Industrial Accident Claim

A worker may also pursue a civil claim for damages against the employer.

In that situation, a tort under the Civil Act provides the legal basis, and damages may be claimed only where the work-related accident resulted from the employer's intent or negligence.

The amount of damages is determined by converting the loss the worker actually suffered into a monetary figure.

If a worker injured in an industrial accident has already received civil damages, however, the Korea Workers' Compensation and Welfare Service does not pay insurance benefits to the extent of the money and goods received as damages, up to the limit of those benefits.

If the worker has received, or is entitled to receive, insurance benefits through an industrial accident claim, the employer is relieved of accident compensation liability for the same cause within that scope.

• Medical care benefits: the full cost of treatment, such as examination and diagnostic fees, hospitalization fees, surgery fees, medication costs, transportation costs, and prosthetic and orthotic devices
• Temporary disability benefits: where a worker cannot work and receives no wages during medical care, 70% of the average wage is paid
• Disability benefits: where a permanent disability remains after treatment, a lump sum or annuity is paid according to the disability grade
• Nursing benefits: paid where a recipient of medical care benefits still requires nursing care after recovery
• Survivors' benefits: paid to the surviving family where a worker dies from a work-related cause
• Injury-disease compensation annuity: paid where the illness remains uncured more than two years after a recipient of medical care benefits began medical care, or where the worker is in a severe medical condition of grade 1 to 3 and cannot work because of the ongoing treatment

Funeral expenses and vocational rehabilitation benefits, among others, can also be received through an industrial accident claim.

A key point is that any accident requiring four or more days of treatment qualifies for industrial accident compensation, and the same applies to daily workers, part-time workers, foreign workers, and field trainees.

Where the injury can be treated through medical care within three days, or where the workplace is not subject to industrial accident compensation insurance, an industrial accident claim cannot be filed.

In that situation, the accident compensation provisions of the Labor Standards Act may apply instead.

The employer then pays the worker treatment costs (medical care compensation), 60% of the average wage during the medical care period (temporary disability compensation), and, where a disability has arisen, disability compensation according to its grade.

The medical care benefits that an industrial accident claim can additionally recognize are as follows.

• Dental prosthetics
• Rehabilitation aids
• Medications and treatment materials for burn patients
• Prescription and inspection fees for rehabilitation aids
• Transportation fees
• Treatment aids
• Herbal medicine packets and decoction fees in Korean medicine
• Rehabilitation treatment fees
• Vaccination costs

When filing an industrial accident application, you generally need to gather first the materials that establish the facts showing that medical care benefits should be paid because of an industrial accident.

1. Basic Documents

• Application for medical care benefits (Korea Workers' Compensation and Welfare Service form)
• Statement of the circumstances of the accident (preferably prepared separately)

2. Supporting Documents

• Employment contract, job description, and work log
• Accident photographs, CCTV footage, and witness statements
• Medical records, medical certificate, and emergency activity log
• Employment insurance insured-status history inquiry, and health insurance benefit history (10 years)

3. Additional Documents in Case of Death

• Death certificate, postmortem examination certificate, and autopsy report
• Resident registration certificate and marriage relationship certificate for compensation of the victim and surviving family

• Secure evidence immediately after the accident occurs (photographs, statements, medical certificate)
• Prepare four copies of the application for medical care benefits
• Prepare a separate statement of the circumstances of the accident
• Collect supporting materials such as CCTV footage and work records
• After filing with the Service, check the progress regularly (follow up if it is delayed)
• If the claim is not approved, prepare a request for review and a request for reexamination
  

For an industrial accident application, filing the application for medical care benefits is the true starting point, and you generally need to prepare sufficient supporting materials carefully until the approval decision becomes final.

If the facts are complex and the application is not straightforward, or if there is a concern that it may be rejected, it can help to obtain the assistance of professionals such as a labor attorney or a lawyer who concentrates on labor matters.

If you have any questions about an industrial accident application, you may leave a consultation request with our firm's Labor and Industrial Accident Group.

Legal professionals well versed in the laws relating to industrial accidents, including experience with a court division dedicated to labor crimes as well as with the Ministry of Employment and Labor and the Labor Relations Commission, will work with you.