[Direct answer]In the Beijing area, the treatment costs for recurring old injuries that are confirmed to require treatment shall be paid by the work injury insurance fund in accordance with the regulations. If the employer has not participated in the insurance in accordance with the law, the employer shall bear the responsibility. According to Article 38 of the "Regulations on Work Injury Insurance" (promulgated on April 27, 2003 and amended on December 20, 2010), workers who suffer from recurring work-related injuries and are confirmed to require treatment shall enjoy medical expenses, hospitalization subsidies, transportation and accommodation expenses for medical treatment outside the coordinated area, and rehabilitation benefits for work-related injuries; the wages and welfare benefits during the period of suspension of work and payment of wages shall still be paid by the employer on a monthly basis. For the recognition of recurrence and the application for benefits, please refer to the relevant provisions.Work-related injuriesColumn.

I. Problem Background and Typical Scenarios

The recurrence of old work-related injuries refers to the reappearance or aggravation of injuries caused by previous work-related injuries, which require treatment. It commonly occurs in two situations: first, fractures or internal fixation reactions or recurrent fractures that occur many years after internal fixation surgery; second, the progression of occupational diseases such as pneumoconiosis and chemical substance poisoning that require continued treatment. Workers often wonder whether the recurrence-related expenses can still be reimbursed and whether they need to be re-identified as work-related injuries. When handling similar cases in Beijing, the authorities usually first determine the causal relationship between the recurrence and the original work-related injury, and then determine the eligible benefits. The relevant procedures can be referred to for reference.Work-related injuriesColumn.

II. Key points of contention

Firstly, regarding the determination of recurrence, it is necessary for medical institutions to confirm whether it is truly caused by the original work-related injury rather than a new injury. Secondly, regarding the burden of expenses, the fund will pay for the medical expenses that meet the catalogue, and the unit that has not participated in the insurance shall pay for them. Thirdly, regarding the treatment of recurrence, the original wages and benefits during the treatment period shall be paid by the unit on a monthly basis. Fourthly, regarding the distinction between old injuries and new injuries, new injuries shall be handled as new work-related injuries. Fifthly, regarding the responsibilities of units that have not participated in the insurance, the specific provisions shall be subject to the currently effective laws and regulations and judicial rulings. For matters involving the payment of benefits, reference can be made to the relevant provisions.Creditor's rights and debts, and enforcement casesColumn.

III. Professional analysis by Henglue Law Firm

From the practical experience of lawyers handled by our firm, disputes over recurrence of old injuries are mostly concentrated on the scope of expense reimbursement and the employer's suspension of salary payments. Common situations include: the employer denying the connection between the recurrence and the work-related injury, refusing to pay the salary during the period of suspension of work and payment; the work injury insurance agency refusing to pay for some rehabilitation expenses on the grounds that they are not in the catalogue. Lawyers handled by our firm suggest that after the worker's recurrence, the medical institution that signed the service agreement first issue a diagnosis and confirm the need for treatment, and then claim that the fund should pay the expenses in accordance with the regulations, and require the employer to continue to pay the salary during the period of suspension of work and payment. In cases involving personal injury, reference can also be made to it.Personal injury and medical disputesAn analysis of the relevant aspects of the column.

IV. Practical suggestions and legal basis

Action suggestions: First, seek medical treatment promptly after a recurrence and have the medical institution confirm that "treatment is necessary", keeping the diagnosis certificate and medical records; Second, organize the original materials of work-related injury identification and labor capacity assessment to prove the causality; Third, apply to the work-related injury insurance fund for reimbursement of medical expenses that meet the catalogue; Fourth, require the unit to continue paying the wages during the period of suspension of work and retention of salary, and apply for labor arbitration if the unit refuses to pay. In terms of legal basis, Article 30 of the "Regulations on Work-related Injury Insurance" stipulates medical benefits, Articles 32 and 33 respectively stipulate auxiliary devices and benefits during the period of suspension of work and retention of salary, and Article 38 clearly stipulates that those who have been confirmed to have recurrence of work-related injuries and need treatment shall enjoy the above-mentioned benefits. For related application points, please refer to the relevant materials.Work-related injuriesColumn.

5. Henglue Law Firm's Advice

Risk Warning: Firstly, the recurrence of old injuries still requires the premise of "confirming the need for treatment", and workers should obtain standard medical confirmation; Secondly, the wages during the period of suspension of work and retention of salary shall be borne by the unit and shall not be suspended due to recurrence; Thirdly, the recurrence expenses of units that have not participated in insurance shall still be paid by them, and workers can claim their rights; Fourthly, the rehabilitation expenses must comply with the catalogue of diagnosis and treatment items for work-related injuries. It is recommended to fix the diagnosis of recurrence and the original materials of work-related injuries as soon as possible, and to consult when necessary.Beijing Henglue Law FirmOn the official website, there is a similar column where professional lawyers assist with reimbursement and rights protection.

VI. Frequently Asked Questions

Q1: Does the unit still need to cover the cost of recurring old injuries?

It should be regulated. If the recurrence of the work-related injury is confirmed and requires treatment, the medical expenses that meet the requirements shall be paid by the work-related injury insurance fund; if the employer fails to participate in the insurance according to law, the relevant expenses and the wages during the period of suspension of work and retention of salary shall be borne by the employer. The original wages and welfare benefits during the period of suspension of work and retention of salary shall still be paid by the employer on a monthly basis. It can be seen that the recurrence is not a one-time settlement, and the original employer and the fund are still responsible within the legal scope. The specific provisions shall be subject to the conclusions of work-related injury identification and medical confirmation.

Q2: What evidence should be prepared if an old injury recurs?

The following materials should be prepared: 1. The original work-related injury identification decision and the conclusion of the labor capacity assessment; 2. The diagnosis certificate, medical records, and examination reports of the current recurrence, indicating the need for treatment and the connection with the old injury; 3. Medical expense receipts and expense lists; 4. Evidence of unpaid wages during the work suspension and salary compensation period, such as pay slips; 5. Labor relationship and insurance enrollment records. The more complete the materials are, the smoother the reimbursement and rights protection process will be. For more details, please refer to the relevant procedures.Work-related injuriesColumn.

Q3: How much does it cost to reimburse the recurrence-related expenses?

The eligible recurrent medical expenses shall be borne by the fund or the unit, and the employees generally do not need to advance the compliant part; if the unit refuses to pay, the labor arbitration does not charge fees, and the litigation acceptance fees are relatively low. The fees for hiring a lawyer shall be negotiated according to the circumstances of the case, and there is no unified standard. Compared with the cumulative medical expenses that can be reimbursed, the cost of safeguarding rights is usually controllable. Specifically, it should be evaluated based on the scale of the expenses and whether it involves litigation. It is recommended to consult first and then make a decision.

Q4: How long does it usually take to get reimbursement for a recurrence of an old injury?

First, the medical institution confirms the need for treatment, then submits the expenses to the handling agency. If all the materials are complete, the settlement is usually done on a monthly basis. For those who disagree with the rejection of payment, labor arbitration generally concludes the case within 45 days, and the complex cases are extended by 15 days. The first-instance litigation should not exceed six months. The key is to obtain the recurrence diagnosis as soon as possible and keep the receipts to avoid losing the receipts and causing difficulties in reimbursement.

Q5: What should I do if my employer doesn't recognize the recurrence of an old injury?

The first step is to obtain a recurrence diagnosis and treatment opinion issued by the medical institution that signed the service agreement; the second step is to organize the original work-related injury materials to prove the causality; the third step is to apply to the work-related injury insurance fund, and if the application is rejected, claim according to Article 38 of the "Regulations on Work-related Injury Insurance"; the fourth step is to apply for labor arbitration if the unit refuses to pay the stop-work and salary compensation. When necessary, hire a professional lawyer to formulate a protection plan.

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

If you are 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 Henglue 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 you encounter disputes, please consult a practicing lawyer in time.