[Direct answer]In the Beijing area, the period of suspension of work with pay is not indefinitely extendable, but if the employee is still unable to work after the expiration of the period, it does not mean they will lose protection. According to Article 33 of the "Regulations on Work-Related Injury Insurance", the period of suspension of work with pay generally does not exceed 12 months; if the injury is serious or there are special circumstances, it can be appropriately extended upon confirmation by the municipal-level labor capacity appraisal committee, but the extension shall not exceed 12 months; after the expiration of the period, the employee will continue to enjoy work-related injury medical benefits. Therefore, you have two options: one is to apply for an extension of the period of suspension of work with pay, and the other is to apply for a labor capacity appraisal as soon as possible. After the appraisal of the disability level, the original wage benefits will be discontinued, and the employee will instead enjoy one-time disability allowances, disability pensions, and living care fees, among other disability benefits. If the employer terminates the labor contract on the grounds of absenteeism, there is a risk of illegal termination.
I. Problem background and typical scenarios
The period of suspension of work and continued payment of wages for workers injured at work is usually determined by the opinions of the treatment institutions and the recovery of their injuries. Employers often unilaterally declare the expiration of this period according to their internal standards. Typical scenarios include: fractures, craniocerebral injuries, etc., which take a long time to recover. When the period expires, the workers still need rehabilitation treatment but have been notified to return to work; the employer issues a notice to return to work, but the workers do not report to work and are treated as absenteeism and have their wages suspended; the workers fail to undergo labor capacity appraisal in time, resulting in a gap between their wage benefits and disability benefits; and workers with level 5 or 6 disabilities are required to return to their original jobs, but their injuries really make them unfit for work. When handling similar cases in Beijing, arbitration institutions and courts generally require the conclusion of labor capacity appraisal, medical records, and materials confirming the extension as the basis for judgment, and the parties may first refer to these materials.Labor arbitration and legal services for work-related injury compensationOrganize the materials.
II. Key points of contention
The controversy focuses on four aspects. Firstly, whether the start and end of the period of suspension of work with pay and its extension have been confirmed by the municipal-level labor capacity appraisal committee directly determines whether the benefits can be continued. Secondly, the handling of cases where the treatment period has expired but further treatment is still needed. According to Article 33, the worker should continue to enjoy work-related injury medical treatment benefits, and the employer cannot refuse to reimburse the work-related injury medical expenses on the grounds that the treatment period has expired. Thirdly, the connection with labor capacity appraisal. According to Article 21 of the Work Injury Insurance Regulations, if the worker has a disability or impaired labor capacity after the treatment of the injury has stabilized, a labor capacity appraisal should be conducted. Delaying the appraisal is unfavorable to the worker. Fourthly, the legality of terminating the labor contract. According to Article 42 of the Labor Contract Law of the People's Republic of China, if a worker is injured at work in the current unit and is confirmed to have lost or partially lost his labor capacity, the employer shall not terminate the labor contract in accordance with Articles 40 and 41.
III. Professional analysis by Henglue Lawyers
Based on practical observations in handling work-related injury compensation cases, the dividing line of disputes over the period of suspension of work and retention of wages lies in "whether the appraisal and extension confirmation are carried out in a timely manner". Henglue Lawyers usually advise workers to handle the matter in the following order: First, the medical institution treating the work-related injury issues a diagnosis certificate recommending continued treatment and rest, on the basis of which the worker applies to the municipal-level labor capacity appraisal committee for confirmation of the extension of the period of suspension of work and retention of wages, and obtains a written conclusion; at the same time, the worker applies for labor capacity appraisal as soon as possible to avoid a gap period during which there is neither wage compensation nor disability compensation. After the disability level is assessed, the worker enjoys corresponding benefits in accordance with Articles 35 to 37: for Disability Levels I to IV, the labor relationship is maintained and the worker retires from the job, and the work injury insurance fund pays a monthly disability allowance; for Disability Levels V and VI, the employer arranges appropriate work for the worker, and if it is difficult to arrange such work, the employer pays a monthly disability allowance to the worker; if it is confirmed that the worker needs nursing care, the work injury insurance fund pays a monthly nursing care allowance in accordance with Article 34. If the employer terminates the labor contract on the grounds of absenteeism or long-term sick leave during the period of suspension of work and retention of wages or fails to carry out the appraisal in accordance with the law, it constitutes an evasion of statutory obligations, and the worker may claim continued performance or request compensation. Disputes over nursing care and follow-up treatment costs can be addressed in conjunction with the above.Personal injury and medical dispute servicesAccounting.
IV. Practical suggestions and legal basis
Legal basis: Article 21 (Labor Capacity Appraisal) and Article 33 (The period of suspension of work and retention of salary shall not exceed twelve months. If the municipal-level labor capacity appraisal committee confirms that it can be extended and the extension shall not exceed twelve months, the worker shall continue to enjoy work-related injury medical treatment after the expiration of the period) of the "Regulations on Work-Related Injury Insurance" (promulgated on April 27, 2003, amended on December 20, 2010, and implemented on January 1, 2011); Articles 42 and 45 of the "Labor Contract Law of the People's Republic of China" (amended on December 28, 2012). Practical suggestions: 1. Apply to the labor capacity appraisal committee for an extension of the period of suspension of work and retention of salary on schedule and retain the written conclusion; 2. Apply for labor capacity appraisal immediately after the treatment is relatively stable to determine the disability level as soon as possible; 3. Send a written reply to the employer after receiving the notice of returning to work, explaining the injury situation and the progress of the appraisal to avoid being deemed as absenteeism; 4. Keep the diagnosis certificates, expense receipts, and wage payment records; 5. If the worker believes that the termination of the labor contract is unlawful, he/she may apply for arbitration to protect his/her rights within the one-year arbitration statute of limitations. For the review of labor contract clauses and termination grounds, please refer to the relevant provisions.Business and contract dispute resolution services for enterprisesFor those who need to formulate unified protection and enforcement plans, they can refer to the following examples for reference.Special services and other case services.
5. Henglu Law Firm's Advice
The expiration of the paid leave period is not the end of the protection, but a turning point for the transition of benefits. Three reminders: First, do not substitute written procedures with "resting at home". Extending the paid leave period requires confirmation by statutory agencies, and oral requests for leave are easily regarded as absenteeism; Second, do not wait passively for the evaluation of the injury. The disability rating directly determines the amount of disability allowances, one-time disability compensation, and living care fees; Third, if the employer terminates the labor contract on the grounds of long-term absence from work, it is necessary to review whether the grounds for termination are legal. Work-related injury victims are protected against termination under statutory circumstances. If the employer stops paying wages or refuses to arrange appropriate work, they can take legal action against the employer through the labor arbitration committee or the people's court.Creditor-debtor relations and enforcement case servicesUnderstand the path of seeking compensation and enforcement, and consult a professional lawyer as soon as possible to grasp the statute of limitations.
VI. Frequently Asked Questions
Q1: If I still can't go back to work after the expiration of the paid leave period, can I still maintain my current benefits?
Yes, but the procedures must be handled in a timely manner. According to Article 33 of the Regulations on Work-Related Injury Insurance, if the injury is serious or the circumstances are special and confirmed by the municipal-level labor capacity appraisal committee, the period of suspension of work with pay may be extended, but the extension shall not exceed twelve months. After the expiration of the period, if the employee still needs treatment, they will continue to enjoy work-related injury medical benefits. Therefore, you should apply for an extension of the confirmation based on the diagnosis and rest certificate from the medical institution before the expiration of the period, and at the same time apply for a labor capacity appraisal. After the assessment of the disability level, the original wage benefits will be discontinued, and the employee will instead enjoy disability benefits such as disability allowances, one-time disability compensation, and living care fees. Overall, the protection will not be interrupted.
Q2: What evidence is needed to request an extension of the paid leave period or disability benefits?
The core materials include: the decision on the determination of work-related injury; the diagnosis certificate, medical records, and recommended rest period issued by the medical institution treating the work-related injury; the confirmation conclusion of the labor capacity appraisal committee on extending the period of suspension of work and payment of wages; the labor capacity appraisal conclusion (determining the disability grade and whether living care is needed); the wage payment records or bank statements (proving the original wage standard and the time of suspension of payment); the return-to-work notice communicated with the unit, WeChat or email records. The purpose of the evidence is to prove that the injury still needs treatment and that the victim cannot perform his/her original job, as well as the fact that the unit has suspended the payment of wages. It is recommended to organize the evidence into a booklet in chronological order.
Q3: How much does it cost to resolve such disputes, and are there arbitration fees involved?
Arbitration for labor and personnel disputes does not charge fees. Claims such as wages during the suspension of work with pay and the difference in disability benefits can be resolved through arbitration. If the arbitration decision is not accepted and the case proceeds to litigation, the litigation fees shall be paid in accordance with the "Measures for the Payment of Litigation Fees". Generally, the litigation fee for labor disputes is 10 yuan per case, which shall be borne by the losing party. Lawyer's fees depend on the complexity of the case, the amount of the dispute, and the workload, and are charged on a per-case or hourly basis, subject to the terms of the contract. There is no uniform standard. It is recommended to first calculate the amount of the wage difference and disability benefits that can be claimed, then evaluate the cost of hiring a lawyer, and if necessary, proceed in stages.
Q4: How long does it typically take from applying for an extension or arbitration to receiving a final decision?
The timeframe depends on the procedure. Labor capacity appraisals are generally accepted and concluded by the municipal-level labor capacity appraisal committees in the regions. In practice, it usually takes a certain period of time. After the appraisal conclusion is made, it is possible to apply for a re-appraisal according to law. Labor arbitration shall be concluded within 45 days from the date of acceptance, and the period may be extended by no more than 15 days upon approval for complex cases; if the party is not satisfied with the arbitration award and files a lawsuit, the first-instance ordinary procedure generally takes six months, and the summary procedure takes three months; the second-instance procedure generally takes three months. Overall, it takes several months. It is recommended to initiate the application for extension and the appraisal procedure in advance before the expiration to avoid a break in benefits.
Q5: My employer wants me to return to work, but I really can't go to the office. What should I do specifically?
It is recommended to follow four steps to handle this: First, immediately go to the medical institution treating the work-related injury to obtain a diagnosis certificate indicating the need for continued treatment and recommended rest, which can serve as objective evidence of being unable to return to work; Second, before the expiration of the work suspension and pay period, apply to the municipal-level labor capacity appraisal committee for confirmation of an extension, and retain the materials related to the acceptance and conclusion of the application; Third, simultaneously apply for labor capacity appraisal to determine the disability grade as soon as possible, and claim disability allowances, one-time disability compensation, and living care expenses according to the disability grade; Fourth, respond in writing to the unit's notice to return to work, explaining the injury situation and the progress of the appraisal, and retain the evidence of delivery; If the unit stops paying wages or terminates the employment relationship on the grounds of absenteeism, apply for arbitration within the one-year statute of limitations to claim continued performance of the contract or compensation.
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 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 Henglue 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. If you encounter disputes, please consult a practicing lawyer in time.