[Direct answer]In the Beijing area, the work-related injury insurance fund pays according to the standard. According to Article 32 of the "Regulations on Work-Related Injury Insurance", workers who have suffered work-related injuries may, upon the confirmation of the Labor Capacity Appraisal Committee, install prosthetic limbs, orthoses, artificial eyes, artificial teeth, and wheelchairs and other assistive devices for daily life or employment needs. The necessary expenses shall be paid from the work-related injury insurance fund in accordance with the national standards. If the employer fails to participate in work-related injury insurance in accordance with the law, the employer shall pay according to the same standards. In other words, whether to install assistive devices requires professional confirmation, and the expenses are subject to national standards. Any expenses exceeding the standard for optional high-end devices are usually borne by the workers themselves.

I. Problem background and typical scenarios

When an employee is disabled due to a work-related injury and requires the installation of prosthetic limbs or the provision of a wheelchair, the cost can range from a few thousand yuan to tens of thousands of yuan. Who should bear the cost and how much can be reimbursed has become a focus of attention. Some units evade responsibility by saying "we've never applied for it before and don't know what can be reimbursed", while some employees purchase high-end equipment on their own and then demand full reimbursement. There are clear procedures and standards for handling assistive device expenses, which not only ensure necessary needs but also avoid unreasonable spending.

II. Key points of contention

First, the confirmation procedure of the configuration. Second, the fee standard and the part exceeding the standard. Third, the handling of replacement and repair costs. Fourth, the entity responsible for the costs when the unit is not insured.

III. Professional analysis by Henglue Law Firm

The first level is the confirmation process: The configuration of assistive devices must be confirmed by the Labor Capacity Appraisal Committee, which includes determining whether assistive devices are needed, the type of devices to be provided, and the configuration period. If the devices are configured without confirmation, reimbursement may be limited, so it is necessary to apply for confirmation before configuring them. In emergency situations, the relevant procedures should also be completed promptly. The second level is the fee standard: The required expenses are paid from the work-related injury insurance fund in accordance with national standards, including the purchase cost of assistive devices. If high-end devices exceed the national standards, the excess cost is generally borne by the employee, who can negotiate with the employer to share the cost. The third level is replacement and maintenance: The normal replacement and necessary maintenance of assistive devices during their service life are generally covered by the standard payment scope. If replacement is required after reaching the specified service life, a new application for confirmation must be submitted, and the receipts for replacement and maintenance must be retained. The fourth level is the employer's responsibility in the absence of insurance coverage: If the employer fails to purchase insurance in accordance with the law, the assistive device expenses that should be paid by the work-related injury insurance fund must be paid by the employer in accordance with the standard. If the employer refuses to pay or defaults on payments, the employee can file a labor arbitration claim and, if necessary, advance the payment for the configuration and retain the receipts. Henglue Tip: Before configuring assistive devices, it is necessary to complete the appraisal and confirmation process, select devices and products that meet the standards, and properly preserve the purchase invoices, configuration agreements, and confirmation documents to facilitate reimbursement and protection of rights. When handling such matters in Beijing, the authorities will focus on reviewing the necessity of configuration and compliance with standards. If the employee has objections to the confirmation results or fee standards, they can file a claim in accordance with the law and follow the relevant procedures to avoid being unable to obtain reimbursement after configuring the devices on their own.

IV. Practical suggestions and legal basis

The first step is to apply to the Labor Capacity Appraisal Committee to confirm whether assistive devices are needed and the configuration standards. The second step is to select products and institutions in accordance with national standards, and keep the invoices and configuration agreements. The third step is to reapply for confirmation and keep the certificates if the devices need to be replaced or repaired after reaching the service life. The fourth step is to apply for labor arbitration to claim the expenses if the unit does not participate in insurance or refuses to pay. The main legal basis: Article 32 and Article 62 of the "Regulations on Work-Related Injury Insurance" (amended in 2010 and implemented on January 1, 2011) and the relevant provisions on the configuration of assistive devices for work-related injury insurance. The specific application shall be subject to the currently effective regulations.

5. Henglu Law Firm's Reminder

The cost of assistive devices is divided into three parts: it must be confirmed by the Labor Capacity Appraisal Committee before being provided, and the expenses are paid by the fund according to national standards; the difference between the cost of high-end devices exceeding the standard shall be borne by the individual; and for units that have not purchased insurance, the cost shall be borne by the unit according to the standard. For matters involving assistive devices and work-related injury benefits, you can consult through the following channels:Labor arbitration and work-related injury compensationFor services requiring an overall solution, including disability assessments, relevant information can be combined accordingly.Personal injury and medical disputesFor plates involving fee collection, you can refer to the following for more information.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: Who pays for the cost of prosthetic limbs?

If the labor capacity appraisal committee confirms that the installation is necessary, the cost shall be paid from the work-related injury insurance fund in accordance with the national standards; if the unit has not purchased insurance, the unit shall bear the cost in accordance with the same standards.

Q2: Can I choose expensive equipment myself?

You can purchase it, but the part that exceeds the national standard usually needs to be borne by yourself. It is recommended to choose within the confirmed configuration and discuss with your unit about the way to bear the part that exceeds the standard. If your unit agrees to bear the part that exceeds the standard verbally, you should request a written confirmation and keep it for future reference.

Q3: Who is responsible for replacing the old equipment?

For those that need to be replaced after reaching the prescribed service life, the replacement cost shall be paid in accordance with the prescribed standards after reapplying for confirmation; necessary maintenance costs are generally included in the payment scope and receipts must be kept; the configuration should be selected from service institutions that meet the prescribed conditions, and the configuration agreement and acceptance records should be kept.

Q4: Do I need to get it appraised first before getting it fitted?

In principle, the device must be approved by the Labor Capacity Appraisal Committee before being provided, otherwise the reimbursement may be limited. In emergencies, the device can be provided first and the approval and reporting procedures can be completed in time. It is advisable to complete the re-approval as soon as possible to avoid affecting the reimbursement due to exceeding the deadline.

Q5: What should I do if my employer refuses to report my overtime hours?

You can first advance the payment and keep the invoice and the configuration agreement, then apply for labor arbitration to claim the expenses; at the same time, you can check the fund payment situation with the social insurance agencies to clarify the responsible parties.

The above Q&A is mainly based on the judicial practice in the Beijing area. There may be differences in the adjudication standards in different regions. It is recommended to consult a professional lawyer based on the specific circumstances of the case.

If you are currently facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the relevant evidence materials, so as 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 publicly available 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. If a dispute arises, please consult a practicing lawyer in a timely manner.