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Laws of the Republic of Korea |
ENFORCEMENT DECREE OF THE INDUSTRIAL ACCIDENT COMPENSATION INSURANCE ACT
Presidential Decree No. 14628, Apr. 15, 1995
Amended by Presidential Decree No. 15318, Mar. 27, 1997 Presidential Decree No. 15589, Dec. 31, 1997
Presidential Decree No. 16871, Jun. 27, 2000
Presidential Decree No. 17977, May. 7, 2003
Presidential Decree No. 18270, Jan. 29, 2004
Presidential Decree No. 18573, Oct. 29, 2004
Presidential Decree No. 19513, Jun. 12, 2006
Presidential Decree No. 19649, Aug. 17, 2006
Presidential Decree No. 20142, Jun. 29, 2007
Wholly Amended by Presidential Decree No. 20875, Jun. 25, 2008 Presidential Decree No. 20947, Jul. 29, 2008
Presidential Decree No.20966, Aug. 7, 2008
CHAPTER
General Provisions
Article 1 (Purpose)
The purpose of this Decree is to provide for the matters
delegated by the Industrial Accident Compensation Insurance
Act and those
necessary for the enforcement thereof.
Article 2 (Businesses Excluded from Application of the Act)
(1) ßÖBusinesses prescribed
by the Presidential Decreeß×in
the proviso of Article 6 of the Industrial Accident Compensation
Insurance Act (hereinafter referred
to as "the Act") mean
businesses or workplaces (hereinafter referred to as "businesses")
which fall under any of the following
subparagraphs:
1. Businesses for which accident compensation is made
under the Public OfficialsßÓPension Act or the VeteranßÓs
Pension Act ;
2. Businesses for which accident compensation is made
under the Seaman Act, the Act on Accident Compensation
Insurance for Fishermen
and Fishing Boats or the Private
School Teachers Pension Act ;
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3. Construction work falling under any of the following
items and carried out by those other than housing
constructors under the
Housing Act, constructors under
the Framework Act on the Construction Industry,
constructors under the Electrical Construction Business
Act, information and communication-related constructors
under the Information
and Communication Work Business
Act, fire-fighting systems constructors under the
Fire-fighting Systems Construction Act or repair
business
operators of cultural properties under the Protection of
Cultural Properties Act :
A. Construction work whose total construction amount
(hereinafter referred to as "total construction amount")
prescribed in Article
2 (1) 2 of the Enforcement Decree
of the Act on the Collection, etc., of Premiums for
Employment Insurance and Industrial Accident
Compensation
Insurance is less than 20 million won; and
B. Construction work involving the construction of a
building with a total floor area of 100 or less or
renovation of a building
with a total floor area of 200
or less;
4. Employment activities within households;
5. Businesses other than those referred to in subparagraphs
1 through 4, where the number of workers who are employed
ordinarily
does not exceed one. In this case, the method
of calculating the number of workers who are employed
ordinarily shall be prescribed
by the Ordinance of the
Ministry of Labor; and
6. Businesses other than incorporations in the fields of
agriculture, forestry (excluding the logging industry),
fishery and hunting,
where the number of workers who
are employed ordinarily is less than five. In this case, the
method of calculating the number of
workers who are
employed ordinarily shall be prescribed by the
Ordinance of the Ministry of Labor.
(2) Unless otherwise provided in this Decree, the scope of
the businesses referred to in the subparagraphs of paragraph (1)
shall
be subject to the Korean Standard Industrial
Classification announced publicly by the head of the
National Statistical Office under
the Statistics Act.
(3) If construction work whose total construction amount is
less than twenty million won becomes subject to
the blanket
application under Article 8 (1) or (2) of the Act on the
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Collection, etc., of Premiums for Employment Insurance and
Industrial Accident Compensation Insurance (hereinafter referred
to
as the "Insurance Premium Collection Act"), or the total
construction amount becomes more than twenty million won
due to a design
change (including cases where an actual change
is made to the design), it shall be subject to the Act from that
time.
Article 3 (Functions of Industrial Accident Compensation Insurance
Deliberation Committee)
The Industrial Accident Compensation Insurance Deliberation
Committee (hereinafter referred to as the ßÖCommitteeß×) referred to
in Article 8 (1) of the Act shall deliberate matters described in
any of the following subparagraphs:
1. Matters concerning the criteria for calculating medical care
benefits, such as the scope and amount of medical care
benefits,
referred to in Article 40 (5) of the Act;
2. Matters concerning the determination of the rates of
industrial accident compensation insurance premiums
referred to in Article
14 (3) and (4) of the Insurance
Premium Collection Act;
3. Matters concerning the establishment of the plan for the
operation of the Industrial Accident Compensation
Insurance and Prevention
Fund referred to in Article 98
of the Act; and
4. Other matters referred to discussion by the Minister of
Labor with respect to industrial accident compensation
insurance activities
(hereinafter referred to as "insurance
activities").
Article 4 (Composition of the Committee)
The members of the Committee shall be appointed or
commissioned by the Minister of Labor as follows:
1. Members representing workers shall be five persons who
are recommended by trade unions which are a
confederation of trade unions;
2. Members representing employers shall be five persons
who are recommended by employers' organizations
representing the whole country; and
3. Members representing the public interests shall be five
persons, each described in the following items.
A. Vice Minister of Labor
B. One public official of Grade III in charge of industrial
accident compensation insurance affairs in the Ministry
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of Labor or one general public official in the Senior
Civil Service
C. Three persons among those recommended by citizens'
groups (referring to non-profit private organizations
prescribed in Article
2 of the Assistance for Non-Profit
Non-Governmental Organizations Act) and those with
plenty of academic knowledge or experiences
in social
insurance
Article 5 (Term of Office of Members)
(1) The term of office of the members shall be three years
and may be renewed: Provided that in case of the members
who are the
Vice Minister of Labor and a public official of
Grade III in charge of industrial accident compensation
insurance affairs or a
general public official in the Senior Civil
Service, it shall be the tenure of their offices.
(2) The term of any member filling
a vacancy shall be the
remaining period of his predecessor's term.
Article 6 (Chairman and Vice Chairman)
(1) The Committee shall have a chairman and a vice chairman.
(2) The chairman shall be the Vice Minister of Labor, and
the vice
chairman shall be elected by the Committee from among
the members representing the public interest.
(3) The chairman shall represent the Committee, and take
general control over the affairs of the Committee.
(4) The vice chairman
shall assist the chairman, and if the
chairman cannot perform his/her duties for inevitable reasons,
he/she shall act for the chairman.
Article 7 (Meeting of Committee)
(1) The chairman shall convene a meeting of the Committee,
and preside at it.
(2) A meeting of the Committee shall be convened at the
request of the Minister of Labor or a majority of all the members.
(3)
A meeting of the Committee shall be held with the
attendance of a majority of all the members, and make a
decision with the approval
of a majority of the members
present.
Article 8 (Expert Committees)
(1) A policy expert committee and a medical care expert
committee shall be set up in the Committee pursuant to Article
8 (3) of
the Act.
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(2) The policy expert committee shall professionally examine
and coordinate matters concerning the finances, application,
collection,
benefits, rehabilitation and welfare of industrial
accident compensation insurance on the order of the chairman
of the Committee
and the medical care expert committee shall
examine and coordinate medical care benefit standards, such as
the scope and amounts
of medical care benefits, and matters
concerning medical care, on the order of the chairman of the
Committee and then both shall
report the results to the
Committee.
(3) Each expert committee shall be composed of less than 25
non-standing members.
(4) The members of the policy expert committee shall be
commissioned by the chairman from among those falling under
any of the
following subparagraphs:
1. General public officials of Grade IV or higher in charge
of industrial accident compensation insurance affairs in the
Ministry
of Labor;
2. Persons recommended by trade unions which are a
confederation of trade unions or nationwide employers'
organizations; and
3. Persons with plenty of academic knowledge or experience
in the finances, application, collection, benefits, etc., of social
insurance.
(5) The members of the medical care expert committee shall
be commissioned by the chairman from among those falling
under any of
the following subparagraphs:
1. General public officials of Grade IV or higher in charge
of industrial accident compensation insurance affairs in the
Ministry
of Labor;
2. Persons recommended by trade unions which are a
confederation of trade unions or nationwide employers'
organizations; and
3. Persons with plenty of medical knowledge and experience
in each professional field, such as industrial medicine.
(4) The composition
and operation of the expert committees
and other necessary matters shall be determined by the chairman
after resolution of the
Committee.
Article 9 (Executive Secretary of Committee)
(1) The Committee shall have an executive secretary for the
management of its affairs.
(2) The executive secretary shall be appointed by the Minister
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of Labor from among public officials under his/her control.
Article 10 (Allowances of Member)
Members of the Committee or the expert committee, who
attend a meeting of the Committee or the expert committee
may be paid allowances
within the limits of the budget:
Provided that this shall not apply in case members who are a
public official attend the committee
concerning work directly
related to their duties.
Article 11 (Operational Regulations)
Except as provided in this Act, matters necessary for the
operation of the Committee shall be determined by the
chairman after
resolution of the Committee.
Article 12 (Vicarious Implementation of Survey and Research
Projects)
The Minister of Labor, pursuant to Article 9 (2) of the Act,
may have a research institution established in accordance with
Article
8 of the Act on the Establishment, Operation and Fosterage
of Government-Invested Research Institutions, etc., carry out part
of
survey and research projects concerning industrial accident
compensation insurance affairs. In this case, when selecting the
research
institution, the institution's research staff and
performance records regarding industrial accident
compensation insurance affairs
shall be considered.
CHAPTER
Korea Workers' Compensation & Welfare Service
Article 13 (Non-standing Director of Corporation)
(1) The ex officio directors of the Korea Workers'
Compensation & Welfare Service
under Article 10 of the Act
(hereinafter referred to as the ßÖCorporationß×) shall be any of the
persons described in the following
subparagraphs :
1. Public officials of Grade III in charge of the budget of the
Corporation in the Ministry of Strategic Planning and
Finance or
general public officials in the Senior Civil
Service ; and
2. Public officials of Grade III in charge of insurance activities
in the Ministry of Labor or general public officials in the
Senior
Civil Service.
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(2) Non-standing directors excluding the ex officio directors of
the Corporation shall be a person falling under any of the following
subparagraphs. In this case, the number of non-standing directors
falling under subparagraphs 1 and 2 shall be equal:
1. Persons recommended by trade unions which are a
confederation of trade unions
2. Persons recommended by nationwide employers'
organizations; and
3. Persons with plenty of academic knowledge or experience
in social insurance or labor welfare activities.
Article 14 (Approval of Budgets and Operational Plan)
(1) If the Corporation intends to obtain approval from the
Minister of Labor
concerning budgets for the following fiscal
year pursuant to Article 25 (1) of the Act, it shall submit a
request for budgets and
business prospectus based on the
budgets to the Minister of Labor until before the start of the
following fiscal year:
(2) If the Corporation intends to obtain approval from the
Minister of Labor concerning an operational plan
pursuant to Article 25 (1) of the Act, it shall establish an
operational plan and submit it to the Minister of Labor
without delay
after the approved budgets are confirmed.
(2) If the Corporation intends to modify the operational plan
and budget approved under
paragraphs (1) and (2), it shall
submit a document specifying the reason and contents of such
modification to the Minister of Labor
to obtain his/her approval.
Article 15 (Submission of Statement of Accounts)
When the Corporation submits a statement of accounts for
each fiscal year to the Minister of Labor under Article 25 (2) of
the
Act, it shall be accompanied by the following documents:
1. The financial statements (including written audit opinions
expressed by a certified public accountant or an
accounting firm) and all documents annexed thereto; and
2. Other documents necessary for clarifying the contents of
the statement of accounts.
Article 16 (Approval of Corporation Regulations)
When the Corporation intends to establish or revise its
regulations on matters described in the following subparagraphs,
it shall
obtain the approval of the Minister of Labor:
1. Matters concerning the organization and the full number
of personnel of the Corporation;
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2. Matters concerning the personnel administration and
remuneration of the officers and employees;
3. Matters concerning the accounting of the Corporation;
and
4. Other important matters concerning the operation,
insurance activities and labor welfare activities of the
Corporation.
Article 17 (Application for Approval on Borrowing, etc. of Funds)
(1) If the Corporation intends to obtain approval on any
borrowing
of funds under Article 27 (1) of the Act, it shall
submit to the Minister of Labor the application for approval
specifying the
following matters:
1. Reasons for the borrowing;
2. Source from which the funds are borrowed;
3. Amount of borrowed money;
4. Conditions of the borrowing;
5. Repayment method and period; and
6. Other matters necessary for the borrowing and repayment
(2) If the Corporation intends to obtain approval on the
appropriation
by bringing in funds from the Industrial Accident
Compensation Insurance and Prevention Fund under Article 27
(2) of the Act, it
shall submit to the Minister of Labor the
application for approval specifying matters concerning reasons
for the appropriation
by bringing in funds, the amount, etc.
Article 18 (Delegation of Authority of President of Corporation)
(1) The scope of the work
of the Corporation over which
the authority of the president of the Corporation may be
delegated to the head of its branch office
(hereinafter referred
to as "affiliate organization") is shown in Table 1.
(2) Notwithstanding the delegation of the authority
of the
president of the Corporation under paragraph (1), the authority
over litigation proceedings, requests for appeal under the
Administrative Appeals Act and requests for examination under
the Board of Audit and Inspection Act, to which the
Corporation
is a party, shall rest with the president of the
Corporation.
Article 19 (Entrustment of Affairs)
(1) The scope of the work entrusted by the Corporation
pursuant to Article 29 (1) of the Act is as follows :
1. Matters concerning the payment of insurance benefits; and
2. Work incidental to those matters referred to in subparagraph 1
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(2) If the Corporation has entrusted its work pursuant to
paragraph (1), it may pay the entrusted person fees
resulting from the
entrustment.
Article 20 (Investment, etc.)
If the Corporation intends to make any investment or
contribution pursuant to Article 32 (1) of the Act, it shall submit
to the
Minister of Labor an application specifying the following
matters to obtain his/her approval:
1. Needs for the investment or contribution;
2. Kinds and value of the property to be invested or
contributed;
3. Outline of the business; and
4. Other matters necessary for the investment or contribution
CHAPTER III
Insurance Benefits
SECTION 1
Insurance Benefit Standards
Article 21 (Claim for Insurance Benefits, Notification of Decision,
etc.)
(1) A person who intends to receive any of the following
insurance benefits pursuant to Article 36 (2) of the Act shall file
an
application or a claim for such insurance benefits with the
Corporation:
1. Wage replacement benefits;
2. Lump sum disability compensation or disability
compensation annuities (including the lump sum payments
prescribed in Article
57 (5) of the Act);
3. Nursing benefits;
4. Lump sum survivorsßÓ compensation or survivors'
compensation annuities(including the lump sum payments
prescribed in Article
62 (4) of the Act);
5. Injury-disease compensation annuities;
6. Funeral expenses; and
7. Vocational rehabilitation benefits
(2) The Corporation shall, upon receiving an application or
- 10 -
a claim for insurance benefits as referred to in paragraph (1),
decide whether or not to pay the insurance benefits, the contents
of the payment, etc., and inform the claimant of them.
(3) If the Corporation has decided to pay disability
compensation annuities
or survivorsßÓcompensation annuities, it
shall deliver an annuity certificate to the person entitled thereto.
Article 22 (Increase
or Decrease in Average Wage)
(1) The criteria for and methods of calculating the rate of
increase or decrease in the average wage
of all workers and the
rate of increase or decrease in comsumer prices under Article
36 (3) and (4) of the Act are shown in Table
2.
(2) The increase or decrease of the average wage under
Article 36 (3) of the Act may be made at the request of the
person entitled
to the insurance benefits or by virtue of the
authority of the Corporation.
Article 23 (Scope of Workers in Unusual Type of Employment)
"The cases prescribed by the Presidential Decree where it is
deemed
inappropriate to apply the average wage of the worker
due to his/her unusual type of employmentß×in Article 36 (5)
of the Act refer
to cases of applying average wages for workers
(hereinafter referred to as ßÖdaily workersß×) who are employed
on a daily basis
or paid wages on a daily basis (referring to
the wages paid as a reward for the set number of working
hours in one day) for the
number of days worked : Provided
that if a daily worker falls under any of the following
subparagraphs, he/she shall be seen as
such :
1. Where his/her employment relations have continued for
three months or more ;
2. Where his/her type of employment is considered similar
to that of a permanent worker after comprehensive
consideration of the
working conditions, type of
employment contract, specific employment conditions, etc.,
of other daily workers engaged in the same kind of job
in the same business
as the worker concerned.
Article 24 (Method of Calculation of Average Wage for Workers
in Unusual Type of Employment)
(1) "An amount calculated according to the calculation
method prescribed by the Presidential Decree" in Article 36 (5)
of the Act
refers to an amount calculated by multiplying the
daily wage of the daily worker concerned by the working
day coefficient (hereinafter
referred to as "ordinary working
day coefficient") announced by the Minister of Labor after
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taking into account the number of days actually worked by
daily workers for a month, etc.
(2) A daily worker who has worked in the business
concerned for not less than one month as of the date of
occurrence of causes
for calculating the average wage may
apply for exclusion from the application of the calculation
method referred to in paragraph
(1) to the Corporation by
submitting the application together with documents proving the
actual wage and number of days worked,
if given the actual
wage and number of days worked, it is not appropriate to take
the amount calculated according to the calculation
method
referred to in paragraph (1) as the average wage.
Article 25 (Special Case for Calculation of Average Wages for
Persons
with Occupational Disease)
(1) ßÖThe occupational diseases prescribed by the Presidential
Decree, such as pneumoconiosisß×in Article 36 (6) of the Act
refer
to diseases (hereinafter in this Article referred to as
"occupational diseases") falling under any of the following
subparagraphs
among the work-related diseases (hereinafter
referred to as "work-related diseases") referred to in Article 37 (1)
2 of the Act
: Provided that diseases that acutely arise due to
temporary exposure to large amounts of harmful or hazardous
elements shall be
excluded :
1. Pneumoconiosis;
2. Any of the diseases described in subparagraph 2 A and
B, subparagraph 4 B, subparagraphs 5 through 7, subparagraph
8 A and B,
subparagraph 9, subparagraph 10 A, subparagraph
11 A, subparagraph 12 A, subparagraph 13 A, subparagraph 14
A, subparagraph 15
A and B, subparagraph 16 A, subparagraph
17 A, subparagraph 18, subparagraph 19 A and B, subparagraph
20, subparagraph 21 and subparagraph
22 E through I in Table
3; and
3. Other diseases which result from long-term exposure to
harmful or hazardous elements or are recognized as having
occurred after
a latent period after exposure to harmful or
hazardous elements.
(2) "An amount calculated according to the calculation
methods prescribed by the Presidential Decree refers to an
amount obtained
by dividing the sum of all the average
monthly wages of workers with similar wage levels to that of
the worker for the one year
preceding the last day of the
quarter two quarters before the occupational disease is
- 12 -
confirmed by the total number of days in that period.
(3) The day when the occupational disease is confirmed,
referred to in paragraph
(2), shall be the date of issuance of the
medical certificate or medical opinion issued when it is
confirmed that the occupational
disease is eligible for insurance
benefits : Provided that in any of the following cases, it shall
be the date described therein:
1. In case there is time and medical continuity between the
examination, treatment, etc., of the occupational disease and the
issuance
of the medical certificate or medical opinion, the start
date of the medical care; or
2. In case of noise-induced hearing loss, the date on which
the worker has stopped engaging in work involving exposure to
noise
(4) All the average monthly wages of workers with similar
wage levels referred to in paragraph (2) shall be all the average
monthly
wages of workers who are similar to the worker with
the occupational disease in terms of sex, occupation, and type
and size of
business they belong to according to data on
average monthly wages for workers from the survey on wage
and working hours at establishments
(hereinafter referred to as
the "survey on wages and working hours at establishments")
prepared by the Minister of Labor as the
designated statistics
prescribed in Article 3 of the Statistics Act. In this case, the
criteria for judging such workers similar
to the worker in terms
of sex, occupation and type and size of business they belong to
shall be determined by the Corporation.
(5) In applying the provisions of Article 36 (6) of the Act, if
the occupational disease is confirmed after the shutdown or
closure
of the business to which the worker belongs (including
cases where the worker has retired before the business
shutdown or closure),
an amount obtained by increasing or
decreasing the amount calculated on the basis of the date of
the business shutdown or closure
pursuant to paragraph (2)
in accordance with subparagraph 1 of Table 2 shall be
regarded as the average wage of the worker.
(6) If a person entitled to insurance benefits intends to be
subject to the special case for the calculation of average wages
as
referred to in article 36 (6) of the Act, he/she shall apply for
the special case for the calculation of average wages to the
Corporation.
Article 26 (Method of Calculating Maximum and Minimum Standard
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Amount of Compensation)
(1) The average wages of all workers used as the basis for
calculating the maximum standard amount of compensation
(hereinafter
referred to as the "maximum standard amount of
compensation) and the minimum standard amount of
compensation (hereinafter referred to as the "minimum standard
amount of compensation) referred to in Article 36 (7) of the Act
shall be an amount obtained by dividing the sum of all the
average monthly wages of every worker from July 1st of the
insurance
year two insurance years ago to June 30th of the
preceding insurance year by 365 (or 366 in case the month of
February during that
period has 29 days).
(2) When calculating the maximum standard amount of
compensation and the minimum standard amount of
compensation, amounts less than one Won shall be rounded off.
(3) The application period for the maximum standard
amount of compensation
and the minimum standard amount of
compensation shall be from January 1st to December 31st of the
insurance year concerned.
SECTION 2
Criteria for Recognition of Work-related Accidents
Article 27 (Accidents While Performing Duties)
(1) An accident that happens while the worker is carrying
out any of the following acts shall be seen as the work-related
accident
under Article 37, (1) 1 A of the Act:
1. Acts of performing his/her duties in accordance with
his/her employment contract;
2. Physiologically necessary acts, such as going to the toilet,
in the course of performing his/her duties;
3. Acts of preparing for or wrapping up work and other
necessary acts incidental to his/her duties; and
4. Acts expected as a social norm, such as acts of
emergency refuge or rescue caused by unexpected accidents,
such as natural disasters,
fires, etc., which happen inside the
workplace
(2) An accident that happens while the worker is
performing his/her duties outside the workplace following
instructions from the employer shall be seen as the work-related
accident
under Article 37 (1) 1 A of the Act : Provided that an
accident that happens while the worker is carrying out an act
- 14 -
violating specific instructions from the employer or his/her
private act or is off his/her normal business travel course shall
not be seen as a work-related accident.
(3) An accident that happens in relation to the work a
worker who has no fixed place of work because of the nature
of his/her duties
performs from the time when he/she starts to
work after first arriving at the place of work until he/she
leaves work after finally
completing work shall be seen as the
work-related accident under Article 37 (1) 1 A of the Act.
Article 28 (Accidents Due to Defect,
etc., in Facilities, etc.)
(1) An accident that happens due to a defect in, or the
careless management by the employer of, the
facilities,
equipment, vehicles, etc., (hereinafter referred to as "facilities,
etc.") provided by the employer shall be seen as
the
work-related accident under Article 37 (1) 1 B of the Act.
(2) An accident that happens due to the use of the facilities,
etc., provided by the employer in violation of specific
instructions from the employer and an accident that happens
during the
management or use of the facilities, etc., while the
worker has entire and exclusive responsibility to manage or use
them shall
not be seen as the work-related accident under
Article 37 (1) 1 B of the Act.
Article 29 (Accidents During Commute to and from Work)
(1) If an accident that happens while the worker is
commuting to and from
work meet all of the following
conditions, it shall be seen as the work-related accident under
Article 37 (1) 1 C of the Act:
1. The accident should happen while the worker is using a
means of transport which either is provided by the employer
for the worker's
commute to and from work or can be
regarded as being provided by the employer;
2. The worker should not have entire and exclusive
responsibility to manage or use the means of transport used for
his/her commute
to and from work.
Article 30 (Accidents During Events)
(1) If a worker's participation in various events, (hereinafter
referred to as "events") such as sports events, picnics and
mountain-climbing
events, is deemed necessary for labor
management or business operation under social norms, and the
case falls under any of the
following subparagraphs, an accident
happening during his/her participation in such events (including
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preparation and rehearsal for such events) shall be seen as the
work-related accident under Article 37 (1) 1 D of the Act :
1. Where for the worker participating in the event, the
employer recognizes his/her hours spent to participate in the
event as hours
worked;
2. Where the employer orders the worker to participate in
the event;
3. Where the worker participates in the event after obtaining
approval from the employer in advance; and
4. Other cases equivalent to subparagraphs 1 through 3
where the employer has usually and customarily recognized the
worker's participation
in the event.
Article 31 (Accidents in Particular Place)
(1) An accident that happens due to natural disasters, such
as typhoons, floods, earthquakes and avalanches, or unexpected
incidents,
while the worker is doing an act deemed possible to
do inside the workplace under social norms shall be seen as
the work-related
accident under Article 37 (1) 1 F of the Act,
except when it is obvious that the accident happens while the
worker is engaging
in an act not related to his/her work, such
as private acts and walking out on his/her jobs.
Article 32 (Accidents During Medical Care)
(1) If an accident falling under any of the following
subparagraphs happens to a worker who is receiving medical
care for a work-related
injury or disease, the accident shall be
seen as the work-related accident under Article 37 (1) 1 F of
the Act:
1. Medical accident happening in relation to medical care
benefits; or
2. Accident happening in relation to medical care for
work-related injuries or diseases at the industrial accident
insurance-related
medical institution where the worker is
receiving medical care
Article 33 (Accidents Caused by Third Person's Acts)
(1) In case where an accident happens to a worker because
of a third person's
act, if the work the worker are in charge of
is deemed possible, by nature, to cause the third person to do
an harmful act under
social norms, the accident shall be seen
as the work-related accident under Article 37 (1) 1 F of the Act.
Article 34 (Criteria
for Recognition of Work-related Diseases)
- 16 -
(1) If a worker gets a disease included in the scope of
work-related diseases referred to in Article 44 (1) and Table 5
of the
Enforcement Decree of the Labor Standards Act and
meets all of the following conditions, the disease shall be seen
as the work-related
disease under Article 37 (1) 2 A of the Act:
1. The worker has ever handled, or been exposed to,
harmful or hazardous elements while performing his/her duties;
2. The disease is deemed possible to arise in the light of
the hours for which the worker has handled or been exposed
to harmful
or hazardous elements, the period during which the
worker has been engaged in such work, work environments,
etc.,; and
3. The fact that the worker's exposure to or handling of
harmful or hazardous elements has caused the disease to arise
should be
medically recognized.
(2) If a disease that arises in a worker suffering from a
work-related injury meets all of the following conditions, the
disease
shall be seen as the work-related disease under Article
37 (1) 2 B of the Act:
1. The causal relationship between the work-related injury
and the disease should be medically recognized; and
2. The underlying illness or existing disease should not be a
naturally happening symptom.
(3) The specific criteria for the recognition of work-related
diseases (excluding pneumoconiosis) under paragraphs (1) and
(2)
are shown in Table 3.
(4) When deciding whether to recognize a worker's
work-related diseases or death caused by such work-related
disease, the Corporation
shall take into account the worker's
sex, age, health, physical constitution, etc.
Article 35 (Criteria for Recognition of Work-related Diseases
Due to Pneumoconiosis)
(1) If a worker contracts pneumoconiosis as a result of
engaging in the dust work prescribed by the Ordinance of the
Ministry of
Labor, he/she shall be seen as having the
work-related disease under Article 37 (1) 2 A of the Act.
(2) The types of pneumoconiosis
and criteria for judging
cardiopulmonary disabilities to consider when insurance benefits
are paid to a worker suffering from pneumoconiosis
as
prescribed in paragraph (1) are shown in Table 4.
(3) If a worker has type 1 pneumoconiosis referred to in
Table 4, and is
deemed in need of medical care as she/he falls
- 17 -
under any of the following subparagraphs, the worker shall be
eligible for medical care benefits :
1. As a complication of pneumoconiosis, the worker has
active pulmonary tuberculosis (including cases where the type
of pneumoconiosis
is suspected pneumoconiosis), pleuritis,
bronchitis, bronchiectasis, pneumothorax, pulmonary emphysema
(limited to cases where
the cardiopulmonary function has a
mild disability or worse), cor pulmonale, primary lung cancer
(limited to those who have ever
engaged in dust work in the
mining industry) or atypical mycobacterial infection; or
2. The cardiopulmonary function has a severe disability due
to pneumoconiosis
(4) If a worker has type 4 pneumoconiosis and is
deemed in need of the prevention of complications or other
measures as the size of large opacity is more than half of one
lung,
the worker shall be eligible for medical care benefits.
Article 36 (Criteria for Recognition of Work-related Diseases
Due to Self-Harm)
"The cause prescribed by the Presidential Decree" in the
proviso of Article 37 (2) of the Act refers to cases falling under
any
of the following subparagraphs :
1. Where a person who received or is receiving medical
treatment for mental illness arising for work-related reasons
does self-harm
in a state of mental disorder;
2. Where a person who is receiving medical care due to an
work-related accident does self-harm in a state of mental
disorder caused
by the work-related accident; or
3. Other cases where the fact that self-harm is done in a
state of mental disorder due to work-related reasons is
medically recognized
Article 37 (Presumption of Death)
(1) Cases where a person is presumed to be dead under
Article 39 (1) of the Act shall be those falling under any of the
following
subparagraphs :
1. Where an accident happens in which a ship is sunk,
capsized, destroyed or missing, or aircraft is crushed,
destroyed or missing,
and the life or death of a worker
aboard the ship or aircraft has been unknown for three
months after the accident occurs;
2. Where a worker aboard a ship or aircraft on voyages
went missing, and his/her life or death has been
- 18 -
unknown for three months after he/she went missing; or
3. Where the life and death of a worker on the site of
various accidents such as natural disasters, fires and
building collapses,
etc., has been unknown for three months
after the accident occurs.
(2) A person who is presumed dead under paragraph (1),
shall be presumed to have died on the day the accident
occurred or he/she
went missing.
(3) If a person whose life or death has been unknown due
to any of the causes as referred to in each subparagraph of
paragraph
(1) is confirmed to be dead within three months after
the accident occurred, or he/she went missing, but the date of
his/her death
is obscure, he/she shall be presumed to be dead
on the day as referred to in paragraph (2).
(4) An insurance subscriber shall make without delay a
report on the confirmation of the missing or death of the
worker to the
Corporation, when any of the causes as referred to
in subparagraphs of paragraph (1) occurs, or when the death is
confirmed (including
the case where the worker is presumed
dead under paragraph (3)).
(5) If after the payment of insurance benefits under Article
39 (1) of the Act, the worker's survival was confirmed, the
person
who has received the insurance benefits and the
insurance subscriber shall make a report on the confirmation of
the workerßÓs survival
to the Corporation, within fifteen days after
the survival was confirmed.
(6) If the worker's survival is confirmed, the Corporation
shall notify the person who has received the insurance benefits
that
he/she should pay the amount referred to in Article 39 (2)
of the Act.
(7) A person who is given notification pursuant to
paragraph (6) shall pay the notified amount to the Corporation
within thirty
days after he/she is given the notification.
SECTION 3
Medical Care Benefits, etc.
Article 28 (Claim, etc., for Medical Care Expenses)
(1) The medical care expenses an entitled person can receive
pursuant to the
proviso of Article 40 (2) of the Act are
described in the following subparagraphs :
1. Medical care expenses incurred in case the person
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receives urgent medical care, such as emergency treatment, at a
medical institution other than the industrial accident
insurance-related
medical institutions (hereinafter referred to as
"industrial accident insurance-related medical institutions")
referred to in Article
43 (1) of the Act;
2. Expenses (limited to cases where such expenses are not
provided by industrial accident insurance-related medical
institutions)
spent for any of the following medical care benefits:
A. Provision of artificial limbs or other prosthetic devices
under Article
40 (4) 2 of the Act;
B. Patient caring under Article 40 (4) 6 of the Act; and
C. Transfers under Article 40 (4) 7 of the Act
3. Other medical care expenses deemed by the Corporation
to have a justifiable cause
(2) A person who intends to receive the medical care
expenses referred to in paragraph (1) shall file the claim with
the Corporation.
(3) If it is urgent or there are other inevitable reasons, the
Corporation may pay in advance the expenses required for the
transfers
referred to in Article 40 (4) 7 of the Act after
receiving the claim from the worker concerned.
Article 39 (Criteria for Imposition and Payment of Penalties)
(1) If the Corporation intends to impose penalties pursuant
to Article
44 (1) of the Act, it shall investigate and confirm the
offense and then notify the person subject to the imposition that
he/she
should pay such penalties, specifying the facts of
offense, the amount of penalties, how to file an objection, the
period for filing
an objection, etc.
(2) The person notified pursuant to paragraph (1) shall pay
the penalties to the agency designated by the Corporation
within twenty
days after receiving the notification: Provided that
in case he/she is unable to pay the penalties within the said
period for a
natural disaster or other inevitable reasons, he/she
shall pay the penalties within seven days after the reason has
disappeared.
(3) The agency which has received the penalties pursuant to
paragraph (2) shall issue a receipt to the person who paid the
penalties.
(4) The agency responsible for receiving penalties, upon
receiving penalties pursuant to paragraph (2), shall inform the
Corporation
of the receipt without delay.
(5) The criteria for the imposition of penalties by type and
- 20 -
degree of offense, etc., referred to in Article 44 (2) of the Act
are shown in Table 5.
Article 40 (Submission of Medical Treatment Plans)
(1) An industrial accident insurance-related medical
institution shall include
the following matters in a medical
treatment plan (hereinafter referred to as "medical treatment
plan") referred to in Article
47 (1) of the Act:
1. Name of the injury or disease the worker is suffering
from due to a work-related accident;
2. Progress in, details of the treatment of, and current state
of, the injury or disease of the worker;
3. Medical necessity of extending the medical care period;
4. Methods, contents and period of future treatment, such as
in-hospital treatment, outpatient treatment or treatment while in
employment;
and
5. Other matters necessary for the treatment of the worker
(2) An industrial accident insurance-related medical
institution shall
prepare a medical treatment plan referred to in
paragraph (1) on a three monthly basis (on a yearly basis if the
injury or disease
requires long-term medical care lasting one
year or longer due to its characteristics and is the ones
determined by the Corporation)
and submit it to the
Corporation at least seven days before the end of the previous
medical care period (referring to the changed
medical care
period in case the Corporation makes changes pursuant to
Article 41 (2) 1).
Article 41 (Examination of Medical Treatment Plan and Measures
to Change)
(1) When the Corporation examines a medical treatment
plan pursuant to Article 47 (2) of the Act, it may seek advice
from an advisory
doctor referred to in Article 42 or undergo
deliberation by a panel of advisory doctors referred to in
Article 43:
(2) "The necessary measures prescribed by the Presidential
Decree" in Article 47 (2) of the Act refer to the measures
described
in the following subparagraphs:
1. Termination of treatment or reduction of scheduled
treatment periods;
2. Changes to treatment methods, such as hospitalization,
outpatient treatment, etc.;
3. Transfer to another hospital; and
4. Other changes to medical treatment plans
- 21 -
(3) If the Corporation intends to take any of the measures
referred to in paragraph (2) with regard to a medical treatment
plan,
it shall notify the worker and industrial accident
insurance-related medical institution concerned of its content.
Article 42 (Advisory
Doctor)
(1) The Corporation may commission or appoint doctors,
dentists or oriental medicine doctors (including doctors, dentists
or oriental
medicine doctors who are an employee of the
Corporation) as advisory doctors in order to give medical
advice necessary for making
decisions on the payment of
insurance benefits, medical expenses, medicine expenses, etc.,
resulting from work-related accidents
or for other insurance
activities.
(2) Necessary matters concerning qualifications for advisory
doctors (hereinafter referred to as "advisory doctors") referred to
in paragraph (1) and procedures, etc., for the commission and
appointment thereof shall be determined by the Corporation
Article
43 (Panel of Advisory Doctors)
(1) The Corporation shall have a panel of advisory doctors
under its affiliate organization in order to give systematic
advice
on decisions on the payment of insurance benefits,
medical expenses, medicine expenses, etc., resulting from
work-related accidents
and on matters relating to other
insurance activities, which need medical judgments.
(2) The panel of advisory doctors shall be
composed of five
advisory doctors or more.
(3) The panel of advisory doctors shall deliberate on the
following matters which need medical judgments, in response to
a request
for advice by the Corporation:
1. Whether to terminate treatment for a worker receiving
medical care (limited to cases where there is a difference of
medical opinion
regarding the termination of treatment between
doctor in charge and advisory doctor);
2. Adequacy of reasons for a transfer to another hospital
under Article 48 (1) 4 of the Act;
3. Medical opinions regarding the calculation of the amount
of lump-sum insurance benefits referred to in Article 72;
4. Medical opinions regarding the adjudication or judgment
referred to in the proviso of Article 118 (4); and
5. Other matters concerning insurance benefits, medical
expenses and medicine expenses, which the head of the affiliate
organization
of the Corporation deems in need of deliberation
- 22 -
by the panel of advisory doctors
(4) Matters necessary for the composition and operation of
the panel of advisory doctors shall be determined by the
Corporation.
Article 44 (Hospital Transfer)
"The procedures prescribed by the Presidential Decree" in
Article 48 (1) 4 of the Act refer to the procedures for
deliberation
by the panel of advisory doctors.
Article 45 (Additional Injury or Disease)
Injuries or diseases resulting from the accidents during
medical care under Article 32 shall be regarded as the
additional injury
or disease under Article 49 of the Act in
applying for medical care benefits.
Article 46 (Industrial Accident Insurance-related Medical
Institutions Subject to Evaluation)
(1) "The medical institutions prescribed by the Presidential
Decree" in the former part of Article 50 (1) of the Act shall be
the
industrial accident insurance-related medical institutions
referred to in Article 43 (1) 3 of the Act : Provided that the
medical
institutions evaluated pursuant to Article 58 of the
Medical Service Act shall be evaluated only against the
evaluation categories
relating to the quality of medical care,
which are excluded from the evaluation under the same Act.
(2) The Corporation may select
medical institutions to be
evaluated from among the industrial accident insurance-related
medical institutions subject to evaluation
pursuant to paragraph
(1) after taking into consideration their manpower, facilities,
size, outcomes of medical treatment for workers
suffering from
a work-related accident, amount of medical expenses claimed,
results, etc., of previous evaluations regarding medical
care
benefits, etc.
Article 47 (Method, etc., of Evaluating Industrial Accident
Insurance-related Medical Institutions)
(1) The method of the evaluation of industrial accident
insurance-related medical institutions under Article 50 of the Act
shall
be either on-site evaluation or written evaluation. In this
case, industrial accident insurance-related medical institutions
selected
for on-site evaluation shall be so notified in advance.
(2) The evaluation criteria for industrial accident
insurance-related medical
institutions are as follows:
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1. Manpower, facilities and equipment;
2. Content and level of medical service;
3. Satisfaction levels of workers who have received medical
care
4. Outcomes of medical treatment for workers suffering from
a work-related accident; and
5. Other matters concerning the quality of medical care for
workers suffering from a work-related accident
(3) Details necessary for the evaluation under paragraph (2)
shall be determined by the Corporation.
Article 48 (Requirements and Procedures for Additional Medical
Care)
(1) The additional medical care (hereinafter referred to as
"additional medical care") under Article 51 of the Act shall be
provided
in cases where a person has received medical care
benefits (or disability benefits in the case of injuries or diseases
for which
disability benefits not medical care benefits have been
received) for a work-related injury or disease and satisfy all of
the following
requirements :
1. There is causal relations between the work-related injury
or disease cured and the injury or disease subject to additional
medical
care;
2. The state of the injury or disease subject to additional
medical care has deteriorated compared with when the person
was cured
and the deterioration is not due to age or other
reasons unrelated to work;
3. Active treatments, such as surgical operations (including
operations to remove a fixed object from the body or
reoperations on
mutilated parts in order to attach artificial
limbs), are deemed necessary for improving the state of the
injury or disease subject
to additional medical care; and
4. The injury or disease subject to additional medical care
should be expected to be able to be treated by the additional
medical
care
(2) A person who intends to receive additional medical care
shall apply for additional medical care to the Corporation under
the
conditions prescribed by the Ordinance of the Ministry of
Labor.
SECTION 4
Wage Replacement Benefits
- 24 -
Article 49 (Requirements for Payment of Partial Wage
Replacement Benefits)
A person who intends to receive the partial wage
replacement benefits referred to in Article 53 of the Act shall
meet all of the following requirements:
1. While receiving medical care, the person should be
employed in a fixed business, be engaged in a fixed job and
has fixed working
hours; and
2. There should be a doctor's opinion that even the
worker's employment will neither delay the cure of, nor
aggravate, his/her injury
and disease.
Article 50 (Procedures for Payment of Partial Wage Replacement
Benefits)
(1) A person who intends to receive partial wage
replacement benefits shall file the claim with the Corporation
with the documents prescribed by the Ordinance of the Ministry
of
Labor attached thereto.
(2) Upon receipt of the claim referred to in paragraph (1),
the Corporation shall decide whether to make that payment
after taking
into consideration the worker's state of injury or
disease, work, working hours, etc., and inform the worker of
the decision.
Article 51 (Grace Period Before Payment of Wage Replacement
Benefits in Reduced Amount for the Aged)
"The period prescribed by the Presidential Decree" in the
proviso of Article 55 of the Act refers to two years after the
start
of medical care due to a work-related accident.
Article 52 (Date of Occurrence of Reasons for Calculating Average
Wage Due to Additional
Medical Care)
"The date of the occurrence of reasons for calculating the
average wage" in the latter part of Article 56 (1) of the Act
refers
to any of the following days:
1. The day when the injury or disease subject to additional
medical care is diagnosed as requiring additional medical care:
Provided
that if there is time or medical continuity between the
diagnosis and the examination or treatment of the injury or
disease subject
to additional medical care prior to the diagnosis,
the start day of the examination or treatment; or
2. In the case of diseases for which whether or not they are
subject to additional medical care should be judged following
- 25
-
the procedures prescribed by the Ordinance of the Ministry of
Labor because of the characteristics of the diseases, the date of
issuance on the medical certificate or medical opinion available
at the time of applying for such judgment
SECTION 5
Disability Benefits
Article 53 (Criteria, etc., for Disability Grades)
(1) The criteria for disability grades referred to in Article 57
(2) of the
Act shall be governed by Table 6. In this case,
detailed criteria, etc., for the judgement of disability grades by
body part shall
be prescribed by the Ordinance of the Ministry
of Labor.
(2) If there are two or more disabilities falling under the
criteria for disability grades as prescribed in Table 6, the
disability
grade of the worker concerned shall be that of the
more severe disability, and if there are two or more disabilities
falling under
grade 13 or higher, the disability grade of the
worker concerned shall be the one adjusted according to the
following subparagraphs:
Provided that if the disability grade is
arithmetically higher than grade 1 as a result of the
adjustment, grade 1 shall be the
disability grade of the worker
concerned, and if the degree of the disability is deemed
obviously lower than the degree of the
other disabilities set
forth for the adjusted grade, the grade just below the adjusted
grade shall be the disability grade of the
worker concerned:
1. If there are two or more disabilities falling under grade 5
or higher, the grade shall be adjusted upwards by three;
2. If there are two or more disabilities falling under grade 8
or higher, the grade shall be adjusted upwards by two;
and
3. If there are two or more disabilities falling under grade
13 or higher, the grade shall be adjusted upwards by
one.
(3) If there is a disability not prescribed in Table 6, the grade
of a similar disability shall be the grade of the disability.
(4) If a person, who already has a disability, has
disabilities in the same body part aggravated due to a
work-related injury
or disease, the amount of disability benefits
shall be the one calculated on the basis of the number of
- 26 -
payment days for lump-sum disability compensation or
disability compensation annuities by grade of disability as
shown in Table
2 in accordance with the following
subparagraphs :
1. When the benefits are paid in the form of lump-sum
disability compensation : the number of payment days
for lump-sum disability
compensation corresponding to
the aggravated disability minus the number of payment
days for lump-sum disability compensation corresponding
to the existing disability and then multiplied by the
amount of average wage at the time when the reason for
claiming the payment
of the benefits occurs; or
2. When the benefits are paid in the form of disability
compensation annuities: the number of payment days for
disability compensation
annuities corresponding to the
aggravated disability minus the number of payment days
for disability compensation annuities corresponding
to the
existing disability (if the existing disability is a disability
falling under grades 8 through 14, the number of payment
days for lump-sum disability compensation corresponding
to such disability multiplied by 22.2/100) and then
multiplied by the
amount of average wage at the time of
the payment of the annuities.
(5) "The disability grades prescribed by the Presidential Decree,
which are characterized as a complete loss of work ability" in
the
proviso of Article 57 (4) of the Act refer to disability grades 1
to 3 as set forth in Table 6.
(6) A person who intends to receive a lump sum payment
pursuant to Article 47 (5) of the Act shall make the claim with
the Corporation.
Article 54 (Interest Rate for Disability Compensation Annuities
Paid in Advance)
If disability compensation annuities are paid in advance
pursuant to Article 57 (4) of the Act, the payment shall be
made after
subtracting 2/100 of the annuities to be paid in
advance.
Article 55 (Persons Subject to Redetermination of Disability
Grades)
(1) Those subject to the redetermination of disability grades
pursuant to Article 59 (3) of the Act shall be persons entitled to
disability compensation annuities, who fall under any of the
- 27 -
following subparagraphs:
1. Where the person has one or more of the disabilities
eligible for disability compensation annuities, which fall under
grades
1-3, 2-5, 3-3, 5-8, 7-4, 9-15 or 12-15 set forth in Table 6;
2. Where the person has one or more of the disabilities
eligible for disability compensation annuities, which fall under
grades
6-5, 7-14, 8-2, 9-17, 10-8, 11-7 or 12-16 set forth in Table
6 (limited to cases where the disability grade is determined
based
on spinal nerve root disorder);
3. Where the person has one or more of the disabilities
eligible for disability compensation annuities, which fall under
grades
1-6, 1-8, 4-6, 5-4, 5-5, 6-6, 6-7, 7-7, 7-11, 8-4, 8-6, 8-7,
9-11, 9-13, 10-10, 10-13, 10-14, 11-9, 11-10, 12-9, 12-10, 12-12,
12-14, 13-8 or 13-11 set forth in Table 6 (limited to cases where
the disability grade is determined based on the motor functions
of body joints);
4. Where the person is left with any of the disabilities
(limited to disabilities related to pneumoconiosis) eligible for
disability
compensation annuities, which fall under grades 3-6,
5-9 or 7-15 set forth in Table 6 ; or
5. Where the person has disabilities referred to in Article 53
(3), which are eligible for disability compensation annuities and
include one or more of the disabilities prescribed in
subparagraphs 1 through 3
(2) Notwithstanding the provision of paragraph (1), if the
final disability grade of a person entitled to disability
compensation
annuities has not changed because of his/her
other disabilities even though the grades of some of his/her
disabilities have changed
pursuant to subparagraphs of
paragraph (1), he/she shall be excluded from those subject to
the redetermination of disability grades.
Article 55 (Period, etc., for Redetermination of Disability Grades)
(1) The redetermination of disability grades under Article 59
of the Act shall be made within one year after two years have
passed since the day when the decision to pay disability
compensation
annuities was made.
(2) Notwithstanding the provision of paragraph (1), if a
person subject to the redetermination of disability grades
receives additional
medical care, the redetermination shall be
made within one year after two years have passed since the
day when he/she was cured
after the additional medical care
(in case his/her disability grade has changed, the day when the
- 28 -
decision to pay disability compensation annuities according to
that change was made).
(3) If the Corporation intends to redetermine a disability
grade pursuant to paragraphs (1) or (2), it shall demand the
person
subject to the redetermination to undergo the medical
examination under Article 117 (1) 2.
(4) A person who intends to have his/her disability grade
redetermined pursuant to Article 59 (1) of the Act shall make
the application
to the Corporation under the conditions
prescribed by the Ordinance of the Ministry of Labor.
(5) If the Corporation intends to
redetermine a disability
grade, it shall inform the worker concerned of the industrial
accident insurance-related medical institution
which will examine
the degree of disability, the date of medical examination or
other matters necessary for the redetermination
at least 30 days
before the date of the medical examination.
Article 57 (Method of Payment of Disability Benefits According
to Redetermination of Disability Grades)
(1) If a person files a claim for disability compensation
annuities as his/her disability grade has changed as a result of
the
redetermination of disability grades pursuant to Article 59
of the Act, disability compensation annuities corresponding to
the
changed disability grade shall be paid beginning from the
month following the month in which the date of medical
examination falls.
(2) If a person files a claim for lump-sum disability
compensation as his/her disability grade has changed as a
result of the redetermination
of disability grades pursuant to
Article 59 of the Act, the payment shall be made in accordance
with the following subparagraphs:
1. In case the disability has worsened : the person shall be
paid the number of payment days for lump-sum disability
compensation
corresponding to the changed disability grade
minus the sum of the numbers of days obtained by dividing
the amount of disability
compensation annuities already paid by
each average wage at the time of the payment and then
multiplied by the average wage; or
2. In case the disability has improved (including cases
where the changed disability grade is between grade 8 and
grade 14) : only
when the number of payment days for
lump-sum disability compensation corresponding to the changed
disability grade is larger than
the sum of the numbers of days
- 29 -
obtained by dividing the amount of disability compensation
annuities already paid by each average wages at the time of the
payment,
shall the person be paid the amount of average wage
multiplied by the difference in the number of days.
(3) In the case of paying
disability compensation annuities
pursuant to paragraph (1), Article 57 (4) of the Act shall not
apply.
Article 58 (Disability Benefits After Additional Medical Care)
(1) If a person who has received disability compensation
annuities
files a claim for disability compensation annuities as
his/her disability grade has changed after receiving additional
medical
care, disability compensation annuities corresponding to
the changed disability grade shall be paid beginning from the
month following
the month in which the day he/she was cured
after additional medical care falls.
(2) If a person who has received disability compensation
annuities files a claim for lump-sum disability compensation as
his/her
disability grade has changed after receiving additional
medical care, the payment shall be made in accordance with the
following
subparagraphs :
1. In case where the disability has worsened : the person
shall be paid the number of payment days for lump-sum
disability compensation
corresponding to the changed disability
grade minus the sum of the numbers of days obtained by
dividing the amount of disability
compensation annuities already
paid by each average wage at the time of the payment and
then multiplied by the average wage; or
2. In case where the disability has improved (including
cases where the changed disability grade is between grade 8
and grade 14)
: only when the number of payment days for
lump-sum disability compensation corresponding to the changed
disability grade is larger
than the sum of the numbers of days
obtained by dividing the amount of disability compensation
annuities already paid by each average
wages at the time of the
payment, shall the person be paid the amount of average wage
multiplied by the difference in the number
of days
(3) If a person who has received lump-sum disability
compensation has his/her disability worsened compared with
before
after additional medical care, the disability benefits shall
be paid according to the following methods:
1. In case where he/she files a claim for the payment in the
form of disability compensation annuities : disability
- 30 -
compensation annuities corresponding to the changed disability
grade shall be paid beginning from the month following the
month
in which the day he/she was cured after additional
medical care falls, but he/she shall not be paid the amount of
disability compensation
annuities corresponding to the number
of days for which the lump-sum disability compensation has
been paid;
2. In case where he/she files a claim for the payment in the
form of lump-sum disability compensation : he/she shall be
paid the
number of payment days for lump-sum disability
compensation corresponding to the changed disability grade
minus the number of payment
days for lump-sum disability
compensation corresponding to the previous disability grade and
then multiplied by the average wage.
(4) The average wage used to calculate disability benefits
after additional medical care shall be the amount obtained by
increasing
or decreasing the average wage (the average wage at
the time of the termination of the previous medical care in case
disability
benefits have not been received before) used to
calculate the previous disability benefits pursuant to Article 22.
(5) In the case
of paying disability compensation annuities
after additional medical care, Article 57 (4) shall not apply :
Provided that this
shall not apply if a person who was
previously ineligible for disability benefits receives disability
compensation annuities after
additional medical care.
SECTION 6
Nursing Benefits
Article 59 (Payment Standard and Method of Nursing Benefits)
(1) Those eligible for the nursing benefits referred to in
Article
61 (1) of the Act are shown in Table 7.
(2) Nursing benefits shall be paid for days during which a
person eligible for nursing benefits pursuant to paragraph (1)
actually
receives nursing care.
(3) The standard amount of nursing benefits shall be the
one announced by the Minister of Labor on the basis of total
monthly wages,
etc., by occupation according to the survey on
labor conditions by type of employment prepared by the
Minister of Labor among the
designated statistics referred to in
Article 3 of the Statistics Act. In this case, the amount of
- 31 -
nursing benefits to be paid to those eligible for occasional
nursing benefits shall be two thirds of the amount to be paid
to those
eligible for permanent nursing benefits.
(4) Notwithstanding the provision of paragraph (1), a person
eligible for nursing benefits
spends no nursing expenses as
he/she enters a free-of-charge nursing home, etc., or spends less
than the standard amount under
paragraph (3), the amount
actually spent shall be paid as his/her nursing benefits.
(5) If a person entitled to nursing benefits
receives
additional medical care pursuant to Article 51 of the Act,
nursing benefits shall not be paid during the additional medical
care.
(6) The method of claiming nursing benefits shall be
prescribed by the Ordinance of the Ministry of Labor.
SECTION 7
Survivors Benefits
Article 60 (Appointment, etc., of Representative for Claiming
Survivors' Compensation Annuity)
(1) If there are two or more persons entitled to a survivorsßÓ
compensation annuity, one of them may be appointed as a
representative
to claim and receive the survivorsßÓcompensation
annuity.
(2) If a representative is appointed under paragraph (1), or
the appointed representative is dismissed, it shall be reported
without
delay to the Corporation together with documents to attest
such appointment or dismissal.
Article 61 (Scope of Surviving Family Members Supported by
Worker)
(1) "The surviving family members whose livelihood was
supported by the worker" in Article 63 (1) of the Act refer to
persons falling
under any of the following subparagraphs :
1. A surviving family member who is described as having
lived with the worker in the same household in the resident
registration
index book under the Resident Registration Act
and all or substantial part of whose livelihood was maintained
by the worker's incomes;
2. A surviving family member all or substantial part of
whose livelihood was maintained by the worker's incomes but
who is registered
as having resided in a different household
- 32 -
from, or did not live with, the worker due to study,
employment, medical care and other residential circumstances;
3. Surviving family members other than those referred to in
paragraphs (1) and (2), all or most part of whose livelihood
was maintained
with the help of money and other valuable
goods or economic support regularly provided by the worker
Article 62 (Suspension, etc.,
of Payment of Survivors Compensation
Annuity)
(1) In case the right to receive a survivorsßÓcompensation
annuity has been transferred pursuant to Article 64 (2) of the
Act,
a person who intends to newly receive a survivorsßÓ
compensation annuity shall file with the Corporation for a
change of the person
entitled to survivors' compensation
annuities.
(2) In case a person entitled to a survivorsßÓcompensation
annuity has been missing for three months or more pursuant to
Article
64 (3) of the Act, the payment of the annuity to that
missing person shall be suspended at the request of a person
(in case no
such person exists, the person next in the order)
at the same priority level in the order as the entitled person for
the period
of disappearance starting from the month following
the month in which the entitled person went missing and the
amount calculated
in accordance with Article 62 (2) and Table 3
of the Act shall be paid as a survivors' compensation annuity.
In this case, the
missing person previously entitled to survivorsßÓ
compensation annuity shall not be regarded as those entitled to
survivorsßÓcompensation
annuity, to whom additional payment
referred to in Article 62 (2) and Table 3 of the Act applies.
(4) A person for whom the payment
of a survivorsßÓ
compensation annuity is suspended pursuant to paragraph (2)
may apply any time for the nullification of the suspension.
Article 63 (Adjustment of Survivors' Compensation Annuity)
If there occur the causes described in the following
subparagraphs,
the Corporation may adjust, at the request of a
person entitled to survivorsßÓcompensation annuities or by
virtue of its authority,
the amount of survivorsßÓcompensation
annuities for months following the month in which those causes
occur :
1. Where a child who was a fetus at the time of the
workerßÓs death is born;
2. Where the suspension of payment is lifted under Article
62 (3)
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3. Where the person entitled to survivorsßÓcompensation
annuities is disqualified under Article 64 (1); and
4. Where the person entitled to survivorsßÓcompensation
annuities is missing
SECTION 8
Injury-Disease Compensation Annuities
Article 64 (Payment, etc., of Injury-Disease Compensation
Annuities)
(1) A person who intends to receive an injury-disease
compensation annuity as prescribed in Articles 66 through 69 of
the Act shall
file a claim with the Corporation for injury-disease
compensation annuity, together with a medical certificate issued
by a doctor,
which can attest to his/her state of invalidity.
(2) If the invalidity grade of a worker receiving an injury-
disease compensation
annuity has changed, the Corporation
may pay, at the request of the entitled person or by virtue
of its authority, injury-disease
compensation annuities based
on the new invalidity grade starting from the month following
the month in which such a change has
taken place.
(3) When a worker receiving injury-disease compensation
annuities files a claim for injury-disease compensation annuities
due to a change of his/her invalidity grade under paragraph
(2), he/she shall attach a medical certificate issued by a doctor,
which can attest to his/her state of invalidity.
Article 65 (Criteria, etc., for Invalidity Grades)
(1) The criteria for invalidity grades based on which
injury-disease compensation
annuities are paid pursuant to
Articles 66 through 69 of the Act are shown in Table 8.
(2) With regard to the adjustment of invalidity
grades in
case there are two invalidities or more, the provision of Article
53 (2) shall apply mutatis mutandis. In this case,
"disability
grades" shall be read as "invalidity grades" and "disability" as
"invalidity" and the disability grades 4 to 14 set
forth in Table
6 shall be regarded as respective corresponding invalidity
grades.
(3) If an existing invalidity is aggravated due to a new
work-related injury or disease, the amount of injury-disease
compensation
annuity for the aggravated invalidity grade shall
be calculated by subtracting the number of payment days for
- 34 -
injury-disease compensation annuities corresponding to the
existing validity grade from the number of payment days for
injury-disease
compensation annuities corresponding to the
aggravated validity grade and then multiplying the resulting
number by the average
wage at the time of the payment of the
annuity.
SECTION 9
Funeral Expenses
Article 66 (Calculation of Maximum and Minimum Funeral Expenses)
(1) The maximum and minimum amounts of funeral expenses
prescribed
in Article 71 (2) of the Act shall be calculated in
accordance to the following subparagraphs:
1. Maximum amount of funeral expenses : 90 days of the
average funeral expenses per person paid to a person
entitled to funeral
expenses in the previous year + 30 days of
the maximum standard amount of compensation under Article
36 (7) of the Act; and
2. Minimum amount of funeral expenses : 90 days of the
average funeral expenses per person paid to a person
entitled to funeral
expenses in the previous year + 30 days of
the minimum standard amount of compensation under Article
36 (7) of the Act
(2) In calculating the maximum and minimum amounts of
funeral expenses, amounts less than ten Won shall be rounded
off.
(3) The application period for the maximum and minimum
amounts of funeral expenses shall be from January 1 to
December 31 of the
following year.
SECTION 10
Vocational Rehabilitation Benefits
Article 67 (Support for Vocational Rehabilitation)
(1) For the vocational rehabilitation of a person suffering
from a work-related
accident, the Corporation may provide
psychological counseling, information necessary for vocational
rehabilitation, vocational
assessment in consideration of the
worker's vocational desire, skills, etc., assistance in establishing
- 35 -
a plan to return to work or other necessary supports while or
after the worker receives medical care.
(2) The Corporation may ask for cooperation in counseling,
assessment or other areas from a person suffering from a
work-related
accident, if such cooperation is needed for providing
the support for vocational rehabilitation referred to in paragraph
(1).
Article 68 (Persons Eligible for Vocational Rehabilitation Benefits)
(1) The training targets (hereinafter referred to as "training
targets") referred to in Article 72 (1) 1 of the Act shall be those
who meet all of the following requirements :
1. The person should fall under any of disability grades 1
to 9;
2. The person should be aged under 60 when applying for
vocational training;
3. The person should be unemployed. In this case, the scope
of unemployment shall be defined by the Ordinance of the
Ministry of
Labor;
4. The person is not receiving any other vocational training;
and
5. The person has established a plan to return to work
pursuant to Article 67 (1).
(2) Notwithstanding the provisions of paragraph (1) 3, if a
training target who is receiving vocational training is employed
during
the vocational training period, he/she may be allowed
to receive the vocational training until it ends, but shall not be
paid vocational
training allowances for the period of
employment.
(3) If the training target referred to in paragraph (1) receives
job-seeking benefits under the Employment Insurance Act or
wage
replacement benefits under this Act during his/her
vocational training period, he/she may be allowed to receive
the vocational
training, but shall not be paid vocational training
allowances.
(4) The recipients of disability benefits (hereinafter referred
to as "recipients of disability benefits) referred to in Article
72
(1) 2 of the Act shall be those who are left with a disability
falling under any of disability grades 1 to 9 when they return
to the work concerned.
Article 69 (Restrictions on Payment of Vocational Training Costs)
(1) "Such cases as prescribed by the Presidential Decree" in
the proviso of Article 73 (2) of the Act refer to cases where a
vocational training institution falls under any of the following
subpargraphs with regard to vocational training for the training
- 36 -
target concerned:
1. Where it has received support for job adaptation training
pursuant to Article 11 of the Act on Employment Promotion
and Vocational
Rehabilitation for the Disabled and support for
vocational skills development training pursuant to Article 12 of
the same Act;
2. Where it has received support for vocational skills
development training pursuant to Article 29 of the Employment
Insurance Act;
3. Where it has received support for vocational skills
development training pursuant to Articles 12 through 15, 18 and
21 of the
Workers Vocational Skills Development Act;
4. Where the employer who intends to employ the training
target has borne the vocational training costs; or
5. Where it has received support equivalent to the
vocational training costs under other Acts or subordinate
statutes
Article 70 (Requirements for Payment of Return-to-work Subsidy, etc.)
(1) The return-to-work subsidy referred to in Article 75 (2)
of the Act shall be paid if an employer has retained a recipient
of disability benefits for not less than six months since the
termination of the medical care and paid resulting wages :
Provided that if the recipient of disability benefits voluntarily
retires
less than six months after the termination of the medical
care, the return-to-work subsidy until the retirement day shall
be paid.
(2) The work adaption training costs and rehabilitation
exercise costs referred to in Article 75 (3) of the Act shall be
paid if
an employer has provided work adaption training or
rehabilitation exercise programs necessary for a recipient of
disability benefits
to perform his/her duties or switch to other
duties and meets all of the following requirements :
1. The employer started the work adaptation training or
rehabilitation exercise programs within six months after the
termination
of the medical care;
2. The employer has retained the worker for six months or
more after the end of the work adaptation training or
rehabilitation exercise
programs : Provided that this shall not
apply if the recipient of disability benefits voluntarily retires
less than six months
after the end of the work adaptation
training or rehabilitation exercise programs
Article 71 (Restrictions on Payment of Return-to-work Subsidy, etc.)
(1) "Such cases as prescribed by the Presidential Decree" in
- 37 -
Article 75 (4) of the Act refer to cases where an employer
employing a recipient of disability benefits fall under any of the
following
subparagraphs:
1. Where he/she has received support under Articles 23, 27
and 32 of the Employment Insurance Act;
2. Where he/she has received employment subsidy under
Article 30 of the Act on Employment Promotion and Vocational
Rehabilitation
for the Disabled;
3. Where he/she has received support under Article 20 (1)
of the Workers Vocational Skills Development Act;
4. Where in the three months before or six months after a
recipient of disability benefits returns to work, he/she makes
another
recipient of disability benefits or a disabled person
prescribed by the Act on Employment Promotion and
Vocational Rehabilitation
for the Disabled retire from the
business for the purpose of getting return-to-work subsidy;
5. Where he/she employs a disabled person required to be
employed pursuant to Article 28 of the Act on Employment
Promotion and
Vocational Rehabilitation for the Disabled
(limited to return-to-work subsidy); or
6. Where he/she has received support equivalent to the
return-to-work subsidy, work adaptation training costs or
rehabilitation
exercise costs under other Acts or subordinate
statues
SECTION 11
Lump-sum Payment, etc. of Insurance Benefits
Article 72 (Criteria for Lump-sum Payment of Insurance Benefits)
"Each amount converted according to the methods prescribed
by
the Presidential Decree" in Article 76 (2) of the Act refers to
the amount of insurance benefits referred to in each
subparagraph
of the same paragraph minus 2/100 of that
amount. In this case, the amount of injury-disease compensation
annuity shall be the
amount of lump-sum disability
compensation for the disability grade corresponding to the
invalidity grade and the amount of disability
compensation
annuity shall be the amount of lump-sum disability
compensation for the disability grade.
Article 73 (Criteria, etc., for Payment of Special Disability Benefits)
(1) "The grades of disability prescribed by the Presidential
Decree" in Article 78 (1) of the Act refer to disability grades 1
to 3 as prescribed in Table 6.
- 38 -
(2) "The special disability benefits as prescribed by the
Presidential Decreeß×in Article 78 (1) of the Act refer to the
amount
calculated by subtracting the lump sum disability
compensation referred to in Article 57 of the Act from the
amount calculated
by multiplying 30 days of average wages by
the rate of work ability loss for each disability grade shown in
Table 5 and by Leibniz's
coefficient corresponding to the period
to be employed as prescribed in Table 11.
(3) The period to be employed in the future under paragraph
(2) shall be from the date of the determination of disability
grade
to the day when the person reaches the mandatory
retirement age set by the collective agreements or the
employment rules. In this
case, if the collective agreements or
the employment rules do not provide for a mandatory
retirement age, sixty years of age shall
be considered as the
mandatory retirement age.
Article 74 (Criteria, etc., for Payment of Special Survivors' Benefits)
(1) "The special survivorsßÓbenefits prescribed by the
Presidential Decreeß×in Article 79 (1) of the Act refer to the
amount obtained by subtracting the living costs (the amount
calculated
by multiplying 30 days of his/her average wages by
the rate of living costs as set forth in Table 6) of the deceased
person from
30 days of his/her average wages and then
subtracting the lump sum survivorsßÓcompensation referred to in
Article 62 of the Act
from the resulting amount multiplied by
Leibniz's coefficient corresponding to the number of months to
be employed as set forth
in Table 11.
(2) The provisions of Article 73 (3) shall apply mutatis
mutandis to the calculation of the period to be employed as
referred to
in paragraph (1). In this case, "the date of the
determination of disability grade" shall be read as "the date of
death".
Article 75 (Collection of Special Benefits)
(1) An insurance subscriber may, upon receiving a payment
notice on special disability benefits or special survivorsßÓbenefits
pursuant to Articles 78 (3) and 79 (2) of the Act, pay them in
four equal installments over the course of one year.
(2) If special
disability benefits or special survivorsßÓbenefits
are paid in installments pursuant to paragraph (1), the first
installment shall
be paid by the end of the quarter in which
the payment thereof is notified, and thereafter the
- 39 -
remaining installments by the end of respective quarters.
- 40 -
Article 76 (Criteria for Adjustment to Other Compensation or
Indemnity)
(1) The ßÖamount calculated by converting the money and
valuable goods received according to the method as prescribed
by the Presidential
Decree" in the text of Article 80 (3) of the
Act means the amount of insurance benefits corresponding to
the number of days obtained
by dividing the received money
and valuable goods by the average wages at the time of the
calculation of the damages : Provided
that if the received money
and valuable goods are medical care, the amount shall be the
one spent for the medical care.
(2) In the application of the provisions of paragraph (1), if
the insurance benefits to be paid to an entitled person are
survivorsßÓcompensation
annuities or wage replacement benefits, the
number of days obtained by dividing the survivorsßÓ
compensation annuities or wage
replacement benefits by the
average wages (the minimum wage in the case of the wage
replacement benefits referred to in Article
54 (2) and 56 (2) of
the Act) at the time of the calculation of the insurance benefits
concerned shall be considered as the number
of payment days
for the insurance benefits and the average wages as the daily
amount of the insurance benefits.
Article 77 (Decision, etc., on Person With Right to Claim Unpaid
Insurance Benefits)
The provisions of Article 65 (1), (2) and (4) shall apply
mutatis mutandis to decisions on a person with the right to
claim any
unpaid insurance benefits as prescribed in Article 81
of the Act.
Article 78 (Scope, etc., of Restrictions on Payment of Insurance
Benefits)
(1) If a person entitled to insurance benefits falls under
Article 83 (1) 1 of the Act, the Corporation shall not pay
him/her an
amount equivalent to 20 days (if the period until
the occurrence of reasons for the payment is less than 20 days,
that period)
of the wage replacement benefits or injury-disease
compensation annuities whose reason for payment occurs after
the decision to
restrict the payment of insurance benefits has
been made.
(2) If a person entitled to injury-disease compensation
annuities falls under Article 83 (1) 2 of the Act, the Corporation
shall
pay his/her disability benefits in accordance with the
following subparagraphs:
- 41 -
1. If the state of disability has worsened compared with the
previous disability grade, the Corporation shall pay disability
compensation
annuities corresponding to the previous disability
grade; or
2. If it was confirmed by medical opinions, etc., that the
state of disability had improved compared with the previous
disability
grade but the state of disability has worsened before
the redetermination of disability grades, the Corporation shall
pay disability
benefits corresponding to the improved disability
grade.
Article 79 (Collection of Undue Gains)
(1) When the Corporation has decided to collect any undue
gains as prescribed in Article 84 of the Act, it shall notify
without
delay the person liable for the payment that he/she
should pay such amount.
(2) The person who receives the notification under paragraph
(1) shall pay the amount within thirty days after receiving the
notification.
Article 80 (Limit to and Procedure for Appropriation of Insurance
Benefits, etc.)
(1) When the Corporation appropriates insurance benefits,
medical expenses and medicine expenses pursuant to Article 86
of the
Act, the maximum appropriation limit shall be as follows
:
1. If there are any insurance benefits to be paid to a person
who has taken undue gains pursuant to Article 84 (1) of the
Act, the
maximum appropriation limit shall be 1/10 of the
insurance benefits to be paid : Provided that if the person
entitled to the insurance
benefits agrees in writing to have
more than 1/10 of the insurance benefits appropriated, under
the conditions prescribed by the
Ordinance of the Ministry of
Labor, it shall be the agreed amount;
2. If a person who has taken undue gains pursuant to
Article 84 (1) of the Act or a person held jointly responsible
pursuant to
paragraph (2) of the same Article is an insurance
subscriber, the maximum appropriation limit shall be the
amount of insurance
benefits (including the subrogated amount,
in case the insurance subscriber has subrogated the right to
receive insurance benefits
pursuant to Article 89 of the Act) to
be paid to the insurance subscriber;
3. If there is any medical expenses to be paid to an
industrial accident insurance-related medical institution held
- 42 -
jointly responsible pursuant to Article 84 (2) of the Act, the
maximum appropriation limit shall be an amount equivalent to
the
medical expenses; or
4. If there are any medical expenses or medicine expenses
to be paid to an industrial accident insurance-related medical
institution
or a pharmacy which has taken undue gains
pursuant to Article 84 (3) of the Act, the maximum
appropriation limit shall be an amount
equivalent to the
medical expenses or medicine expenses
(2) If the Corporation intends to make an appropriation
pursuant to paragraph (1), it shall hear opinions from the person
entitled
to insurance benefits, insurance subscriber, industrial
accident insurance-related medical institution or pharmacy and
once it
has decided to appropriate, shall inform without delay
the person entitled to insurance benefits, insurance subscriber,
industrial
accident insurance-related medical institution or
pharmacy of this.
Article 81 (Adjustment of Insurance Benefits for Person Receiving
Damages from Third Person)
If a person entitled to insurance benefits receives
damages from a third person, the provisions of Article 76 shall
apply mutatis
mutandis with regard to the method of
converting the damages into an amount in which insurance
benefits are not paid pursuant to
the proviso of Article 87 (2)
of the Act.
Article 82 (Exercise by Proxy of Right to Benefits)
(1) If an insurance subscriber (including subcontractors
referred to in subparagraph
5 of Article 2 of the Insurance
Premium Collection Act; hereinafter in this Article, the same
shall apply) intends to receive insurance
benefits by exercising
by proxy the right of a person entitled to insurance benefits
pursuant to Article 89 of the Act, he/she
shall file the claim
with the Corporation, together with documents certifying the
fact that he/she has paid the entitled person
money or other
valuable goods equivalent to the insurance benefits for the same
cause as insurance benefits should be paid under
the Act.
(2) If an insurance subscriber files a claim to receive
insurance benefits by exercising by proxy the right pursuant to
paragraph (1), the Corporation shall check whether the person
entitled to the insurance benefits has received money or
other valuable
goods equivalent to the amount of insurance
- 43 -
benefits concerned.
(3) If an insurance subscriber has provided a person entitled
to insurance benefits with money or other valuable goods
equivalent
to his/her disability benefits or survivors' benefits
pursuant to Article 89 of the Act, he/she shall be considered to
have been
provided money or other valuable goods equivalent
to the lump sum disability compensation or lump sum survivorsßÓ
compensation.
- 44 -
Article 83 (Preparation of Benefit Ledger)
(1) The Corporation shall, when paying insurance benefits,
prepare and keep a benefit ledger by worker who has received
the benefits.
(2) The Corporation shall, at the request of a person related
to insurance benefits, allow him/her to inspect the benefit
ledger
and if necessary, may issue a certificate.
CHAPTER IV
Labor Welfare Project
Article 84 (Persons Eligible for Loans for Individual Co-payment
of Medical Care Benefit Costs under National Health Insurance)
(1) "The persons prescribed by the Presidential Decree" in
Article 93 (1) refer to those who meet all of the following
requirements:
1. The Corporation has not take a decision on medical care
benefits until after thirty days have passed since the day the
worker
applied for the medical care benefits pursuant to Article
41 (1) of the Act; and
2. There should be a medical opinion that a causal
relationship is presumed to exist between the worker's job and
disease in relation
to which the worker applies for medical care
benefits
Article 85 (Maximum Limit to and Procedure for Appropriation
for Loans)
(1) When the Corporation makes an appropriation pursuant
to Article 93 (2) of the Act, the maximum appropriation limit
shall be
the full amount of medical care benefits to be paid to
the person provided with the loans.
(2) If the Corporation intends to make an appropriation
pursuant to paragraph (1), it shall hear opinions from the
person entitled
to the medical care benefits and once it has
decided to appropriate, shall inform without delay the person
entitled to the medical
care benefits of this.
CHAPTER V
- 45 -
Industrial Accident Compensation Insurance and
Prevention Fund
Article 86 (Operation of Fund)
(1) "The activities prescribed by the Presidential Decree" in
Article 97 (2) 5 refer to those described in the following
subparagraphs
:
1. Making loans for workers' welfare programs;
2. Buying securities under Article 4 of the Capital Market
and Financial Investment Business Act; and
3. Acquiring and disposing of real estate in order to
increase the Industrial Accident Compensation Insurance
and Prevention Fund
(hereinafter referred to as "the
Fund") under Article 95 of the Act
(2) "The level prescribed by the Presidential Decreeß×in
Article 97 (3) of the Act means the rate of return set by the
Minister
of Labor in consideration of interest rates on regular
savings with maturity of one year in financial institutions
under the Banking
Act, which operate nationwide. In this case,
the Minister of Labor may set a different rate on loans for
workers' welfare programs
as referred to in paragraph (1) from
the rate of return for other businesses after consulting with the
Minister of Strategic Planning
and Finance.
Article 87 (Establishment of Fund Account)
The Minister of Labor shall establish the Fund account with
the Bank of Korea.
Article 88 (Payment, etc. of Premiums, etc. into Fund)
(1) The Corporation shall pay collected insurance
premiums and other charges
into the Fund account.
(2) The Corporation shall report in writing to the Minister
of Labor the amount of collected insurance premiums
and other
charges for the previous month, and the current situation of the
collection of outstanding amounts, etc., by the end
of each
month.
Article 89 (Fund Operation Plan)
The fund operational plan referred to in Article 98 of the Act
shall include matters described in the following subparagraphs :
1. Matters concerning the revenues and expenditures of the
Fund;
- 46 -
2. Matters concerning the business plans, plans on action causing
expenditures and funding plans for the year concerned;
3. Matters concerning the settlement of funds carried over
from the pervious year;
4. Matters concerning the legal liability reserve; and
5. Other matters necessary for the operation of the Fund.
Article 90 (Base Amount for Calculation of Legal Liability
Reserve)
The base amount for calculating the legal liability reserve as
prescribed in Article 99 (3) of the Act shall be the sum of all
insurance benefits determined to be paid from January 1 to
December 31 of the previous year as of December 31 of each
year.
Article 91 (Accounting Organization, etc., of Fund)
(1) The Minister of Labor shall appoint a Fund revenue
collector, Fund financial
officer, Fund expenditure officer and
Fund accounting officer from among the public officials under
his/her control to carry out
affairs concerning the revenues and
expenditures of the Fund.
(2) The Corporation or the president of the Korea Occupational
Health and Safety Agency under the Korea Occupational Health
and
Safety Agency Act may, if entrusted with affairs concerning
the management and operation of the Fund under Article 97 (5)
of the
Act, appoint a director in charge of Fund revenues and a
director in charge of actions causing expenditures from among
the standing
directors and a Fund expenditure employee and
Fund cashier from among the employees, and shall report this
to the Minister of Labor.
In this case, the director in charge of
Fund revenues shall perform the duties of the Fund revenue
collector, the director in charge
of actions causing expenditures
those of the Fund financial officer, the Fund expenditure
employee those of the Fund expenditure
officer, and the Fund
cashier those of the Fund accounting officer.
(3) The Minister of Labor shall notify the Chairman of the
Board of Audit and Inspection and the governor of the Bank of
Korea
of the appointment of a Fund revenue collector, Fund
financial officer, Fund expenditure officer, Fund accounting
officer, director
in charge of Fund revenues, director in charge
of actions causing expenditures, Fund expenditure employee and
Fund cashier under
paragraphs (1) and (2).
Article 92 (Expenditure-causing Action of Fund)
- 47 -
(1) The Minister of Labor shall allot the monthly expenditure
ceiling of the Fund to the Fund financial officer, and notify the
Fund expenditure officer of this.
(2) The Fund financial officer shall take actions causing expenditures
within the limits of the ceiling alloted under paragraph
(1).
Article 93 (Disbursement of Fund)
(1) When the Fund financial officer has the Fund expenditure
officer disburse money from the Fund, he/she shall send
documents
related to the action causing expenditures to the
Fund expenditure officer.
(2) If the Fund expenditure officer intends to disburse
money from the Fund following the expenditure-causing action
of the Fund
financial officer, he/she shall issue checks whose
payer is the Bank of Korea, a financial institution under the
Bank Act or a
postal service agency.
(3) Any amount not disbursed in the fiscal year for
inevitable reasons after the Fund financial officer takes a
expenditure-causing
action may be carried over to and then
executed in, the following year.
Article 94 (Prohibition of Cash Handling)
The Fund expenditure officer and Fund accounting officer
may not keep, receive or disburse cash : Provided that they
may keep,
receive or disburse cash in the case of the operating
expenses of government agencies prescribed in Article 24 of the
National
Treasury Management Act.
Article 95 (Statement of Fund Accounts)
The Minister of Labor shall prepare the following documents
concerning the settlement of the Fund accounts for each fiscal
year,
and submit them to the Minister of Strategic Planning and
Finance by the end of February in the following fiscal year:
1. State of the settlement of the Fund accounts;
2. Financial statements, such as balance sheet, statement of
profit and loss, etc.;
3. Table of comparison between the fund operation plans
and actual results;
4. Statement of the revenue and expenditures; and
5. Other documents necessary for clarifying the contents of
the settlement of accounts.
CHAPTER VI
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Request for Examination and Re-examination
Article 96 (Formalities of Request for Examination)
(1) The request for examination referred to in Article 103 of
the Act shall
be made using a document (hereinafter referred
to as ßÖwritten request for examinationß×) specifying the
following matters :
1. Name and address of the person making the request for
examination (name and location of the corporation and
name of its representative
in case the person making the
request for examination is a corporation);
2. Details of the decision on insurance benefits referred to in
subparagraphs of Article 103 (1) of the Act, which is
subject to
the request for examination;
3. Date on which the decision on insurance benefits is
known;
4. Purpose of and reasons for the request for examination;
and
5. Whether the request for examination is notified or not,
and the contents of the notification.
(2) If the person making the request for examination is not
the worker suffering from the accident (excluding requests for
examination
filed against the decisions referred to in
subparagraphs 2 and 3 of Article 103 (1) of the Act), the
following matters shall be
specified in the written request for
examination in addition to those as referred to in subparagraphs
of paragraph (1):
1. Name of the worker suffering from the accident; and
2. Name and location of the workplace to which the
worker belonged at the time of the accident.
(3) If a request for examination is made by an appointed
representative or agent, the name and address of the
appointed representative
or agent shall be specified in the
written request in addition to those as referred to in paragraphs
(1) and (2).
(4) A written request for examination shall be signed or
sealed by the requesting person or agent.
Article 97 (Correction and Rejection)
(1) If a request for examination is made after the expiration
of the period prescribed in Article 103 (3) of the Act or violates
the formalities as prescribed by the Act and its subordinate
- 49 -
statutes to the point of being unable to be corrected, or fails to
be corrected within the period as referred to in paragraph (2),
the Corporation shall decide to reject it.
(2) Even though a request for examination may violates the
legal formalities, if it is possible to correct such violation, the
Corporation may demand the person making the request for
examination to correct it within a set period of time: Provided
that if
the matters to be corrected are insignificant, the
Corporation may make that correction by virtue of its authority.
(3) If the
Corporation corrects a request for examination by
virtue of its authority pursuant to the proviso of paragraph (2),
it shall notify
the requesting person of this.
Article 98 (Suspension of Execution of Decision on Insurance
Benefits)
(1) A request for examination shall not suspend the
execution of a decision on the insurance benefits concerned:
Provided that
if it is deemed that there is an urgent necessity
to avoid grave losses to be caused by the execution, the
Corporation may suspend
the execution.
(2) The Corporation shall, upon suspending the execution
under the proviso of paragraph (1), notify this without delay
using a
document to the person making the request for
examination and the affiliate organization of the Corporation
which has made the
decision about the insurance benefits
concerned.
(3) The document referred to in paragraph (2) shall
include the following matters :
1. Title of the case involving the request for examination;
2. Decision, etc., on the insurance benefits subject to the
suspension of execution, and the details of the suspension
of execution;
3. Name and address of the person making the request for
examination; and
4. Reasons for the suspension of execution
Article 99 (Composition of Industrial Accident Compensation
Insurance Examination Committee)
(1) The Industrial Accident Compensation Insurance
Examination Committee (hereinafter referred to as "the
Examination Committee")
referred to in Article 104 (1) of the
Act shall be composed of less than 60 members, including one
chairperson, of which two shall
be permanent members.
(2) The members of the Examination Committee shall be
commissioned or appointed by the president of the Corporation
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from among persons falling under any of the following
subparagraphs:
1. Judges, public prosecutors, defence lawyers or certified
public labor affairs consultants with 5 years or more of
experience;
2. Those who are serving or served as an associate professor
or higher at a college prescribed in Article 2 of the Higher
Education
Act;
3. Those who have been engaged in labor-related services or
industrial accident compensation insurance-related services for 10
year
or more; and
4. Those with plenty of knowledge and experience in social
insurance or industrial medical science
(3) The chairperson of the Examination Committee shall be
appointed by the president of the Corporation from among the
permanent
members.
(4) Two fifths of the members of the Examination
Committee shall be commissioned from among persons falling
under any subparagraph of paragraph (2) and recommended by
workers'
and employers' organizations, respectively. In this case,
equal numbers of members shall be recommended by workers'
and employers'
organizations.
(5) The term of office of a member of the Examination
Committee shall be three years and renewable : Provided that a
member whose
term has expired may perform the duties until
his/her successor is appointed.
(6) Except as provided in this Decree, matters necessary for
the organization of the Examination Committee shall be
determined
by the Corporation.
Article 100 (Operation of Examination Committee)
(1) The chairperson of the Examination Committee shall
convene and chair meetings of the Examination Committee :
Provided that
if it is necessary for the smooth operation of the
Examination Committee, a permanent member may preside over
a meeting of the
Examination Committee on the order of the
chairperson.
(2) A meeting of the Examination Committee shall consist of
the chairperson or a permanent member and six members
designated by
the chairperson each time for its meeting.
(3) A meeting of the Examination Committee shall be
opened with attendance of a majority
of the members referred
to in paragraph (2) and a decision shall be taken with approval
of a majority of the members present.
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(4) If the Corporation makes a decision that has to undergo
deliberation by the Examination Committee, in regard of a
request for
examination, it shall draw up a protocol of review
as regards progress in the deliberation.
(5) With regard to the preparation, inspection, etc., of the
protocol of review under paragraph (4), the provision of Article
110
shall apply mutatis mutandis. In this case, "Reexamination
Committee" shall be read as "Examination Committee" and
"request for
reexamination" as "request for examination".
(6) Members, other than the permanent members and those
working as an officer or employee
of the Corporation, who are
present at a meeting of the Examination Committee, may be
paid allowances and travel expenses within
the limits of the
budget.
(7) Except as provided in this Decree, matters necessary for
the operation of the Examination Committee shall be determined
by
the Corporation.
Article 101 (Method of Decision on Request for Examination)
(1) The decision on a request for examination as prescribed
in Article
105 (1) of the Act shall be made in writing.
(2) The decision as referred to in paragraph (1) shall include
the following matters
:
1. Number and title of the case;
2. Name and address of the person making the request for
examination (name and location of the corporation and
name of its representative
in case the person making the
request for examination is a corporation);
3. If the person making the request for examination is not
the worker suffering from the accident, the name and
address of the affected
worker;
4. Main text;
5. Purpose of the request for examination;
6. Reason; and
7. Date of decision
(3) When the Corporation has made a decision on a request
for examination pursuant to paragraph (1), it shall
send an
original copy of the decision on examination to the person
making the request for examination.
(4) In case where the Corporation makes a decision on
insurance benefits or a request for examination, it shall
inform the other
party or the person making the request for
examination of whether or not he/she can make a request
for examination or reexamination
with regard to the decision on
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insurance benefits or a request for examination, and of the request
procedures and period, if he/she makes the request.
Article
102 (Exclusion from Deliberation by Examination
Committee)
(1) "The reasons prescribed by the Presidential Decree" in
Article 105 (2) of the Act refer to cases where the request for
examination
falls under any of the following subparagraphs:
1. Where the decision on the recognition of work-related
disease has been made after deliberation by the Work-related
Disease Adjudication
Committee under Article 38 of the Act;
2. Where the decision on insurance benefits has been made
in accordance with the procedures prescribed by the Ordinance
of the Ministry
of Labor, such as for the recognition of
pneumoconiosis;
3. Where the request for examination falls under any of the
reasons for rejection referred to in Article 97 (1);
4. Where the request for examination is filed against a
decision on medical expenses or medicine expenses (including
medical expenses
or medicine expenses belonging to the medical
care expenses referred to in the proviso of Article 40 (2) of the
Act; or
5. Other cases where it is clear whether or not the decision,
etc., on insurance benefits subject to the request for examination
is legitimate
(2) Notwithstanding the provision of paragraph (1), if a
request for examination falls under any subparagraph of
paragraph (1),
and the Corporation deems it necessary to make
a decision after deliberation by the Examination Committee, the
decision may be
made after deliberation by the Examination
Committee.
Article 103 (Investigation for Review)
(1) The investigation for review on a request for examination
referred to in Article 105 (4) of the Act shall be requested using
a document specifying the following matters :
1. Title of the case relevant to the request for examination;
2. Purpose of and reasons for the request;
3. Names and addresses of related persons asked to appear
(limited to the case of Article 105 (4) 1 of the Act);
4. Indication of documents and other things required to be
submitted, and the name and address of the owner or
custodian thereof
(limited to the case of Article 105 (4) 2 of
the Act);
5. Matters to be appraised and reasons for the appraisal
- 53 -
(limited to the case of Article 105 (4) 3 of the Act);
6. Names and location of the workplace and other places to
enter, the names and addresses of the employer, workers
and other related
persons to be questioned, and the
indication of the documents and other things to be
inspected (limited to the case of Article
105 (4) 4 of the
Act); and
7. Name and address of the worker who is to undergo a
medical examination (limited to the case of Article 105 (4)
5 of the Act).
(2) If the Corporation has conducted an investigation
pursuant to Article 105 (4) of the Act, it shall prepare a
protocol of review
specifying the following matters. In this case,
if it has had the person making the request for examination or
a related person
make statements pursuant to Article 105 (4) 1
of the Act, it shall make a record of the statements and attach
the record:
1. Number and title of the case;
2. Date, time and place of the investigation;
3. Object and method of the investigation; and
4. Result of the investigation.
Article 104 (Payment of Actual Expenses)
A related person who turns up at a designated place
pursuant to Article 105 (4) 1 of the Act, and an appraiser who
makes an appraisal
pursuant to subparagraph 3 of the same
paragraph shall be paid their actual expenses under the
conditions as prescribed by the
Ordinance of the Ministry of
Labor.
Article 105 (Formalities of Request for Reexamination)
(1) The request for reexamination as prescribed in Article
106 of the Act
shall be made using a document specifying the
following matters :
1. Name and address of the person making the request for
reexamination (name and location of the corporation and
name of its representative
in case the person making the
request for reexamination is a corporation);
2. Details of the decision on insurance benefits subject to the
request for reexamination;
3. Date on which the decision (decision, etc., on insurance
benefits in the case of the request for reexamination
referred to in
the proviso of Article 106 (3) of the Act) on
the request for examination is known;
4. Purpose of and reason for the request for reexamination;
- 54 -
5. Whether or not the request for reexamination is informed,
and the details thereof; and
6. Date of the request for reexamination
(2) The provisions of Article 96 (2) through (4) shall apply
mutatis mutandis as regards
the formalities for making a
request for reexamination. In this case, ßÖperson making the
request for examinationß×shall be read
as ßÖperson making the
request for reexaminationß×, ßÖwritten request for examinationß×
as ßÖwritten request for reexamination"
and "request for
examination" as "request for reexamination"..
Article 106 (Composition of Industrial Accident Compensation
Insurance Reexamination Committee)
(1) The Industrial Accident Compensation Insurance
Reexamination Committee (hereinafter referred to as the
ßÖReexamination Committeeß×)
prescribed in Article 107 of the Act
shall have a chairperson and two deputy chairpersons or less.
(2) The deputy chairperson shall
be elected by the
Reexamination Committee from among the members.
(3) The chairperson shall represent the Reexamination
Committee, and have general control over the affairs of the
Examination Committee.
(4) The deputy chairperson shall assist the chairperson, and
if the chairperson is not able to carry out his/her duties owing
to
unavoidable circumstances, he/she shall act for the
chairperson.
Article 107 (Operation of Examination Committee)
(1) The chairperson shall convene and chair meetings of the
Examination Committee. : Provided that the deputy chairperson
may,
if it is necessary for the smooth operation of the
Examination Committee, preside over a meeting of the
Examination Committee on
the order of the chairperson.
(2) When the chairman intends to convene a meeting of the
Examination Committee, he/she shall notify
in writing each
member of the date, time, place and agenda of the meeting five
days before the meeting is held : Provided that
if a meeting
has to be urgently convened, the notification may be given
orally, by phone or through any other means no later than
the
day before the meeting is held.
(3) A meeting of the Reexamination Committee shall consist
of nine members, including the chairperson or the deputy
chairperson,
the permanent members and the members
designated by the chairperson each time for its meeting. In this
- 55 -
case, the members designated by the chairperson shall include
one or more members who have the qualifications prescribed in
Article
107 (4) 2 of the Act and one or more members who
have the qualification prescribed in subparagraph 5 of the same
paragraph.
(4) A meeting of the Reexamination Committee shall take a
decision with attendance of a majority of the members as
prescribed in
paragraph (3) and with approval of a majority
of the members present. In this case, one or more members
with the respective qualifications
referred to in the latter part of
paragraph (3) shall be present.
(5) Members other than the permanent members and
the ex officio members, who attend a meeting of the
Reexamination Committee, may be paid allowances and travel
expenses within
the limits of the budget.
(6) Except as provided in this Decree, matters necessary for
the operation of the Reexamination Committee shall be
determined by
the chairperson after resolution at the
Reexamination Committee.
Article 108 (Notification, etc., of Date and Place of Review on
Request for Reexamination)
(1) The Reexamination Committee shall, upon receiving
a request for reexamination, set the date and place of a review
on the request,
and notify in writing the party and the
Corporation of this at least five days before the review.
(2) The notification as referred
to in paragraph (1) shall be
delivered directly or given by registered mail.
Article 109 (Opening of Review)
(1) A review by the Reexamination Committee shall be open
to the public : Provided that it may not be open to the public
at the
request of the person requesting the reexamination.
(2) The request as referred to in the proviso of paragraph
(1) shall be made
using a document specifying the purpose
and reason.
Article 110 (Protocol of Review)
(1) The Examination Committee shall prepare a protocol of
review specifying the following matters as regards progress in a
review
of a request for reexamination:
1. Number and title of the case;
2. Date and place of the review;
3. Names of the members present;
- 56 -
4. Names of the parties present;
5. Details of the review; and
6. Other necessary matters
(2) The protocol of review as referred to in paragraph (1)
shall contain the year, month and date of
its preparation, and
shall be signed or sealed by the chairperson.
(3) Any party or related person may make a request in
writing to inspect the protocol as referred to in paragraph (1).
(4) If a
party or related person makes a request for
inspection pursuant to paragraph (3), the Reexamination
Committee shall not refuse
without justifiable reasons.
Article 111 (Organization and Operation of Subcommittee)
(1) If it is deemed necessary for making
an efficient review
on a request for reexamination, the Reexamination Committee
may organize and operate a subcommittee composed
of five
members or less, including the following members:
1. Deputy chairperson;
2. Permanent member who is not the chairperson; and
3. Member designated by the chairperson
(2) The subcommittee shall review the case of a request for
reexamination which are designated
by the chairman, and make
a report to the Committee.
(3) The provisions of the main text of Article 107 (1), and
paragraphs (2), (4) and (5) of the same Article shall apply
mutatis
mutandis as regards the operation of the subcommittee.
In this case, "chairperson" shall be read as "deputy chairperson"
and "Reexamination
Committee" as "subcommittee".
Article 112 (Assignment of Researchers)
(1) The Minister of Labor may assign five researchers or less
to conduct professional research and surveys necessary for
reexamination-related
work by the Reexamination Committee, such
as on industrial accident compensation insurance, industrial
medicine, industrial nursing,
management of harmful substances,
radioactive rays, etc.
(2) Necessary matters concerning the qualifications, salaries,
etc. of the researchers shall be prescribed by the Ordinance of
the Ministry of Labor.
- 57 -
Article 113 (Mutatis Mutandis Application)
The provisions of Articles 97, 98, 101, 103 and 104 shall
apply mutatis mutandis as regards the correction and rejection of
a request
for reexamination, the suspension of execution of
decisions, etc. on insurance benefits, the method of ruling,
investigation for
review, the payment of actual expenses, etc. In
this case, ßÖrequest for examinationß×shall be read as ßÖrequest for
reexaminationß×;
ßÖperson making the request for examinationß×as
ßÖperson making the request for reexaminationß× ßÖCorporationß×as
ßÖReexamination
Committeeß×; ßÖaffiliate organization of the Corporationß×
as ßÖCorporationß×; ßÖdecision on a request for examinationß×as
ßÖruling
on a request for reexaminationß×; and ßÖwritten decisionß×
as ßÖwritten rulingß×; person making the request for examinationß×
in
Article 103 (3) as ßÖCorporation and the person making the
request for reexaminationß×; and ßÖrequest for examination or
reexaminationß×in
paragraph (4) of the same Article as
ßÖadministrative lawsuitß×, respectively.
CHAPTER VII
Supplementary Provisions
Article 114 (Report, etc. of Changes in Benefit Entitlement)
(1) "The matters prescribed by the Presidential Decreeß×in
Article
114 (2) of the Act refer to those falling under any of the
following subparagraph :
1. Where a person entitled to insurance benefits has
received money or valuable goods equivalent to such
insurance benefits under
the Civil Act and other Acts or
subordinate statues on the same ground as insurance
benefits are paid under this Act, the details
of such
money or goods;
2. Where a person entitled to insurance benefits has received
damages from a third party, equivalent to such insurance
benefits
on the same ground as insurance benefits are
paid under this Act, the details of such damages;
3. Where a person entitled to survivors' compensation
annuities has changed, the details of such change; and
4. Where other changes have been made to the name,
resident registration numbers, address, etc., of a person
entitled to insurance
benefits, the details of such changes
- 58 -
(2) " The matters prescribed by the Presidential Decreeß×in
Article 114 (3) of the Act refer to those falling under any of the
following subparagraphs :
1. Where there occurs a reason for the termination of
entitlement to a disability compensation annuity, the
details of such reason;
and
2. Where there occurs a reason to change entitlement to a
survivorsßÓcompensation annuity, the details of such
reason
Article 115 (Report of Entitlement of Overseas Residents)
"Such matters as prescribed by the Presidential Decree" in
Article 115
(2) of the Act refer to the following matters. In this
case, the provisions of subparagraphs 3 through 5 shall apply
only to those
entitled to survivors' compensation annuities:
1. Matters concerning survival status;
2. Matters concerning a change of nationality;
3. Matters concerning marital status (including de-facto
marriage);
4. Matters concerning any changes in relationships with
relatives; and
5. Matters concerning disabilities (limited to cases where a
person entitled to survivors' compensation annuities belongs to
the
disabled prescribed in Article 63 (1) 4 of the Act)
Article 116 (Demand for Report and Presentation)
The demand for a report or the presentation of related
documents as prescribed in Articles 114 and 118 of the Act
shall be made
in writing.
Article 117 (Object, etc., of Demand for Medical Examination)
(1) The Corporation may demand the following medical
examinations
under Article 119 of the Act:
1. Medical examination to judge the necessity of continuous
medical care for workers receiving medical care due to a
work-related
accident;
2. Medical examination to determine disability grades or
invalidity grades;
3. Medical examination to judge whether or not a disease is
related to work ; and
4. Medical examination to judge whether or not additional
medical care is needed
(2) Expenses for the medical examination as referred to in
paragraph (1) shall be paid in the amount of the actual
expenses needed
for it.
- 59 -
(3) Among the expenses for medical examinations paid
pursuant to paragraph (2), those for the medical examination
referred to in
paragraph (1) 3 may include medical treatment
expenses if a person with symptoms presumed to be caused by
a work-related accident
receives medical treatment as his/her
condition is critical or according to a medical opinion that
without immediate medical treatment,
his/her condition
would deteriorate rapidly, causing an impediment to medical
examinations and future treatment.
(4) The demand for a medical examination referred to in
Article 119 of the Act shall be made in writing.
Article 118 (Medical Institutions for Special Examination)
(1) The medical examination (hereinafter in this Act referred
to as
"medical examination") referred to in Article 119 of the
Act shall be conducted by industrial accident insurance-related
medical
institutions (hereinafter referred to as "medical
institutions for special examination") falling under any of the
following subparagraphs
:
1. Medical institutions belonging to the Workers Accident
Medical Corporation as referred in Article 43 (1) 1 of the Act;
2. Tertiary hospitals referred to in Article 43 (1) 2 of the
Act; and
3. General hospitals under Article 3 (3) of the Medical
Service Act among industrial accident insurance-related medical
institutions
which do not fall under any of subparagraphs 1
and 2
(2) When demanding a person to undergo a medical
examination, the Corporation may present two medical
institutions for special examination, which are deemed
appropriate to accomplish
the purpose of the medical
examination, in consideration of the purpose of the demand for
medical examination, the residence of
the person who is to
undergo the medical examination, the state of the person's
injury, disease or disability and let the person
who is to
undergo the medical examination choose one of them.
(3) The Corporation may determine and operate a separate
medical
institution for special examination, which conducts the
medical examinations referred to in Article 117 (1) 2.
(4) If the result
of a medical examination by a medical
institution for special examination is different from opinions
from the doctor in charge
and advisory doctor, the Corporation
may make an adjudication or judgment after a second medical
- 60 -
examination : Provided that if after the second medical
examination, it is difficult to make an adjudication or judgment
in accordance
with the purpose of the demand for medical
examinations which fall under any subparagraph of Article 117
(1), the adjudication
or judgment may be made after
deliberation by the panel of advisory doctors.
Article 119 (Temporary Suspension of Insurance Benefits)
(1) Before temporarily suspending the payment of insurance
benefits pursuant
to Article 120 (1) of the Act, the Corporation
shall urge in writing the person who intends to receive the
insurance benefits to
fulfill his/her obligations within a set
period.
(3) The insurance benefits that may be suspended
temporarily under Article 120 of the Act shall be all the
insurance benefits which are to be paid to the person who
intends to
receive them, but the payment of which is difficult
to decide or has been impeded due to his/her failure to fulfill the
obligations
referred to in paragraph (1), and in the case of
Article 120 (1) 1 of the Act, they shall be wage replacement
benefits or injury-disease
compensation annuities.
(3) The period during which the payment of insurance
benefits may be temporarily suspended shall be from
the day
following the date the Corporation sets for the fulfillment of
obligations under paragraph (1) to the day before the
obligations
are completely fulfilled.
Article 120 (Designation of Financial Institution)
A person who intends to receive insurance benefits under
the Act or this Decree
shall open an account with a financial
institution designated by the Corporation.
Article 121 (Payment, etc., of Insurance Benefits for On-the-job
Trainees)
The provisions of Articles 21 through 85, Articles 96 through
98, Articles 101 through 105 and Articles 113 through 120 shall
apply
mutatis mutandis as regards the payment, etc. of
insurance benefits for on-the-job trainees as prescribed in Article
123 of the
Act.
Article 123 (Scope of Employers of Small and Medium Enterprises)
(1) The "employers (including those who do not employ any
worker
; hereinafter in this Article, the same shall apply.) of
small and medium enterprises prescribed by the Presidential
Decree" in
Article 124 (1) of the Act refer to those falling under
- 61 -
any of the following subparagraphs :
1. An employer who has joined the insurance and employs
less than 50 workers; or
2. A person who does not employ any worker and is engaged in
passenger transport service under the Passenger Transport
Service Act
and cargo transport service under the
Trucking Transport Service Act
(2) If the employer of a small and medium enterprise who
has joined the insurance pursuant to paragraph (1) 1 has come
to employ
50 workers or more, he/she shall be considered to
employ less than 50 workers for the insurance year concerned.
(3) If the employer
of a small and medium enterprise who
has joined the insurance pursuant to paragraphs (1) and (2) has
come to employ less than 50
workers, he/she shall be
considered to join the insurance pursuant to paragraph (1) 1.
Article 123 (Criteria for Recognition of
Work-related Accidents for
Employers of Small and Medium Enterprises)
The provisions of Article 27, Article 28 and Articles 30
through 36 shall apply mutatis mutandis as regards the scope
of accidents
recognized as work-related for employers of small
and medium enterprises. In this case, "worker" shall be read as
"employer of
a small and medium enterprise" and "acts of
performing his/her duties in accordance with his/her
employment contract" in Article
27 as "acts of performing the
duties needed for the business concerned".
Article 124 (Restrictions on Payment of Insurance Benefits to
Employers of Small and Medium Enterprises)
The insurance benefits prescribed in Article 36 (1) of the Act
shall not be paid for work-related accidents that occur while the
employer of a small and medium enterprise has his/her
insurance premiums in arrears as prescribed in Article 124 (4)
of the Act.
Article 125 (Scope, etc., of Persons in Special Types of
Employment)
"Persons engaged in the occupations prescribed by the
Presidential Decree" in Article 125 (1) of the Act refer to those
falling
under any of the following subparagraphs :
1. Persons engaged in soliciting insurance policies or
mutual aid contracts and falling under any of the following
items:
A. Insurance agents under Article 83 (1) 1 of the
- 62 -
Insurance Business Act;
B. Employees of any insurance agency or insurance
brokerage company under Article 83 (1) 5 of the Insurance
Business Act, who are
reported to be engaged in insurance
solicitation under the same Act;
C. Persons engaged in soliciting mutual aid contracts
under the Agricultural Cooperatives Act; and
D. Person engaged in soliciting postal insurance policies
under the Postal Savings and Insurance Act as their
full-time job
2. Owner-drivers of ready mixed concrete trucks
registered under the Construction Machinery Management
Act;
3. Those falling into the sub-class of learning-aid tutors
in the Korean Standard Classification of Occupation
announced by the
head of the National Statistical Office
under the Statistics Act; and
4. Golf caddies who assist with golf games at a golf
course registered as a sports facilities business pursuant to
Article 19 of
the Installation and Utilization of Sports
Facilities Act
Article 126 (Report etc., of Provision of Labor Service by Persons
in Special Types of Employment)
(1) If an employer begins or ceases to receive labor service
from a person in special types of employment for the first time
as
prescribed in Article 125 (3) of the Act, he/she shall report
the following matters to the Corporation not later than the 15th
of the month following the month in which the reason has
occurred:
1. Name, resident registration numbers and address of the
person in special types of employment;
2. Date on which the employer begins to receive labor
service from the person in special types of employment and
details of the
work the person in special types of employment
engages in; and
3. Date on which the employer ceases to receive labor
service from the person in special types of employment and the
reason
(2) Upon receiving the report referred to in paragraph (1),
the Corporation shall inform the person in special types of
employment
of the content.
Article 127 (Criteria for Recognition of Work-related Accidents for
- 63 -
Persons in Special Types of Employment)
The provisions of Articles 27 through 36 shall apply mutatis
mutandis as regards the criteria for the recognition of
work-related
accidents for persons in special types of
employment. In this case, "worker" shall be read as "person in
special types of employment".
CHAPTER VIII
Penal Provisions
Article 128 (Imposition of Fine for Negligence)
The amount of a fine for negligence by type of offense
is shown in Table 12: Provided that the Minister of Labor may
raise or reduce
the amount of fine for negligence by up to half
in consideration of the seriousness, frequency, motive and
consequence of the offense
but in the case of the imposition of
a heavier fine, the amount shall not exceed the maximum
amount of fine for negligence prescribed
in Article 129 (1)
and (2) of the Act.
Addenda
This Decree shall enter into force on January 1, 2009.
Articles 2 (Application Examples) The amended provisions of
Article 2 (1)
3 B shall apply to construction work
involving the construction or renovation of a building,
which has started after the enforcement
of this Decree.
- 64 -
[Table 1-2]
Payment Criteria of the Shut-Down Benefits and the
Injury-Disease Compensation Annuity in Reduced Amount
(Relating to Articles
30-3 and 39-2)
Ages Subject to Reduced
Payment
Payment Criteria for
Reduced Shut-Down
Benefits
Payment Criteria for
Reduced Injury-Disease
Compensation Annuity
65 years or older
65/100 of Average
Wages
93/100 of Pension
Amount
All other Tables were omitted.
- 65 -
[Table 9]
Criteria for Imposition of Fine for Negligence by Type of Offense
(related to Article 114 (3))
1. General Criteria
The criteria for the imposition of fines for negligence by
frequency of offense shall be applied in case a fine
for
negligence is imposed for the same types of offenses committed
during the recent one-year period. In this case, the date on
which a fine for negligence is imposed for the same type of
offense and the date on which the offense is discovered again
shall
be used as a basis for the date of the application of the
criteria.
2. Individual Criteria
Offense
Relevant
Provisions
Amount of Fine for Negligence
Once Twice
Three times
or more
1. In case a person uses a similar title in
violation of Article 36 of the Act
Article 106 (1)
of the Act
One million
won
One million
won
One million
won
2. In case a person does not give an answer or
gives a false answer to the questions asked
under Article 89 (2) of the Act (including
cases where it applies mutatis mutandis under
Article 92 (1)) or refuses, interferes with or
evades inspection
Article 106 (2)
2 of the Act
100,000 won 300,000 won 500,000 won
3. In case a person fails to make the report
prescribed in Article 99 (1) or 102 of the Act
or makes a false report
Article 106 (2)
3 of the Act
100,000 won 300,000 won 500,000 won
4. In case a person fails to comply with an order
to submit documents or things as prescribed
in Article 99 (1) or 102 of the Act
Article 106 (2)
4 of the Act
100,000 won 300,000 won 500,000 won
5. In case a person refuses to answer the questions
asked by an employee of the Corporation under
Article 101 or 102 of the Act or refuses,
interferes with or evades inspection
Article 106 (2)
5 of the Act
100,000 won 300,000 won 500,000 won
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