[Direct answer]There are two aspects to distinguish. Firstly, the recurrence of a previous work-related injury that has been confirmed. According to Article 38 of the "Regulations on Work-Related Injury Insurance" (implemented on January 1, 2011), if a worker suffers from a recurrence of a work-related injury and it is confirmed that treatment is needed, they are entitled to the work-related injury benefits stipulated in the regulations, including work-related medical treatment and benefits for suspension of work and continued payment of wages. To confirm the recurrence, it is usually required that the Labor Capacity Appraisal Committee or a medical institution issue a corresponding conclusion, and the worker should apply to the social insurance agency in accordance with local regulations. Therefore, if the original injury has already been recognized as a work-related injury, and the injury worsens after being rehired, the worker can still claim corresponding benefits according to the path of work-related injury recurrence. Secondly, the relationship with the new employer after being rehired. Rehired workers who have already legally enjoyed basic urban employee pension insurance benefits are generally treated as having a labor relationship with the new employer, and the "Regulations on Work-Related Injury Insurance" do not apply to them. If they are injured at work, they can claim medical expenses, loss of income, nursing care expenses, and disability compensation according to the relevant provisions of the "Civil Code of the People's Republic of China" (implemented on January 1, 2021) from the employer or individuals at fault. If the new employer has paid work-related injury insurance premiums for them in accordance with project-based insurance or other methods, the "Regulations on Work-Related Injury Insurance" may apply to them according to relevant provisions. Thirdly, if the worsening of the injury is caused by a new accident, the worker can apply for work-related injury recognition or handle the case as personal injury compensation.Labor arbitration and work-related injury compensationYou can view similar questions in this column.
1. Problem background and typical scenarios
This type of consultation is common in several situations: First, employees who were previously injured at work and recognized as work-related injuries, and who were reemployed after retirement, may experience recurrence or aggravation of the original injury due to increased work intensity. Second, reemployed personnel may suffer new accidents at work, leading to further deterioration of the original injury and disputes over the responsibility for the old and new injuries. Third, reemployed personnel who have already received pensions may be injured, and the employer refuses to assume work-related injury insurance responsibilities on the grounds that the relationship between the employer and the employee does not constitute a labor relationship. Fourth, if the work-related injury recurs but the employee fails to apply for confirmation to the handling agency in a timely manner, medical expenses cannot be reimbursed according to work-related injury benefits. Fifth, if there is no written reemployment agreement, the working hours, compensation, and employment facts need to be proven separately. When handling such cases in Beijing, the authorities usually first verify the status of the original work-related injury and benefits, then determine the causes and causalities of the aggravation of the injury, and finally determine whether to apply work-related injury recurrence benefits, work-related injury insurance responsibilities, or personal injury compensation. For cases involving disability assessment and compensation item calculations, the authorities may refer to them simultaneously.Personal injury and medical disputesColumn.
II. Key points of contention
Focus One: Whether the original work-related injury and its compensation status are still covered by the work-related injury insurance relationship. Focus Two: Whether the worsening of the injury constitutes a recurrence of the work-related injury, which requires a diagnosis and corresponding confirmation from a medical institution. Focus Three: The nature of the reemployment relationship—whether it is an employment relationship or a service relationship—depends on whether the employee has already received pension insurance benefits and whether they have paid work-related injury insurance premiums. Focus Four: The causality and liability division between the old injury and the new injury require medical evidence to support them. Focus Five: The scope of compensation for recurrence of the work-related injury includes medical expenses, the period of suspension of work and payment of wages, and the provision of assistive devices. Focus Six: The determination of the employer's fault and the proportion of compensation. Focus Seven: The statute of limitations and procedural differences under different pathways. The specific determinations shall be based on the currently effective laws, regulations, and judicial rulings.
III. Professional analysis by Henglue Lawyers
From the practical experience of lawyers handled by our firm, there are three key points to grasp in cases involving the aggravation of old injuries after reemployment. First, preserve the evidence chain of the original work-related injury. It is necessary to retrieve previous work-related injury identification decisions, labor capacity assessment conclusions, disability rating assessments, work-related injury medical records, and payment vouchers. These materials can not only prove the existence of the original work-related injury, but also serve as the basis for claiming work-related injury recurrence benefits in the future. Second, establish the correlation between the aggravation of injuries and work. It is necessary to provide outpatient and hospitalization medical records, imaging materials, diagnosis certificates, and examination reports to clarify the time node, location, and severity of the aggravation of injuries. If the aggravation occurs during the reemployment period and is related to work intensity, posture, or environment, it is necessary to obtain the attending physician's opinion on the causality or triggering factors, and if necessary, to determine it through judicial appraisal. Third, distinguish the legal path and seize the opportunity. If it is a recurrence of the original work-related injury requiring treatment, the worker can enjoy work-related injury benefits according to Article 38 of the Work-Related Injury Insurance Regulations and apply to the social insurance agency in accordance with local regulations. If the reemployment relationship is a labor service relationship, it is advisable to claim personal injury compensation according to the provisions of the Civil Code on tort liability, while reviewing whether the reemployment unit has faults in terms of safety assurance, pre-employment health disclosure, and reasonable scheduling. If the aggravation of injuries stems from a new work-related accident, the worker can also apply for work-related injury identification or claim compensation separately. It should be noted that the different legal paths have significant differences in statutes of limitations, appraisal standards, and compensation items. Before making a claim, it is necessary to conduct a preliminary assessment to avoid increasing the cost of evidence collection or omitting compensation items due to improper path selection.
IV. Practical suggestions and legal basis
Action proposal: First, sort out and keep all the materials related to the original work-related injury, including the determination decision, the appraisal conclusion, and the benefit certificates. For the relevant procedures, you can refer to the explanations providedLabor arbitration and work-related injury compensationFirst, report the accident to the insurance company and keep all relevant documents, including medical records and imaging data. Please ask the attending physician to record the time when the injury worsened and the possible causes. Second, if the injury is a recurrence of a work-related injury, apply to the social insurance agency for confirmation and handle it in accordance with work-related injury benefits according to local regulations. Third, if the reemployment relationship is a labor relationship, claim medical expenses, loss of income, nursing care expenses, and disability compensation in accordance with the relevant provisions of the Tort Liability Chapter of the Civil Code of the People's Republic of China. For cases involving disability assessments, continue to follow up on the progress.Personal injury and medical disputes1. Check whether the reemployed unit has paid the work injury insurance premiums in accordance with the project-based insurance and other methods, and keep the insurance certificates; 2. Keep the reemployment agreements, wage payment and attendance records to prove the employment facts and work intensity, and apply for judicial appraisal to clarify the causal relationship when necessary. 3. Legal basis: Article 30, Article 33, and Article 38 of the "Regulations on Work Injury Insurance" (effective January 1, 2011); Article 2 of the "Opinions on Implementing the 'Regulations on Work Injury Insurance'" issued by the Ministry of Human Resources and Social Security (No. 34, 2013); and the relevant provisions on tort liability in the "Civil Code of the People's Republic of China" (effective January 1, 2021). 4. Specific application shall be subject to the currently effective laws, regulations, and judicial rulings.
5. Henglue Law Firm's Advice
First, whether the original work-related injury has recurred needs to be confirmed by medical and appraisal authorities, and claims cannot be based solely on personal feelings. Second, rehired employees who have already received pension insurance benefits are generally handled according to labor relations and follow the path of personal injury compensation. Third, if the rehired unit participates in insurance according to the project, the Work Injury Insurance Regulations may still apply, and the insured status should be actively verified. Fourth, the division of responsibility between aggravation of old injuries and new accident injuries is different, and medical evidence is needed to distinguish them. Fifth, it is essential to keep all original work-related injury materials intact, as this is the basis for claiming recurrence benefits. Sixth, the statutes of limitations and compensation items differ significantly across different paths, so it is recommended to consult a professional lawyer as soon as possible to evaluate the situation and determine the best course of action.
VI. Frequently Asked Questions
Q1: Can I still enjoy work-related injury benefits if the injury recurs?
Yes. According to Article 38 of the "Regulations on Work-Related Injury Insurance", if a worker suffers a recurrence of a work-related injury and it is confirmed that treatment is necessary, they shall enjoy the work-related injury benefits stipulated in these regulations. Usually, they need to apply for confirmation according to local regulations and follow the relevant procedures.
Q2: If a rehired employee is injured at work, does it count as a work-related injury?
For the reemployed personnel who have legally enjoyed the basic old-age insurance benefits for urban workers, the relationship between them and their new employers is generally handled as a labor relationship, and the Work Injury Insurance Regulations do not apply to them. However, if the employer has paid work injury insurance premiums in accordance with project-based insurance or other methods, the Work Injury Insurance Regulations may still apply to them.
Q3: How can I prove that the aggravation of my old injury is work-related?
It is necessary to provide a complete medical history, imaging data, and a diagnosis certificate, explaining the time, location, and severity of the aggravation, and to obtain the doctor's opinion on the causal factors or causal relationship. If necessary, the matter can be determined through a judicial appraisal.
Q4: What kinds of compensation can be claimed under an employment relationship?
Generally, according to the relevant provisions of the Tort Liability Chapter of the Civil Code of the People's Republic of China, one can claim for medical expenses, loss of income, nursing care expenses, nutrition expenses, and disability compensation, etc. The specific amounts shall be determined based on the degree of fault and the actual losses.
Q5: What should I do if I can't find the original work-related injury information?
You can apply to the original employing unit, social insurance agencies, or labor capacity appraisal agencies to retrieve the decision letter of identification, the appraisal conclusion, and the record of benefit payment. If necessary, you can apply for government information disclosure or retrieve the information through legal proceedings.
The above content is based on the compilation of judicial practices in the Beijing area. The facts of individual cases and the jurisdiction of the court may affect the conclusions. Welcome to consult Henglue Lawyers about specific situations.
If you are currently facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the necessary evidence 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 open 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 time.