[Direct answer]Workers can still claim compensation for work-related injuries that recur. According to Article 38 of the "Regulations on Work-Related Injury Insurance", if a worker suffers from a recurrence of work-related injuries and it is confirmed that treatment is needed, they can continue to enjoy work-related medical benefits, assistive device benefits, and wage and welfare benefits during the period of suspension of work and retention of salary; if the disability situation changes, they can apply for a review and appraisal of work capacity in accordance with Article 28 of the regulations, and adjust the disability benefits according to the new disability level. In principle, there is no need to re-conduct a work-related injury identification for recurrence treatment, but the medical institution treating the work-related injury should issue a diagnosis certificate for the recurrence; if it is a new accident injury, it is necessary to re-apply for work-related injury identification within one year from the date of the accident. For disputes over benefits, workers can apply for labor arbitration, with a statute of limitations of one year. For more details, please refer to the relevant provisions.Labor arbitration and legal services for work-related injury compensation.

I. Problem Background and Typical Scenarios

Work-related injury recurrence refers to the situation where the original work-related injury site or the disease caused by the work-related injury relapse, worsens after treatment, or requires continued treatment. It is common in situations such as the removal of internal fixation for fractures, the need for secondary surgery for worsening old injuries, and the recurrence of occupational diseases. Many workers worry that the compensation has already been settled and they will have to bear the cost of recurrence themselves; some workers also don't know who to claim against when the recurrence occurs after they have left their jobs, changed positions, or even after their former employers have been liquidated. In practice, some employers refuse to cooperate on the grounds that "the compensation has already been settled once", resulting in workers delaying treatment. In addition, work-related injury recurrence is easily confused with new accident injuries: the former continues the original work-related injury benefits, while the latter requires reapplying for work-related injury recognition, with completely different processing paths.

II. Key points of contention

  • The causal relationship between recurrence and the original work-related injury: Whether it belongs to recurrence shall be determined by the medical institution's diagnosis certificate and combined with the medical records. In cases of great controversy, it can be confirmed by the Labor Capacity Appraisal Committee. New diseases unrelated to the original injury cannot be treated as recurrence of work-related injuries.
  • Scope of benefits and payment channels: Medical expenses, rehabilitation expenses, hospitalization meal subsidies, wages during the period of suspension of work and payment of wages, nursing fees, etc. shall be borne by the work injury insurance fund and the employing units respectively for insured workers, and all expenses for uninsured workers shall be borne by the employing units.
  • The claim path after changes in labor relations: For those who have already participated in insurance and whose work-related injury insurance relationship is still in effect, the recurrence benefits are generally not affected by job changes; as for whether they can enjoy benefits again after terminating the labor relationship and receiving a one-time work-related injury medical subsidy, there are differences in policies across different regions, and individual cases need to be evaluated on a case-by-case basis.

III. Professional analysis by Henglue Law Firm

Henglue Lawyers observed in handling disputes over work-related injury benefits that the core of recurrence-related cases lies in the word "confirmation". The first step is to fix the facts of recurrence: choose a medical institution that has signed a service agreement for treatment, and keep the outpatient medical records, imaging materials, and diagnosis certificates to ensure that they can correspond to the original work-related injury site and the original recognition documents; if the unit or the handling agency does not recognize it, they can apply to the labor capacity appraisal committee at the municipal level for confirmation. The second step is to distinguish the benefit items: the period of suspension of work and payment of wages is generally not more than 12 months according to Article 33 of the Work-related Injury Insurance Regulations. If the injury is serious and confirmed by the appraisal committee, it can be extended, but the extension shall not exceed 12 months. During this period, the original salary and welfare benefits shall remain unchanged, and the unit shall pay them monthly; the items paid by the fund, such as medical expenses and assistive devices, should be noted that they should be treated at the agreed medical institutions and keep the receipts. The third step is to handle disputes: if there is no agreement with the unit on the confirmation of recurrence and the payment of wages, they can apply to the labor dispute arbitration committee for arbitration; if they are not satisfied with the treatment determined by the handling agency, they can apply for administrative reconsideration or bring administrative litigation according to law. If the work-related injury is caused by the infringement of a third party, the actual expenditure items such as medical expenses shall not be compensated twice, but the rules of concurrence of disability benefits and civil compensation are quite complex, and further consultation is needed. 恒略律师在处理工伤待遇纠纷中观察到，复发类案件的核心是“确认”二字。第一步固定复发事实：选择签订服务协议的医疗机构治疗，保存门诊病历、影像资料与诊断证明，确保记载与原工伤部位、原认定文书能够对应；对单位或经办机构不认可的，可申请设区的市级劳动能力鉴定委员会确认。第二步区分待遇项目：停工留薪期依《工伤保险条例》第三十三条一般不超过12个月，伤情严重经鉴定委员会确认可以延长，但延长不得超过12个月，期间原工资福利待遇不变，由所在单位按月支付；医疗费、辅助器具等由基金支付的项目，应注意在协议医疗机构就医并保留票据。第三步处理争议：与单位就复发确认、工资支付协商不成的，可向劳动争议仲裁委员会申请仲裁；对经办机构核定待遇不服的，可依法申请行政复议或提起行政诉讼。因第三人侵权导致工伤的，医疗费等实际支出项目不得重复获赔，但伤残待遇与民事赔偿的竞合规则较为复杂，需要进一步咨询。Personal injury and medical dispute servicesTeam collaborative evaluation.

IV. Practical suggestions and legal basis

At the legal basis level: Article 38 of the "Regulations on Work-Related Injury Insurance" (promulgated in 2003 and amended in 2010) stipulates that if a worker with a work-related injury needs treatment for a recurrence of the injury, they shall continue to enjoy the work-related injury benefits stipulated in Articles 30, 32, and 33 of the Regulations; Article 28 stipulates that if the worker believes that the disability situation has changed one year after the date of the labor capacity assessment conclusion, they may apply for a review and reassessment; Article 33 stipulates that the original salary and welfare benefits shall remain unchanged during the period of suspension of work and payment of wages. If there are new accident injuries in addition to the recurrence, the worker shall apply for work-related injury identification within one year from the date of the accident injury in accordance with Article 17 of the Regulations. The statute of limitations for applying for arbitration in the event of a dispute over benefits is one year, calculated from the date when the worker knows or should have known that their rights have been infringed. At the practical advice level: Properly preserve the work-related injury identification decision, the labor capacity assessment conclusion, and previous medical records and medical expense receipts; promptly inform the employer in writing after the recurrence and request treatment arrangements; if the employer refuses to pay the relevant benefits, the worker may apply for arbitration or file a complaint with the labor and social security supervision authority within the statute of limitations with evidence; if the employer fails to fulfill the obligations of the effective arbitration award, the worker may apply for compulsory enforcement by the court and obtain further information.Creditor-debtor relations and enforcement case services.

5. Henglu Law Firm's Advice

The recurrence of work-related injuries is not just an end where workers have to bear the costs themselves. There are clear legal channels for claiming compensation, and the key lies in confirming the fact of recurrence and ensuring the completeness of evidence. Workers should avoid two extremes: first, mistakenly believing that their rights are exhausted after receiving a one-time compensation and giving up on treatment and compensation; second, claiming recurrence based on new diseases unrelated to the original injury, which may put them at a disadvantage in the verification process. In terms of timeframes, the review and appraisal must be initiated within one year after the original conclusion is made, and the arbitration statute of limitations is one year. The earlier the evidence is fixed, the more proactive it will be. If you are facing disputes over compensation for recurrence of work-related injuries, you can seek help through the following channels:Beijing Henglu Law FirmConsultation and assessment, or visitLabor arbitration and legal services for work-related injury compensationObtain experience in handling similar cases.

Q1: Do I need to go through the work-related injury identification process again if the work-related injury recurs?

Generally, this is not necessary. Work-related injury identification targets the accident injury itself. Once it has been legally identified as a work-related injury, recurrence is considered a continuation of the original injury and does not require re-application for identification. What workers should do is to obtain evidence of the recurrence: a diagnosis certificate issued by the medical institution treating the work-related injury, with the connection to the original work-related injury noted in the medical records; if the unit or handling agency has objections to the recurrence, they can apply to the Labor Capacity Appraisal Committee for confirmation. It should be noted that if new injuries occur in addition to the recurrence, such as the original injury not healing and being subject to an accident, the new injuries must be applied for work-related injury identification within one year from the date of the accident in accordance with Article 17 of the "Regulations on Work-related Injury Insurance", and the two cannot be treated together.

Q2: During the treatment of a recurrence of work-related injuries, can the employee still receive their full salary?

Yes. According to Article 33 of the Regulations on Work-Related Injury Insurance, if an employee needs to suspend work for treatment due to a work-related injury, their original salary and welfare benefits will remain unchanged during the period of suspension of work and payment of wages. The period of suspension of work and payment of wages shall generally not exceed 12 months. If the injury is serious or the circumstances are special, the period may be extended appropriately upon confirmation by the labor capacity appraisal committee of the city where the unit is located, but the extension shall not exceed 12 months. If the recurrence of the work-related injury requires treatment, the same suspension of work and payment of wages system shall apply. In practice, the employee should obtain a certificate from the medical institution confirming the need to suspend work for treatment and notify the unit in a timely manner. If the unit refuses to pay, the employee may apply for labor arbitration to recover the payment.

Q3: If the disability rating worsens after a relapse, can the benefits be adjusted?

Yes. According to Article 28 of the Regulations on Work-Related Injury Insurance, within one year from the date of the conclusion of the labor capacity appraisal, if the worker with a work-related injury, his/her near relatives, the employing unit, or the handling agency believe that the disability situation has changed, they may apply for a review of the labor capacity appraisal. If the disability level is increased after the review, the worker shall enjoy the disability allowance according to the new standard corresponding to the new level, and the difference in benefits related to the change in the disability level shall be implemented according to the new standard after the new conclusion is made. When applying for a review, the worker shall submit evidence materials such as recent medical records and review images that can reflect the changes in the disability situation, and pay the appraisal fees in accordance with the regulations. The earlier the application is made, the less the losses during the period of the treatment gap will be.

Q4: If I have already resigned or received a one-time subsidy, can I still claim compensation for a recurrence of the disease?

Handle the situation on a case-by-case basis. If the work-related injury insurance relationship remains in effect during the recurrence of the injury, medical benefits and other items can be enjoyed through normal channels, which is not closely related to whether the worker is still employed. However, after the worker terminates the labor relationship with the unit and receives a one-time work-related injury medical subsidy and a one-time disability employment subsidy according to the standards of level 5 to level 10, the work-related injury insurance relationship will terminate. At this time, if the worker claims for the wages during the suspension of work and employment, and other benefits such as one-time subsidies after the recurrence of the injury, most regions will not support it. In some regions, there are still relief arrangements for subsequent medical expenses, but the policies vary greatly from region to region. In such cases, it is recommended to bring the work-related injury identification, appraisal documents, and termination agreements, and consult with relevant authorities.Labor arbitration and legal services for work-related injury compensationThe team conducts a case assessment and then decides on the litigation strategy.

Q5: If the unit refuses to recognize the recurrence of the work-related injury, how can I provide evidence to prove it?

The burden of proof is organized around three levels: 1. The original work-related injury facts: Provide the work-related injury determination decision and the labor capacity assessment conclusion. 2. The recurrence facts: Provide the outpatient medical records, hospitalization records, imaging examinations, and diagnosis certificates from the medical institutions that treated the work-related injury, ensuring that the records correspond to the original injury site as much as possible. 3. The causal relationship: If necessary, apply to the labor capacity assessment committee to confirm the recurrence. If the employer refuses to cooperate, you can first report the matter to the labor supervision and inspection authority or directly apply for labor arbitration to request the implementation of recurrence benefits. Note: Article 27 of the Labor Dispute Mediation and Arbitration Law of the People's Republic of China stipulates that the arbitration statute of limitations is one year, calculated from the date when you know or should have known that your rights have been infringed. Delaying too long may result in the loss of the basis for a successful arbitration outcome.

If you are facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the relevant evidence materials to avoid missing the statutory time limit.Labor arbitration legal services·Beijing Henglue Law Firm