Social insurance benefitsin case of reduced working capacity are a support payment to help employees overcome financial difficulties when they cannot continue working due to their health being affected. Understanding the regulations on this allowance will help you ensure your benefits when encountering health problems and have a timely response plan. Consulting services will provide detailed information for you to easily access and implement social insurance benefits accurately.
How is the level of social insurance benefits when working capacity is reduced?
The time to receive social insurance benefits when working capacity is reduced
Pursuant to Article 48 of the Law on Social Insurance 2014, employees with reduced working capacity will be entitled to social insurance benefits if the employee is discharged from the hospital after treatment;
In case the injury or illness recurs and the employee is re-evaluated for reduced working ability, the time for receiving new benefits will be calculated from the month of the Medical Examination Council’s conclusion.
Conditions for receiving social insurance benefits when working capacity is reduced
Pursuant to Clauses 1 and 2, Article 45 of the Law on Occupational Safety and Hygiene 2015, employees are entitled to social insurance benefits when their working capacity is reduced under the following conditions:
Having an accident in one of the following cases:
At the workplace and during working hours, including when fulfilling necessary daily needs at the workplace or during working hours as permitted by the Labor Code and internal regulations of production and business establishments, including breaks, mid-shift meals, in-kind food, menstrual hygiene, bathing, breastfeeding, and toileting;
Outside the workplace or outside working hours when performing work at the request of the employer or a person authorized in writing by the employer to directly manage labor;
On the route from home to work or from work to home within a reasonable time and route;
Reduced working capacity of 5% or more due to an accident specified in Clause 1 of this Article;
Workers have occupational accidents that do not fall under one of the following causes:
Due to the victim’s own conflict with the person causing the accident that is not related to the performance of work or labor duties;
Because workers intentionally destroy their own health;
Due to the use of drugs and other addictive substances contrary to the provisions of the law.
Conditions for receiving social insurance benefits when working capacity is reduced
Application for social insurance benefits when working capacity is reduced. Where to submit an application?
Pursuant to Article 57 of the Law on Occupational Safety and Hygiene 2015, dossiers for social insurance benefits in case of reduced working capacity include:
Social insurance book.
Hospital discharge certificate or copy of medical records after treatment of occupational accidents for inpatient cases.
Minutes of assessment of loss of working capacity by the Medical Examination Council.
Written request for settlement of occupational accident benefits according to the form issued by Vietnam Social Insurance after reaching an agreement with the Ministry of Labor, War Invalids and Social Affairs.
An application for social insurance benefits when working capacity is reduced is submitted to the employer and the employer sends it to the social insurance agency where the employer is paying social insurance, through which the social insurance agency has a basis for resolving tuberculosis accident benefits.
In addition, the employer must also prepare a dossier on compensation and benefits including the following documents to submit to the local Department of Labor, War Invalids and Social Affairs where the enterprise, agency or organization is headquartered, specifically:
Minutes of occupational accident investigation, minutes of meeting to announce the minutes of occupational accident investigation of the grassroots-level, provincial-level Occupational Accident Investigation Team, or central-level Occupational Accident Investigation Team.
Medical examination record (document determining the degree of loss of working ability due to an occupational accident or the rate of physical injury due to an occupational accident) or the agency’s record determining the death of the employee forensic or court declaration of death in missing cases.
Decision on occupational accident compensation and benefits of the employer (according to the form in Appendix II issued with this Circular).
Document confirming accident on the way to and from work (if any), for the case specified in Point c, Clause 5, Article 35 of the Law on Occupational Safety and Hygiene 2015. The content of the reference confirmation document is according to the form in Appendix IV issued with this Circular.
How is the level of social insurance benefits when working capacity is reduced?
Pursuant to Clause 1 and Clause 2, Article 48 of the Law on Occupational Safety and Hygiene 2015 (in which Clause 2 is guided by Clause 1, Article 9 of Circular 28/2021/TT-BLDTBXH), Clause 1 and Clause 2, Article 49 (In which Clause 2 of this Article is guided by Clause 2, Article 9 of Circular 28/2021/TT-BLDTBXH), the level of social insurance benefits when reducing working capacity is calculated as follows:
One-time allowance
Employees whose working capacity is reduced from 5% to 30% are entitled to a one-time allowance;
A 5% decrease in working capacity is entitled to five times the base salary, then for each additional 1% decrease, the employee is entitled to an additional 0.5 times the base salary;
Receive additional benefits based on the number of years you have contributed to the Labor Accident and Occupational Disease Insurance Fund. From one year or less, it is calculated as 0.5 months, then for each additional year of contributions to the fund, you will receive an additional allowance 0.3 months’ salary paid into the fund of the month immediately preceding the month of the occupational accident or being determined to have an occupational disease; In case you have a work accident in the first month of participating in the fund or have an intermittent period of participation and then return to work, the salary used to calculate this benefit is the salary of that month.
Monthly allowance
A 31% decrease in working capacity is equal to 30% of the base salary, then for each additional 1% decrease, the employee is entitled to an additional 2% of the base salary;
Every month, you will also receive an additional subsidy calculated based on the number of years you have paid into the Labor Accident and Occupational Disease Insurance Fund. From one year or less, it is calculated as 0.5%, then each additional year of payment. The fund is charged an additional 0.3% of the salary paid into the fund for the month immediately preceding the month of the occupational accident or being determined to have an occupational disease; In case you have a work accident in the first month of participating in the fund or have an intermittent period of participation and then return to work, the salary used to calculate this benefit is the salary of that month.
How to calculate social insurance benefits when working capacity is reduced
Consulting services for social insurance benefits when working capacity is reduced
When your working capacity is reduced, it is extremely important to understand the social insurance benefit regulations so you can ensure your rights. However, the system of social insurance regulations can be quite complex and confusing. With a team of experienced experts at Long Phan, you will receive detailed advice and step-by-step support to ensure your rights are protected in the best way. Coming to Long Phan, you will get:
Consulting on conditions and subjects eligible for social insurance
Consulting on when to receive social insurance benefits
Consulting on social insurance benefit levels
Consulting on when to receive benefits
Consulting on forms of social insurance benefits
Consulting on preparing documents and procedures to receive social insurance one time or monthly
Support when having difficulty determining the rate of loss of working capacity
Consulting on changes in social insurance policies related to reduced working capacity
Support complaints and resolve disputes about social insurance benefits.
Regulations on social insurance benefits, when working capacity is reduced, is an important factor to help you stabilize your life and overcome difficulties, so if you have any questions, please contact us. Please contact Long Phan immediately via the hotline: 0906735386for detailed advice and protection of your rights.
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Chuyên gia Nguyễn Khắc Xuân
Nguyen Khac Xuan is a seasoned expert in the fields of insurance consulting, appraisal, and commercial dispute resolution. With extensive knowledge and high professional skills, he has made significant contributions to the development of leading companies in the industry.