All You Need to Know About Labor Accident Policies in 2019

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1. What is an occupational accident?

According to the definition in Clause 8, Article 3 of the Occupational Safety and Hygiene Law 2015, an occupational accident can be understood as an accident causing damage to any part or function of the body or causing death to the employee, occurring during the labor process, associated with the performance of work or labor tasks.

2. Conditions for enjoying occupational accident policies

Under the provisions of Article 45 of the Occupational Safety and Hygiene Law 2015, employees participating in occupational accident and occupational disease insurance are entitled to occupational accident policies when the following conditions are met:

- Suffer an accident in one of the following cases:

- At the workplace and during working hours, including when meeting necessary living needs at the workplace or during working hours as permitted by the Labor Code and the internal rules of the production or business establishment, including rest breaks, mid-shift meals, physical nourishment meals, menstrual hygiene, bathing, breastfeeding, and going to the toilet;- Outside the workplace or outside working hours when performing work at the request of the employer or the person authorized in writing by the employer to directly manage the labor;- On the route from the residence to the workplace or from the workplace to the residence within a reasonable time and route.

- Reduced labor capacity from 5% or more;

- Employees are not entitled to policies paid by the Occupational Accident and Occupational Disease Insurance Fund if under one of the following causes:

- Due to the conflict between the victim and the person causing the accident that is not related to the performance of work or labor tasks;- Due to the employee's intentional self-harm to health;- Due to drug use or other addictive substances contrary to legal regulations.

3. Types of subsidies eligible

* Lump-sum allowance: When employees have reduced labor capacity from 5% to 30%. The allowance level is calculated according to the injury rate and the number of years of social insurance contribution. Specifically:

- Calculated according to the injury rate:

- Reduced by 5%: Enjoy 5 months of the statutory minimum wage;- For each additional 1% reduction, an additional 0.5 months of the statutory minimum wage will be enjoyed.

- Calculated according to the number of years of social insurance contribution: Participation in social insurance for less than 1 year is calculated by 0.5 months of social insurance premium wages and salaries; thereafter, each additional year of social insurance contribution is calculated by 0.3 months of social insurance premium wages and salaries of the month immediately preceding the cessation of work for treatment.

Thus:

Lump-sum allowance = Allowance calculated according to the reduction rate in labor capacity + Allowance calculated according to the number of years contributed to the occupational accident insurance fund = {5 x Lmin + (m-5) x 0,5 x Lmin} + {0,5 x L + (t-1) x 0,3 x L}

Where:

- Lmin: Statutory pay rate at the time of enjoyment;- m: The rate of labor capacity reduction due to occupational accidents or occupational diseases (absolute number 5 ≤ m ≤ 30);- L: Wage level contributing to the occupational accident and occupational disease insurance fund;- t: The total number of years contributing to the occupational accident and occupational disease insurance fund.

Legal basis: Article 48 of the Occupational Safety and Hygiene Law 2015, Clause 1 Article 5 Circular 26/2017/TT-BLDTBXH.

* Monthly allowance: When an employee has reduced labor capacity from 31% or more. The allowance level is also calculated according to the injury rate and the number of years of social insurance contribution. Specifically:

- Calculated according to the injury rate:

- Reduced by 31%: Enjoy 30% of the statutory minimum wage;- For each additional 1% reduction, an additional 2% of the statutory minimum wage will be enjoyed.

- Calculated according to the number of years of social insurance contribution: Participation in social insurance for less than 1 year is calculated by 0.5 % of the social insurance premium wages and salaries; thereafter, each additional year of social insurance contribution is calculated by 0.3% of the social insurance premium wages and salaries of the month immediately preceding the cessation of work for treatment.

Thus:

Monthly allowance = Allowance calculated according to the reduction rate in labor capacity + Allowance calculated according to the number of years contributed to the occupational accident insurance fund = {0.3 x Lmin + (m-31) x 0.02 x Lmin} + {0.05 x L + (t-1) x 0.003 x L}

Where:

- Lmin: Statutory pay rate at the time of enjoyment;- m: The rate of labor capacity reduction due to occupational accidents or occupational diseases (absolute number 31 ≤ m ≤ 100);- L: Wage level contributing to the occupational accident and occupational disease insurance fund;- t: The total number of years contributing to the occupational accident and occupational disease insurance fund.

Legal basis: Article 49 of the Occupational Safety and Hygiene Law 2015, Clause 2 Article 5 Circular 26/2017/TT-BLDTBXH.

* Service subsidy: When an employee has reduced labor capacity from 81% or more and is paralyzed in the spine, blind in both eyes, has amputated or paralyzed limbs, or suffers from mental illness. In addition to the monthly subsidy specified in Article 49 of the Occupational Safety and Hygiene Law 2015, the employee is also entitled to a service subsidy equivalent to the statutory pay rate each month.

* Lump-sum allowance when dying from occupational accident or disease: The family of an employee who dies from an occupational accident or disease while working is entitled to a lump-sum allowance equivalent to 36 months of the statutory minimum wage.

* Provision of living aids and orthopedic devices: Employees who suffer from an occupational accident or disease that affects body function are provided with living aids and orthopedic devices according to the schedule.

* Recuperation and health restoration after treatment:

Employees, after the stabilization of injuries due to occupational accidents or occupational diseases, are entitled to recuperation and health restoration within 30 days from the time they return to work if their health has not fully recovered.

- Rest period:

- Up to 10 days/year if labor capacity is reduced by 51% or more;- Up to 7 days/year if labor capacity is reduced by 31% - 50%;- Up to 5 days/year if labor capacity is reduced by 15% - 30%.

- Allowance level: Equivalent to 30% of the statutory pay rate/day.

4. Time point to receive occupational accident subsidies

According to the provisions of Article 50 of the Occupational Safety and Hygiene Law 2015, the time of enjoying the lump-sum allowance, monthly allowance, and service subsidy is calculated from the month the employee completes treatment, is discharged from the hospital, or from the month of the conclusion by the Medical Assessment Council in the case of non-hospital treatment.

In case of relapse injuries or diseases, employees can be re-assessed for labor capacity reduction, and the time of receiving new subsidies is calculated from the month of conclusion by the Medical Assessment Council.

5. Dossier for resolving occupational accident policy benefits

According to current regulations, the dossier for resolving occupational accident policy benefits includes:

- Social Insurance Book.

- Discharge paper or a copied dossier of the medical record after treating an occupational accident for inpatient cases.

- Accident investigation report according to regulations.

- Assessment record of labor capacity reduction by the Medical Assessment Council.

- Written request for resolving occupational accident policy benefits form issued by Vietnam Social Security after consulting with the Ministry of Labor, Invalids, and Social Affairs.

Note: In case of traffic accidents identified as occupational accidents, one of the following documents is additionally required:

- Field examination record, site diagram of the traffic accident scene.

- Traffic accident report by the police or military criminal investigation agency.

- Nguyen Trinh -

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