receipts, clarify the time and nature of the expenses, and lay a foundation for subsequent claims. Henglue Tip: Medical bills and medical records for work-related injury treatment are important evidence for determination and claims, and should be preserved in full. Do not give up standard treatment due to concerns about expenses. When handling such disputes in Beijing, the authorities will focus on reviewing the necessity of treatment and the reasonableness of the expenses. If the employer refuses treatment on the grounds of non-determination, it is illegal and may be held legally accountable.
IV. Practical suggestions and legal basis
The first step is to seek medical treatment immediately after the injury and keep the medical records, diagnosis certificates, hospitalization records, and all expense receipts. The second step is to report the injury to the employer in a timely manner and demand that they pay the wages during the suspension of work and medical expenses in accordance with the law. The third step is to file an application for work-related injury identification as soon as possible and clarify the basis for expense settlement. The fourth step is to file a complaint with the labor supervision department or apply for labor arbitration if the employer obstructs treatment or refuses to pay expenses. If the injury worsens due to the employer's delay, the employee may also claim corresponding compensation liability. The main legal basis: Articles 30, 33, and 62 of the "Regulations on Work-Related Injury Insurance" (amended in 2010 and implemented on January 1, 2011). The specific application shall be subject to the currently effective provisions.
5. Henglue Law Firm's Advice
There are three key points to note regarding work-related injury treatment: treatment should not wait for the determination of the injury, and treatment should be provided first and then reported; the original salary and benefits of the employee during the period of suspension of work and retention of salary shall remain unchanged, and the employer shall pay them on a monthly basis; and all receipts related to the treatment should be preserved. After the determination of the injury, the treatment expenses shall be settled in accordance with the work-related injury benefits. For matters related to work-related injury treatment and benefits, you can consult the following channels:Labor arbitration and work-related injury compensationThe service provides a comprehensive solution, and in the case of medical disputes, it can be combined with other services.Personal injury and medical disputesFor those involved in the implementation of compensation packages, you may refer to the following for reference.Creditor's rights and debts, and enforcementFor any questions or difficult situations, please feel free to consult us.Special servicesTeam.
VI. Frequently Asked Questions
Q1: Can I be hospitalized before the determination result comes out?
Yes, and it should be treated promptly. Work-related injury identification is a post-event confirmation procedure that does not affect treatment; the hospitalization and treatment costs should be paid in advance and the receipts should be kept, and the costs will be settled in accordance with the regulations after the identification is completed.
Q2: How will my salary be paid during the treatment period?
During the period of suspension of work with pay, the original salary and welfare benefits shall remain unchanged, and the unit where the employee works shall pay them on a monthly basis. The period of suspension of work with pay shall generally not exceed twelve months, and in special circumstances, it may be appropriately extended upon confirmation.
Q3: Who pays for the medical expenses before the determination of disability?
Usually, the employees or the unit will advance the payment and retain the invoices first. If it is recognized as a work-related injury and the expenses meet the requirements, the work-related injury insurance fund will pay for them. If the unit has not subscribed to the insurance, the unit will pay according to the standard.
Q4: What should I do if my unit doesn't allow me to be hospitalized?
You can file a complaint with the labor supervision department, or apply for labor arbitration to claim medical expenses and wages during the period of suspension of work with pay; pay attention to the communication records and evidence of the fixed unit's obstruction.
Q5: Can non-work-related illnesses be reported for compensation?
It cannot be reimbursed according to the work-related injury medical treatment benefits. For the treatment of diseases caused by non-work-related injuries, the patient will not enjoy work-related injury medical treatment benefits, and the treatment will be handled in accordance with the basic medical insurance regulations. The two apply different rules.
This article is written based on the common judicial interpretation in the Beijing area. If the case occurs in other regions, it is recommended to consult local lawyers to verify the regional differences.
If you are facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the evidence materials, to avoid missing the statutory time limit. →Labor arbitration legal services·Beijing Henglu Law Firm
Disclaimer: This article is compiled based on the current effective laws and regulations and public adjudication rules, and is for general reference only. It does not constitute a formal legal opinion on specific cases. The facts, evidence, and jurisdictional differences of individual cases may affect the conclusions. In the event of a dispute, please consult a practicing lawyer in a timely manner.