Let's look at the types of insurance benefits under the Industrial Accident Compensation Insurance Act
The industrial accident insurance system is compulsory insurance that the state is
responsible for guaranteeing the lives of injured workers and their families
In order to guarantee accident compensation liability under the Labor Standards Act, which is originally the responsibility of the employer
the state collects a certain premium from the employer
and compensates the injured worker on behalf of the employer with the fund
The industrial accident insurance system is a no-fault liability system
that takes responsibility for workers' accidents regardless of whether they are intentional or negligent
In principle, the employer pays the full amount of insurance premiums, which are financial resources for the insurance business
and industrial accident insurance benefits are based on average wages rather than
compensating for the entire damage caused by the accident
and the review and re-examination claim system are operated to
expedite objections related to accident compensation
If a worker in a workplace experiences injuries
illness, disability or death due to occupational reasons
What kind of salary should they apply for to receive proper compensation?
There are eight major insurance benefits that can be received in case of an occupational accident
Let's take a look specifically one by one
The first is medical care benefits
Medical care benefits cover the costs of medical care, such as examination
medication, surgery, treatment, and care
which are paid to heal injured or sick workers in occupational accidents
In order to receive medical care benefits, the injured worker's occupational injury or illness
must require at least four days of medical care
This is to prevent administrative processing costs from becoming more excessive than
medical care benefits paid
The extinctive prescription for medical care benefits is 3 years, so you must apply within the period
In principle, medical care benefits are paid in kind
and they are paid directly to pharmacies of designated medical institutions as medical expenses and drug expenses
However, medical expenses already paid by workers before acknowledging occupational accidents
are exceptionally paid in money and goods
As for the payment items, examinations, various tests, drugs and other treatments are provided
and non-benefit items such as plastic surgery for cosmetic purposes and hospitalization in higher rooms are excluded from medical care benefits
The second is the suspension benefit
This is a salary paid instead of wages during the period of non-employment due to occupational accidents
and no suspension benefits are paid if you work at a workplace or are paid by an employer
during the medical treatment period, however, suspension benefits are also paid during outpatient treatment
If occupational accidents are recognized, 70% of the average daily wage will be paid during the period of
not being employed due to medical treatment
If the daily suspension benefit is less than 80% of the minimum compensation standard
90% of the average wage will be paid, and 4% will be reduced every year from the age of 61 to 65
The third is the sickness compensation pension
If one has recuperated for more than two years but does not heal
and is in the grade 1 to 3 severe care status, they will be paid
Grade 1 is paid 329 days of pension, grade 2 is paid 291 days, and grade 3 is paid 257 days of pension
In this case, severe care statuses are mental and physical damage
resulting in loss or reduction of labor capacity
The fourth is disability benefits
It is an income guarantee benefit paid when
an injury or disease has healed but the labor capacity is lost due to mental or physical damage
Disability level is determined according to the degree of loss
and the salary is calculated based on the average wage
Disability benefit payment methods according to disability level are as follows
Here, in the case of grades 1 to 3, only pensions are paid
grades 4 to 7 are paid as pensions or lump sum payments
and grades 8 to 14 are paid only as lump sum payments
The fifth is nursing benefits
It is paid to people with severe disabilities who actually need care after healing
That is, grade 1 and grade 2 disability
The standard amount of nursing benefits is 44,760 won for full time care of professional caregivers
and 29,840 won for part time care of professional caregivers
41,170 won for family and other caregivers for full time care
and 27,450 won for part time care
Here, full time care benefits are paid to people who need other people's care "all the time"
to perform movements necessary for daily life due to the remaining disabilities
and part time care benefits are paid to people who need other people's care
"from time to time" to perform movements necessary for daily life
The sixth is survivors benefits
Survivor benefits refer to insurance benefits paid to guarantee the life of the bereaved family
if a worker is presumed to have died or died due to business reasons
It is a principle to pay as a pension
but if there is no pensioner, it is paid as a lump sum
When a beneficiary applies, 50% is paid as a lump sum
and the pension is paid as a 50% reduction
The pension payment is determined by multiplying the average wage by 52% to 67% of 365 days
and the lump sum is determined by multiplying the average wage by 1,300 days
Eligible persons shall be bereaved family members who were living with the worker at the time of the death
including spouses of the deceased, parents or grandparents aged 60 or older
persons under 25 as children, persons under the age of 25 as grandchildren
persons under the age of 19 or 60 or older as siblings
children, parents, grandchildren, grandparents, or siblings
who do not fall under any of the above number 2 to 5
with severe disabilities under attached Table 1 of
the Enforcement Rules of the Welfare of Persons with Disabilities Act
Livelihood status shall be determined as a person who lived together with a worker
on the resident registration list under the Resident Registration Act
a person who maintained all or a large portion of his or her livelihood with the income of the worker
a family of the worker who maintained all or large portion of their livelihood with the income of the worker
that did not have the same resident registration or did not live together
due to study, employment, nursing, or other housing conditions
and a person apart from the family who maintained all or most of his or her livelihood through
money or financial support regularly paid by the worker
Seventh is the funeral expenses
It is paid to the bereaved family who have been in the funeral of a worker who died due to business reasons
If the bereaved family member performed the funeral, they will be paid an amount equivalent to 120 days of the average wage
and if a person who is not a bereaved family member has performed the funeral
they will be paid the actual expenditure within the range of the amount equivalent to 120 days of the average wage
As of 2023, the maximum amount is 17,241,680 won and the minimum amount is 12,460,160 won
The eighth is vocational rehabilitation benefits
Vocational rehabilitation benefits are insurance benefits that pay
vocational training expenses and vocational training allowances
to those who need vocational training for employment among disability level 1 through 12
and pay return-to-work support, adaptation training expenses
and rehabilitation training expenses to employers who maintain employment of disability beneficiary
The return-to-work support shall be paid to business owners who have made workers among disability levels 1 through 12 return
and maintained employment of their original positions for more than six months from the end of care
Work adaptation training expenses and rehabilitation exercise expenses are paid to employers for
adaptation training and rehabilitation exercises for the workers among disability levels 1 through 12 who returned to their original positions
Vocational training subsidies pay vocational training expenses to training institutions within 6 million won
during vocational training for unemployed injured workers with disabilities levels 1 to 12
and pay trainees a minimum wage per day as a training allowance
Ninth is the insurance benefit for pneumoconiosis
Insurance benefits for pneumoconiosis include care benefits, nursing benefits, funeral expenses
vocational rehabilitation benefits, pneumoconiosis compensation pensions, and pneumoconiosis surviving family pension
Pneumoconiosis compensation pension pays the basic pension plus the pneumoconiosis pension
Pneumoconiosis surviving family pensions pay recipients the same amount as the pneumoconiosis pensions paid or determined to be paid
to pneumoconiosis workers at the time of their death
Let's take a look at the calculation criteria for insurance benefits
First of all, insurance benefits are calculated based on the 'average wage' under the Labor Standards Act in principle
The average wage is increased or decreased every year to guarantee the real wage of long-term benefit recipients such as pensions
and the maximum minimum compensation standard is operated to solve excessive and under-guaranteed problems
Here, the average wage refers to the total amount of wages for the three months prior to the date of occurrence of the calculation reason
divided by the total number of days for the three months prior to the date of occurrence of the calculation reason
If the normal wage is higher than the average wage, the normal wage is used as the average wage
For those with occupational diseases and those with unusual work patterns, the special case for calculating average wages is applied
The special case for calculating the average wage of workers with occupational disease applies to workers who are
exposed to risk factors such as pneumoconiosis and noise-induced hearing loss for a long time or who have an occupational disease with incubation period
and the wages of workers of similar gender, industry, size, and occupation are applied based on wage statistics
Let's look at the case of workers with unusual work patterns
Since the number of working days for daily workers is irregular depending on seasonal factors and etc.
the average wage for daily workers is 73% multiplied by the daily wage
In order to solve the problem of over- and under-guarantee of industrial accident insurance benefits
if the average wage exceeds the maximum compensation standard amount or is less than the minimum compensation standard amount
the maximum and minimum compensation standard amount will be applied as the average wage
As of 2023, the maximum compensation standard amount is 246,036 won per day
and the minimum compensation standard amount is 76,960 won per day