Industrial Accident Compensation Insurance Act
Source: Labor Welfare Corporation Industrial Accident Compensation Guide Page
1. What is an Industrial Accident Compensation Insurance Act?
The Industrial Accident Compensation Insurance Act is a social security system operated to promptly and fairly compensate workers for injuries, illnesses, disabilities, or death resulting from occupational reasons, and to promote the rehabilitation and social reintegration of injured workers.
Employers, not workers, are the ones obligated to enroll in industrial accident insurance. It is mandatory for all workplaces that employ at least one worker to enroll in this insurance.
Workers' compensation claims are not processed by the company (employer). Workers should directly apply to the Workers' Compensation Board or initiate the workers' compensation application process at a designated medical institution for occupational injuries.
2. Industrial Accident Compensation Insurance (Workers' Compensation)
Types of Insurance Benefits include:
Medical Care Benefits (Treatment Expenses)/ Temporary Disability Benefits/ Injury-disease compensation annuity/ Disability compensation/ Caregiver Benefits/ Survivors' Benefits/ Funeral Expenses/ Vocational Rehabilitation Benefits, etc.
Calculation of average wages
The average wage is calculated by dividing the total amount of wages paid to the worker during the three months prior to the occurrence of the reason for calculation by the total number of days in that period. This calculation applies equally to those employed for less than three months, and is calculated on a daily wage basis. Average wage is important as it serves as the basis for calculating insurance benefits.
Average wage = The total amount of wages paid during the three months prior to the occurrence of the calculation reason / The total number of days in the three months prior to the occurrence of the calculation reason
The exclusion period from the calculation period for average wagesIf there is a period within the average wage calculation period that falls under any of the following subparagraphs, both the period and the wages paid during that period are deducted from the total amount of wages and the period of the average wage calculation.
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Period during probationary employment
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Period of suspension due to the fault of the employer (period of suspension due to the fault of the worker is included)
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Period of leave before and after childbirth
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Period of suspension for medical treatment due to work-related injury or illness
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Period of childcare leave
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Period of industrial action (period of illegal industrial action is included)
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Period of leave or inability to work due to military service, reserve duty, or civil defense training, except when wages are paid during that period
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Period of leave approved by the employer for reasons such as injury, illness, or other reasons outside of work
3. Guide to insurance benefits
Medical care benefits
Medical care benefits are provided to workers who suffer injuries or illnesses related to their work. The scope of medical care benefits includes the following (based on the Health Insurance Medical Care Benefit Payment Standards):
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Examination and testing
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Provision of drugs or therapeutic materials, or other auxiliary aids
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Treatment, surgery, and other therapies
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Rehabilitation therapy
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Hospitalization
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Nursing and caregiving
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Transportation
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Other matters as determined by the Ministry of Employment and Labor regulations
The principle is to receive treatment in designated hospitals or medical institutions designated for industrial accidents by the Korea Workers' Compensation & Welfare Service (KCOMWEL), and to provide in-kind benefits. In unavoidable circumstances, if the patient has incurred expenses personally, cash payments can be made to the patient for industrial accident cases. The medical expenses are directly paid by the KCOMWEL to the medical institutions.
** In some cases, there may be some out-of-pocket expenses for non-covered items or items not specified in the standards for calculating industrial accident insurance medical care benefits.
The treatment expenses not covered by the KCOMWEL (patient's responsibility):
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Medical treatment or medication not related to work-related illness or disease treatment purposes
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Non-covered items according to the National Health Insurance standards
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Difference in fees for the use of superior wards (however, if hospitalization care is necessary in tertiary hospitals or higher due to emergency treatment, surgery, etc., and there are no general wards available, the use of superior wards excluding special rooms is recognized within a range of 7 days)
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Elective treatments performed under the 「Rules on Elective Treatments」 (however, if the KCOMWEL requests special treatments under Article 119 of the law, the KCOMWEL covers the treatment costs)
+) Confirmation System for Personal Share of Medical Expenses for Industrial Accident Insurance
The system in which the Workers' Compensation Commission confirms whether the non-reimbursable medical expenses borne by the injured worker fall within the scope of medical benefits, and the Commission verifies this upon request. You can verify and review the personal share of medical expenses recorded in the <medical bill or receipt>, and potentially receive a refund from the medical institution.
Shutdown benefits
We will pay 70/100 of the average daily wage for the period (hospitalization/outpatient visit) during which you were unable to find a job due to injury or illness due to work reasons.
Criteria for calculating shutdown benefits | Shutdown benefits |
Basic | 70% of the average wage |
70% of the average wage ≤ 80% of the minimum compensation standard amount | 90 percent of the average wage |
90% of the average wage > 80% of the minimum compensation standard amount | 80% of the minimum compensation base amount |
90% of the average wage < Minimum wage | the minimum wage |
Injury and disease compensation pension
If a worker receiving medical care benefits is not cured two years after the start of medical care and falls under a severe medical condition (Grades 1 to 3), he or she will be paid instead of the leave benefit.
Average wage × number of days in critical care status / 365 (compensation pension for injury and disease per day)
** If a person eligible for the Injury and Disease Compensation Pension changes his/her severe medical treatment status, he/she shall report it to the governor under the jurisdiction of the medical institution with a medical certificate attached
Disability benefits
It is paid when an employee is injured or cured of a disease due to work reasons, but he or she is still mentally or physically disabled and is eligible for disability benefits.
Average wage X number of days of payment for the disability rating
Disability rating | Disability compensation pension | lump sum payment for disability compensation |
Level 1 | For 329 days | For 1,474 days |
Level 2 | For 291 days | For 1,309 days |
Level 3 | For 257 days | For 1,155 days |
Level 4 | For 224 days | For 1,012 days |
Level 5 | For 193 days | For 869 days |
Level 6 | For 164 days | For 737 days |
Level 7 | For 138 days | For 616 days |
Level 8 | For 495 days | |
Level 9 | For 385 days | |
Level 10 | For 297 days | |
Level 11 | For 220 days | |
Level 12 | For 154 days | |
Level 13 | For 99 days | |
Level 14 | For 55 days |
** payment method
Level 1~ Level 3 disability | Pensions only
The amount equivalent to the ½ for 1 to 4 years can be paid in advance. |
Level 4 ~ Level 7 disability | Choice between lump sum and pension
If a pension is selected, the amount equivalent to ½ for two years of the pension may be received as advance payment. |
Level8 ~ Level 14 disability | Payment in lump sum only |
Caregiving benefits
Caregivers are needed even after treatment, and if care is actually provided, care expenses will be paid according to the disability and the degree of need for care.
(as of 1 day) | regular care | occasional care |
family/other caregivers | 41,170 won | 27,450 won |
a professional caregiver | 44,760 won | 29,840 won |
Subject to full-time care benefit | 1. A person who always needs other people's care in order to perform movements necessary for daily life due to impairments in the function of the nervous system, mental function, or chest abdominal organ.
2. A person who always needs other people's care in order to perform the movements necessary for daily life, with a disability equivalent to Grade 1 disability remaining in either eye, arm, or leg, and a disability equivalent to level 7 or higher in the other area. |
Subject to occasional care benefits | 1. A person who needs care from time to time for the function of the nervous system, mental function, or chest abdominal organ to remain impaired equivalent to level 2 of disability and perform the movements necessary for daily life.
2. A person who needs care from time to time for other persons to perform movements necessary for daily life due to the remaining disability corresponding to level 1 of disability (including cases where it becomes level 1 as a result of adjustment under Article 53 (2). |
A professional caregiver | A person under Article 12 (1) 1 (nurse or nursing assistant under the Medical Service Act) and subparagraph 2 (a person who has received nursing education recognized by the Corporation, such as a nursing care worker under Article 39-2 of the Elderly Welfare Act) of the Enforcement Rules of the Industrial Accident Compensation Insurance Act. |
the bereaved benefits
If a worker dies due to work reasons, he or she will be paid to the bereaved family who were supporting him at that time.
Required documents | - 1 death certificate or body examination certificate
- Part 1 of the worker's autopsy report (in the case of unknown cause of death)
- A copy of resident registration or family register (where it is difficult to confirm the beneficiary with a resident registration copy) - Part 1
- 1 copy each of the other documents proving average wage and occupational death |
Payment method | - Pension payment principle (monthly payment equivalent to 52-67% of average wage)
- 50% lump sum payment: If the pensioner wishes, 50% of the lump sum payment for bereaved family (equivalent to 1,300 days of average wage) shall be paid as a lump sum, and 50% of the survivors' compensation pension shall be reduced
If it is impossible to receive a pension, such as when there is no pensioner, it is paid as a lump sum
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The bereaved' compensation pension
Eligible recipients and rankings
| Among the bereaved families who shared a living with the worker at the time of his death
- spouse
- A parent or grandparent who is 60 years of age or older, respectively
- People under the age of 25 as children and those under the age of 19 as grandchildren
- A person who is under the age of 19 or 60 or older as a sibling
- Children, parents, grandchildren, grandparents, and siblings who do not fall under Article 2 of the Act on Welfare of Persons with Disabilities, who fall under the level of disability prescribed by Ordinance of the Ministry of Employment and Labor (for visually impaired persons, grade 3 factors also apply)
- Ranking of rights to receive: spouse, children, parents, hands, grandparents, and siblings
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Receipt of lump sum compensation for bereaved families | If there is no bereaved family's compensation pension beneficiary, and it is difficult to pay bereaved family's benefits in the form of a pension (if the worker's bereaved family's compensation pension beneficiary resides in a foreign country at the time of death or if the domestic beneficiary moves out of the country), it will be paid as a lump sum.
List of beneficiaries of lump sum compensation for bereaved families
1. Spouses, children, parents, grandchildren, and grandparents who were supported by the worker at the time of his/her death
2. The spouse, children, parents, grandchildren, and grandparents who were not supported by the worker at the time of his death, and brothers and sisters who were supported by the worker at the time of his/her death
3. Siblings
If there are two or more beneficiaries of the same order, equal payments are made to the bereaved family. In parents, adoptive parents are prioritized, and parents of adoptive parents are prioritized in grandparents. Notwithstanding the above order, if a worker designates it as a will, the designation shall be followed
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The bereaved' compensation pension | If the beneficiary wishes, an amount equivalent to 50/100 of the lump sum payment for bereaved family compensation shall be paid as a lump sum, and the survivors compensation pension shall be paid by reducing 50/100.
Disqualification and suspension of payment of persons eligible for The bereaved compensation pension
- at the time of one's death
- When remarrying (limited to spouses of deceased workers, including cases in which they are in fact married)
- When the kinship with the deceased worker is terminated
- When a child turns 25. When a grandchild or sibling turns 19
- When a person with a physical disability is relieved of his or her condition
- Where a person eligible for a survivor's compensation pension who was a citizen of the Republic of Korea at the time of the death of the worker loses his nationality and leaves the country to live in a foreign country.
- Where a person who is eligible for a survivor's compensation pension who is not a national of the Republic of Korea leaves the country to live in a foreign country.
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funeral expenses
If a worker dies due to occupational reasons, the funeral operator will be paid for the funeral.
120 days of the average wage
If the beneficiary of funeral expenses is a bereaved family member, the calculated funeral expenses (120 days of the average wage) exceed the maximum notification amount, or if the minimum notification amount is less than the minimum notification amount, the maximum and minimum notification amount will be applied** Maximum amount of notice for funeral expenses in 2024 : KRW 18,125,360
** Minimum amount of notice for funeral expenses in 2024 : KRW 13,053,080
Even if a funeral is carried out by a person other than the bereaved family for unavoidable reasons, the actual expenses shall be paid within the amount equivalent to 120 days of the average wage
CEO
Number
Address
Inquiry/Error Correction
Jiwon Choi
878-82-00340
120-833 Myeongmul-gil 76-5, Seodaemun-gu, Seoul, Room 103
refugee_health@freemed.or.kr
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2024 FREEMED All Rights Reserved