By Lucy Lu (partner) and Huang Lu(managing associate)
On 27 October 2016, the Jiangsu Provincial Department of Human Resources and Social Security issued the Guidelines for the Implementation of "Work-related Injury Insurance Regulations" (the "Guidelines"), effective on January 1, 2017. The Guidelines provide detailed rules regarding the local implementation of the Work-related Injury Insurance Regulations (the "Regulations") and the Measures for Implementation of "Work-related Injury Insurance Regulations" in Jiangsu Province (the "Implementation Measures"), which help to properly solve significant issues relating to work-related injury insurance.
Although the Regulations have set forth the circumstances for work-related injury determination, the standards are relatively general, leading to different local practices based on different understandings by relevant departments. By specifying some of the conditions for determining work-related injuries, Jiangsu Province's Guidelines may serve as more concrete guidance and reference for other regions in handling such issues.
The Guidelines clearly define some concepts in the Regulations such as "working time", "workplace", "work-related reasons" and suggest how to deal with related issues. The table below contains the details:
| Relevant provisions in the Regulations | Interpretations in the Guidelines |
|---|---|
| Circumstances under which work-related injuries shall be recognized | |
| Circumstances that shall be deemed as work-related injuries | |
| Circumstances that shall not be identified or deemed as work-related injuries | |
| Having sustained injuries due to incidents caused by work-related reasons during working time and at workplace; | "Working time" includes the working hours agreed in the employment contract or the working hours stipulated by the employer and overtime working hours. "Workplace" includes the areas under effective management of the employer during daily production and operation activities, other relevant areas in which an employee performs particular duties, and reasonable areas in which an employee commutes between several workplaces for his/her duties. "Injuries due to accident caused by work-related reasons" refer to direct injuries sustained by an employee due to incidents arising from production and operation activities during working time and at workplace, as well as accidental injuries due to unsafe factors sustained by an employee for temporarily satisfying reasonable and necessary physiological needs in the course of work. |
| Having sustained injuries due to accident while engaging in work-related preparatory or finishing tasks at workplace before or after working time; | No supplementary stipulations in the Guidelines |
| Having been injured by violence or otherwise harmed for performing work duties during working time and at the workplace; | "Having been injured by violence or otherwise harmed for fulfilling work duties" refers to the circumstances where an employee is injured by violence or otherwise harmed for performing work duties; such violence and harm must have a direct causal relationship with the performance of work duties. |
| Having suffered from occupational diseases; | No supplementary stipulations in the Guidelines |
| Having sustained injuries or been missing due to incidents caused by work-related reasons while performing duties outside the workplace. | "While performing duties outside workplace" refers to the period in which an employee participates by himself or herself in work-related activities outside the workplace as per employer's assignment or job requirements. Recreational and sport activities arranged or organized by the employer shall be classified as "work-related reasons"; circumstances that could not be recognized as "work-related reasons" include: (1) catering, traveling/sightseeing, entertainment or similar activities arranged or organized by the employer in the name of work, or activities relating to the private interest of one's superior manager or other individuals; (2) activities unrelated to work while performing work duties outside the workplace. The status of "missing" should be supported by conclusive opinion from competent authorities or legal instruments such as effective court judgments. |
| Having sustained injuries due to a traffic accident for which the employee is not primarily responsible, or an accident of urban rail transit, passenger ferry or train on the commute between home and office. | "The commute between home and office" refers to: (1) reasonable route from the regular residential place to a place of work and back within reasonable time; (2) reasonable route from residences of one's spouse, parents, children to the place of work and back within reasonable time; (3) necessary activities for daily work and life on reasonable route to or back from work. "A traffic accident for which the employee is not primarily responsible" should be evidenced by Traffic Accident Liability Confirmation issued by competent authorities or legal instruments such as effective court judgments; if competent authorities are unable to provide the confirmation or the issued legal instruments are unable to distribute the parties' liabilities in the accident, the social insurance agency may make conclusions according to relevant evidence which has been investigated and verified. |
| Circumstances that shall be deemed as work-related injuries | |
| Having died abruptly during working hours and on duty due to sudden illness or died within 48 hours after failed rescue attempts; | "Died abruptly during working hours and on duty due to sudden illness or died after failed rescue attempts" refers to the circumstances where an employee died in the workplace during working time and while performing his/her job due to sudden illness or died after failed rescue attempts in hospital. The "48 hours" shall be counted from the time when initial diagnosis by medical institutions is issued. |
| Having sustained injuries in protecting the national and public interest, such as emergency or disaster rescue, etc.; | No supplementary provisions in the Guidelines |
| For those previously served in the military, while working for the current employer, having suffered a recurrence of previous disabling injuries caused during war or when performing his/her military duties with Certificate of Handicapped Revolutionary Soldier. | No supplementary provisions in the Guidelines |
| Circumstances that shall not be identified or deemed as work-related injuries | |
| Having wilfully committed a crime; | Should be evidenced by effective legal instruments or conclusive opinion from criminal investigation agencies, prosecuting agencies and judicial agencies. |
| Having been intoxicated by alcohol or taken drug; | Should be evidenced by conclusive opinion issued by competent authorities or legal instruments such as effective court judgments. |
| Self-harm or suicide. | |
Editor's note: this article was simultaneously published on Chinalawinsight.com
