Occupational accident and disease regime in Vietnam Social Insurance Law

The company allocates a portion of its funds to support workers in case of risks in this case.

(2) Conditions for enjoying occupational accident and disease insurance benefits Employees participate in social insurance when meeting one of the following conditions:

prescribed in Article 39, Article 40 of the Law on Social Insurance 2006 and Article 19

Decree No. 152/2006/ND-CP is entitled to occupational accident and disease insurance. Specifically:

- Suffering from work-related accidents and having a reduced working capacity of 5% or more.

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Cases covered by occupational accident insurance are stipulated in Article 19 of Decree No. 152/2006/ND-CP, including:

+ Accidents at work and during working hours including breaks, meals, preparation and completion of work.

+ Having an accident outside the workplace or outside working hours while performing work as required by the employer.

+ Having an accident on the way to and from the place of residence to the place of work and within a reasonable time and route. Within a reasonable time is the time needed to arrive at the place of work before work hours or return after work hours. A reasonable route is the regular route to and from the place of permanent residence or temporary residence to the place of work and vice versa.

In addition, according to Joint Circular No. 12/2012/TTLT-BLDTBXH-BYT, in case employees of enterprises operating in Vietnam, while performing tasks abroad assigned by the employer such as attending conferences, seminars, short-term study, practical research, and having an accident, it is also considered a work-related accident.

- Suffering from a disease on the list of insured occupational diseases prescribed by the Ministry of Health and the Ministry of Labor, War Invalids and Social Affairs when doing heavy work or occupation,

toxic or directly exposed to toxic environments according to the list prescribed by the state and have a reduced working capacity of 5% or more.

In case the employee suffers from a disease listed in the occupational disease list during the working period under normal working conditions or without exposure to toxic substances related to that disease, it is necessary to find out the cause and origin of the disease. If the employee has previously worked in arduous, toxic conditions and their illness is a consequence of that working period, it is necessary to pay attention to the occupational disease guarantee period. This is a certain period of time prescribed by the State (depending on the type and severity of the disease) calculated from the date the employee leaves the working environment with toxic factors that can cause occupational disease, during which time, if the employee gets sick (caused by toxic factors in the previous working environment), it will be considered an occupational disease and will be entitled to social insurance under the occupational disease insurance regime. If the employee gets sick when the guarantee period has expired, he/she will only be entitled to insurance under the sickness regime. Thus, medical records, confirmation from a competent medical organization, minutes confirming the environment has toxic factors causing occupational diseases from a competent authority or certification of occupational disease insurance period, medical examination minutes... are all necessary documents in the insurance benefit file of employees under this regime.

b. Benefit level and duration

The employer is the one who hires the labor, has the right to organize and manage the labor process of the laborer, so the inevitable consequence is that they must be responsible for the risks that occur during the labor process that affect the health, life and living of the laborer, especially in the case of labor accidents and occupational diseases. In addition to having to pay social insurance for the laborer, the employer must also be directly responsible.

Regarding occupational accidents and diseases occurring in one's unit, first of all is the responsibility towards the workers or their families, followed by the responsibility towards the State and society.

According to the provisions of Clause 3, Article 107 and Clause 1, Article 143 of the Labor Code, the employer must be responsible for first aid, taking the employee to the emergency room and paying all medical expenses and wages for the employee until the injury is stable; compensation or allowance for the employee (or the family of the deceased) not lower than the minimum level prescribed by the State; complete the documents for the employee or the family of the deceased to receive social insurance from the social insurance fund according to the provisions of law or compensate the employee if he/she has not participated in social insurance; arrange other work suitable for the employee's health and properly perform the obligation to monitor and take care of the employee's health according to a separate regime (if they continue to work at the unit).

The responsibility of the Social Insurance agency arises from the time the employee is discharged from the hospital after stable treatment for his/her injury. The types and levels of occupational accident and occupational disease insurance for employees from the Social Insurance Fund depend on their health status, medical examination results, and the duration of their social insurance participation, and must include all essential expenses to compensate for damages, overcome difficulties, and serve the lives of employees with occupational accidents and occupational diseases. At the same time, employees can enjoy multiple types of benefits in this regime and can enjoy other insurance regimes if eligible.

Specifically, employees can enjoy the following types of benefits at corresponding levels from the Social Insurance Fund:

- Medical examination: the introduction of workers for examination at the competent medical examination board and related costs are all borne by the employer.

Social insurance performs. Medical examination is both a right of the employee and a basis for social insurance to pay the next insurance regimes for them.

According to Article 41 of the Law on Social Insurance 2006, employees are assessed for the level of reduced working capacity after the injury or illness has been treated and stabilized; after the injury or illness relapses and has been treated and stabilized. In case an employee has both a work accident and a work disease, or has suffered multiple work accidents or work diseases, the level of reduced working capacity will be assessed in total.

- Disability and illness allowance (generally called disability allowance): this is the main regime applied to workers with occupational accidents and diseases. Disability allowance can be paid once or monthly depending on the level of reduction in the worker's ability to work. The purpose of this regime is to partially compensate for the income of workers reduced due to reduced ability to work or to replace income due to the worker's inability to continue working. Therefore, cases of wage replacement allowance must, in principle, at least ensure a minimum standard of living for the insured. From this purpose, the State specifically regulates the types and levels of disability allowances for workers. Currently, the State provides one-time allowances for workers with a reduction in ability to work from 5% to 30%. Workers with a reduction in ability to work from 31% or more are entitled to monthly allowances and the allowance level generally ensures a minimum standard of living for these subjects. Current disability benefits for workers include two amounts: benefits based on the general minimum wage prescribed by the State (depending on the rate of loss of working capacity) and benefits based on the salary used as the basis for social insurance contributions of the worker (depending on the time the worker has participated in social insurance). Specifically as follows:

One-time allowance:

The one-time subsidy level is stipulated in Article 42 of the Law on Social Insurance 2006 and specified in Article 21 of Decree No. 152/ND-CP, accordingly, employees who suffer from occupational accidents or occupational diseases will receive a one-time subsidy based on the rate of disability and the number of years of social insurance contributions. The subsidy level applies to employees whose working capacity is reduced from 5% to 30% with the benefit level calculated as follows:

Calculated according to the disability rate: workers with a 5% reduction in working capacity will receive 5 months of the common minimum wage, then for each additional 1% reduction, they will receive an additional 0.5 months of the common minimum wage.

Calculated by the number of years of social insurance contributions: Employees are also entitled to an additional allowance calculated by the number of years of social insurance contributions. For 1 year or less, it is calculated as 0.5 months. After that, for each additional year of social insurance contributions, 0.3 months of salary and wages for social insurance contributions of the month immediately preceding the leave for treatment will be calculated.

In case a worker dies due to a work-related accident or occupational disease while working or dies during the first treatment period due to a work-related accident or occupational disease, the worker's relatives will receive a one-time allowance equal to 36 months of the general minimum wage. In addition, depending on the conditions of age and income, the worker's relatives will also receive a funeral allowance equal to 10 months of the general minimum wage and a monthly death benefit equal to 50% of the general minimum wage (if the relative has no one to support them, the benefit will be equal to 70% of the general minimum wage) or a one-time death benefit if there are no relatives eligible for the monthly allowance.

Monthly allowance:

The one-time subsidy level is stipulated in Article 43 of the Law on Social Insurance 2006 and specified in Article 22 of Decree No. 152/ND-CP, accordingly, employees who suffer from occupational accidents or diseases will receive a one-time subsidy based on the injury rate.

disability and number of years of social insurance contributions. The subsidy level applies to people with a working capacity reduction of 31% or more, the benefit level is calculated as follows:

Calculated by disability rate: workers with a 31% reduction in working capacity will receive 30% of the general minimum wage, then for each additional 1% reduction, they will receive an additional 2% of the general minimum wage.

Calculated by the number of years of social insurance contributions: Every month, employees are also entitled to an additional allowance calculated based on the number of years of social insurance contributions. From 1 year or less, it is calculated at 0.5%, then for each additional year of social insurance contributions, an additional 0.3% of the salary and wages of the month immediately preceding the leave for treatment is calculated.

- Other benefits accompanying disability benefits

Due to health decline or damage to the functioning of body parts... directly affecting the daily life of workers, therefore, along with the disability allowance, workers are also guaranteed other conditions to solve newly arising needs. These regimes include: provision of living aids when workers are injured in the functioning of their legs, arms, teeth; ears, eyes, spine; monthly service allowance in case workers are disabled and cannot take care of themselves; health insurance when leaving work; assessment and adjustment of disability allowance when relapsed (according to Articles 45 and 46 of the Social Insurance Law 2006).

In case the employee is eligible for pension insurance (monthly or one-time), he/she will receive both regimes (occupational accident and occupational disease insurance and pension insurance).

- Allowance for families of workers who die due to work accidents or occupational diseases

When a worker dies, reasonable expenses arising from the burial of the deceased must be compensated. Moreover, the income and livelihood of their family will be reduced, causing great difficulties for the family's common life, especially for those who the worker was responsible for supporting while alive. The Social Insurance Law of our State in any period has stipulated insurance subsidies for the worker's family in this case. This amount of money is both meaningful as a spiritual encouragement and to compensate for the expenses incurred and the lack of livelihood for the worker's relatives.

Currently, the State stipulates that in the event of a worker dying from a work-related accident or occupational disease (including death during the first treatment period), their relatives will receive a funeral allowance equal to 10 months of minimum wage (as stipulated in Article 63 of the 2006 Law on Social Insurance). Along with these benefits, relatives of the deceased worker will receive a one-time or monthly death benefit from the Social Insurance Fund in accordance with the law. The one-time benefit will not apply in the event of a worker dying after the first treatment period, regardless of whether the cause is a work-related accident or occupational disease. Whether or not the death benefit is available in this case will depend on the worker's time participating in social insurance or whether the worker is currently receiving a monthly benefit from the Social Insurance Fund.

- Recuperation and health recovery after treatment of work-related accidents and occupational diseases

After stable treatment of injuries caused by work-related accidents or illnesses caused by occupational diseases, employees who are still in poor health are entitled to rest and recuperate. The time for rest and recuperation in a year includes holidays, Tet holidays, weekly holidays, and days of departure and return (if staying at a centralized facility). The number of days for rest and recuperation is determined by the Executive Committee of the grassroots trade union.

The time for recuperation is determined based on the level of reduced working capacity as prescribed in Article 24 of Decree No. 152/2006/ND-CP as follows:

+ Maximum 10 days off for people with reduced working capacity of 51% or more;

+ Maximum 7 days off for people with reduced working capacity from 31% to 50%;

+ 5 days off for people with reduced working capacity from 15% to 30%.

Article 48 of the 2006 Law on Social Insurance stipulates that the daily allowance for recuperation and health recovery of employees is equal to 25% of the general minimum wage if recuperating at home, and equal to 40% of the general minimum wage if recuperating at a centralized facility.

In the case of employees whose working capacity is reduced by 81% or more, who are paralyzed by the spine or blind in both eyes or have amputated or paralyzed limbs or are mentally ill, in addition to the above benefits, the employee is also entitled to a monthly service allowance equal to the common minimum wage.

Workers who suffer from work-related accidents that damage their body functions will be provided with life-support equipment and orthopedic devices based on the age and severity of their injury or illness.

- Other benefits:

Employees receiving monthly accident benefits are entitled to the following benefits:

+ If the employee is no longer working, he/she will receive health insurance guaranteed by the Social Insurance Fund;