Article Content

  Chapter 2 Occupational Accident Insurance

   Section 4 Insurance Benefits

     Subparagraph 4 Permanent disability benefits

Article 56
Those who apply for permanent disability benefit by the provisions of Article 43 of the Act shall submit the following documents:
1. Permanent disability benefits application form and benefit payment receipt.
2. Permanent disability diagnosis certificate.
3. Those who have undergone medical examination shall submit the examination report and relevant images.
In reviewing permanent disability benefits, the insurer may, in addition to designating an NHI hospital or physician for re-examination by the provisions of Article 47 of the Act, may also notify the hospital or clinic that issued the permanent disability diagnosis certificate to review relevant examination records or medical records.
Article 57
For those who apply for permanent disability benefits by the provisions of Article 43 of the Act, the day when the actual permanent disability is diagnosed by the NHI hospital or clinic, the day of the occurrence of the insurance accident, and the day on which the application can be made as specified in Article 37 of the Act.
If the insured suffers an injury or illness during the effective period of the insurance, after the insurance validity is terminated the insured still meets the treatment period stipulated in the permanent disability benefit standard of labor occupational accident insurance and is diagnosed as a permanent disability by a specialist, and the degree of disability is consistent with the validity of the insurance, and the degree of disability one year after the termination of the insurance, the symptoms are fixed, and the disability compensation may be claimed by the provisions of Paragraph 2 of Article 27 of the Act, and the date of the expiration of one-year period after the termination of the insurance validity is considered as the date allowing making the claim.
If the date of the diagnosis of permanent disability in the preceding two Paragraphs is unknown or there is any apparent doubt, the insurer may confirm it based on the medical records or relevant information.
If the insured requests a permanent disability diagnosis certificate, the NHI hospital or clinic shall deliver it to the insurer within five days after such certificate is issued.
Article 58
If the marriage relationship specified in Subparagraphs 1 and 2 of Paragraph 1 of Article 44 of the Act has been existing for more than one year, it shall be calculated continuously from the date of application.
Article 59
The term “schooled” as mentioned in Subparagraph 3, Paragraph 1, Article 44 of the Act refers to those who have a formal student identity and are enrolled in public schools, private schools approved and registered by the competent educational administration at all levels or foreign schools that meet the requirements of the Ministry of Education.
Article 60
Those who apply for additional allowances for dependents by Paragraph 1 of Article 44 of the Act shall provide the following documents:
1. The application form and a payment receipt for the additional allowance of permanent disability benefit for the dependents.
2. Transcripts of the complete household registration of the insured; if the family members and the insured are not recorded in the same household registration, the transcript of each household registration shall be submitted at the same time, and the following items shall be stated:
(1) When dependents are spouses, the date of marriage shall be stated.
(2) When dependents are foster children, the date of adoption and registration shall be stated.
3. If the children are schooled, it is required to additionally attach the photocopy of the tuition receipt or proof of school attendance. The applicant shall re-submit the relevant certificates before the end of September each year and send them to the insurer for verification. Those who meet the conditions after verification shall continue to be distributed with the allowance until the end of August of the following year.
4. For spouses and children who are unable to make a living, certificates of physical and mental disabilities, or certificates of guardianship declaration shall also be attached.
Article 61
After approving the permanent disability annuity benefit of the insured, the insurer shall provide the approving documents and materials to the competent authority for use in assisting workers with occupational accidents inappropriate medical rehabilitation, social rehabilitation, functional rehabilitation, occupational rehabilitation, and other rehabilitation services.
When the insurer assesses the degree of disability of the insured by the provisions of Paragraph 1 of Article 45 of the Act, the functional rehabilitation in the preceding Paragraph shall be included in the assessment.
Article 62
The same part referred to in Paragraphs 1 and 4 of Article 46 of the Act refers to the same part as the disability category specified in the labor insurance disability benefit criteria.
Article 63
If the insured is directly withdrawn by the insurer by the provisions of Article 48 of the Act, the date of withdrawal shall be the date of the diagnosis of actual permanent disability in the NHI hospital or clinic.