[Direct answer]In the Beijing area, the fact that the determination conclusion has not been issued does not mean that no one is responsible for the expenses: emergency treatment cannot wait, and the medical expenses are paid by the work injury insurance fund on a per-item basis or reimbursed by the unit after advance payment in the case of insurance coverage. For those without insurance coverage, all expenses are borne by the unit; during the period of suspension of work and retention of salary, the original salary and welfare benefits remain unchanged, and the unit shall pay them on a monthly basis. The determination is just a procedural node, which changes the allocation ratio between the fund and the unit, rather than the outcome of "who will pay the money".

I. Problem Background and Typical Scenarios

The period of 30 to 60 days after a work-related injury accident is the most cost-intensive and responsibility-ambiguous window: surgical fees, hospitalization deposit collection, and the employer saying "wait until the determination is finalized", while the family members are overwhelmed by the pressure of advance payment. Typical scenarios include: the employer not having insurance coverage, delaying the payment of medical expenses by citing "the determination hasn't come out"; the employer having insurance coverage but refusing to advance payment, forcing employees to pay out of pocket first; and suspending the payment of wages during the period of work suspension and salary retention on the grounds that "the determination hasn't come out". If the rules for advance payment of expenses are clarified, this window period will not turn into a period of argument and disputes.

II. Key points of contention

First, the division of responsibilities between those who are insured and those who are not. For those who are insured, the medical expenses for treating work-related injuries are paid by the fund according to the provisions of the Work-Related Injury Insurance Treatment Item Catalog, etc.; for those who are not insured, all expenses shall be borne by the employing unit in accordance with legal standards, regardless of the progress of the injury identification. Second, the relationship between advance payment and recovery. If the worker or his/her family members advance the payment first, they can apply for reimbursement with receipts; if the unit advances the payment, the insured can settle the payment from the fund under the insured circumstances. Third, the wages during the period of suspension of work and retention of salary. During the period of suspension of work and retention of salary, the unit shall pay the original wages and welfare benefits on a monthly basis. If the injury is serious and needs to be extended, it can be extended after confirmation, which is not inconsistent with the progress of the work-related injury identification certificate.

III. Professional analysis by Henglue Lawyers

The operation of the expense window period can be clarified according to the "three timelines". **Timeline 1: Emergency Treatment Timeline**: Seek medical treatment immediately after the accident and inform the doctor of the work-related nature of the injury. All medical bills, diagnosis certificates, and medical records should be archived from the first day. Even if the injury has not been recognized as a work-related injury, the fund may advance payment under certain conditions for insured employees, while uninsured employees should be paid by the employer. The principle of "treatment first, settlement later" will not be interrupted due to unfinished procedures. **Timeline 2: Identification Procedure Timeline**: The employer should apply for work-related injury identification within 30 days from the date of the injury. Work-related injury victims or their immediate family members may also apply independently within one year. A conclusion must be reached within 60 days (15 days for clear-cut cases) after the application is accepted. During this period, medical expenses will continue to be handled according to the above rules. The employer's argument of "waiting for identification" is completely invalid in uninsured cases. **Timeline 3: Wage Payment Timeline**: The period of work-related leave begins from the date of injury, with the duration determined by the injury severity and the work-related leave catalogue. During this period, the employer should pay the employee's original salary monthly. If the employer stops paying wages on the grounds of "no identification certificate", the employee can immediately file for arbitration with the labor contract and payroll records. The three pieces of evidence for claiming expenses include: proof of employment relationship (contract, work badge, payroll records), evidence of the injury process (surveillance footage, colleague testimonies, police reports or work-related accident records), and medical expense bills. Beijing Henglu Law Firm's experience in work-related injury cases shows that: - Account management during the pre-identification window period determines the bargaining power in subsequent negotiations. For cases with complete bills and written proof of payment responsibility, recovery is almost unimpeded after identification. - For cases with lost bills or unclear responsibilities, each expense must be re-proven at the later stage. For uninsured employers, it is also necessary to highlight the escalating legal consequences: the fund may advance payment and recover the amount from the employer, and refusal to pay may lead to administrative penalties. Employees, on the other hand, can use a combination of arbitration and payment orders to secure compensation as soon as possible.

IV. Practical suggestions and legal basis

The first step is to save lives first and settle accounts later: Emergency hospitalization should not be interrupted due to disputes over costs, and the invoices should be archived on the same day; The second step is to apply through two channels: Urge the unit to report the work-related injury within 30 days. If the report is not made within the time limit, the employee can apply for compensation within one year; The third step is to send written reminders: Send written reminders separately for medical expenses and wages during the period of suspension of work, and keep fixed evidence; The fourth step is to combine procedures: After the conclusion of the identification, claim one-time benefits based on the disability assessment, and handle the arrears during the period through arbitration or payment orders. Main legal basis: Articles 14 to 17 (identification application), Article 30 (medical benefits), Article 33 (wages during the period of suspension of work), and Article 62 (liability for non-insurance) of the "Regulations on Work-related Injury Insurance" (revised in 2010); Article 41 (advance payment) of the "Social Insurance Law of the People's Republic of China" (amended in 2018); the specific application shall be subject to the currently effective laws and regulations.

5. Henglu Law Firm's Advice

The certificate has not been issued, but the responsibilities for the costs have already been determined: for those who are insured, the fund will cover the costs; for those who are not insured, the employer will bear the responsibility. During the period of suspension of work and payment of wages, the employer shall continue to pay the wages as usual. These three fundamental principles will not be relaxed due to procedural delays. The key action during the window period is to preserve evidence: do not miss any invoices, diagnoses, or records of payment reminders. For cases involving advance payment of work-related injury expenses and recovery of compensation, you can proceed through the following channels:Labor disputes and work-related injury compensationObtain a comprehensive solution for the service, which involves confirming disputes in labor relations and may refer to the topic of labor arbitration procedures. For issues related to the rectification of the unit's compliance with social insurance regulations, relevant reference materials can be consulted.Business and contract disputes in enterprisesFor those interested in advance payment applications, please pay attention to the following sectionsSpecialised legal servicesFor those interested in the criminal risks related to refusing to pay labor compensation, please pay attention to the following sectionsCriminal legal services板块。

VI. Frequently Asked Questions

Q1: What should I do if my employer refuses to advance the medical expenses?

In the event of an insurance coverage, the employee can use the work-related injury medical settlement according to the regulations; if the employee is not insured or the employer refuses to pay, the employee should first pay for the treatment themselves, and then seek compensation through arbitration with the receipts as evidence. If necessary, the employee can apply for advance payment.

Q2: What is the standard for calculating the salary during the period of suspension of work with pay?

The compensation shall be paid monthly according to the original salary and welfare benefits before the injury, generally not exceeding twelve months. If the injury is serious and confirmed by appraisal, the compensation period may be extended.

Q3: How long does it take to get the certification? Do I have to wait until then to pay the fees?

Within 60 days after acceptance (15 days if the facts are clear), a determination shall be made. If the determination concludes that the medical expenses and the wages paid are not equal, the process shall proceed in accordance with the aforementioned rules.

Q4: Who pays for work-related injuries caused by third parties?

The medical expenses incurred by the third party's infringement shall be borne by the third party. If the third party fails to pay or cannot be identified, the fund shall pay in advance and have the right to seek reimbursement afterwards.

Q5: Can self-paid medicines and imported materials be reimbursed?

It shall be implemented in accordance with the catalogue of medical treatment items, the catalogue of drugs, and the standards of inpatient services for work-related injury insurance. For items outside the catalogue, the reasonableness and case-by-case flexibility shall be evaluated.

The above answer is based on the judicial practice in Beijing. The judicial interpretation in other provinces and cities may vary. For specific cases, please refer to the local rules and evidence situation.

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