Human Resources and Social Security Bureau:
I (an employee of our company) suffered an industrial accident due to work reasons on X, X, X, and was unable to submit the corresponding industrial injury identification materials within the specified time (what reasons should be stated, if it was a traffic accident, the traffic police did not issue an accident responsibility certificate, if it was a violent injury accident, the public security organ did not close the case or the people's court did not decide). According to the Regulations on Work-related Injury Insurance, we now apply to your bureau for extending the work-related injury identification.
Hereby apply
Applicant (seal is required for company application, and fingerprint is required for individual application)
Date, year and month
Legal basis: Regulations on Industrial Injury Insurance
Fourteenth employees in any of the following circumstances, should be identified as work-related injuries:
(1) Being injured by an accident during working hours and in the workplace;
(two) before and after working hours, in the workplace, engaged in preparatory or finishing work related to the work and was injured by an accident;
(three) during working hours and workplaces, due to the performance of duties by violence and other accidental injuries;
(4) Suffering from occupational diseases;
(five) during the business trip, injured or missing due to work reasons;
(six) on the way to work, I was injured by a traffic accident or an urban rail transit, passenger ferry or train accident for which I was not primarily responsible;
(seven) other circumstances that should be recognized as work-related injuries as stipulated by laws and administrative regulations.
Thirtieth employees who suffer from accidents or occupational diseases at work shall enjoy medical treatment for work-related injuries.
Workers with work-related injuries should seek medical treatment in medical institutions that have signed service agreements. In case of emergency, they can go to the nearest medical institution for first aid.
If the expenses required for work-related injury treatment meet the catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs and the hospitalization service standard of work-related injury insurance, they shall be paid from the work-related injury insurance fund. The catalogue of work-related injury insurance diagnosis and treatment items, the catalogue of work-related injury insurance drugs and the hospitalization service standard of work-related injury insurance shall be stipulated by the social insurance administrative department of the State Council in conjunction with the health administrative department of the State Council, the food and drug supervision and management department and other departments.
Food subsidies for hospitalization of workers with work-related injuries, and certificates issued by medical institutions and approved by agencies. The transportation and accommodation expenses required for workers with work-related injuries to seek medical treatment outside the overall planning area shall be paid by the work-related injury insurance fund, and the specific standards for fund payment shall be stipulated by the people's government of the overall planning area.
Workers with work-related injuries who treat non-work-related diseases do not enjoy medical treatment for work-related injuries, and shall be treated according to the basic medical insurance method.
The expenses for work-related injury rehabilitation treatment for workers with work-related injuries to medical institutions that have signed service agreements shall be paid by the work-related injury insurance fund if they meet the requirements.
Article 39 If an employee dies at work, his close relatives shall receive funeral subsidies, pension for supporting relatives and one-time work-related death subsidies from the industrial injury insurance fund according to regulations.