CONTENTS
- 1. Industrial Accident Processing Criteria | Meaning and Scope of Application of Industrial Accident Processing
- 2. Industrial Accident Processing Criteria | Requirements and Types for Recognition as an Industrial Accident
- - Occupational Accidents Caused by Accidents
- - Accidents During Breaks and Events
- - Occupational Accidents Caused by Illness
- 3. Industrial Accident Processing Criteria | Industrial Accident Processing Procedure
- - Industrial Accident Processing When Industrial Accident Insurance Is Not Held
- 4. Industrial Accident Processing Criteria | Issues in Industrial Accident Denial and Responses
- - Materials to Preserve Regarding the Injured Person When a Disaster Occurs
1. Industrial Accident Processing Criteria | Meaning and Scope of Application of Industrial Accident Processing
The industrial accident processing criteria are the standards prescribed for processing a matter as an industrial accident where certain requirements under the Industrial Accident Compensation Insurance Act and the Occupational Safety and Health Act are met.
Where a worker is injured or dies due to an accident or illness in the course of performing work, if it is processed as an industrial accident in accordance with the industrial accident processing criteria, the worker can receive compensation lawfully.
Industrial accident insurance applies, in principle, to all workers who provide labor under an employment contract.
Coverage is excluded only where compensation is provided under separate laws, such as for certain public service personnel, military personnel, and private school faculty and staff.
The employer must file a notice of establishment of industrial accident insurance within 14 days from the date the business commences, and a violation results in an administrative fine of up to 3 million won.
2. Industrial Accident Processing Criteria | Requirements and Types for Recognition as an Industrial Accident
An industrial accident refers to a case of injury, illness, disability, or death requiring medical care of 4 days or more.
Occupational accidents, occupational illnesses, and commuting accidents fall under this.
However, even if a worker suffers a disaster in the course of performing work, not every accident is recognized as an industrial accident.
All three of the following requirements must be met.
1. Performance of work
The accident must occur while the work under the employment contract is being performed under the employer's direction and management, or due to a defect in the employer's facilities or a fault in their management.
2. Substantial causal relationship
A substantial causal relationship must exist between the accident and the injury or death (the burden of proof lies with the worker).
3. Exclusion of intent and crime
An accident arising from the worker's intent, self-harm, criminal act, or the like is not recognized as an industrial accident
However, in the case of suicide, where a mental disorder caused by extreme work-related stress is medically recognized, it may exceptionally be processed as an industrial accident.
Occupational Accidents Caused by Accidents
An accident that occurs while a worker is working during working hours, or while performing acts incidental to the work (such as work preparation, cleanup, or using the restroom), is, in principle, regarded as an industrial accident.
However, where the causal relationship between the accident and the work can be clearly denied, it is not recognized as an industrial accident.
Outside working hours
Even outside working hours, an accident caused by a defect in or careless management of a facility managed by the employer is recognized as an industrial accident.
However, an accident in which a worker voluntarily engages in a hazardous act, or one that occurs in a personal-use facility outside the scope of the employer's management, is not regarded as an industrial accident.
Accidents while commuting
An accident while commuting is recognized as an industrial accident only if it meets the following requirements.
1) The accident occurs while using transportation provided by the employer
2) It occurs during commuting by the usual route and method
3) The authority to manage the means of transportation is not the exclusive authority of the worker's side
Where the commuting route is deviated from or interrupted, it is not recognized as a commuting accident; however, where the deviation is to purchase daily necessities, to exercise the right to vote and the like, or to stop by a hospital, it is recognized as an accident.
Commuting accidents recognized under the industrial accident processing criteria
- An accident during commuting by ‘carpool’ approved by the employer
- An accident occurring while a company vehicle used for other purposes is being used as a means of commuting with tacit approval
- A traffic accident occurring while commuting by driving a vehicle provided by a staffing agency
Accidents during a business trip (field work)
If an accident occurs while a worker is performing field work or a business trip on the employer's instruction, it is recognized as an industrial accident.
Even during a business trip, an accident in which the worker deviates from the route for a personal errand or that occurs during a personal, private act is not recognized as an industrial accident.
Accidents During Breaks and Events
Accidents during break time
Where a worker has an accident during break time while engaging in an act within the workplace that is normally permissible according to social norms, it is recognized as an industrial accident.
For example, an accident occurring while resting in a workplace break room falls under an industrial accident.
Accidents during an event (athletic meet, outing, and the like)
An accident occurring while a worker participates in an event such as an athletic meet, an outing, or a mountain-climbing event, or while preparing for one, conforms to the industrial accident processing criteria.
• Where the employer recognizes the time spent participating in the event as working hours
• Where the employer instructed or approved participation in the event
• Where it is a customary or routine event that the company recognizes as necessary for labor management or organizational management
Examples of events not recognized as occupational accidents
- An outing among dormitory staff for fellowship
- An athletic event held to demonstrate union solidarity
Occupational Accidents Caused by Illness
An illness caused by an occupational injury, or an illness caused by work-related mental stress from workplace bullying or abusive language from customers, is recognized as an industrial accident under the industrial accident processing criteria.
In such cases, the Occupational Disease Determination Committee of the Korea Workers' Compensation and Welfare Service deliberates on whether it is an occupational illness.
- Cerebrovascular and cardiac diseases
- Musculoskeletal and respiratory diseases
- Neuropsychiatric diseases (post-traumatic stress, adjustment disorder, depression, and the like)
- Lymphohematopoietic diseases
- Skin, eye, and ear diseases
- Liver and infectious diseases (hepatitis B, scrub typhus, malaria, and the like)
- Acute poisoning and similar diseases (vinyl chloride, lead, mercury poisoning, and the like)
- Occupational cancers (asbestos-exposure lung cancer, laryngeal cancer, ovarian cancer, and the like)
- Diseases from physical factors such as exposure to abnormal atmospheric pressure, heatstroke, and hypothermia
3. Industrial Accident Processing Criteria | Industrial Accident Processing Procedure
When an industrial accident occurs to a worker within the workplace, the employer must take prompt on-site measures and comply with the following procedure.
- Emergency measures and accident reporting
When an injured person occurs, they must immediately be given emergency treatment and transported to a hospital.
At the same time, the employer must report to the supervisor and preserve the scene. - Submission of the industrial accident investigation report
When an industrial accident occurs, the cause of the accident must be recorded together with measures to prevent recurrence and submitted to the competent local employment and labor office within 1 month.
A serious accident (such as a fatal accident) must be reported immediately by telephone, fax, or other means. - Application for medical care benefits
A worker may submit the medical care benefit application directly to the Korea Workers' Compensation and Welfare Service, and the employer's seal is not mandatory.
The Service notifies the employer of the receipt and may obtain a written opinion from the employer, but whether to approve is determined at the Service's discretion.
Industrial Accident Processing When Industrial Accident Insurance Is Not Held
Even if the workplace is one that has not enrolled in industrial accident insurance, if an industrial accident has occurred, the worker may apply for the industrial accident directly without the company's approval or consent.
Even if the matter is smoothed over by a private settlement with the worker, if the worker applies for the industrial accident, the concealment of the industrial accident will be uncovered regardless of the settlement, so if an industrial accident that meets the industrial accident processing criteria has occurred, the industrial accident report and investigation should begin immediately.
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4. Industrial Accident Processing Criteria | Issues in Industrial Accident Denial and Responses
A worker's industrial accident application is not always approved.
The main grounds for denial include the following.
• Insufficient causal relationship between the work and the disaster
• An accident caused by the worker's private act
• Failure to prove the occupational nature of the connection between the illness and the work
The employer may file an objection to the recognition of an industrial accident.
A request for review may be filed to contest the Service's decision on insurance benefits, and a request for reexamination or administrative litigation may also be raised to object.
A request for review may be filed within 90 days from the day on which the decision became known (the same applies to a request for reexamination).
Materials to Preserve Regarding the Injured Person When a Disaster Occurs
When an injured person occurs, the employer must preserve the following materials.
A company must establish a safety and health management system and, when an accident occurs, develop measures to prevent recurrence through immediate reporting and investigation.
In particular, because the risk of additional criminal liability under the Serious Accidents Punishment Act is significant when a serious accident occurs, prevention-focused risk management is critical.
Paying industrial accident insurance in accordance with the industrial accident processing criteria is a minimum safety net for protecting workers.
If an occupational accident occurs due to the employer's intent or negligence, the worker may file a civil claim for damages and the like, and the employer also bears criminal liability for violations of the Criminal Act and the Serious Accidents Punishment Act.
If you have any questions regarding the industrial accident processing criteria, you may request a consultation with an attorney at our firm who handles serious accident matters.
We form a task force of attorneys who have handled numerous cases under the Serious Accidents Punishment Act and the Occupational Safety and Health Act, including attorneys with experience at the Ministry of Employment and Labor and as construction site safety inspection managers, together with labor attorneys, to respond quickly.
Our firm keeps a consultation channel open for clients regardless of weekends and holidays, which you may find helpful.
