Workers’ compensation insurance is a system that provides financial assistance and compensation to workers when they are injured or become ill on the job. It is a very important form of social insurance that protects the health and livelihood of workers. Workers’ compensation insurance is characterized by the following main points: .
– The cause of the injury or illness must be work-related: it applies only if the worker is injured during work activities or develops the illness in the workplace. In other words, injuries or illnesses that occur in everyday life are not covered.
– Financial support: Workers’ compensation insurance covers a portion of a worker’s salary if the injury or illness requires the worker to take time off from work. This helps stabilize their lives and allows the worker to focus on rehabilitation.
– Compensation for Medical Expenses: Workers’ compensation insurance may cover some or all medical expenses related to an injury or illness. This reduces the burden of getting the medical care you need.
– Disability Pension: In some cases, a disability pension may be awarded if a work-related injury or illness leaves you disabled. This provides financial assistance due to loss of work capacity.
Workers’ compensation insurance is an important tool to help workers and their families cope with financial hardship resulting from a sudden accident or illness.
Eligible peroson and premiums
Workers’ compensation insurance is a system that applies to businesses that employ even one worker. A worker is defined as a person who is employed by the business and receives wages, regardless of the type of occupation. Workers are covered by this system regardless of their employment status (e.g., part-time workers, fixed-term employment contractors, etc.).
In addition, the employer bears all workers’ compensation insurance premiums. This means that every worker employed by a company is covered by workers’ accident compensation insurance, and is entitled to compensation for injuries and illnesses sustained on the job or while commuting to and from work.
Types of insurance benefits
・Medical treatment (compensation) benefits
Medical treatment (compensation) benefits are provided when a worker needs medical treatment for an injury or illness caused by work or commuting. There are two types of benefits: “medical treatment benefits” as benefits in kind and “payment of medical treatment expenses” as cash benefits, but “medical treatment benefits” are provided in principle.
“Medical treatment benefits” is a system under which, as a general rule, medical treatment is provided free of charge until the injury or illness is cured, provided that the patient visits a workers’ accident compensation hospital or a hospital designated for workers’ accident compensation. On the other hand, “payment of medical treatment expenses” is a system that pays the expenses incurred for medical treatment at hospitals other than workers’ accident hospitals or hospitals designated for workers’ accident treatment.
This includes treatment expenses, hospitalization expenses, nursing fees, transportation expenses, and other expenses normally required for medical treatment. (However, special treatment that is not generally recognized as effective or hiring an escort nurse who is deemed unnecessary due to the extent of the injury or illness will not be covered.)
・Compensation for absence from work
Compensation for absence from work is paid from the fourth day after the day on which a worker is unable to work and receive wages due to medical treatment for an injury or illness caused by work-related reasons or commuting. (However, in the case of work-related accidents, the employer must provide compensation for absence from work based on the provisions of the Labor Standards Law for three days from the first day of absence from work.)
In this case, 60% of the basic daily benefit amount is paid per day of absence from work as absence (compensation) benefits, and 20% of the basic daily benefit amount is paid as a special allowance.
The basic daily benefit amount is the total amount of wages paid to the affected worker during the three months prior to the date of the disaster, divided by the total number of days during that period.
The minimum guaranteed amount of the basic daily benefit amount in workers’ compensation insurance is determined and is applied when the affected worker’s basic daily benefit amount is less than this amount.
・Accident and sickness (compensation) pension
If the patient has not recovered after one year and six months of medical treatment, and the injury or illness is classified as a Grade 1 to 3 injury or illness, a pension equivalent to 313 to 245 days of the basic daily benefit amount will be paid in lieu of compensatory absence from work benefits.
・Disability (compensation) benefits
When an injury or illness is cured and a person is left with a disability, a disability (compensation) pension equivalent to 313 to 131 days of the basic benefit amount will be granted for disability grades 1 to 7, and a disability (compensation) lump sum equivalent to 503 to 56 days of the basic benefit amount will be granted for grades 8 to 14.
・Survivor (compensation) benefits
A survivor’s (compensation) pension is paid to a certain range of surviving family members who were earning a living from the worker’s income at the time of his or her death. If there is no pension recipient, a survivor’s (compensation) lump-sum payment equivalent to 1,000 days of the basic daily benefit amount is granted to a certain range of surviving family members.
・Funeral expenses (funeral benefits)
The higher of 315,000 yen plus 30 days of the basic daily benefit amount or 60 days of the basic daily benefit amount will be paid to the person who performed the funeral service.
・Nursing care (compensation) benefits
If you receive an injury/disease (compensation) pension due to a certain disability and you are currently receiving nursing care, the amount will be paid on a monthly basis.
In the case of full-time nursing care, the amount spent for nursing care (up to the maximum amount) will be paid.
However, if the person was being cared for by a relative, etc. and has not paid for the care, or if the amount paid is less than a certain amount, that certain amount will be paid.
In addition, in the case of nursing care at any time, the amount spent as nursing care expenses (up to a maximum amount) will be paid.
However, in the case of a person who was cared for by a relative, etc. and has not spent any expenses for nursing care or the amount spent is less than a certain amount, that certain amount will be paid.
コメント