Blog, Labor

Did you know that in Korea, every workplace with 1 or more employees needs to register their employees for Worker’s Compensation Insurance? This means that if an employee has a work-related accident, injury, or disease, they will get monetary compensation for their medical costs and they will be aided in their return to work. This is also called Occupational Accident Compensation or Industrial Accident Compensation. It is very important that every employee in Korea understands the benefits of Occupational Accident Insurance. In this article, we will explain what is seen as occupational accidents, what the benefits are of the Worker’s Compensation Insurance, and how to claim them.

What are Occupational Accidents?

According to the Korean Ministry of Employment and Labor (MOEL), the Industrial Accident Compensation Insurance covers three types of accidents:

• Accident on duty
• Occupational disease
• Commuting accident

It is important to understand that the word accident also covers instances such as disability, injury, disease, and even death. 

1. Accident On Duty

Accidents on duty are any accidents that occur while an employee performs their duties. Accidents that happen during work events or even on break – if the accident can be seen as caused by the employer – also fall under accidents on duty.

According to Article 37 (1) 1 of the Industrial Accident Compensation Insurance Act, any of the following can be accidents on duty.

• Any accident that occurs while they perform a duty under their employment contract or other acts incidental thereto
• Any accident that occurs while they use a facility, etc. provided by their business owner, due to any defect in or any careless management of such facility, etc.
• Any accident that occurs while they participate in an event sponsored by or under the direction of their business owner or prepares for such event
• Any accident that occurs at recess due to an act deemed to be under the control and management of their business owner
• Any other accident that occurs in connection with their duties. 

For example, if you are a restaurant worker and you get badly burned by hot water while on duty, you might be eligible to claim the benefits. 

2. Occupational Disease

According to Article 37 (1) 2 of the Industrial Accident Compensation Insurance Act, any of the following can be occupational diseases.

• Any disease caused by handling or being exposed to any physical agent, chemical substance, dust, pathogen, work imposing a burden on the worker’s body, or any other agent causing trouble to their health while performing their duties;
• Any disease caused by an occupational injury;
• Diseases attributable to mental stress at workplace caused by workplace harassment, verbal abuse by customers, and other causes;
• Any other disease caused in connection with their duties.

For example, if frequent handling of heavy metals has led to metal poisoning, you are eligible to file a claim for benefits under the Industrial Accident Occupation Insurance. Occupational diseases also include damage to the body due to undue strain, such as heavy lifting, physical exertion, heat stroke, dehydration, etc.

3. Commuting Accident

Any accidents that occur whilst commuting to work using means of transportation that are provided by the employer, or under the control of the employer, is also an occupational accident. 

For example, if you ride a shuttle bus that is provided by your employer and the bus gets into an accident, you are eligible to file for benefits.

Any accidents that occur while commuting using “common route and method” are also covered by the Industrial Accident Compensation Insurance, but it depends on case by case.

4. Exceptions

If there is no causal relationship between the workplace and the accident, the accident is not considered an occupational accident. This means that it is very important to explain the relationship between the workplace and the cause of the accident to receive the proper insurance benefits.

Also, if the damage was caused by your intentional action, self-harm, or other criminal act, you are not eligible to apply for compensation. But if that intentional action, self-harm, or other criminal act was done in a state of mental disorder from an occupational accident, the damage can still be covered by the insurance.

What is Occupational Accident Compensation in Korea?

As stated, almost every employee is covered by Occupational Accident Compensation. Most foreign employees should be covered by it as well. Make sure to check with your employer if you cannot remember signing the insurance form. You and your employer pay a small monthly contribution.

Industrial Accident Compensation (산업재해보상보험 in Korean) provides insurance benefits in the case of any of the occupational accidents described above. These benefits are:

• Medical care benefits – Compensation for medical costs due to the injury or disease.
• Temporary layoff benefits – Compensation for if you are not able to work temporarily due to the nature of your injury.
• Disability benefits – Compensation to help with the costs of lasting disability after you recover from injury or disease.
• Nursing benefits – Compensation for costs of nurses and other medical help.
• Survivors’ benefits – In case of death, compensation for the remaining family.
• Injury and disease compensation pensions – Compensation for inability to work longer than two years due to serious conditions caused by the injury or disease.
• Funeral expenses – In case of death, compensation to help with funeral costs.
• Vocational rehabilitation benefits – Help with being able to resume your work activities.

1. Work Accident Insurance Benefit Claim

How to claim the benefits depends on the type of benefits you are trying to claim. For all claims goes: you need to acquire the proper forms from either your employer or the insurance agency. The forms often need to be signed by doctors and additional proof might be required.

1.1 Medical Care Benefits

Medical care benefits can only be claimed if the medical treatment takes four or more days. If the treatment takes three days or less, no benefits will be received. The application can be submitted by the employee, or by the hospital or pharmacy, to Korea Workers’ Compensation & Welfare Service (COMWEL). In principle, the application should be filed before the treatment is done, using special forms that can be found through the Workers Compensation Insurance. It can also be filed on the internet through COMWEL’s official website.

When the application is filed, COMWEL decides whether they would sustain or overrule it within seven days. When it is sustained, COMWEL either provides the employee medical care in “industrial accident insurance-related medical institution,” or pays the expenses in lieu of the medical care. Usually the latter happens when the employee already received their medical care in another medical institution and paid for the bill themselves.

1.2 Temporary Layoff Benefits

These benefits can be claimed when four or more days of work, and thus income, are missed due to medical treatment because of an occupational accident. Employees or their bosses can file for these benefits to COMWEL, who decides whether they would pay the money or not.70% of the wage is paid by insurance, within 14 days after the decision for payment.

1.3 Disability Benefits

Disability benefits will compensate for the loss of the labor force, which is caused by a physical or mental disability, after recovering from any injury or disease. The application can be filed by the employee or employer to COMWEL. When filing the application, the employee should attach the documents proving their state of disability such as a disability certificate, radiography results, or medical records. 

When the application is filed, COMWEL lets the doctor define the damage and judge the employee’s disability grades, which are divided into 14 grades from Grade 1 to Grade 14. Grade 1 is the most serious one, such as being completely blind or completely losing both arms, while Grade 14 is the least serious, such as not being able to use one pinky finger properly. The compensation is paid according to the disability grade.

The employee can choose whether they would be paid the money in the form of an annuity or lump-sum. However, they can only be paid in the form of annuity if they are Grade 1 to 3.

1.4 Nursing Benefits

Nursing benefits are for the employee who is in need of medically constant or frequent nursing care after their cure (when their disability grades are Grade 1 to 2) and is actually receiving nursing care. They can either apply for regular nursing benefits (= Permanent nursing benefits) or frequent nursing benefits (= Occasional nursing benefits), depending on how often nursing care is required. Frequent nursing benefits will cover ⅔ of the costs, whilst regular nursing benefits will cover the full amount. It is claimed using specific forms gotten through the employer or the insurance agency.

1.5 Survivor’s Benefits

If an employee has passed away, their relatives are entitled to claim survivor’s benefits. These can be claimed by spouses, children under age 25, parents over age 60, siblings under age 19 or over age 60, whose livelihood had been supported by the deceased. Even if they don’t meet their age requirements, they are eligible if they have severe disabilities. 

Once again, there are forms that need to be filed to submit this claim to COMWEL

1.6 Injury-Disease Compensation Annuities

If the treatment for the injury or disease extends more than two years, and the employee still can’t get a job because of it, they will no longer receive temporary layoff benefits, but instead will receive injury and disease compensation pensions. This type of benefit can be claimed when the doctor pronounces the injury or disease ‘incurable, and the grade of serious conditions caused by the injury or disease is judged to be under Grades 1 to 3. The insurance pays 329 days of their average daily wages for Grade 1, 291 days for Grade 2, and 257 days for Grade 3.

1.7 Funeral Expenses 

If an employee has passed away due to an occupational accident, their next of kin are entitled to claim funeral expenses. The insurance covers an amount equivalent to 120 days of the average daily wage of the deceased, although it cannot be over KRW 16,334,840 or less than KRW 11,729,120.

1.8 Vocational Rehabilitation Benefits

An employee who requires vocational training to be reemployed, who is already receiving disability benefits because they are in Grade 1 through 12, can be paid vocational training costs and vocational training allowances. Meanwhile, the business owners who hire the recipients of disability benefits, can be paid return-to-work subsidies, vocational adaption training costs, and rehabilitation exercise costs.

2. Work Accident Compensation Appeal Procedure

After an employee, their employer, their doctor, or their surviving family has filed the industrial accident compensation claim, COMWEL will then determine how much money you will receive. This is based on the severity of the injury or disease, the costs made, the wages missed, etc.

If, however, the applicant disagrees with the amount of the benefits, they can submit an appeal by requesting for examination to COMWEL within 90 days after the decision, which would let COMWEL rethink their decision within 60 days. If that is still unsatisfactory, the applicant can either request for re-examination to Industrial Accident Compensation Insurance Reexamination Committee, or file an administrative lawsuit against COMWEL. 

Industrial Accident Compensation Insurance Act

The law that contains everything described in this article is called the Industrial Accident Compensation Insurance Act, 산업재해보상보험법 in Korean. This act describes in detail what is seen as occupational accidents, workers, disabilities, survivors, etc. It is good to take a look at the law when filing a benefits claim to ensure you understand the benefits you will receive.

Civil Damage Claim for Illegal Acts 

If an employee is unsatisfied with the compensation under the Industrial Accident Compensation Insurance, they can file a civil damage claim for illegal acts against their employer or third party responsible for the accident and damage. If won, the amount granted shall include active damages (treatment expenses, nursing expenses, etc) and passive damages (lost income, lost severance pay, etc.). Sometimes, mental damages are also granted.