劳动法新规:关于执行《工伤保险条例》若干问题的意见(二)

来源:保华劳动法作者:日期:2016-07-30

劳动新规内容概要:本规定是人力资源和社会保障部对《工伤保险条例》实施过程中出现的争议较为集中的一些问题的梳理与解答,对于实践中发生的工伤有关争议具有重要的指导意义。
Content Summary: This Regulation is formulated by the Ministry of Human Resources and Social Security aiming to sort out and answer the questions on some of the disputed issues which have occurred during the process of implementing the Regulation on Work-Related Injury Insurance, and has guiding significance to dispute settlement in practice regarding work-related injuries. 
人力资源社会保障部关于执行《工伤保险条例》若干问题的意见(二)Opinion (II) of the Ministry of Human Resources and Social Security on Several Issues concerning the Implementation of the Regulation on Work-Related Injury Insurance
文号:人社部发〔2016〕29号File Number: No. 29[2016] issued by MOHRSS
实施日期:2016年3月28日Date Issued: March 28, 2016
亮点介绍:1.本规定首次明确了对于达到或超过法定退休年龄,但未办理退休手续或者未依法享受城镇职工基本养老保险待遇,继续在原用人单位工作期间受到事故伤害或患职业病的情形的处理方式,即由用人单位依法承担工伤保险责任。
2.本规定首次将职工在参加用人单位组织或者受用人单位指派参加其他单位组织的活动中受到事故伤害的视为工作原因发生的伤害。
3.本规定首次明确了员工驻外时工伤该如何认定的问题,即职工因工作原因驻外,有固定的住所、有明确的作息时间,工伤认定时按照在驻在地当地正常工作的情形处理。
4.“上下班途中”的概念在该规定中得到明确阐释,即职工以上下班为目的、在合理时间内往返于工作单位和居住地之间的合理路线。
5.本规定对实践中存在争议的工伤保险缴纳地以及工伤认定申请地进行了明确。在实践中,用人单位注册地与生产经营地不在同一统筹地区的,原则上应在注册地为职工参加工伤保险;未在注册地参加工伤保险的职工,可由用人单位在生产经营地为其参加工伤保险。而职工受到事故伤害或者患职业病后,在参保地进行工伤认定、劳动能力鉴定,并按照参保地的规定依法享受工伤保险待遇;未参加工伤保险的职工,应当在生产经营地进行工伤认定、劳动能力鉴定,并按照生产经营地的规定依法由用人单位支付工伤保险待遇。
Introduction of the Highlights:1.This Regulation has explicitly stipulated for the first time as to how to deal with the situation where an employee, who reaches or exceeds the statutory retirement age but does not go through the retirement formalities or enjoy the benefits of the basic old-age insurance for urban workers according to law, is injured in an accident or suffers from an occupational disease during the period when the employee continues to work for his/her original employer, and in which situation the responsibility for work-related injury insurance shall be borne by the employer.
2.This Regulation has stipulated for the first time that in a situation where an employee is injured in an accident when participating in the activities organized by the employer or participating in other activities organized by other entities as designated by the employer, it shall be deemed that the employee is injured due to work.
3.This Regulation has stipulated for the first time on the issue of how to define the work-related injury when an employee is dispatched out of the workplace, i.e. when an employee is dispatched out of the workplace due to work reasons and has a fixed residence and specific work schedule, the work-related injury shall be identified according to the normal working situation locally.
4.The concept of “the way between home and office” has been explicitly defined in this Regulation, which refers to the reasonable route between the workplace and the place of residence during the reasonable time that the employee commutes for the purpose of work.
5.This Regulation explicitly stipulates on the disputed issues in practice regarding the place where the premium of work-related insurance is contributed and the place where the application for the identification of work-related injury is made. In practice, if the place where the employer is registered and the place where the employer’s business is operated are not within the same coordinating area, in principle, the employer shall contribute the premiums of work-related injury insurance for its employees at the registered place; and for the employee who is not covered by the work-related injury insurance at the registered place, the employer may contribute the premium of work-related injury insurance for the employee at the place where the business is operated. After an employee is injured in an accident or suffers from an occupational disease, the identification of the employee’s work-related injury and the appraisal of his/her work capacity shall be conducted at the place where he/she is insured and the employee shall legally enjoy the benefits of work-related injury insurance according to the local regulation at the place where he/she is insured; and for the employee who is not covered by any work-related injury insurance, the identification of the employee’s work-related injury and the appraisal of his/her work capacity shall be conducted at the place where the business is operated and the employer shall pay the benefits of work-related injury insurance for the employee according to the local regulation at the place where the business is operated.
新规全文:

人力资源社会保障部关于执行《工伤保险条例》若干问题的意见(二)(人社部发〔2016〕29号)
各省、自治区、直辖市及新疆生产建设兵团人力资源社会保障厅(局):  为更好地贯彻执行新修订的《工伤保险条例》,提高依法行政能力和水平,妥善解决实际工作中的问题,保障职工和用人单位合法权益,现提出如下意见:  一、一级至四级工伤职工死亡,其近亲属同时符合领取工伤保险丧葬补助金、供养亲属抚恤金待遇和职工基本养老保险丧葬补助金、抚恤金待遇条件的,由其近亲属选择领取工伤保险或职工基本养老保险其中一种。  二、达到或超过法定退休年龄,但未办理退休手续或者未依法享受城镇职工基本养老保险待遇,继续在原用人单位工作期间受到事故伤害或患职业病的,用人单位依法承担工伤保险责任。  用人单位招用已经达到、超过法定退休年龄或已经领取城镇职工基本养老保险待遇的人员,在用工期间因工作原因受到事故伤害或患职业病的,如招用单位已按项目参保等方式为其缴纳工伤保险费的,应适用《工伤保险条例》。  三、《工伤保险条例》第六十二条规定的“新发生的费用”,是指用人单位参加工伤保险前发生工伤的职工,在参加工伤保险后新发生的费用。其中由工伤保险基金支付的费用,按不同情况予以处理:  (一)因工受伤的,支付参保后新发生的工伤医疗费、工伤康复费、住院伙食补助费、统筹地区以外就医交通食宿费、辅助器具配置费、生活护理费、一级至四级伤残职工伤残津贴,以及参保后解除劳动合同时的一次性工伤医疗补助金;  (二)因工死亡的,支付参保后新发生的符合条件的供养亲属抚恤金。  四、职工在参加用人单位组织或者受用人单位指派参加其他单位组织的活动中受到事故伤害的,应当视为工作原因,但参加与工作无关的活动除外。  五、职工因工作原因驻外,有固定的住所、有明确的作息时间,工伤认定时按照在驻在地当地正常工作的情形处理。  六、职工以上下班为目的、在合理时间内往返于工作单位和居住地之间的合理路线,视为上下班途中。  七、用人单位注册地与生产经营地不在同一统筹地区的,原则上应在注册地为职工参加工伤保险;未在注册地参加工伤保险的职工,可由用人单位在生产经营地为其参加工伤保险。  劳务派遣单位跨地区派遣劳动者,应根据《劳务派遣暂行规定》参加工伤保险。建筑施工企业按项目参保的,应在施工项目所在地参加工伤保险。  职工受到事故伤害或者患职业病后,在参保地进行工伤认定、劳动能力鉴定,并按照参保地的规定依法享受工伤保险待遇;未参加工伤保险的职工,应当在生产经营地进行工伤认定、劳动能力鉴定,并按照生产经营地的规定依法由用人单位支付工伤保险待遇。  八、有下列情形之一的,被延误的时间不计算在工伤认定申请时限内。  (一)受不可抗力影响的;  (二)职工由于被国家机关依法采取强制措施等人身自由受到限制不能申请工伤认定的;  (三)申请人正式提交了工伤认定申请,但因社会保险机构未登记或者材料遗失等原因造成申请超时限的;  (四)当事人就确认劳动关系申请劳动仲裁或提起民事诉讼的;  (五)其他符合法律法规规定的情形。  九、《工伤保险条例》第六十七条规定的“尚未完成工伤认定的”,是指在《工伤保险条例》施行前遭受事故伤害或被诊断鉴定为职业病,且在工伤认定申请法定时限内(从《工伤保险条例》施行之日起算)提出工伤认定申请,尚未做出工伤认定的情形。  十、因工伤认定申请人或者用人单位隐瞒有关情况或者提供虚假材料,导致工伤认定决定错误的,社会保险行政部门发现后,应当及时予以更正。  本意见自发文之日起执行,此前有关规定与本意见不一致的,按本意见执行。执行中有重大问题,请及时报告我部。

人力资源社会保障部2016年3月28日

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