INDUSTRIAL ACCIDENT COMPENSATION INSURANCE ACT [See entire ACT]

CHAPTER Ⅲ Insurance Benefits

Article 36 (Categories of Insurance Benefits and Standards for their Calculation)

(1) The types of insurance benefits shall be as follows: Provided, That the types of insurance benefits for pneumoconiosis shall be medical care benefits under subparagraph 1, nursing benefits under subparagraph 4, funeral expenses under subparagraph 7, vocational rehabilitation benefits under subparagraph 8, pneumoconiosis compensation annuity under Article 91-3 and pneumoconiosis survivors’ annuity under Article 91-4:

1. Medical care benefits;

2. Temporary layoff benefits;

3. Disability benefits;

4. Nursing benefits;

5. Survivors' benefits;

6. Injury and disease compensation pensions;

7. Funeral expenses;

8. Vocational rehabilitation benefits.

(2) The insurance benefits referred to in paragraph (1) shall be paid upon request from any person entitled to such insurance benefits pursuant to Articles 40, 52 through 57, 60 through 62, 66 through 69, 71, 72, 91-3, and 91-4 (hereinafter referred to as "beneficiary").

(3) In calculating insurance benefits, the average wage shall be increased or decreased every year in conformity with the fluctuation rate of the average amount of the entire employees' wages after one year from the date when the ground for calculating the average wage of the relevant employee occurs, and the average wage shall increase or decrease every year in conformity with the fluctuation rate of consumer price index after the relevant employee attains the age of 60 years: Provided, That the insurance benefits for employees with pneumoconiosis whose average wage is deemed the amount calculated pursuant to paragraph (6) shall be excluded herefrom.

(4) The standards and methods for calculating the fluctuation rate of the average amount of the entire employees' wages and the fluctuation rate of consumer price index under paragraph (3) shall be prescribed by Presidential Decree. In such cases, the fluctuation rates so calculated shall be publicly notified each year by the Minister of Employment and Labor.

(5) In calculating insurance benefits (excluding pneumoconiosis compensation annuities and pneumoconiosis survivors’ annuities), where it is deemed inappropriate to apply the average wage to the relevant employee due to his or her unusual type of work as prescribed by Presidential Decree, an amount calculated according to the calculation method prescribed by Presidential Decree shall be deemed the average wage for the employee.

(6) In calculating insurance benefits, where it is deemed inappropriate to apply the average wage to any employee who is eligible to receive insurance benefits due to any work-related disease prescribed by Presidential Decree, such as pneumoconiosis, for protecting such employee, an amount calculated according to the calculation method prescribed by Presidential Decree shall be deemed the average wage for the employee.

(7) In calculating insurance benefits (excluding funeral expenses), where the average wage of the employee concerned or the average wage that forms the basis for calculating the insurance benefits in accordance with paragraphs (3) through (6) exceeds 1.8 times the average amount of the wages of the entire employees of a business entity that has at least five regular employees based on the statistics concerning the employment structure, demand for human resources, etc. under Article 17 of the Framework Act on Employment Policy (hereinafter referred to as "maximum standard amount of compensation") or falls short of 1/2 of such average amount (hereinafter referred to as "minimum standard amount of compensation"), the maximum standard amount of compensation or the minimum standard amount of compensation shall each be deemed the average wage for the employee concerned, but if the minimum standard amount of compensation is less than the hourly minimum wage under Article 5 (1) of the Minimum Wage Act, multiplied by 8, (hereinafter referred to as "minimum wage"), the minimum wage shall be deemed the minimum standard amount of compensation: Provided, That the minimum standard amount of compensation shall not apply to the calculation of temporary layoff benefits and injury-disease compensation annuities.

(8) Method for calculation and the effective period of the maximum standard amount of compensation or the minimum standard amount of compensation shall be prescribed by Presidential Decree. In such cases, the maximum or minimum standard amount of compensation so calculated shall be publicly notified each year by the Minister of Employment and Labor.

Enforcement Ordinance

Article 21 (Claim for Insurance Benefits, Notification of Decision, etc.)

(1) A person who intends to receive any of the following insurance benefits pursuant to Article 36 (2) of the Act shall file a respective application or request for each of the insurance benefits with the Service:

1. Temporary disability compensation benefits;

2. Lump-sum disability compensation benefits or disability compensation annuities (including lump-sum payments prescribed in Article 57 (5) of the Act);

3. Constant attendance benefits;

4. Lump-sum survivors' compensation benefits or survivors' compensation annuities (including lump-sum payments prescribed in Article 62 (4) of the Act);

5. Injury-disease compensation annuities;

6. Funeral expenses;

7. Vocational rehabilitation benefits;

8. Pneumoconiosis compensation annuities;

9. Pneumoconiosis survivors' annuities.

(2) Upon receiving an application or request for insurance benefits under paragraph (1), the Service shall decide whether to pay the insurance benefits, details of payment, etc., and notify a person who has filed such application or request thereof.

(3) If the Service decides to pay a disability compensation annuity, survivors' compensation annuity, pneumoconiosis compensation annuity, or pneumoconiosis survivors' annuity, it shall deliver an annuity certificate to an eligible beneficiary.

Enforcement Ordinance

Article 22 (Increase or Decrease in Average Wage)

(1) The criteria for and methods of calculating the rate of increase or decrease in the average wage of all workers and the rate of increase or decrease in comsumer prices under Article 36 (3) and (4) of the Act are shown in Table 2.
(2) The increase or decrease of the average wage under Article 36 (3) of the Act may be made at the request of the person entitled to the insurance benefits or by virtue of the authority of the Corporation.

Enforcement Ordinance

Article 23 (Scope of Workers in Unusual Type of Employment)

“The cases prescribed by the Presidential Decree where it is deemed inappropriate to apply the average wage of the worker due to his/her unusual type of employment” in Article 36 (5) of the Act means any of the following ;
1. where applying average wages for workers (hereinafter referred to as “daily workers”) who are employed on a daily basis or paid wages on a daily basis (referring to the wages paid as a reward for the set number of working hours in one day; hereinafter the same shall apply) for the number of days worked:Provided that if a daily worker falls under any of the following subparagraphs, he/she shall be seen as such:
A. Where his/her employment relations have continued for three months or more;
B. Where his/her type of employment is considered similar to that of a permanent worker after comprehensive consideration of the working conditions, type of employment contract, specific employment conditions, etc. of other daily workers engaged in the same kind of job in the same business as the worker concerned.
2. Where applying the average wage to a part-time worker defined in subparagraph 8 of Article 2 of the Labor Standards Act (excluding daily workers; hereinafter referred to as “part-time worker”), who works for two or more businesses (businesses operated by a policy holder of the occupational health and safety insurance provided in Article 5 (3) and (4), and Article 6 (2) and (3), of the Insurance Premium Collection Act).

Enforcement Ordinance

Article 24 (Method of Calculation of Average Wage for Workers in Unusual Type of Employment)

(1) “An amount calculated according to the calculation method prescribed by Presidential Decree” in Article 36 (5) of the Act means an amount calculated as follows:
1. Where falling under subparagraph 1 of Article 23: An amount calculated by multiplying the daily wage of the relevant daily worker by the working day coefficient announced by the Minister of Employment and Labor after taking into account the number of days of actual service by the daily worker for a month, etc. (hereinafter referred to as "ordinary working day coefficient");
2. Where falling under subparagraph 2 of Article 23: An amount calculated by dividing the aggregate of the wages that the relevant part-time worker received in the business where the accident occurred during the average wage calculation period and the wages he/she received in other businesses during the same period, by the number of days of the relevant period.
(2) A daily worker who has worked for not less than one month as of the date of occurrence of causes for calculating the average wage may apply for exclusion from the application of the calculation method referred to in paragraph (1) 1 to the Corporation by submitting the application together with documents proving the actual wage and number of days worked, if given the actual wage and number of days worked, it is not appropriate to take the amount calculated according to the calculation method referred to in paragraph (1) 1 as the average wage.
(3) When a part-time worker applies for insurance benefits pursuant to Article 36 (2) of the Act, he/she shall submit documents evidencing the fact that he/she was employed in a business other than the business where the accident occurred, and his/her working hours and wages, to the Service.

Enforcement Ordinance

Article 25 (Special Case for Calculation of Average Wages for Persons with Occupational Disease)

(1) “The occupational diseases prescribed by the Presidential Decree, such as pneumoconiosis” in Article 36 (6) of the Act refer to diseases (hereinafter in this Article referred to as “occupational diseases”) falling under any of the following subparagraphs among the work-related diseases (hereinafter referred to as “work-related diseases”) referred to in Article 37 (1) 2 of the Act:Provided, That if time and medical continuity exists between the examination, treatment, etc., of such work-related disease and the issuance of the medical certificate or medical opinion, it shall be the date on which the medical care begins:
1. Pneumoconiosis;
2. Any of the diseases described in subparagraph 2 A and B, subparagraph 3 A to G, subparagraph 3 I to K, subparagraph 4 B, subparagraphs 5 through 7, subparagraphs 6 A to C, subparagraphs 6 E, I, K, subparagraphs 7 E to J subparagraph 8 A and B, subparagraph 9, subparagraph 10 A, subparagraph 11 A B to G, subparagraph 11 H 1), 2) and paragraph 12 AB to D, subparagraph 13 A, subparagraph 14 A, subparagraph 15 A and B, subparagraph 16 A, subparagraph 17 A, subparagraph 18, subparagraph 19 A and B, subparagraph 20, subparagraph 21 and subparagraph 22 E through I in Table 3;and
3. Other diseases which result from long-term exposure to harmful or hazardous elements or are recognized as having occurred after a latent period after exposure to harmful or hazardous elements.
(2) “An amount calculated according to the calculation methods prescribed by the Presidential Decree” in Article 36 (6) of the Act refers to the following:[Amended by Presidential Decree No. 22492, Nov. 15, 2010 and Presidential Decree No. 24651, Jun. 28, 2013]
1. In case of occupational diseases falling under paragraph (1) 1:the amount pronounced by the Minister of Employment and Labor every year, after taking into account the average wages of all workers as defined under Article 26 (1), based on the date when the occupational disease concerned is confirmed
2. In case of occupational diseases falling under paragraph (1) 2 or 3:an amount obtained by dividing the sum of all the average monthly wages of workers with similar wage levels to that of the worker concerned for the period of one full year preceding the last day of the previous two quarters to the quarter when the occupational disease is confirmed by the total number of days during that period. All the average monthly wages of workers with similar wage levels referred to in paragraph (2) shall be all the average monthly wages of workers who are similar to the worker with the occupational disease in terms of gender, occupation, and type and size of business they work for according to data on average monthly wages for workers from the survey on workforce at establishments (hereinafter referred to as the “survey on workforce at establishments”) prepared by the Minister of Employment and Labor as the designated statistics prescribed in subparagraph 2 of Article 3 of the Statistics Act. In this case, the criteria for judging such workers similar to the worker in terms of gender, occupation and type and size of business they work for shall be determined by the Corporation.
(3) The day when the occupational disease is confirmed, referred to in paragraph (2), shall be the date of issuance of the medical certificate or medical opinion issued when it is confirmed that the occupational disease is eligible for insurance benefits:Provided, That if time and medical continuity exists between the examination, treatment, etc., of such work-related disease and the issuance of the medical certificate or medical opinion, it shall be the date on which the medical care begins:
(1) through (2) Deleted.
(4) Deleted. [Presidential Decree No. 22492, Nov. 15, 2010]
(5) In applying the provisions of Article 36 (6) of the Act, if the occupational disease as prescribed under paragraph (1) 2 and 3 is confirmed after the shutdown or closure of the business to which the worker belongs (including cases where the worker has retired before the business shutdown or closure), an amount obtained by increasing or decreasing the amount calculated from the date of the business shutdown or closure pursuant to paragraph (2) 2 until the date the pertinent occupational disease as prescribed under paragraph (1) 2 and 3 is confirmed in accordance with subparagraph 1 of Table 2 shall be regarded as the average wage of the worker. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]
(6) Special cases for the calculation of average wages as referred to in article 36 (6) of the Act may apply either when such request has been made by those entitled to the insurance benefits or by the official authority of the Corporation. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]

Enforcement Ordinance

Article 26 (Method of Calculating Maximum and Minimum Standard Amount of Compensation)

(1) The average wages used as the basis for calculating the maximum standard amount of compensation (hereinafter referred to as the “maximum standard amount of compensation”) and the minimum standard amount of compensation (hereinafter referred to as the “minimum standard amount of compensation”) referred to in Article 36 (7) of the Act shall be an amount obtained by dividing the sum of all the average monthly wages of every worker of businesses which hire 5 or more workers from July 1st of the insurance year of two years ago to June 30th of the preceding insurance year by 365 (or 366 in case the month of February during that period has 29 days) according to the statistics concerning the employment structure, demand for human resources, etc. pursuant to Article 17 of Framework Act on Employment Policy. [Amended by Presidential Decree No. 24177, Nov. 12, 2012]
(2) When calculating the maximum standard amount of compensation and the minimum standard amount of compensation, amounts less than one Won shall be rounded off.
(3) The application period for the maximum standard amount of compensation and the minimum standard amount of compensation shall be from January 1st to December 31st of the insurance year concerned.

Article 37 (Criteria for Recognition of Work-related Accidents)

(1) If an employee suffers any injury, disease, or disability or dies due to any of the following causes, it shall be deemed an occupational accident: Provided, That this shall not apply where there is no proximate causal relation between his or her duties and the accident:

1. Accident on duty:

(a) Any accident that occurs while he or she performs a duty under his or her employment contract or other acts incidental thereto;

(b) Any accident that occurs while he or she uses a facility, etc. provided by his or her business owner, due to any defect in or any careless management of such facility, etc.;

(c) Deleted;

(d) Any accident that occurs while he or she participates in an event sponsored by or under the direction of his or her business owner or prepares for such event;

(e) Any accident that occurs at recess due to an act deemed to be under the control and management of his or her business owner;

(f) Any other accident that occurs in connection with his or her duties;

2. Occupational disease:

(a) Any disease caused by handling or being exposed to any physical agent, chemical substance, dust, pathogen, work imposing a burden on his or her body, or any other agent causing trouble to his or her health while performing his or her duties;

(b) Any disease caused by an occupational injury;

(c) Any disease caused by work-related mental stress due to workplace harassment, verbal abuse from customers, etc. under Article 76-2 of the Labor Standards Act;

(d) Any other disease caused in connection with his or her duties;

3. Accident on commuting:

(a) Any accident that occurs while he or she commutes to or from work using a transportation means provided by his or her business owner or another similar means under the control and management of his or her business owner;

(b) Any accident that occurs while he or she commutes to or from work using other common route and method.

(2) No injury, disease, disability or death of an employee due to his or her intentional action, self-harm or other criminal act, or caused by such act shall be deemed an occupational accident: Provided, That when the injury, disease, disability or death is caused by any act committed in the state of a marked decline in his or her normal cognitive function, etc. as prescribed by Presidential Decree, it shall be deemed an occupational accident.

(3) Where there is any deviation or suspension of route for commuting in the accidents referred in paragraph (1) 3 (b), any accident occurred from the relevant deviation or suspension or accident occurred during the movement thereafter shall not be deemed an accident on commuting: Provided, That when the deviation or suspension which is an action necessary for daily life has any reason prescribed by Presidential Decree, it shall be deemed an accident on commuting.

(4) An accident on commuting under paragraph (1) 3 (b) shall not apply to a type of work that does not have a regular route and method, as prescribed by Presidential Decree.

(5) The detailed standards for recognition of occupational accidents shall be prescribed by Presidential Decree.

[Paragraph (1) 1 (c) of this Article was deleted by Act No. 14933 promulgated on Oct. 24, 2017, following the decision of nonconformity to the Constitution made by the Constitutional Court on Sep. 29, 2016]

Enforcement Ordinance

Article 27 (Accidents While Performing Duties)

(1) An accident that happens while the worker is carrying out any of the following acts shall be seen as the work-related accident under Article 37, (1) 1 A of the Act:
1. Acts of performing his/her duties in accordance with his/her employment contract;
2. Physiologically necessary acts, such as going to the toilet, in the course of performing his/her duties;
3. Acts of preparing for or wrapping up work and other necessary acts incidental to his/her duties;and
4. Acts expected as a social norm, such as acts of emergency refuge or rescue caused by unexpected accidents, such as natural disasters, fires, etc., which happen inside the workplace
(2) An accident that happens while the worker is performing his/her duties outside the workplace following instructions from the employer shall be seen as the work-related accident under Article 37 (1) 1 A of the Act:Provided that an accident that happens while the worker is carrying out an act violating specific instructions from the employer or his/her private act or is off his/her normal business travel course shall not be seen as a work-related accident.
(3) An accident that happens in relation to the work a worker who has no fixed place of work because of the nature of his/her duties performs from the time when he/she starts to work after first arriving at the place of work until he/she leaves work after finally completing work shall be seen as the work-related accident under Article 37 (1) 1 A of the Act.

Enforcement Ordinance

Article 28 (Accidents Due to Defect, etc. in Facilities, etc.)

(1) An accident that happens due to a defect in, or the careless management by the employer of, the facilities, equipment, vehicles, etc. (hereinafter referred to as “facilities, etc.”) provided by the employer shall be seen as the work-related accident under Article 37 (1) 1 B of the Act.
(2) An accident that happens due to the use of the facilities, etc., provided by the employer in violation of specific instructions from the employer and an accident that happens during the management or use of the facilities, etc., while the worker has entire and exclusive responsibility to manage or use them shall not be seen as the work-related accident under Article 37 (1) 1 B of the Act.

Enforcement Ordinance

Article 29 deleted.

Enforcement Ordinance

Article 30 (Accidents During Events)

If a worker’s participation in various events, (hereinafter referred to as “events”) such as sports events, picnics and mountain-climbing events, is deemed necessary for labor management or business operation under social norms, and the case falls under any of the following subparagraphs, an accident happening during his/her participation in such events (including preparation and rehearsal for such events) shall be seen as the work-related accident under Article 37 (1) 1 D of the Act:
1. Where for the worker participating in the event, the employer recognizes his/her hours spent to participate in the event as hours worked;
2. Where the employer orders the worker to participate in the event;
3. Where the worker participates in the event after obtaining approval from the employer in advance;and
4. Other cases equivalent to subparagraphs 1 through 3 where the employer has usually and customarily recognized the worker’s participation in the event.

Enforcement Ordinance

Article 31 (Accidents in Particular Place)

An accident that happens due to natural disasters, such as typhoons, floods, earthquakes and avalanches, or unexpected incidents, while the worker is doing an act deemed possible to do inside the workplace under social norms shall be seen as the work-related accident under Article 37 (1) 1 F of the Act, except when it is obvious that the accident happens while the worker is engaging in an act not related to his/her work, such as private acts and walking out on his/her jobs.

Enforcement Ordinance

Article 32 (Accidents During Medical Care)

If an accident falling under any of the following subparagraphs happens to a worker who is receiving medical care for a work-related injury or disease, the accident shall be seen as the work-related accident under Article 37 (1) 1 F of the Act:
1. Medical accident happening in relation to medical care benefits;
2. Accident happening in relation to medical care for work-related injuries or diseases at the industrial accident insurance-related medical institution where the worker is receiving medical care
3. Accidents occurring in the course of going to an industrial accident insurance-related medical institution from the residence or the workplace, for treatment of a work-related injury or occupational disease.

Enforcement Ordinance

Article 33 (Accidents Caused by Third Person’s Acts)

In case where an accident happens to a worker because of a third person’s act, if the work the worker are in charge of is deemed possible, by nature, to cause the third person to do an harmful act under social norms, the accident shall be seen as the work-related accident under Article 37 (1) 1 F of the Act.

Enforcement Ordinance

Article 34 (Criteria for Recognition of Work-related Diseases)

(1) If a worker gets a disease included in the scope of work-related diseases referred to in Article 44 (1) and Table 5 of the Enforcement Decree of the Labor Standards Act(including cases where a worker has undergone a miscarriage, stillbirth, or premature birth. Hereinafter the same shall apply in this article) and meets all of the following conditions, the disease shall be seen as the work-related disease under Article 37 (1) 2 A of the Act:
1. The worker has ever handled, or been exposed to, harmful or hazardous elements while performing his/her duties;
2. The disease is deemed possible to arise in the light of the hours for which the worker has handled or been exposed to harmful or hazardous elements, the period during which the worker has been engaged in such work, work environments, etc.,;and
3. The fact that the worker’s exposure to or handling of harmful or hazardous elements has caused the disease to arise should be medically recognized.
(2) If a disease that arises in a worker suffering from a work-related injury meets all of the following conditions, the disease shall be seen as the work related disease under Article 37 (1) 2 B of the Act:
1. The causal relationship between the work-related injury and the disease should be medically recognized;and
2. The underlying illness or existing disease should not be a naturally happening symptom.
(3) The specific criteria for the recognition of work-related diseases (excluding pneumoconiosis) under paragraphs (1) and (2) are shown in Table 3.
(4) When deciding whether to recognize a worker’s work-related diseases or death caused by such work-related disease, the Corporation shall take into account the worker’s sex, age, health, physical constitution, etc.

Enforcement Ordinance

Article 35 (Accidents during a Commute)

(1) An accident which occurs during a worker’s commute shall be deemed a commuting accident as prescribed by Article 37 paragraph (1) subparagraph 3 a of the Act if all of the following subparagraphs are applicable:
1. The accident occurred while the worker was using a means of transportation provided by the employer or can be deemed as provided by the employer;
2. The management and availability of the means of transportation was not exclusively up to the worker.
(2) The “causes prescribed by Presidential Decree as an act necessary for everyday life” in the proviso of Article 37 paragraph (3) of the Act refer to any of details in the following subparagraphs:
1. Purchasing goods that are necessary for everyday life;
2. Receiving education or training which can contribute to the development and improvement of vocational abilities at schools prescribed in Article 2 of the Higher Education Act or at vocational education and training institutions prescribed in Article 2 of the Vocational Education and Training Promotion Act;
3. Exercising one’s right to vote or participate in a referendum;
4. Bringing a child or a person with disabilities, for whom the worker is the de facto guardian, to or from a daycare or educational institution;
5. Receiving medical care to treat or prevent a disease at a medical institution or a health center;
6. Looking after a family member recuperating at a medical institution etc. and needing the worker’s care;
7. Any acts that the Minister of Employment and Labor deems necessary for everyday life and that correspond to subparagraphs (1) through 6.
<This Article inserted on Dec. 26, 2017>

Enforcement Ordinance

Article 35-2 (Businesses Excluded from Determination of an Accident as a Commuting Accident, Etc.)

"Type of work prescribed by Presidential Decree that does not have a regular route and method" in Article 37 (4) of the Act means a case where a person who engages in any of the following types of work (referring to a person who has purchased an insurance policy designating himself/herself or his/her survivors as the insured under Article 124 of the Act and does not employ any employee) has a garage in his/her residence for a motor vehicle, etc. used for business:

1. On-demand passenger transport business under Article 3 (1) 3 of the Passenger Transport Service Act;

2. Owner-driven taxi transport business under subparagraph 2 (d) of Article 3 of the Enforcement Decree of the Passenger Transport Service Act;

3. Delivery operation performed by a person falling under Article 122 (1) 2 (d).

[This Article Newly Inserted by Presidential Decree No. 28506, Dec. 26, 2017]

Enforcement Ordinance

Article 36 (Standards for Recognition of Occupational Accidents Due to Self-Harm)

"Any of the grounds as prescribed by Presidential Decree" in the proviso to Article 37 (2) of the Act refers to a case falling under any of the following:

1. Where a person who received or is receiving medical treatment for mental illness arising from a work-related ground does self-harm in a state of mental disorder;

2. Where a person who is receiving medical care due to an occupational accident does self-harm in a state of mental disorder caused by the occupational accident;

3. Other cases where the fact that self-harm is done in a state of mental disorder due to a work-related ground is medically recognized.

Article 38 (Work-related Disease Adjudication Committee)

(1) To deliberate on whether or not to recognize a disease as the work-related disease referred to in Article 37 (1) 2, the Work-related Disease Adjudication Committee (hereinafter referred to as the “Adjudication Committee”) shall be set up within an affiliate organization of the Corporation.
(2) The diseases excluded from the deliberation of the Adjudication Committee and deliberation procedures shall be prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Act No. 10339, Jun. 4, 2010]
(3) Necessary matters concerning the composition and operation of the Adjudication Committee shall be prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Act No. 10339, Jun. 4, 2010]
Article 39 (Presumption of Death)
(1) If a worker aboard a ship or aircraft which had an accident has not been found dead or alive or if a worker aboard a ship or aircraft on voyages went missing or has not been found dead or alive for other reasons, he/she shall be presumed to be dead under the conditions as prescribed by the Presidential Decree, and the provisions concerning survivors benefits and funeral expenses shall apply.
(2) If after insurance benefits are paid under the presumption of death as referred to in paragraph (1), the survival of the worker concerned is confirmed, the paid amount in case of a bona fide recipient and twice that amount in case of a mala fide recipient shall be collected from the person who received the benefits.

Article 39 (Presumption of Death)

(1) If it is unclear whether an employee aboard a ship or aircraft in which an accident occurs is alive, or if it is unclear whether an employee aboard a ship or aircraft on navigation is alive, because the employee is missing or because of other reasons, he or she shall be presumed to be dead as prescribed by Presidential Decree, and the provisions concerning survivors' benefits and funeral expenses shall be applicable.

(2) Where an employee is confirmed to be alive after insurance benefits for the employee are paid due to the presumption of death referred to in paragraph (1), if the person who received such benefits did so bona fide, the Service shall collect the amount received, and if he or she did so mala fide, an amount equivalent to twice the amount received.

Enforcement Ordinance

Article 37 (Presumption of Death)

(1) Cases where a person is presumed to be dead under Article 39 (1) of the Act shall be those falling under any of the following subparagraphs:
1. Where an accident happens in which a ship is sunk, capsized, destroyed or missing, or aircraft is crushed, destroyed or missing, and the life or death of a worker aboard the ship or aircraft has been unknown for three months after the accident occurs;
2. Where a worker aboard a ship or aircraft on voyages went missing, and his/her life or death has been unknown for three months after he/she went missing;or
3. Where the life and death of a worker on the site of various accidents such as natural disasters, fires and building collapses, etc., has been unknown for three months after the accident occurs.
(2) A person who is presumed dead under paragraph (1), shall be presumed to have died on the day the accident occurred or he/she went missing.
(3) If a person whose life or death has been unknown due to any of the causes as referred to in each subparagraph of paragraph (1) is confirmed to be dead within three months after the accident occurred, or he/she went missing, but the date of his/her death is obscure, he/she shall be presumed to be dead on the day as referred to in paragraph (2).
(4) An insurance subscriber shall make without delay a report on the confirmation of the missing or death of the worker to the Corporation, when any of the causes as referred to in subparagraphs of paragraph (1) occurs, or when the death is confirmed (including the case where the worker is presumed dead under paragraph (3)).
(5) If after the payment of insurance benefits under Article 39 (1) of the Act, the worker’s survival was confirmed, the person who has received the insurance benefits and the insurance subscriber shall make a report on the confirmation of the worker’s survival to the Corporation, within fifteen days after the survival was confirmed.
(6) If the worker’s survival is confirmed, the Corporation shall notify the person who has received the insurance benefits that he/she should pay the amount referred to in Article 39 (2) of the Act.
(7) A person who is given notification pursuant to paragraph (6) shall pay the notified amount to the Corporation within thirty days after he/she is given the notification.

Article 40 (Medical Care Benefits)

(1) Medical care benefits shall be paid to a worker if the worker gets an injury or a disease for work-related causes.
(2) The medical care benefits referred to in paragraph (1) shall require the worker to receive medical care at an industrial accident insurance-related medical institution prescribed in Article 43 (1):Provided that in inevitable cases, medical care expenses may be paid in lieu of providing medical care.
(3) In the case of paragraph (1), if the injury or disease can be cured after three days or less of medical care, the medical care benefits shall not be paid.
(4) The scope of the medical care benefits referred to in paragraph (1) is as follows:[Amended by Act No. 10339, Jun. 4, 2010]
1. Medical examination and test;
2. Provision of medicines or medical supplies, artificial limbs, and other prosthetic devices;
3. Treatment, operation and other treatments;
4. Rehabilitation treatment
5. Hospitalization;
6. Nursing and patient caring;
7. Transfers and
8. Other matters prescribed by the Ordinance of the Ministry of Employment and Labor.
(5) The criteria for the calculation of medical care benefits, such as the scope and amount of medical care benefits as referred to in paragraphs (2) and (4), shall be prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Act No. 10339, Jun. 4, 2010]
(6) If the industrial accident insurance-related medical institution where a worker suffering from a work-related accident intends to receive medical care is to be a high-grade general hospital prescribed in Article 43 (1) 2, the worker shall be an emergency patient prescribed in subparagraph 1 of Article of the Emergency Medical Service Act or except when other inevitable reasons exist, there shall be an medical opinion that the worker needs to get medical care at a high-grade general hospital. [Amended by Act No. 10305, May 20, 2010]

Enforcement Ordinance

Article 38 (Claim, etc. for Medical Care Expenses)

(1) The medical care expenses an entitled person can receive pursuant to the proviso of Article 40 (2) of the Act are described in the following subparagraphs:
1. Medical care expenses incurred in case the person receives urgent medical care, such as emergency treatment, at a medical institution other than the industrial accident insurance-related medical institutions (hereinafter referred to as “industrial accident insurance-related medical institutions”) referred to in Article 43 (1) of the Act;
2. Expenses (limited to cases where such expenses are not provided by industrial accident insurance-related medical institutions) spent for any of the following medical care benefits:
A. Provision of artificial limbs or other prosthetic devices under Article 40 (4) 2 of the Act;
B. Patient caring under Article 40 (4) 6 of the Act;and
C. Transfers under Article 40 (4) 7 of the Act
3. Other medical care expenses deemed by the Corporation to have a justifiable cause
(2) A person who intends to receive the medical care expenses referred to in paragraph (1) shall file the claim with the Corporation.
(3) If it is urgent or there are other inevitable reasons, the Corporation may pay in advance the expenses required for the transfers referred to in Article 40 (4) 7 of the Act after receiving the claim from the worker concerned.
Article 41 (Application for Medical Care Benefits)
(1) A person who intends to receive medical care benefits (with the exception of medical care benefits for pneumoconiosis, hereinafter the same shall apply in this article) pursuant to Article 40 (1), shall make an application for medical care benefits to the Corporation, together with documents indicating his/her workplace, the background of the accident, and medical opinions about the accident. In this case, the procedures for and method of application for medical care benefits shall be prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Act No. 10305, May 20, 2010, and Act No. 10339, Jun. 4, 2010]
(2) An industrial accident insurance-related medical institution prescribed in Article 43 (1), which gives medical examination and treatment to a worker, if the accident is judged as a work-related accident, may apply for medical care benefits on behalf of the worker with his/her consent.

Article 41 (Application for Medical Care Benefits)

(1) Any person who intends to receive medical care benefits (excluding medical care benefits for pneumoconiosis; hereafter in this Article the same shall apply) pursuant to Article 40 (1), shall file an application with the Service for the medical care benefits, along with documents indicating his or her workplace, reasons for the accident, medical opinions on the accident, and other matters prescribed by Ordinance of the Ministry of Employment and Labor. In such cases, the procedures and methods for application for medical care benefits shall be prescribed by Ordinance of the Ministry of Employment and Labor.

(2) An industrial accident insurance-related medical institution as prescribed in Article 43 (1), which provides medical treatment to an employee suffering from an accident, may apply for medical care benefits on behalf of the employee with his or her consent, if the accident is determined to be an occupational accident.

Article 41-2 (Verification of Eligibility for Medical Care Benefits)

(1) A person who receives medical care benefits under Article 40 (1) may request the Service to verify whether the expenses he or she has borne are excluded from the scope of medical care benefits pursuant to paragraph (5) of the same Article.

(2) The Service in receipt of a request for verification under paragraph (1) shall notify the person who requested verification of the result. In such cases, if the expenses for which verification is requested are found to be within the scope of medical care benefits, the Service shall notify an industrial accident insurance-related medical institution under Article 43 (1) of such facts.

(3) An industrial accident insurance-related medical institution in receipt of notification under the latter part of paragraph (2) shall, without delay, refund the amount it has collected in excess of the amount it should have collected to the person who requests verification (hereinafter referred to as "overpaid amount"): Provided, That where the relevant industrial accident insurance-related medical institution fails to refund the overpaid amount, the Service may refund the person who requests verification the amount obtained by deducting such overpaid amount from the medical expenses referred to in Article 45 it is liable to pay to such health care institution.

[This Article Newly Inserted on Dec. 8, 2020]

Article 42 (Preferential Application of Health Insurance)

(1) Any person who applies for medical care benefits pursuant to Article 41 (1) may be entitled to medical care benefits under Article 41 of the National Health Insurance Act or medical benefits under Article 7 of the Medical Care Assistance Act (hereinafter referred to as "medical care benefits under health insurance, etc.") before the Service makes a decision on the medical care benefits under this Act.

(2) Where a person who has received medical care benefits under health insurance, etc. pursuant to paragraph (1) is determined as a beneficiary of medical care benefits under this Act after paying his or her co-payment amount under Article 44 of the National Health Insurance Act or Article 10 of the Medical Care Assistance Act to an industrial accident insurance-related medical institution, he or she may file a claim with the Service for an amount equivalent to the medical care benefits referred to in Article 40 (5) out of his or her co-payment amount already paid.

Article 43 (Designation of Industrial Accident Insurance-related Medical Institutions, Cancellation of Designation, etc.)

(1) Medical institutions which shall provide medical care for employees suffering from occupational accidents (hereinafter referred to as "industrial accident insurance-related medical institutions") are as follows:

1. Medical institutions established in the Service under Article 11 (2);

2. Tertiary care hospitals referred to in Article 3-4 of the Medical Service Act;

3. Medical institutions or public health clinics designated by the Service, from among medical institutions referred to in Article 3 of the Medical Service Act and public health clinics referred to in Article 10 of the Regional Public Health Act (including public health clinics referred to in Article 12 of the Regional Public Health Act; hereinafter the same shall apply) which satisfy the standards set by Ordinance of the Ministry of Employment and Labor in terms of manpower, facilities, etc.

(2) When designating a medical institution or public health clinic as an industrial accident insurance-related medical institution pursuant to paragraph (1) 3, the Service shall take into account each of the following factors:

1. Manpower, facilities, equipment, and areas of practice of the medical institution or public health clinic;

2. Regional distribution of industrial accident insurance-related medical institutions.

(3) If an industrial accident insurance-related medical institution referred to in paragraph (1) 2 and 3 falls under any of the following subparagraphs, the Service may revoke its designation (applied only to the case of paragraph (1) 3), restrict its medical treatment for employees suffering from occupational accidents for not more than 12 months, or order necessary improvements (hereinafter referred to as "restriction on medical treatment, etc."):

1. Where the medical institution diagnoses or certifies matters concerning an occupational accident by fraud or other improper means;

2. Where the medical institution claims medical expenses referred to in Article 45 by fraud or other improper means;

3. Where revocation of the designation or restriction on medical treatment, etc. is found necessary as a result of an evaluation referred to in Article 50;

4. Where the medical institution or a doctor thereof is not able to engage in medical service temporarily or permanently due to a violation of the Medical Service Act or any other reason;

5. Where the medical institution fails to meet the standards of manpower, facilities, etc. referred to in paragraph (1) 3;

6. Where the medical institution violates a restriction on medical treatment, etc.

(4) No industrial accident insurance-related medical institution whose designation is revoked pursuant to paragraph (3) may be re-designated as such for the period set by Ordinance of the Ministry of Employment and Labor within the limit of one year from the date of such revocation.

(5) If an industrial accident insurance-related medical institution under paragraph (1) 2 and 3 falls under any of the following subparagraphs, the Service may impose a restriction on medical treatment, etc. for not more than 12 months:

1. Where the medical institution unduly claims medical expenses referred to in Article 45, in violation of the criteria for the calculation of medical care benefits referred to in Article 40 (5) and 91-9 (3);

2. Where the medical institution claims medical expenses from a person other than the Service, in violation of Article 45 (1);

3. Where the medical institution fails to submit a medical treatment plan referred to in Article 47 (1);

4. Where the medical institution fails to make a report or to respond to a request for submission of materials or investigation referred to in Article 118;

5. Where the medical institution violates the conditions of designation as an industrial accident insurance-related medication institution.

(6) Where the Service seeks to revoke designation or restrict medical treatment pursuant to paragraph (3) or (5), it shall hold a hearing.

(7) The procedures for designation referred to in paragraph (1) 3 and the criteria and procedures for revocation of designation and restrictions on medical treatment, etc. referred to in paragraphs (3) and (5) shall be prescribed by Ordinance of the Ministry of Employment and Labor.

Article 44 (Penalties, etc. for Industrial Accident Insurance-related Medical Institutions)

(1) If the Corporation has to restrict medical treatment for any of the reasons described in subparagraphs 1 and 2 of paragraph (3) and subparagraph 1 of paragraph (5) of Article 43 and considers that the restriction on medical treatment causes serious inconvenience to the workers who use the medical institution in question or that there are other special reasons, it may impose a penalty not exceeding five times the amount of insurance benefits received in a false or fraudulent way or the amount of medical expenses received in a false, fraudulent or illegitimate ways in lieu of restricting medical treatment. [Amended by Act No. 9988, Jan. 27, 2010]
(2) The amount, etc. of the penalty imposed pursuant to paragraph (1) according to type and degree of offence, etc., shall be prescribed by the Presidential Decree.
(3) If a person subject to the imposition of a penalty pursuant to paragraph (1) fails to pay the penalty by the deadline, the penalty shall be collected with the approval of the Minister of Employment and Labor in accordance with the process for the recovery of national taxes in arrears. [Amended by Act No. 9988, Jan. 27, 2010 and Act No. 10339, Jun. 4, 2010]

Enforcement Ordinance

Article 39 (Criteria for Imposition and Payment of Penalties)

(1) If the Corporation intends to impose penalties pursuant to Article 44 (1) of the Act, it shall investigate and confirm the offense and then notify the person subject to the imposition that he/she should pay such penalties, specifying the facts of offense, the amount of penalties, how to file an objection, the period for filing an objection, etc.
(2) The person notified pursuant to paragraph (1) shall pay the penalties to the agency designated by the Corporation within twenty days after receiving the notification:Provided that in case he/she is unable to pay the penalties within the said period for a natural disaster or other inevitable reasons, he/she shall pay the penalties within seven days after the reason has disappeared.
(3) The agency which has received the penalties pursuant to paragraph (2) shall issue a receipt to the person who paid the penalties.
(4) The agency responsible for receiving penalties, upon receiving penalties pursuant to paragraph (2), shall inform the Corporation of the receipt without delay.
(5) The criteria for the imposition of penalties by type and degree of offense, etc. referred to in Article 44 (2) of the Act are shown in Table 5.

Article 45 (Claim, etc. for Medical Expenses)

(1) If an industrial accident insurance-related medical institution which has provided medical care pursuant to Article 40 (2) or Article 91-9 (1) is to receive the expenses (hereinafter referred to as “medical expenses”), it shall claim the expenses from the Corporation. [Amended by Act No. 10305, May. 20, 2010]
(2) Examination and decision concerning the medical expenses claimed pursuant to paragraph (1) and procedures for and method of the payment of such expenses shall be prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Act No. 10339, Jun. 4, 2010]

Article 46 (Claim, etc. for Medicine Expenses)

(1) The Corporation may provide medicines under Article 40 (4) 2 through a pharmacy registered pursuant to Article 20 of the Pharmaceutical Affairs Act.
(2) If the pharmacy referred to in paragraph (1) intends to receive medicine expenses, it shall claim the expenses from the Corporation.
(3) Examination and decision concerning the medicine expenses claimed pursuant to paragraph (2), and procedures for and method of the payment of such expenses shall be prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Act No. 10339, Jun. 4, 2010]

Article 47 (Submission of Medical Treatment Plan)

(1) When it is necessary to extend the period of medical care for an employee receiving medical care benefits pursuant to Article 41 or 91-5, the relevant industrial accident insurance-related medical institution shall submit to the Service a medical treatment plan containing the progress relating to the disease or injury of the employee, expected treatment period, treatment methods, etc., as prescribed by Presidential Decree.

(2) The Service may examine the adequacy of a medical treatment plan submitted pursuant to paragraph (1), and take necessary measures prescribed by Presidential Decree (hereinafter referred to as "measures, etc. to change a medical treatment plan"), such as ordering the industrial accident insurance-related medical institution to change the treatment period.

Enforcement Ordinance

Article 40 (Submission of Medical Treatment Plans)

(1) An industrial accident insurance-related medical institution shall include the following matters in a medical treatment plan (hereinafter referred to as “medical treatment plan”) referred to in Article 47 (1) of the Act:
1. Name of the injury or disease the worker is suffering from due to a work-related accident;
2. Progress in, details of the treatment of, and current state of, the injury ordisease of the worker;
3. Medical necessity of extending the medical care period;
4. Methods, contents and period of future treatment, such as in-hospital treatment, outpatient treatment or treatment while in employment;and
5. Other matters necessary for the treatment of the worker
(2) An industrial accident insurance-related medical institution shall prepare a medical treatment plan referred to in paragraph (1) on a three monthly basis (on a yearly basis if the injury or disease requires long-term medical care lasting one year or longer due to its characteristics and is the ones determined by the Corporation) and submit it to the Corporation at least seven days before the end of the previous medical care period (referring to the changed medical care period in case the Corporation makes changes pursuant to Article 41 (2) 1).

Enforcement Ordinance

Article 41 (Examination of Medical Treatment Plan and Measures to Change)

(1) When the Service examines a medical treatment plan pursuant to Article 47 (2) of the Act, it may seek advice from an advisory doctor under Article 42 or submit the plan to a panel of advisory doctors under Article 43 for deliberation.

(2) "Necessary measures prescribed by Presidential Decree" in Article 47 (2) of the Act refer to the following measures:

1. Termination of treatment or reduction of scheduled treatment period;

2. Changes to treatment methods, such as hospitalization and outpatient treatment;

3. Transfer to another hospital pursuant to Article 48 (1) of the Act;

4. Other changes to medical treatment plans.

(3) If the Service seeks to take any of the measures referred to in paragraph (2) with regard to a medical treatment plan, it shall notify the employee and industrial accident insurance-related medical institution concerned of the plan's contents.

Enforcement Ordinance

Article 42 (Advisory Doctor)

(1) The Corporation may commission or appoint doctors, dentists or oriental medicine doctors (including doctors, dentists or oriental medicine doctors who are an employee of the Corporation) as advisory doctors in order to give medical advice necessary for making decisions on the payment of insurance benefits, medical expenses, medicine expenses, etc. resulting from work-related accidents or for other insurance activities.
(2) Necessary matters concerning qualifications for advisory doctors (hereinafter referred to as “advisory doctors”) referred to in paragraph (1) and procedures, etc., for the commission and appointment thereof shall be determined by the Corporation

Enforcement Ordinance

Article 43 (Panel of Advisory Doctors)

(1) The Service shall have a panel of advisory doctors under its affiliated agency to give systematic advice on decisions on the payment of insurance benefits, medical expenses, medicine expenses, etc. resulting from occupational accidents and on matters requiring medical determinations otherwise in relation to insurance affairs.

(2) The panel of advisory doctors shall be comprised of five advisory doctors or more.

(3) The panel of advisory doctors shall deliberate on the following matters which need medical determinations, in response to a request for advice by the Service:

1. Whether to terminate treatment for an employee receiving medical care (limited to cases where there is a difference of medical opinion regarding the termination of treatment between a doctor in charge and an advisory doctor);

2. Adequacy of reasons for a transfer to another hospital under Article 48 (1) 4 of the Act;

3. Medical opinions regarding calculation of the amount of lump-sum insurance benefits referred to in Article 72;

4. Medical opinions regarding adjudication or determination referred to in the proviso to Article 118 (4);

5. Other matters concerning insurance benefits, medical expenses and medicine expenses, of which deliberation by the panel of advisory doctors deemed necessary by the head of an affiliated agency of the Service.

(4) Matters necessary for the constitution and operation of the panel of advisory doctors shall be determined by the Service.

Article 48 (Change of Medical Institution Providing Medical Care)

(1) If any of the following events occurs to an employee in the course of medical care, the Service may transfer such employee to another industrial accident insurance-related medical institution to provide medical care:

1. Where the employee needs to be transferred to another industrial accident insurance-related medical institution because the manpower, facilities, etc. of the industrial accident insurance-related medical institution currently providing medical care are unfit for the specialized treatment or rehabilitative treatment of the employee;

2. Where the employee needs to be transferred to another industrial accident insurance-related medical institution to receive medical care near where he or she lives;

3. Where the employee needs to be transferred to another industrial accident insurance-related medical institution after receiving specialized treatment at a tertiary care hospital under Article 43 (1) 2;

4. Where it is deemed that any unavoidable ground exists through a procedure prescribed by Presidential Decree.

(2) If any of the events under paragraph (1) 1 through 3 occurs to an employee in the course of medical care, he or she may file an application with the Service for his or her transfer to another medical institution providing medical care.

[Title Amended on Jan. 26, 2021]

Enforcement Ordinance

Article 44 (Transfer to Another Medical Institution)

“The procedures prescribed by the Presidential Decree” in Article 48 (1) 4 of the Act refer to the procedures for deliberation by the panel of advisory doctors.

Article 49 (Application for Medical Care Benefits for Additional Injury or Disease)

If a worker receiving medical care due to a work-related accident falls under any of the following subparagraphs, he/she may apply for medical care benefits for an additional injury or disease (hereinafter referred to as “additional injury or disease”):
1. Where medical care is needed as an injury or a disease which has arisen from the work-related accident is additionally found;
2. Where medical care is needed as a new disease occurs as a result of an injury or a disease arising from the work-related accident.

Enforcement Ordinance

Article 45 (Additional Injury or Disease)

Injuries or diseases resulting from the accidents during medical care under Article 32 shall be regarded as the additional injury or disease under Article 49 of the Act in applying for medical care benefits.

Article 50 (Evaluation of Industrial Accident Insurance-related Medical Institutions)

(1) In order to improve the quality of medical service with regard to work-related accidents, the Corporation may evaluate the medical institutions prescribed by the Presidential Decree, from among the industrial accident insurance-related medical institutions referred to in Article 43 (1) 3, in terms of manpower, facilities, medical services and other matters relating to the quality of medical care. In this case, the evaluation method and criteria shall be prescribed by the Presidential Decree.
(2) Considering the results of the evaluation referred to in paragraph (1), the Corporation may preferentially treat the evaluated industrial accident insurance-related medical institutions administratively or financially, or cancel their designation or impose restrictions, etc., on medical treatment pursuant to Article 43 (3) 3.

Enforcement Ordinance

Article 46 (Industrial Accident Insurance-related Medical Institutions Subject to Evaluation)

(1) “The medical institutions prescribed by the Presidential Decree” in the former part of Article 50 (1) of the Act shall be the industrial accident insurance-related medical institutions referred to in Article 43 (1) 3 of the Act:Provided that the medical institutions authenticated pursuant to Article 58 of the Medical Service Act shall be evaluated only against the evaluation categories relating to the quality of medical care, which are excluded from the evaluation under the same Act. [Amended by Presidential Decree No. 24177, Nov. 12, 2012]
(2) The Corporation may select medical institutions to be evaluated from among the industrial accident insurance-related medical institutions subject to evaluation pursuant to paragraph (1) after taking into consideration their manpower, facilities, size, outcomes of medical treatment for workers suffering from a work-related accident, amount of medical expenses claimed, results, etc. of previous evaluations regarding medical care benefits, etc.

Enforcement Ordinance

Article 47 (Method, etc. of Evaluating Industrial Accident Insurance-related Medical Institutions)

(1) The method of the evaluation of industrial accident insurance-related medical institutions under Article 50 of the Act shall be either on-site evaluation or written evaluation. In this case, industrial accident insurance-related medical institutions selected for on-site evaluation shall be so notified in advance.
(2) The evaluation criteria for industrial accident insurance-related medical institutions are as follows:
1. Manpower, facilities and equipment;
2. Content and level of medical service;
3. Satisfaction levels of workers who have received medical care
4. Outcomes of medical treatment for workers suffering from a work-related accident;and
5. Other matters concerning the quality of medical care for workers suffering from a work-related accident
(3) Details necessary for the evaluation under paragraph (2) shall be determined by the Corporation.

Article 51 (Additional Medical Care)

(1) If a person who has received medical care benefits under Article 40 suffers a recurrence of an occupational injury or disease that was the object of the medical care after the cure, or if there is a medical opinion that active treatment of his or her occupational injury or disease is needed because his or her injury or disease gets worse, he or she is entitled to medical care benefits under Article 40 again (hereinafter referred to as "additional medical care").

(2) Matters necessary for requirements, procedures, etc. for additional medical care shall be prescribed by Presidential Decree.

Enforcement Ordinance

Article 48 (Requirements and Procedures for Additional Medical Care)

(1) The additional medical care (hereinafter referred to as “additional medical care”) under Article 51 of the Act shall be provided in cases where a person has received medical care benefits (or disability benefits in the case of injuries or diseases for which disability benefits not medical care benefits have been received) for a work-related injury or disease and satisfy all of the following requirements:
1. There is causal relations between the work-related injury or disease cured and the injury or disease subject to additional medical care;
2. The state of the injury or disease subject to additional medical care has deteriorated compared with when the person was cured and the deterioration is not due to age or other reasons unrelated to work;
3. Active treatments, such as surgical operations (including operations to remove a fixed object from the body or reoperations on mutilated parts in order to attach artificial limbs), are deemed necessary for improving the state of the injury or disease subject to additional medical care;and
4. The injury or disease subject to additional medical care should be expected to be able to be treated by the additional medical care
(2) A person who intends to receive additional medical care shall apply for additional medical care to the Corporation under the conditions prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Presidential Decree No. 22269, Jul. 12, 2010]

Article 52 (Wage Replacement Benefits)

Wage replacement benefits shall be paid to a worker who gets injured or contract a disease for work-related reasons for a period during which the worker concerned is unable to work due to medical care, and the amount to be paid for a day shall be the equivalent amount of 70/100 of the average wages:Provided that if the period of not being able to work is three days or less, they shall not be paid.

Article 53 (Partial Wage Replacement Benefits)

(1) If a worker who is undergoing medical care or additional medical care is employed for a certain period or part-time, he/she may be paid 90/100 of the amount calculated by subtracting the wage paid for those days or hours employed from the average wage corresponding to the number of days or hours employed:Provided that if the minimum wage (the amount of reduction in case the amount is reduced in accordance with subparagraph 2 of Table 1) is taken as the daily wage replacement benefits pursuant to Article 54 (2) and Article 56 (2), an amount equivalent to the minimum wage minus the wage paid for days or hours employed may be paid.
(2) If a worker is employed part-time as referred to in paragraph (1), for the number of hours unemployed (referring to the number of hours remaining after subtracting the number of hours employed from eight hours), an amount produced by multiplying the daily wage replacement benefits calculated pursuant to Article 52 or Articles 54 through 56 by the ratio of the number of hours unemployed to eight hours shall be paid.
(3) Requirements and procedures for the payment of partial wage replacement benefits referred to in paragraph (1) shall be prescribed by the Presidential Decree.

Enforcement Ordinance

Article 49 (Requirements for Payment of Partial Wage Replacement Benefits)

A person who intends to receive the partial wage replacement benefits referred to in Article 53 of the Act shall meet all of the following requirements:
1. While receiving medical care, the person should be employed in a fixed business, be engaged in a fixed job and has fixed working hours;and
2. There should be a doctor’s opinion that even the worker’s employment will neither delay the cure of, nor aggravate, his/her injury and disease.

Enforcement Ordinance

Article 50 (Procedures for Payment of Partial Wage Replacement Benefits)

(1) A person who intends to receive partial wage replacement benefits shall file the claim with the Corporation with the documents prescribed by the Ordinance of the Ministry of Employment and Labor attached thereto. [Amended by Presidential Decree No. 22269, Jul. 12, 2010]
(2) Upon receipt of the claim referred to in paragraph (1), the Corporation shall decide whether to make that payment after taking into consideration the worker’s state of injury or disease, work, working hours, etc., and inform the worker of the decision.

Article 54 (Wage Replacement Benefits for Low-income Workers)

(1) If the daily amount of wage replacement benefits calculated pursuant to Article 52 is less than or equal to 80/100 of the minimum standard amount of compensation, the daily wage replacement benefits for the worker shall be an amount equivalent to 90/100 of his/her average wage:Provided that an amount equivalent to 90/100 of the average wage of the worker is more than 80/100 of the minimum standard amount of compensation, an amount equivalent to 80/100 of the minimum standard amount of compensation shall be the daily wage replacement benefits.
(2) If the amount of wage replacement benefits calculated pursuant to paragraph (1) is less than the minimum wage, the minimum wage shall be the daily wage replacement benefits for the worker.

Article 55 (Wage Replacement Benefits for the Aged)

If an employee who receives temporary layoff benefits reaches the age of 61, his or her temporary layoff benefits thereafter shall be an amount calculated in accordance with attached Table 1: Provided, That when a person who remains employed after the age of 61 receives medical care due to an occupational accident or when a person who has received disability benefits before the age of 61 due to an occupational disease pursuant to Article 37 (1) 2 receives medical care for the first time due to the occupational disease after the age of 61, the provisions of attached Table 1 shall not apply during such period prescribed by Presidential Decree.

Enforcement Ordinance

Article 51 (Grace Period Before Payment of Wage Replacement Benefits in Reduced Amount for the Aged)

“The period prescribed by the Presidential Decree” in the proviso of Article 55 of the Act refers to two years after the start of medical care due to a work-related accident.

Article 56 (Wage Replacement Benefits During Additional Medical Care)

(1) For a person who receives additional medical care, an amount equivalent to 70/100 of the average wage calculated on the basis of the wage as at the time of receiving such additional medical care shall be the daily amount of temporary layoff benefits. In such cases, the date of the occurrence of a cause for calculating the average wage shall be prescribed by Presidential Decree.

(2) If the daily amount of temporary layoff benefits calculated pursuant to paragraph (1) is less than the minimum wage, or if there is no wage subject to the calculation of the average wage as at the time of receiving additional medical care, the minimum wage shall be the daily amount of temporary layoff benefits.

(3) Where a person who receives a disability compensation annuity receives additional medical care, if the sum of the daily disability compensation annuity (referring to the amount of disability compensation annuity, calculated pursuant to attached Table 2, divided by 365; hereinafter the same shall apply) and the daily amount of temporary layoff benefits calculated pursuant to paragraph (1) or (2) exceeds 70/100 of the average wage, which is applied in calculating the disability compensation annuity, an amount equivalent to the temporary layoff benefits, out of the excess amount, shall not be paid.

(4) In calculating temporary layoff benefits during the period of additional medical care, Article 54 shall not apply.

Enforcement Ordinance

Article 52 (Date of Occurrence of Reasons for Calculating Average Wage Due to Additional Medical Care)

“The date of the occurrence of reasons for calculating the average wage” in the latter part of Article 56 (1) of the Act refers to any of the following days:[Amended by Presidential Decree No. 22269, Jul. 12, 2010]
1. The day when the injury or disease subject to additional medical care is diagnosed as requiring additional medical care:Provided that if there is time or medical continuity between the diagnosis and the examination or treatment of the injury or disease subject to additional medical care prior to the diagnosis, the start day of the examination or treatment;or
2. In the case of diseases for which whether or not they are subject to additional medical care should be judged following the procedures prescribed by the Ordinance of the Ministry of Employment and Labor because of the characteristics of the diseases, the date of issuance on the medical certificate or medical opinion available at the time of applying for such judgment
Article 57 (Disability Benefits)
(1) Disability Benefits shall be paid to a worker who has a disability after receiving medical care due to injuries or diseases he/she got for work-related reasons.
(2) Disability benefits shall be paid in the form of a disability compensation annuity or lump sum disability compensation set forth in Table 2 based on grade of disability, and criteria for disability grades shall be prescribed by the Presidential Decree.
(3) Either disability compensation annuity or lump sum disability compensation referred to in paragraph (2) shall be paid depending on the choice of the entitled person:Provided that a worker with the disability grades prescribed by the Presidential Decree, which are characterized as a complete loss of work ability, shall be paid a disability compensation annuity and a worker who was not a Korean national when the reason for claiming the payment of disability benefits occurred and resides in a foreign country shall be paid lump sum disability compensation.
(4) Disability compensation annuities may be paid in advance at the request of the entitled person in an amount equivalent to 1/2 of one- to two-year annuities (one to four-year annuities for the workers prescribed in the proviso of paragraph (3)). In this case, interest may be deducted from the amount paid in advance at the rate prescribed by the Presidential Decree, which is not more than 5/100.
(5) In the event that the entitlement of a person entitled to a disability compensation annuity is terminated pursuant to Article 58, if the sum of the number of days obtained by dividing the already paid annuity by each of the average wages at the time of payment is less than the number of days for lump sum disability compensation prescribed in Table 2, an amount calculated by multiplying the shortfall in the number of days by the average wage at the time of the termination shall be paid in a lump sum to the worker or his/her surviving family members.

Article 57 (Disability Benefits)

(1) Disability benefits shall be paid to any employee who suffers from a physical disability, etc. after recovering from any injury or disease caused by reason of his or her duties.

(2) Disability benefits shall be paid in the form of a disability compensation annuity or lump-sum disability compensation as set out in attached Table 2 according to disability grades, and the standards for disability grades shall be prescribed by Presidential Decree.

(3) The beneficiary may choose between a disability compensation annuity or lump-sum disability compensation benefit referred to in paragraph (2): Provided, That an employee with such disability grade prescribed by Presidential Decree as a complete loss of work ability shall be paid a disability compensation annuity, and an employee who is not a Korean national and resides in a foreign country when the cause for claiming disability benefits occurs shall be paid a lump-sum disability compensation benefit.

(4) A disability compensation annuity may be paid in advance upon request of the beneficiary in an amount equivalent to 1/2 of the first year or two-year annuity (the first year to four-year annuity for any such employee as prescribed in the proviso of paragraph (3)). In such cases, interest, within the limit of 5/100, may be deducted from the amount paid in advance at the rate prescribed by Presidential Decree.

(5) Where a beneficiary’s entitlement to a disability compensation annuity is extinguished under Article 58, if the total number of days obtained by dividing the amount of the already paid annuity by each average wage as at the time when the annuity is paid is short of the number of days for lump-sum disability compensation benefits set forth in attached Table 2, the amount calculated by multiplying the insufficient number of days by the average wage as at the time when the entitlement is extinguished shall be paid in a lump sum to the relevant survivors or the relevant employee.

Enforcement Ordinance

Article 53 (Criteria, etc. for Disability Grades)

(1) The criteria for disability grades referred to in Article 57 (2) of the Act shall be governed by Table 6. In this case, detailed criteria, etc., for the judgement of disability grades by body part shall be prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Presidential Decree No. 22269, Jul. 12, 2010]
(2) If there are two or more disabilities falling under the criteria for disability grades as prescribed in Table 6, the disability grade of the worker concerned shall be that of the more severe disability, and if there are two or more disabilities falling under grade 13 or higher, the disability grade of the worker concerned shall be the one adjusted according to the following subparagraphs:Provided that if the disability grade is arithmetically higher than grade 1 as a result of the adjustment, grade 1 shall be the disability grade of the worker concerned, and if the degree of the disability is deemed obviously lower than the degree of the other disabilities set forth for the adjusted grade, the grade just below the adjusted grade shall be the disability grade of the worker concerned:
1. If there are two or more disabilities falling under grade 5 or higher, the grade shall be adjusted upwards by three;
2. If there are two or more disabilities falling under grade 8 or higher, the grade shall be adjusted upwards by two;and
3. If there are two or more disabilities falling under grade 13 or higher, the grade shall be adjusted upwards by one.
(3) If there is a disability not prescribed in Table 6, the grade of a similar disability shall be the grade of the disability.
(4) If a person, who already has a disability, has disabilities in the same body part aggravated due to a work-related injury or disease, the amount of disability benefits shall be the one calculated on the basis of the number of payment days for lump-sum disability compensation or disability compensation annuities by grade of disability as shown in Table 2 in accordance with the following subparagraphs:
1. When the benefits are paid in the form of lump-sum disability compensation:the number of payment days for lump-sum disability compensation corresponding to the aggravated disability minus the number of payment days for lump-sum disability compensation corresponding to the existing disability and then multiplied by the amount of average wage at the time when the reason for claiming the payment of the benefits occurs;or
2. When the benefits are paid in the form of disability compensation annuities:the number of payment days for disability compensation annuities corresponding to the aggravated disability minus the number of payment days for disability compensation annuities corresponding to the existing disability (if the existing disability is a disability falling under grades 8 through 14, the number of payment days for lump-sum disability compensation corresponding to such disability multiplied by 22.2/100) and then multiplied by the amount of average wage at the time of the payment of the annuities.
(5) “The disability grades prescribed by the Presidential Decree, which are characterized as a complete loss of work ability” in the proviso of Article 57 (4) of the Act refer to disability grades 1 to 3 as set forth in Table 6.
(6) A person who intends to receive a lump sum payment pursuant to Article 47 (5) of the Act shall make the claim with the Corporation.

Enforcement Ordinance

Article 54 (Interest Rate for Disability Compensation Annuities Paid in Advance)

Deleted

Article 58 (Termination of Entitlement to Disability Compensation Annuity, etc)

If a person entitled to receive a disability compensation annuity or a pneumoconiosis compensation annuity (hereinafter referred to as ‘entitled’ in this Article) falls under any of the following subparagraphs, his/her entitlement shall be terminated:[Amended by Act No. 10305, May 20, 2010]
1. Where he/she dies;
2. Where the entitled person was once a Korean national but has lost Korean nationality and now lives in a foreign country or leaves Korea to live in a foreign country;
3. Where the entitled person is not a Korean national and leaves Korea to live in a foreign country;
4. Where he/she is excluded from those to be paid disability compensation annuities or pneumoconiosis disability annuities as a result of a change of his/her disability or pneumoconiosis disability grade
[Title of this Article Amended by Act No. 10305, May. 20, 2010]

Article 59 (Redetermination of Disability Grades, etc)

(1) With regard to any beneficiary of disability compensation annuities or pneumoconiosis compensation annuities whose disability or pneumoconiosis grade already determined (hereafter in this Article referred to as "disability grade, etc.") is possible to be changed as the state of his or her disability has improved or worsened, the Service may redetermine his or her disability grade, etc. upon request of the beneficiary or by virtue of its authority.

(2) If a disability grade, etc. is changed as a result of redetermination referred to in paragraph (1), disability benefits or pneumoconiosis compensation annuities shall be paid according to the changed disability grade, etc.

(3) Redetermination of a disability grade, etc. referred to in paragraphs (1) and (2) shall be made only once, and the eligible persons and period for such redetermination and the methods for paying disability benefits or pneumoconiosis compensation annuities based on the results thereof shall be prescribed by Presidential Decree.

[Title Amended on May 20, 2010]

Enforcement Ordinance

Article 55 (Persons Subject to Redetermination of Disability Grades, Etc.)

(1) Those subject to the redetermination of disability grades or pneumoconiosis disability grades (hereinafter referred to as “disability grades, etc”) pursuant to Article 59 (3) of the Act shall be persons entitled to disability compensation annuities or pneumoconiosis compensation annuities, who fall under any of the following subparagraphs:[Amended by Presidential Decree No. 22492, Nov. 15, 2010]
1. Where the person has one or more of the disabilities eligible for disability compensation annuities, which fall under grades 1-3, 2-5, 3-3, 5-8, 7-4, 9-15 or 12-15 set forth in Table 6;
2. Where the person has one or more of the disabilities eligible for disability compensation annuities, which fall under grades 6-5, 7-14, 8-2, 9-17, 10-8, 11-7 or 12-16 set forth in Table 6 (limited to cases where the disability grade is determined based on spinal nerve root disorder);
3. Where the person has one or more of the disabilities eligible for disability compensation annuities, which fall under grades 1-6, 1-8, 4-6, 5-4, 5-5, 6-6, 6-7, 7-7, 7-11, 8-4, 8-6, 8-7, 9-11, 9-13, 10-10, 10-13, 10-14, 11-9, 11-10, 12-9, 12-10, 12-12, 12-14, 13-8 or 13-11 set forth in Table 6 (limited to cases where the disability grade is determined based on the motor functions of body joints);
4. Where the person sustains any of the pneumoconiosis disabilities comparable to grades 1 through 7 set forth in subparagraph 2 of Table 11-2 from among disabilities eligible for pneumoconiosis disability compensation annuities;
5. Where the person has disabilities referred to in Article 53 (3), which are eligible for disability compensation annuities and include one or more of the disabilities prescribed in subparagraphs 1 through 3
(2) Notwithstanding the provision of paragraph (1), if the final disability grade of a person entitled to disability compensation annuities has not changed because of his/her other disabilities even though the grades of some of his/her disabilities have changed pursuant to subparagraphs of paragraph (1), he/she shall be excluded from those subject to the redetermination of disability grades.
[Title of this Article Amended by Presidential Decree No. 22493, Nov. 15, 2010]

Enforcement Ordinance

Article 56 (Period, etc. for Redetermination of Disability Grades, Etc.)

(1) The redetermination of disability grades, etc. under Article 59 of the Act shall be made within one year after two years have passed since the day when the decision to pay disability compensation annuities or pneumoconiosis compensation annuities was made. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]
(2) Notwithstanding the provision of paragraph (1), if a person subject to the redetermination of disability grades receives additional medical care, the redetermination shall be made within one year after two years have passed since the day when he/she was cured after the additional medical care (in case his/her disability grades, etc. has changed, the day when the decision to pay disability compensation annuities or pneumoconiosis compensation annuities according to that change was made). [Amended by Presidential Decree No. 22492, Nov. 15, 2010]
(3) If the Corporation intends to redetermine disability grades, etc. pursuant to paragraphs (1) or (2), it shall demand the person subject to the redetermination to undergo the medical examination under Article 117 (1) 2. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]
(4) A person who intends to have his/her disability grade, etc. redetermined pursuant to Article 59 (1) of the Act shall make application to the Corporation under the conditions prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Presidential Decree No. 22269, Jul. 12, 2010 and Presidential Decree No. 22492, Nov. 15, 2010]
(5) If the Corporation intends to redetermine disability grades, etc., it shall inform the worker concerned of the industrial accident insurance-related medical institution (or medical examination institutes in accordance with Article 91-6 (1) of the Act, in the case of redetermining pneumoconiosis disability grades) which will examine the degree of disability, the date of the medical examination or other matters necessary for the redetermination at least 30 days before the date of the medical examination. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]
[Title of this Article Amended by Presidential Decree No. 22493, Nov. 15, 2010]

Enforcement Ordinance

Article 57 (Method of Payment of Disability Benefits or Pneumoconiosis Compensation Annuities According to Redetermination of Disability Grades, Etc.)

(1) If a person files a claim for disability compensation annuities or pneumoconiosis compensation annuities as his/her disability grade, etc has changed as a result of the redetermination of disability grades, etc pursuant to Article 59 of the Act, disability compensation annuities, or pneumoconiosis compensation annuities corresponding to the changed disability grade, etc, shall be paid beginning from the month following the month in which the date of medical examination falls. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]
(2) If a person files a claim for lump-sum disability compensation as his/her disability grade has changed as a result of the redetermination of disability grades pursuant to Article 59 of the Act, the payment shall be made in accordance with the following subparagraphs:
1. In case the disability has worsened:the person shall be paid the number of payment days for lump-sum disability compensation corresponding to the changed disability grade minus the sum of the numbers of days obtained by dividing the amount of disability compensation annuities already paid by each average wage at the time of the payment and then multiplied by the average wage;
2. In case the disability has improved (including cases where the changed disability grade is between grade 8 and grade 14):only when the number of payment days for lump-sum disability compensation corresponding to the changed disability grade is larger than the sum of the numbers of days obtained by dividing the amount of disability compensation annuities already paid by each average wages at the time of the payment, shall the person be paid the amount of average wage multiplied by the difference in the number of days.
(3) In the case of paying disability compensation annuities pursuant to paragraph (1), Article 57 (4) of the Act shall not apply.
[Title of this Article Amended by Presidential Decree No. 22493, Nov. 15, 2010]

Article 60 (Disability Benefits Due to Additional Medical Care)

(1) Even in case a person entitled to a disability compensation annuity receives additional medical care, the payment of the annuity shall not be suspended.
(2) If after a person is cured by additional medical care, his/her state of disability has improved or worsened compared with before, the disability benefits shall be paid according to the disability grade corresponding to the improved or worsened state of disability.

Enforcement Ordinance

Article 58 (Disability Benefits After Additional Medical Care)

(1) If a person who has received disability compensation annuities files a claim for disability compensation annuities as his/her disability grade has changed after receiving additional medical care, disability compensation annuities corresponding to the changed disability grade shall be paid beginning from the month following the month in which the day he/she was cured after additional medical care falls.
(2) If a person who has received disability compensation annuities files a claim for lump-sum disability compensation as his/her disability grade has changed after receiving additional medical care, the payment shall be made in accordance with the following subparagraphs:
1. In case where the disability has worsened:the person shall be paid the number of payment days for lump-sum disability compensation corresponding to the changed disability grade minus the sum of the numbers of days obtained by dividing the amount of disability compensation annuities already paid by each average wage at the time of the payment and then multiplied by the average wage;
2. In case where the disability has improved (including cases where the changed disability grade is between grade 8 and grade 14):only when the number of payment days for lump-sum disability compensation corresponding to the changed disability grade is larger than the sum of the numbers of days obtained by dividing the amount of disability compensation annuities already paid by each average wages at the time of the payment, shall the person be paid the amount of average wage multiplied by the difference in the number of days
(3) If a person who has received lump-sum disability compensation has his/her disability worsened compared with before after additional medical care, the disability benefits shall be paid according to the following methods:
1. In case where he/she files a claim for the payment in the form of disability compensation annuities:disability compensation annuities corresponding to the changed disability grade shall be paid beginning from the month following the month in which the day he/she was cured after additional medical care falls, but he/she shall not be paid the amount of disability compensation annuities corresponding to the number of days for which the lump-sum disability compensation has been paid;
2. In case where he/she files a claim for the payment in the form of lump-sum disability compensation:he/she shall be paid the number of payment days for lump-sum disability compensation corresponding to the changed disability grade minus the number of payment days for lump-sum disability compensation corresponding to the previous disability grade and then multiplied by the average wage.
(4) The average wage used to calculate disability benefits after additional medical care shall be the amount obtained by increasing or decreasing the average wage (the average wage at the time of the termination of the previous medical care in case disability benefits have not been received before) used to calculate the previous disability benefits pursuant to Article 22.
(5) In the case of paying disability compensation annuities after additional medical care, Article 57 (4) shall not apply:Provided that this shall not apply if a person who was previously ineligible for disability benefits receives disability compensation annuities after additional medical care.

Article 61 (Nursing Benefits)

(1) Nursing benefits shall be paid to any beneficiary of medical care benefits under Article 40 who is in need of medically constant or frequent nursing care after his or her cure and is actually receiving nursing care.

(2) Matters necessary for the standards, methods, etc. for paying nursing benefits under paragraph (1) shall be prescribed by Presidential Decree.

Enforcement Ordinance

Article 59 (Payment Standard and Method of Nursing Benefits)

(1) Those eligible for the nursing benefits referred to in Article 61 (1) of the Act are shown in Table 7.
(2) Nursing benefits shall be paid for days during which a person eligible for nursing benefits pursuant to paragraph (1) actually receives nursing care.
(3) The standard amount of nursing benefits shall be the one announced by the Minister of Employment and Labor on the basis of total monthly wages, etc., by occupation according to the survey on labor conditions by type of employment prepared by the Minister of Employment and Labor among the designated statistics referred to in Article 3 of the Statistics Act. In this case, the amount of nursing benefits to be paid to those eligible for occasional nursing benefits shall be two thirds of the amount to be paid to those eligible for permanent nursing benefits. [Amended by Presidential Decree No. 22269, Jul. 12, 2010]
(4) Notwithstanding the provision of paragraph (1), a person eligible for nursing benefits spends no nursing expenses as he/she enters a free-of-charge nursing home, etc., or spends less than the standard amount under paragraph (3), the amount actually spent shall be paid as his/her nursing benefits.
(5) If a person entitled to nursing benefits receives additional medical care pursuant to Article 51 of the Act, nursing benefits shall not be paid during the additional medical care.
(6) The method of claiming nursing benefits shall be prescribed by the Ordinance of the Ministry of Employment and Labor. [Amended by Presidential Decree No. 22269, Jul. 12, 2010]

Article 62 (Survivors’ Benefits)

(1) Survivors' benefits shall be paid to a survivor of any employee who has died due to a cause related to his or her duties.

(2) Survivors' benefits shall be paid in the form of a survivors' compensation annuity or lump-sum survivors' compensation set out in attached Table 3, and the lump-sum survivors' compensation benefits shall be paid where there is no person eligible for a survivors' compensation annuity pursuant to Article 63 (1) as at the time the employee dies.

(3) If a person eligible for a survivors' compensation annuity under paragraph (2) chooses, an amount equivalent to 50/100 of the lump-sum survivors' compensation benefits set out in attached Table 3 shall be paid in a lump sum, and the survivors' compensation annuity shall be paid in an amount reduced by 50/100.

(4) Where a person who has received a survivors' compensation annuity loses eligibility therefor, and if there is no other beneficiary with eligibility and the total number of days calculated by dividing the amount of the annuity already paid by each average wage as at the time of paying the annuity is short of 1,300, the amount calculated by multiplying such insufficient number of days by the average wage as at the time of losing the eligibility shall be paid in a lump sum to the survivors as at the time the eligibility is lost.

(5) Standards and methods for paying survivors' compensation annuities under paragraph (2) and other necessary matters shall be prescribed by Presidential Decree.

Enforcement Ordinance

Article 60 (Appointment, etc. of Representative for Claiming Survivors Compensation Annuity)

(1) If there are two or more persons entitled to a survivors compensation annuity, one of them may be appointed as a representative to claim and receive the survivors compensation annuity.
(2) If a representative is appointed under paragraph (1), or the appointed representative is dismissed, it shall be reported without delay to the Corporation together with documents to attest such appointment or dismissal.

Article 63 (Scope of Persons Entitled to Survivors' Compensation Annuities)

(1) A person entitled to a survivors' compensation annuity (hereinafter referred to as "persons entitled to a survivors' compensation annuity") shall be the spouse of the relevant employee and any of the following survivors whose livelihood had been supported by such employee as at the time of the employee's death (excluding those who were not Korean nationals and were living in foreign countries as at the time of the employee’s death). In such cases, the criteria for determining survivors whose livelihood had been supported by the employee shall be prescribed by Presidential Decree:

1. Parents or grandparents respectively aged at least 60 years;

2. Children aged below 25 years;

2-2. Grandchildren aged below 19 years;

3. Siblings aged below 19 years or at least 60 years;

4. Any person who is a child, parent, grandchild, grandparent, or sibling who does not fall under any of subparagraphs 1 through 3 and who falls under a disability level prescribed by Ordinance of the Ministry of Employment and Labor, among persons with disabilities provided for in Article 2 of the Act on Welfare of Persons with Disabilities.

(2) In applying paragraph (1), if a child who was a fetus as at the time of the employee's death is born, the child shall be deemed, at birth and thereafter, a survivor whose livelihood had been supported by such employee as at the time of his or her death.

(3) The order of priority for entitlement to a survivors' compensation annuity in persons entitled to the survivors' compensation annuity shall be in accordance with the following order: Spouse, children, parents, grandchildren, grandparents, and siblings.

Enforcement Ordinance

Article 61 (Scope of Surviving Family Members Supported by Worker)

“The surviving family members whose livelihood was supported by the worker” in Article 63 (1) of the Act refer to persons falling under any of the following subparagraphs:
1. A surviving family member who is described as having lived with the worker in the same household in the resident registration index book under the Resident Registration Act and all or substantial part of whose livelihood was maintained by the worker’s incomes;
2. A surviving family member all or substantial part of whose livelihood was maintained by the worker’s incomes but who is registered as having resided in a different household from, or did not live with, the worker due to study, employment, medical care and other residential circumstances;
3. Surviving family members other than those referred to in paragraphs (1) and (2), all or most part of whose livelihood was maintained with the help of money and other valuable goods or economic support regularly provided by the worker

Article 64 (Losing Eligibility of and Suspension of Payment for Persons Entitled to Survivors' Compensation Annuities)

(1) Any survivor entitled to a survivors' compensation annuity shall lose his or her eligibility when he or she falls under any of the following subparagraphs:

1. Where the beneficiary dies;

2. When he or she is remarried (limited to the spouse of the deceased employee and including the case of a de facto marital relationship as for remarriage);

3. Where the kinship with the deceased employee ceases to exist;

4. When a child reaches the age of 25 years;

4-2. When a grandchild or sibling reaches the age of 19 years;

5. Where a person who has been disabled as prescribed in Article 63 (1) 4 recovers from such disability;

6. Where a person entitled to a survivors' compensation annuity who was a Korean national as at the time of the employee's death has lost his or her Korean nationality and who now lives in a foreign country or leaves Korea to live in a foreign country;

7. Where a person entitled to a survivors' compensation annuity who is not a Korean national leaves Korea to live in a foreign country.

(2) Where a person entitled to a survivors' compensation annuity (hereinafter referred to as "survivors' compensation annuitant") loses eligibility, the entitlement to the survivors' compensation annuity shall be transferred to a person in the same priority status, if any, and, when there is no such person, to the person next in order.

(3) If a survivors' compensation annuitant has been missing for at least three months, the payment of such annuity to him or her shall be suspended as prescribed by Presidential Decree, and the annuity shall be paid to a person in the same priority status, if any, and, when there is no such person, to the person next in order.

Enforcement Ordinance

Article 62 (Suspension, etc. of Payment of Survivors Compensation Annuity)

(1) In case the right to receive a survivors compensation annuity has been transferred pursuant to Article 64 (2) of the Act, a person who intends to newly receive a survivors compensation annuity shall file with the Corporation for a change of the person entitled to survivors’ compensation annuities.
(2) In case a person entitled to a survivors compensation annuity has been missing for three months or more pursuant to Article 64 (3) of the Act, the payment of the annuity to that missing person shall be suspended at the request of a person (in case no such person exists, the person next in the order) at the same priority level in the order as the entitled person for the period of disappearance starting from the month following the month in which the entitled person went missing and the amount calculated in accordance with Article 62 (2) and Table 3 of the Act shall be paid as a survivors’ compensation annuity. In this case, the missing person previously entitled to survivors compensation annuity shall not be regarded as those entitled to survivors compensation annuity, to whom additional payment referred to in Article 62 (2) and Table 3 of the Act applies.
(3) A person for whom the payment of a survivors compensation annuity is suspended pursuant to paragraph (2) may apply any time for the nullification of the suspension.

Article 65 (Order of Priority of Survivors who are Survivors' Compensation Annuitants)

(1) The order of priority for entitlement to a survivors' compensation annuity among survivors under Articles 57 (5) and 62 (2) (limited to lump-sum survivors' compensation benefits) and (4) shall be in accordance with the following order, but the order of priority for the said entitlement among persons under the same subparagraph shall follow the order in which they are listed in the subparagraph. In such cases, where at least two annuitants are in the same priority status, the annuity shall be divided and paid equally among them:

1. The spouse, children, parents, grandchildren, and grandparents whose livelihood had been supported by the employee as at the time of his or her death;

2. The spouse, children, parents, grandchildren, and grandparents whose livelihood had not been supported by the employee as at the time of his or her death, and siblings whose livelihood had not been supported by the employee as at the time of his or her death;

3. Siblings.

(2) In the case of paragraph (1), an adoptive parent has priority over a biological parent, a parent of an adoptive parent over a parent of a biological parent, and an adoptive parent of any parent over a biological parent of any such parent.

(3) If a survivor who is a survivors' compensation annuitant dies, the insurance benefits shall be paid to a person in the same priority status, if any, and, when there is no such person, to the next person in order.

(4) Notwithstanding paragraphs (1) through (3), if an employee designates a survivor to receive insurance benefits in his or her will, such designation shall be honored in the payment of such insurance benefits.

Enforcement Ordinance

Article 63 (Adjustment of Survivors Compensation Annuity)

If there occur the causes described in the following subparagraphs, the Corporation may adjust, at the request of a person entitled to survivors compensation annuities or by virtue of its authority, the amount of survivors compensation annuities for months following the month in which those causes occur:
1. Where a child who was a fetus at the time of the worker’s death is born;
2. Where the suspension of payment is lifted under Article 62 (3)
3. Where the person entitled to survivors compensation annuities is disqualified under Article 64 (1);and
4. Where the person entitled to survivors compensation annuities is missing

Article 66 (Injury-Disease Compensation Annuity)

(1) If a worker who has received medical care benefits continues to be in a state that meets all the requirements described in the following subparagraphs, after two years have passed since the start of the medical care, he/she shall be paid an injury-disease compensation annuity instead of wage replacement benefits:[Amended by Act No. 9988, Jan. 27, 2010]
1. The injury or disease remains uncured;and
2. The degree of invalidity caused by the wound or disease meets the standards for invalidity grades prescribed by the Presidential Decree;
3. The worker has not been employed because of medical care
(2) Injury-disease compensation annuities shall be paid according to the grades of invalidity shown in Table 4.

Enforcement Ordinance

Article 64 (Payment, etc. of Injury-Disease Compensation Annuities)

(1) A person who intends to receive an injury-disease compensation annuity as prescribed in Articles 66 through 69 of the Act shall file a claim with the Corporation for injury-disease compensation annuity, together with a medical certificate issued by a doctor, which can attest to his/her state of invalidity.
(2) If the invalidity grade of a worker receiving an injury-disease compensation annuity has changed, the Corporation may pay, at the request of the entitled person or by virtue of its authority, injury-disease compensation annuities based on the new invalidity grade starting from the month following the month in which such a change has taken place.
(3) When a worker receiving injury-disease compensation annuities files a claim for injury-disease compensation annuities due to a change of his/her invalidity grade under paragraph (2), he/she shall attach a medical certificate issued by a doctor, which can attest to his/her state of invalidity.

Enforcement Ordinance

Article 65 (Criteria, etc. for Invalidity Grades)

(1) The criteria for invalidity grades based on which injury-disease compensation annuities are paid pursuant to Articles 66 through 69 of the Act are shown in Table 8.
(2) With regard to the adjustment of invalidity grades in case there are two invalidities or more, the provision of Article 53 (2) shall apply mutatis mutandis. In this case, “disability grades” shall be read as “invalidity grades” and “disability” as “invalidity” and the disability grades 4 to 14 set forth in Table 6 shall be regarded as respective corresponding invalidity grades.
(3) If an existing invalidity is aggravated due to a new work-related injury or disease, the amount of injury-disease compensation annuity for the aggravated invalidity grade shall be calculated by subtracting the number of payment days for injury-disease compensation annuities corresponding to the existing validity grade from the number of payment days for injury-disease compensation annuities corresponding to the aggravated validity grade and then multiplying the resulting number by the average wage at the time of the payment of the annuity.

Article 67 (Injury-Disease Compensation Annuity for Low-income Workers)

(1) In calculating a injury-disease compensation annuity pursuant to Article 66, if the average wage of the worker is less than an amount produced by multiplying the minimum wage by 100/70, 100/70 of the minimum wage shall be seen as the minimum wage of the worker.
(2) If the amount of daily injury-disease compensation annuity obtained by dividing the amount of injury-disease compensation annuity calculated pursuant to Article 66 or paragraph (1) by 365 is less than the daily wage replacement benefits calculated pursuant to Article 54, the amount calculated pursuant to Article 54 shall be the daily injury-disease compensation annuity. [Amended by Act No. 9988, Jan. 27, 2010]

Article 68 (Injury-Disease Compensation Annuity for the Aged)

If a worker who receives an injury-disease compensation annuity reaches the age of 61, the amount of injury-disease compensation annuity to be paid thereafter shall be calculated in accordance with the standards for payment of daily injury-disease compensation annuities in Table 5. [Amended by Act No. 9988, Jan. 27, 2010]

Article 69 (Injury-Disease Compensation Annuities during Additional Medical Care)

(1) A person whose state of injury or disease meets all the requirements described in the subparagraphs of Article 66 (1) two years after the commencement of additional medical care shall be paid an injury-disease compensation annuity, instead of temporary layoff benefits, in accordance with the grades of invalidity set out in attached Table 4. In such cases, the average wage applicable in the calculation of temporary layoff benefits during the additional medical care shall be applied in calculating the injury-disease compensation annuity; but if such average wage is less than the minimum wage multiplied by 100/70 or there is no wage subject to the calculation of the average wage as at the time of the additional medical care, the amount equivalent to 100/70 of the minimum wage shall be deemed the average wage for the employee in calculating the annuity.

(2) If an employee who receives an injury-disease compensation annuity pursuant to paragraph (1) receives a disability compensation annuity, the number of payment days for the injury-disease compensation annuity by grade of invalidity shown in attached Table 4, minus the number of payment days for the disability compensation annuity by grade of disability set out in attached Table 2, and then multiplied by the average wage under the latter part of paragraph (1) shall be the amount of injury-disease compensation annuity for the employee.

(3) If an employee who receives an injury-disease compensation annuity pursuant to paragraph (2) reaches the age of 61, an injury-disease compensation annuity per day calculated in accordance with attached Table 5, minus the amount of disability compensation annuity per day calculated on the basis of the average wage pursuant to the latter part of paragraph (1), shall be the amount of injury-disease compensation annuity per day to be paid thereafter.

(4) Notwithstanding paragraphs (1) through (3), if an employee who receives a disability compensation annuity pursuant to the proviso of Article 57 (3) receives additional medical care, no injury-disease compensation annuity shall be paid: Provided, That when his or her grade of invalidity is raised during additional medical care, two years shall be deemed to have passed since the commencement of additional medical care, notwithstanding the former part of paragraph (1), and the amount of injury-disease compensation annuity calculated pursuant to paragraphs (2) and (3) shall be paid.

(5) Article 67 shall not apply in calculating injury-disease compensation annuities during additional medical care.

Article 70 (Period and Time of Paying Annuities

(1) The payment of a disability compensation annuity, survivors' compensation annuity, pneumoconiosis compensation annuity, or pneumoconiosis survivors' annuity shall begin on the first day of the month following the month in which a reason for the payment thereof occurs, and shall end on the last day of the month in which the entitlement to such annuity is extinguished.

(2) If a reason for suspending payment of a disability compensation annuity, survivors' compensation annuity, pneumoconiosis compensation annuity, or pneumoconiosis survivors' annuity occurs, no such annuity shall be paid from the first day of the month following the month in which the reason occurs, to the last day of the month in which the reason ceases to exist.

(3) A disability compensation annuity, survivors' compensation annuity, pneumoconiosis compensation annuity or pneumoconiosis survivors' annuity, shall annually be paid in twelve equal installments, each of which shall be paid on the 25th of every month; but if the payment date falls on a Saturday or holiday, it shall be paid on the preceding day.

(4) If entitlement to a disability compensation annuity, survivors' compensation annuity, pneumoconiosis compensation annuity, or pneumoconiosis survivors' annuity is extinguished, it may be paid even before the payment date referred to in paragraph (3).

Article 71 (Funeral Expenses)

(1) Where an employee dies due to any cause related to his or her duties, funeral expenses equivalent to an amount calculated by multiplying the average wage by 120 days shall be paid to a survivor who arranges funeral services: Provided, That when there is no survivor who will arrange funeral services or when a person other than survivors arranges funeral services due to unavoidable reasons, the amount actually spent on the funeral services shall be paid to the person who arranges the funeral services, within the limits of an amount equivalent to an amount calculated by multiplying the average wage by 120 days.

(2) Where the funeral expenses referred to in paragraph (1) exceed the maximum amount or fall short of the minimum amount, as publicly notified by the Minister of Employment and Labor as prescribed by Presidential Decree, such maximum amount or minimum amount shall be each deemed the funeral expenses.

[Title Amended on Jan. 26, 2021]

Enforcement Ordinance

Article 66 (Calculation of Maximum and Minimum Funeral Expenses)

(1) The maximum and minimum amounts of funeral expenses prescribed in Article 71 (2) of the Act shall be calculated in accordance with the following classification:

1. Maximum amount of funeral expenses: The average per capita funeral expenses for 90 days paid to those entitled to funeral expenses in the previous year + the maximum standard amount of compensation for 30 days

2. Minimum amount of funeral expenses : The average per capita funeral expenses for 90 days paid to those entitled to funeral expenses in the previous year + the minimum standard amount of compensation for 30 days

(2) In calculating the maximum and minimum amounts of funeral expenses, the amount of less than ten Won shall be discarded.

(3) The application period for the maximum and minimum amounts of funeral expenses shall be from January 1 to December 31 of the following year.

Article 72 (Vocational Rehabilitation Benefits)

(1) The types of vocational rehabilitation benefits shall be as follows:

1. Vocational training costs and vocational training allowances for persons who require vocational training to be reemployed (hereinafter referred to as "trainees") among persons who have received disability benefits or pneumoconiosis compensation annuities or who are clearly expected to receive disability benefits as prescribed by Presidential Decree (hereinafter referred to as "recipients of disability benefits");

2. Return-to-work subsidies, vocational adaption training costs, and rehabilitation exercise costs to be paid respectively where a business owner retains employment or conducts vocational adaptation training (including vocational adaptation training conducted before returning to work) or a rehabilitation exercise program for the recipients of disability benefits who return to business they worked for as at the time of the occurrence of the occupational accident.

(2) The trainees referred to in paragraph (1) 1 and the recipients of disability benefits referred to in subparagraph 2 of the same paragraph shall be prescribed by Presidential Decree, in consideration of the degree of disability, age, etc.

Enforcement Ordinance

Article 67 (Support for Vocational Rehabilitation)

(1) For the vocational rehabilitation of a person suffering from a work-related accident, the Corporation may provide psychological counseling, information necessary for vocational rehabilitation, vocational assessment in consideration of the worker’s vocational desire, skills, etc., assistance in establishing a plan to return to work or other necessary supports while or after the worker receives medical care.
(2) The Corporation may ask for cooperation in counseling, assessment or other areas from a person suffering from a work-related accident, if such cooperation is needed for providing the support for vocational rehabilitation referred to in paragraph (1).

Enforcement Ordinance

Article 68 (Persons Eligible for Vocational Rehabilitation Benefits)

(1) The training targets (hereinafter referred to as “training targets”) referred to in Article 72 (1) 1 of the Act shall be those who meet all of the following requirements:[Amended by Presidential Decree No. 22101, Mar. 26, 2010, Presidential Decree No. 22269, Jul. 12, 2010 and Presidential Decree No. 22492, Nov. 15, 2010]
1. The person shall fall under any of the following items:
A. The person falls into any of disability grades 1 to 12;or
B. The person is under medical care due to a work-related injury or disease, and there is a medical opinion that the injury and disease, even after cured, will result in the person falling into any of disability grades 1 to 12.
2. Deleted. [Presidential Decree No. 24177, Nov. 12, 2012]
3. The person is unemployed. In this case, the scope of unemployment is defined by the Ordinance of the Ministry of Employment and Labor;[Amended by Presidential Decree No. 22269, Jul. 12, 2010]
4. The person is not receiving any other vocational training;and
5. The person has established a plan to return to work pursuant to Article 67 (1).
(2) Notwithstanding the provisions of paragraph (1) 3, if a training target who is receiving vocational training is employed during the vocational training period, he/she may be allowed to receive the vocational training until it ends, but shall not be paid vocational training allowances for the period of employment.
(3) If the training target referred to in paragraph (1) receives job-seeking benefits under the Employment Insurance Act during his/her vocational training period, he/she may be allowed to receive the vocational training, but shall not be paid vocational training allowances. [Amended by Presidential Decree No. 22101, Mar. 26, 2010]
(4) The recipients of disability benefits (hereinafter referred to as “recipients of disability benefits”) referred to in Article 72 (1) 2 of the Act shall be those who fall under subparagraph 1 of paragraph (1) when they return to the work concerned. [Amended by Presidential Decree No. 22101, Mar. 26, 2010]

Article 73 (Vocational Training Costs)

(1) Vocational training for trainees shall be provided at a vocational training institution which has contracted with the Service (hereinafter referred to as "vocational training institution").

(2) Vocational training costs under Article 72 (1) 1 (hereinafter referred to as "vocational training costs") shall be paid to a vocational training institution which provides vocational training pursuant to paragraph (1): Provided, That they shall not be paid in cases prescribed by Presidential Decree, including where a vocational training institution has received an amount equivalent to vocational training costs under the Act on the Employment Promotion and Vocational Rehabilitation of Persons with Disabilities, the Employment Insurance Act, the Act on the Development of Vocational Skills of Workers, or other statutes.

(3) Vocational training costs shall be the amounts actually spent within the limits of the amounts publicly notified by the Minister of Employment and Labor considering training costs, training period, labor market conditions, etc., but the training period during which the vocational training costs are paid shall not exceed 12 months.

(4) Matters necessary for the scope, criteria, procedure, and method for paying vocational training costs, the conclusion and termination of contracts with vocational training institutions, etc. shall be prescribed by Ordinance of the Ministry of Employment and Labor.

Enforcement Ordinance

Article 69 (Restrictions on Payment of Vocational Training Costs)

“Such cases as prescribed by the Presidential Decree” in the proviso of Article 73 (2) of the Act refer to cases where a vocational training institution falls under any of the following subpargraphs with regard to vocational training for the training target concerned:[Amended by Presidential Decree No. 22356, Aug. 25, 2010]
1. Where it has received support for job adaptation training pursuant to Article 11 of the Act on Employment Promotion and Vocational Rehabilitation for the Disabled and support for vocational skills development training pursuant to Article 12 of the same Act;
2. Where it has received support for vocational skills development training pursuant to Article 29 of the Employment Insurance Act;
3. Where it has received support for vocational skills development training pursuant to Articles 11-2, 12, 15 and 17 of the Workers Vocational Skills Development Act;
4. Where the employer who intends to employ the training target has borne the vocational training costs;or
5. Where it has received support equivalent to the vocational training costs under other Acts or subordinate statutes

Article 74 (Vocational Training Allowances)

(1) Vocational training allowances under Article 72 (1) 1 shall be paid to trainees who receive vocational training pursuant to Article 73 (1) for a period during which they are unemployable due to the vocational training, and their daily payments shall be the amount equivalent to the minimum wage: Provided, That the trainees who receive temporary layoff benefits or injury-disease compensation annuities shall not be paid.

(2) Where a recipient of vocational training allowances pursuant to paragraph (1) receives a disability compensation annuity or pneumoconiosis compensation annuity, if the sum of the amount of disability compensation annuity per day or pneumoconiosis compensation annuity per day (referring to the amount calculated by dividing, by 365, the amount of the pneumoconiosis compensation annuities calculated pursuant to Article 91-3 (2)) and the amount of vocational training allowances per day exceeds 70/100 of the average wage which is applied for calculating the disability compensation annuity or pneumoconiosis compensation annuity of the relevant employee, no amount equivalent to the vocational training allowances out of such excess shall be paid.

(3) Matters necessary for the payment, etc. of vocational training allowances referred to in paragraph (1), shall be prescribed by Ordinance of the Ministry of Employment and Labor.

Article 75 (Return-to-work Subsidy, etc.)

(1) The return-to-work subsidy, work adaptation training costs and rehabilitation exercise costs referred to in Article 72 (1) 2 shall be paid, respectively, to an employer who retains, or carries out work adaptation training or a rehabilitation exercise program for, recipients of disability benefits. In this case, the conditions for the payment of return-to-work subsidy, work adaptation training costs and rehabilitation exercise costs shall be prescribed by the Presidential Decree.
(2) The return-to-work subsidy referred to in paragraph (1) shall be the amount of wages paid by the employer to a recipient of disability benefits within the limits of the amount announced by the Minister of Employment and Labor after taking into account wage levels, labor market conditions, etc., and the payment period shall be less than 12 months. [Amended by Act No. 10339, Jun. 4, 2010]
(3) The work adaptation training costs and rehabilitation exercise costs referred to in paragraph (1) shall be the amount actually spent within the limits of the amount announced by the Minister of Employment and Labor after taking into account the amount spent on work adaptation training and rehabilitation exercise, and the payment period shall be less than three months. [Amended by Act No. 10339, Jun. 4, 2010]
(4) In the cases prescribed by the Presidential Decree, such as when an employer who employs a recipient of disability benefits has received the subsidy under 23 of the Employment Insurance Act, the subsidy for employment of the disabled under Article 30 of the Act on Employment Promotion and Vocational Rehabilitation for the Disabled or an amount equivalent to the return-to-work subsidy, work adaptation training costs or rehabilitation exercise costs (hereinafter referred to as “return-to-work subsidy, etc.”) under other Acts and subordinate statues, the return-to-work subsidy, etc., minus the amount received shall be paid. [Amended by Act No. 9988, Jan. 27, 2010]
(5) In the cases prescribed by the Presidential Decree, such as when an employer employs a disabled person in compliance with the obligation under 28 of the Act on Employment Promotion and Vocational Rehabilitation for the Disabled, the return-to-work subsidy, etc., shall not be paid. [Newly Inserted by Act No. 9988, Jan. 27, 2010]

Enforcement Ordinance

Article 70 (Requirements for Payment of Return-to-work Subsidy, etc.)

(1) The return-to-work subsidy referred to in Article 75 (2) of the Act shall be paid if an employer has retained a recipient of disability benefits for not less than six months since the termination of the medical care or the return-to-work date and paid resulting wages:Provided that if the recipient of disability benefits voluntarily retires less than six months after the date of medical care termination or the return-to-work date, the return-to-work subsidy until the retirement day shall be paid. [Amended by Presidential Decree No. 22101, Mar. 26, 2010]
(2) The work adaption training costs referred to in Article 75 (3) of the Act shall be paid if an employer has provided work adaption training necessary for a recipient of disability benefits to perform his/her duties or switch to other duties and meets all of the following requirements:[Amended by Presidential Decree No. 22101, Mar. 26, 2010]
1. The employer started the work adaptation training or rehabilitation exercise programs within six months after the date of medical care termination or date of return to work;
2. The employer has retained the worker for six months or more after the end of the work adaptation training or rehabilitation exercise programs:Provided that this shall not apply if the recipient of disability benefits voluntarily retires less than six months after the end of the work adaptation training or rehabilitation exercise programs
(3) The rehabilitation exercise costs pursuant to Article 75 (3) of the Act shall be paid when the employer has performed the rehabilitation exercise necessary for performing the duties or conversion to other duties for the person suffering the disability. 1. Rehabilitation exercise shall begin within 6 months from the date of medical care termination or the date of return to work; 2. From the day after the end of the rehabilitation exercise, the employer must retain employment of the person suffering the disability for at least 6 months. However, the person who has received the disability may voluntarily leave before 6 months pass from the day following the end of the rehabilitation exercise.
(4) When the date of medical care termination or date of return to work is applied, among recipients of disability benefits, those who have received disability benefits shall be subject to the date of medical care termination, and those who will obviously receive disability benefits shall be subject to the date of return to work. [Newly Inserted by Presidential Decree No. 22101, Mar. 26, 2010]

Enforcement Ordinance

Article 71 (Restrictions on Payment of Return-to-work Subsidy, etc.)

(1) “Such cases as prescribed by the Presidential Decree” in Article 75 (4) of the Act refer to cases where an employer employing a recipient of disability benefits falls under any of the following subparagraphs:[Amended by Presidential Decree No. 22101, Mar. 26, 2010]
1. Where he/she has received support under Articles 23, 27 and 32 of the Employment Insurance Act;
2. Where he/she has received employment subsidy under Article 30 of the Act on Employment Promotion and Vocational Rehabilitation for the Disabled;
3. Where he/she has received support under Article 20 (1) of the Workers Vocational Skills Development Act;or
4. Where he/she has received an amount of money equivalent to the return-to-work subsidy, work adaptation training costs or rehabilitation exercise costs under other Acts or subordinate statues
5. Deleted. [Presidential Decree No. 22101, Mar. 26, 2010]
(2) “Such cases as prescribed by the Presidential Decree, including when a disabled person is employed according to the obligation under Article 28 of the Act on Employment Promotion and Vocational Rehabilitation for the Disabled” in Article 75 (5) of the Act refer to cases where an employer employing a recipient of disability benefits falls under any of the following subparagraphs:[Newly inserted by Presidential Decree No. 22101, Mar. 26, 2010]
1. Where he/she employs a disabled person required to be employed pursuant to Article 28 of the Act on Employment Promotion and Vocational Rehabilitation for the Disabled (Only return-to-work subsidy shall not be provided);or
2. Where in the three months before or six months after a recipient of disability benefits returns to work, he/she makes another recipient of disability benefits or a disabled person prescribed by the Act on Employment Promotion and Vocational Rehabilitation for the Disabled retire from the business for the purpose of getting return-to-work subsidy

Article 76 (Lump-sum Payment of Insurance Benefits)

(1) If an employee who is not a Korean national applies for the lump-sum payment of insurance benefits with the intention of departing from Korea while receiving medical care due to an injury or disease resulting from an occupational accident before it is cured, the insurance benefits expected to be claimed following the date on which the medical care is suspended due to the departure from Korea may be paid in a lump sum.

(2) The amount payable in a lump sum under paragraph (1) shall be the sum of each amount obtained by converting each of the following insurance benefits in consideration of the interest accrued for the advance payment period, etc. according to the methods prescribed by Presidential Decree. In such cases, if the relevant employee is medically recognized as meeting all requirements for the payment of insurance benefits described in subparagraphs 3 and 4, the amount of insurance benefits falling under subparagraph 4 shall not be included in the said sum:

1. Medical care benefits from the date on which medical care is suspended due to departure from Korea until the date on which an injury or disease resulting from an occupational accident is expected to be cured;

2. Temporary layoff benefits from the date on which medical care is suspended due to departure from Korea until the date on which an occupational injury or disease is expected to be cured or to be improved to the state of being employed (where the expected date falls more than two years after the date of commencing the medical care, until the second anniversary from the date of commencing the medical care);

3. Lump-sum disability compensation benefits corresponding to the grade of a disability expected to remain as at the time medical care is suspended due to departure from Korea, after an injury or disease resulting from an occupational accident is cured;

4. Where the invalidity subject to the payment of an injury-disease compensation annuity is expected to remain uncured after two years from the date of commencing medical care as at the time the medical care is suspended due to departure from Korea, an amount equivalent to the lump-sum disability compensation benefits corresponding to the same disability grade as the expected grade of invalidity (where the medical care is suspended due to departure from Korea after two years from the date of commencing the medical care, the grade of invalidity corresponding to the then state of injury or disease);

5. Pneumoconiosis compensation annuities based on the pneumoconiosis grade which is determined as at the time the medical care is provided.

(3) Procedures for applying for and paying lump-sum payment referred to in paragraph (1) shall be prescribed by Ordinance of the Ministry of Employment and Labor.

Enforcement Ordinance

Article 72 (Criteria for Lump-sum Payment of Insurance Benefits)

“Each amount converted according to the methods prescribed by the Presidential Decree” in the former part of Article 76 (2) of the Act, other than each subparagraph, refers to the amount of insurance benefits referred to in each subparagraph of the same paragraph minus 2/100 of that amount. In this case, the amount of injury-disease compensation annuity shall be the amount of lump-sum disability compensation for the disability grade corresponding to the invalidity grade and the amount of disability compensation annuity shall be the amount of lump-sum disability compensation for the disability grade. [Amended by Presidential Decree No. 22101, Mar. 26, 2010]

Enforcement Ordinance

Article 72-2 (Persons subject to prevention and control of complications, etc.)

(1) A person who is likely to be placed under additional medical care due to the development of a complication, etc. under Article 77 (1) of the Act (hereinafter referred to as “person subject to measures for prevention of a complication, etc.”) shall be one determined by the Service as requiring measures for prevention of complications, etc., subject to advice by advisory doctors or deliberation by the panel of advisory doctors under Article 43.

(2) The Service may require a person subject to measures for prevention of a complication, etc. to undergo a measure falling under any of the following subparagraphs at an industrial accident insurance-related medical institution, and reimburse expenses involved within the budgetary limits. In such cases, the expenses shall be calculated based on the standards for calculating medical care benefits under Article 40 (5) of the Act:

1. Medical examination and checkup;

2. Prescription of medicines or treatment materials;

3. Treatment other than operations, and other medical care;

4. Rehabilitative treatment;

5. Hospitalization.

(3) The standards and procedures for determinating the persons subject to measures for prevention of complications, etc., the coverage of expenses for measures under paragraph (2), and other necessary matters, shall be determined by the Service.

[This Article Newly Inserted by Presidential Decree No. 29354, Dec. 11, 2018]

Article 77 (Measures for Prevention of Complications)

(1) The Service may allow any person who is likely to be placed under additional medical care due to the development of a complication, etc., among persons who their occupational injuries or diseases have been cured, to receive treatment necessary for the prevention thereof at an industrial accident insurance-related medical institution.

(2) The detailed matters necessary for preventive measures under paragraph (1), such as the subjects and details of treatment and the standards for calculating treatment costs, shall be prescribed by Presidential Decree.

[This Article Wholly Amended on Jan. 27, 2010]

Article 78 (Special Disability Benefits)

(1) Where an employee has sustained any disability falling under such disability grade or pneumoconiosis grade as determined by Presidential Decree due to an occupational accident caused by any intentional or negligent conduct by the policyholder, if the beneficiary claims special disability benefits in lieu of a claim for compensation of damage as prescribed by the Civil Act, special disability benefits prescribed by Presidential Decree may be paid in addition to disability benefits under Article 57 or pneumoconiosis compensation annuities under Article 91-3: Provided, That it shall be limited to cases where an agreement between the employee and the policyholder is made on the special disability benefits.

(2) If a beneficiary has received special disability benefits under paragraph (1), he or she may not claim for damages pursuant to the Civil Act or other statutes, against the policyholder for the same cause.

(3) If the Service has paid special disability benefits under paragraph (1), it shall collect the total of such benefits from the policyholder as prescribed by Presidential Decree.

Enforcement Ordinance

Article 73 (Criteria, etc. for Payment of Special Disability Benefits)

(1) “The grades of disability or pneumoconiosis disability grades prescribed by the Presidential Decree” in Article 78 (1) of the Act refer to disability grades 1 to 3 as prescribed in Table 6, or pneumoconiosis disability grades 1 through 3 as shown in Table 11-2. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]
(2) “The special disability benefits as prescribed by the Presidential Decree” in Article 78 (1) of the Act refer to the amount calculated by subtracting the lump sum disability compensation (in the case of pneumoconiosis compensation annuities recipients, referring to the lump-sum disability compensation corresponding to the same disability grade of the pneumoconiosis disability grade concerned) referred to in Article 57 of the Act from the amount calculated by multiplying 30 days of average wages by the rate of work ability loss for each disability grade or pneumoconiosis disability grade shown in Table 9 and by Leibniz’s coefficient corresponding to the period to be employed as prescribed in Table 11. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]
(3) The period to be employed in the future under paragraph (2) shall be from the date of the determination of disability grades, etc., to the day when the person reaches the mandatory retirement age set by the collective agreements or the employment rules. In this case, if the collective agreements or the employment rules do not provide for a mandatory retirement age, sixty years of age shall be considered as the mandatory retirement age. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]

Article 79 (Special Survivors Benefits)

(1) In the event that a worker has died due to a work-related accident caused by the intention or negligence of the insurance subscriber, if the entitled person claims special survivors benefits in lieu of the claim for damage prescribed by the Civil Act, the special survivors benefits prescribed by the Presidential Decree may be paid in addition to the survivors’ benefits referred to in Article 62 or pneumoconiosis survivors annuities prescribed in Article 91-4. [Amended by Act No. 10305, May 20, 2010]
(2) The proviso of paragraph (1) and paragraphs (2) and (3) of Article 78 shall apply mutatis mutandis to the special survivors’ benefits as referred to in paragraph (1). In this case, “special disability benefits” shall be read as “special survivors’ benefits”.

Enforcement Ordinance

Article 74 (Criteria, etc. for Payment of Special Survivors Benefits)

(1) "Special survivors' benefits prescribed by Presidential Decree" in Article 79 (1) of the Act refer to the amount obtained by subtracting living costs of the deceased person (referring to the amount calculated by multiplying 30 days of his/her average wage by the rate of his/her living costs set forth in attached Table 10) from his/her average wage for 30 days and then subtracting the lump-sum survivors' compensation benefits referred to in Article 62 of the Act from the amount obtained by multiplying the Leibniz's coefficient corresponding to the number of employable months set forth in attached Table 11.

(2) Article 73 (3) shall apply mutatis mutandis to the calculation of the number of employbale months referred to in paragraph (1). In such cases, the "date of determination of a disability grade" shall be construed as the "date of death."

Enforcement Ordinance

Article 75 (Collection of Special Benefits)

(1) An insurance subscriber may, upon receiving a payment notice on special disability benefits or special survivors benefits pursuant to Articles 78 (3) and 79 (2) of the Act, pay them in four equal installments over the course of one year.
(2) If special disability benefits or special survivors benefits are paid in installments pursuant to paragraph (1), the first installment shall be paid by the end of the quarter in which the payment thereof is notified, and thereafter the remaining installments by the end of respective quarters.

Article 80 (Relation with Other Compensation or Indemnity)

(1) If a beneficiary has received or can receive any insurance benefit pursuant to this Act, the policyholder shall be exempted from liability for accident compensation, as prescribed by the Labor Standards Act for the same cause.

(2) If a beneficiary has received any insurance benefit as prescribed by this Act for the same cause, the policyholder shall be exempted from liability for indemnity as prescribed by the Civil Act and other statutes, within the limits of the amount of such insurance benefit. In such cases, a person who receives a disability compensation annuity, or survivors' compensation annuity shall be deemed to receive a lump-sum disability compensation benefit or survivors' compensation benefit.

(3) If a beneficiary has received, under the Civil Act or other statutes, any money or valuables equivalent to the amount of insurance benefits prescribed by this Act for the same cause, the Service shall not pay insurance benefits prescribed by this Act within the limits of the amount calculated by converting the money or valuables so received according to the method determined by Presidential Decree: Provided, That this shall not apply to the amount of annuity corresponding to the lump-sum disability compensation benefit or survivors' compensation benefit deemed to have been paid to the beneficiary under the latter part of paragraph (2).

(4) If an employee who receives medical care benefits has received any injury-disease compensation annuity after the third anniversary from the commencement of medical care, the relevant employer shall be deemed to have paid lump-sum compensation benefits as prescribed in Article 84 of the Labor Standards Act after such third anniversary, in application of the proviso of Article 23 (2) of the same Act.

Enforcement Ordinance

Article 76 (Criteria for Adjustment to Other Compensation or Indemnity)

(1) The "amount calculated by converting money or valuables so received according to the method determined by Presidential Decree" in the main sentence of Article 80 (3) of the Act refers to the amount of insurance benefits corresponding to the number of days obtained by dividing money or valuables received by the average wage at the time of calculation of the damages: Provided, That if money or valuables received are medical care, the amount shall be that spent for the medical care.
(2) In application of the provisions of paragraph (1), if the insurance benefits to be paid to an entitled person are pneumoconiosis compensation annuities, pneumoconiosis survivors annuities, survivors compensation annuities or wage replacement benefits, the number of days obtained by dividing the pneumoconiosis compensation annuities, pneumoconiosis survivors annuities, survivors compensation annuities or wage replacement benefits by the average wages (the minimum wage in the case of the wage replacement benefits referred to in Article 54 (2) and 56 (2) of the Act) at the time of the calculation of the insurance benefits concerned shall be considered as the number of payment days for the insurance benefits and the average wages as the daily amount of the insurance benefits. [Amended by Presidential Decree No. 22492, Nov. 15, 2010]

Article 81 (Unpaid Insurance Benefits)

(1) In the event that a person entitled to insurance benefits has died, if there are any insurance benefits to be paid, but not yet paid to, the entitled person, such insurance benefits shall be paid upon claim of his/her surviving family members (in case of survivors’ benefits, other survivors who are entitled to receive survivors’ benefits).
(2) In the case of paragraph (1), if the entitled person fails to claim insurance benefits prior to his/her death, the insurance benefits shall be paid upon claim of his/her survivors pursuant to the same paragraph.

Enforcement Ordinance

Article 77 (Decision, etc. on Person With Right to Claim Unpaid Insurance Benefits)

The provisions of Article 65 (1), (2) and (4) shall apply mutatis mutandis to decisions on a person with the right to claim any unpaid insurance benefits as prescribed in Article 81 of the Act.

Enforcement Ordinance

Article 77-2 (Insurance benefits account)

(1) “a tele-communications error or other unavoidable reasons prescribed by Presidential Decree” under the proviso of Article 82 (2) refers to a person to whom any of the following subparagraphs apply:
1. When financial institutions where an insurance benefits account pursuant to Article 82 (2) (hereinafter referred to as insurance benefits account) is opened find it impossible to continue business as usual due to closure, suspension of operation, or tele-communications error, etc. and are not able to transfer the insurance benefits to the insurance benefits account;
2. Other situations recognized by the Minister of Employment and Labor where it is impossible to transfer insurance benefits to the insurance benefits account within fourteen days after the payment thereof is decided.
(2) The Corporation may pay in cash directly when it is impossible to transfer insurance benefits to the insurance benefits account pursuant to the proviso of Article 82 (2) of the Act.
(3) The Corporation shall inform recipients that they may receive the insurance benefits through an insurance benefits account when they apply for it according to Article 82 (2) of the Act.
<This Article Newly Inserted by Presidential Decree No. 29354, Dec, 11, 2018>

Article 82 (Payment of Insurance Benefits)

(1) Insurance benefits shall be paid within fourteen days after the payment thereof is decided.
(2) Where there exists an application from an entitled person, the Corporation shall deposit insurance benefits into the confirmed account under the name of the entitled person (hereinafter referred to as an insurance benefits account): Provided that, in the event it is impossible to transfer the insurance benefits to the insurance benefits account due to an information-communication technology disability or other unavoidable reason prescribed by Presidential Decree, the insurance benefits may be paid as determined by Presidential Decree.
(3) The relevant financial institutions for the insurance benefits account shall direct management of the benefits so that only the insurance benefits pursuant to this Act can be deposited into an insurance benefits account.
(4) The application methods and process pursuant to paragraph (2) and the matters concerning management of insurance benefits accounts pursuant to paragraph (3) shall be prescribed by Presidential Decree.

Article 83 (Restrictions on Payment of Insurance Benefits)

(1) If a worker falls under any of the following subparagraphs, the Corporation may not pay all or part of the insurance benefits:[Amended by Act No. 10305, May 20, 2010]
1. Where while undergoing medical care, the worker has aggravated the state of his/her injury, disease or physical disability, or obstructed the cure thereof by violating instructions relating to medical care without any justifiable reasons;
2. Where a person entitled to disability or pneumoconiosis compensation annuities aggravated the state of his/her disability on purpose, such as through self-harm, before the disability or pneumoconiosis disability grade is redetermined pursuant to Article 59.
(2) If the Corporation has decided not to pay insurance benefits pursuant to paragraph (1), it shall notify this without delay to the insurance subscriber and the worker concerned.
(3) The types of insurance benefits subject to the restrictions on the payment of insurance benefits under paragraph (1) and the scope of the restrictions shall be prescribed by the Presidential Decree.

Enforcement Ordinance

Article 78 (Scope, etc. of Restrictions on Payment of Insurance Benefits)

(1) If a person entitled to insurance benefits falls under Article 83 (1) 1 of the Act, the Corporation shall not pay him/her an amount equivalent to 20 days (if the period until the occurrence of reasons for the payment is less than 20 days, that period) of the wage replacement benefits or injury-disease compensation annuities whose reason for payment occurs after the decision to restrict the payment of insurance benefits has been made.
(2) If a person entitled to disability compensation annuities or pneumoconiosis compensation annuities falls under Article 83 (1) 2 of the Act, the Corporation shall pay his/her disability benefits in accordance with the following subparagraphs:[Amended by Presidential Decree No. 22492, Nov. 15, 2010]
1. If the state of disability has worsened compared with the previous disability grades, etc., the Corporation shall pay disability compensation annuities or pneumoconiosis compensation annuities corresponding to the previous disability grades, etc.;or
2. If it was confirmed by medical opinions, etc., that the state of disability had improved compared with the previous disability grades, etc. but the state of disability has worsened before the redetermination of disability grades, etc., the Corporation shall pay disability benefits or pneumoconiosis compensation annuities corresponding to the improved disability grades, etc.

Article 84 (Collection of Undue Gains)

(1) Where any person who has received insurance benefits falls under any of the following subparagraphs, the Service shall collect an amount equivalent to such insurance benefits (in the case of subparagraph 1, an amount equivalent to double the benefits). In such cases, the amount which the Service has claimed and received from the National Health Insurance Corporation, etc. pursuant to Article 90 (2) shall be excluded from the amount to be collected:

1. Where he or she has received the insurance benefits by fraud or other improper means;

2. Where a beneficiary or former beneficiary has unjustly received the insurance benefits by failing to perform his or her duty to report under Article 114 (2) through (4);

3. Where there exist mistakenly paid insurance benefits.

(2) In the case of paragraph (1) 1, if the payment of the insurance benefits is based on false reporting, diagnosis or certification by the policyholder, an industrial accident insurance-related medical institution, or a vocational training institution, they shall be held jointly liable for the insurance benefits.

(3) If an industrial accident insurance-related medical institution or a pharmacy prescribed in Article 46 (1) falls under any of the following subparagraphs, the Service shall collect an amount equivalent to the medical expenses or medicine expenses: Provided, That in the case of subparagraph 1, an amount equivalent to double the medical expenses or medicine expenses (an amount equivalent to the medical expenses where penalty surcharges are imposed pursuant to Article 44 (1)) shall be collected:

1. Where the medical expenses or medicine expenses are obtained by fraud or other improper means;

2. Where the medical expenses or medicine expenses are obtained unjustly in violation of the standards for calculating medical care benefits prescribed in Article 40 (5) or 91-9 (3) and the standards for calculating treatment costs prescribed in Article 77 (2);

3. Where the medical expenses or medicine expenses are obtained mistakenly.

(4) Notwithstanding paragraph (1) and the proviso of paragraph (3), if a person who has received any insurance benefits, medical expenses or medicine expenses by fraud or other improper means (including any person who is held jointly liable under paragraph (2)) voluntarily reports the fact of unlawful receipt before an investigation into the unlawful receipt is commenced, the Service may exempt him or her from the collection of any amount in excess of the insurance benefits, medical expenses, or medicine expenses.

Article 84-2 (Disclosure of the List of Fraudulent Recipients)

(1) The Corporation may disclose the list of persons to whom Article 84 paragraph 1, subparagraph 1, or paragraph 3, subparagraph 1 applies (hereinafter referred to as “fraudulent recipient”) and to whom any of the following subparagraphs applies every three years from the previous year: In this case, the list of persons taking joint responsibility pursuant to paragraph 2 may be disclosed together.
1. Persons who submit fraudulent receipts 2 or more times and whose total value on those fraudulent receipts is KRW 100 million or more;
2. Persons who have received KRW 200 million won or more in one case of fraud.
(2) Where disclosure of the list is not practicable due to cases determined by Presidential Decree such as the death of a fraudulent recipient or a person taking joint responsibility, etc., the list under paragraph (1) may not be disclosed.
(3) The Corporation may disclose the list after the process for objection or appeal of dissatisfaction is completed with respect to the disposition of the collection of undue gains as the objection or appeal of dissatisfaction process is under way.
(4) The Corporation shall notify the person subject to disclosure under paragraph (1) in advance as provided in the Ordinance from the Ministry of Employment and Labor and shall give that person opportunity to explain.
(5) Other matters necessary for the method and procedure of disclosure shall be determined by Ordinance of the Ministry of Employment and Labor.
<This Article Inserted by Act No. 15665, Jun. 12, 2018>

Enforcement Ordinance

Article 79-2 (The Reasons for Exceptions to Inclusion on a Disclosed List of Fraudulent Recipients )

Cases under Article 84-2 (2) of the Act where “inclusion on the list to be disclosed is not practicable due to cases determined by Presidential Decree such as the death of a fraudulent recipient or a person taking joint responsibility, etc.” refer to cases that fall under any of the following subparagraphs:
1. Where fraudulent recipients pursuant to the former part of Article 82-2 (1) of the Act or a person taking joint responsibility in the latter part of the same Article have died;
2. Where fraudulent recipients pursuant to the former part of Article 82-2 (1) of the Act or a person taking joint responsibility in the latter part of the same Article makes payment equal to 30/100 of the amount that the Corporation shall collect pursuant to the Article 84 (1) of the Act;
3. Where the Corporation, as authorizing rehabilitation plans pursuant to Article 243 of the Debtor Rehabilitation and Bankruptcy Act is determined , defers collection of the amount to be collected pursuant to Article 84 (1) of the Act and in the period of deferment, or where payment is made according to the payment schedule in the revitalization plan.
4. Where the Corporation recognizes, pursuant to the former part of Article 84-2 (1) of the Act, that it is inappropriate or not practicable to include in the list to be disclosed of fraudulent recipients due to the state of his/her assets, whether he/she is a minor or other circumstances.
<This Article Inserted by Presidential Decree No. 29354, Dec. 11, 2018>

Enforcement Ordinance

Article 79 (Collection of Undue Gains)

(1) When the Corporation has decided to collect any undue gains as prescribed in Article 84 of the Act, it shall notify without delay the person liable for the payment that he/she should pay such amount.
(2) The person who receives the notification under paragraph (1) shall pay the amount within thirty days after receiving the notification.

Article 85 (Collection of Charges)

The provisions of Articles 27, 28, 29, 30, 39, 41 and 42 of the Insurance Premium Collection Act shall apply mutatis mutandis to the collection of insurance benefits under Article 39 (2), the collection of special disability benefits under Article 78, the collection of special survivors’ benefits under Article 79 and the collection of undue gains under Article 84. In this case, “the National Health Insurance Corporation” shall be read as “the Corporation”. [Amended by Act No. 9988, Jan. 27, 2010]

Article 86 (Appropriation of Insurance Benefits, etc.)

(1) The Corporation, if there are any insurance benefits, medical expenses or medicine expenses it has to pay to a person who has taken undue gains pursuant to Article 84 (1) and (3), or an insurance subscriber or an industrial accident insurance-related medical institution held jointly responsible pursuant to Article 84 (2), may appropriate them to the amount to be collected pursuant to Article 84.
(2) The maximum limit to and procedure for the appropriation of insurance benefits, medical expenses and medicine expenses shall be prescribed by the Presidential Decree.

Enforcement Ordinance

Article 80 (Limit to and Procedure for Appropriation of Insurance Benefits, etc.)

(1) When the Corporation appropriates insurance benefits, medical expenses and medicine expenses pursuant to Article 86 of the Act, the maximum appropriation limit shall be as follows:[Amended by Presidential Decree No. 22269, Jul. 12, 2010]
1. If there are any insurance benefits to be paid to a person who has taken undue gains pursuant to Article 84 (1) of the Act, the maximum appropriation limit shall be 1/10 of the insurance benefits to be paid:Provided that if the person entitled to the insurance benefits agrees in writing to have more than 1/10 of the insurance benefits appropriated, under the conditions prescribed by the Ordinance of the Ministry of Employment and Labor, it shall be the agreed amount;
2. If a person who has taken undue gains pursuant to Article 84 (1) of the Act or a person held jointly responsible pursuant to paragraph (2) of the same Article is an insurance subscriber, the maximum appropriation limit shall be the amount of insurance benefits (including the subrogated amount, in case the insurance subscriber has subrogated the right to receive insurance benefits pursuant to Article 89 of the Act) to be paid to the insurance subscriber;
3. If there is any medical expenses to be paid to an industrial accident insurance-related medical institution held jointly responsible pursuant to Article 84 (2) of the Act, the maximum appropriation limit shall be an amount equivalent to the medical expenses;or
4. If there are any medical expenses or medicine expenses to be paid to an industrial accident insurance-related medical institution or a pharmacy which has taken undue gains pursuant to Article 84 (3) of the Act, the maximum appropriation limit shall be an amount equivalent to the medical expenses or medicine expenses
(2) If the Corporation intends to make an appropriation pursuant to paragraph (1), it shall hear opinions from the person entitled to insurance benefits, insurance subscriber, industrial accident insurance-related medical institution or pharmacy and once it has decided to appropriate, shall inform without delay the person entitled to insurance benefits, insurance subscriber, industrial accident insurance-related medical institution or pharmacy of this.

Article 87 (Claim for Indemnification to Third Persons)

(1) Where insurance benefits are paid due to an accident caused by a third person's act, the Service shall be subrogated to the rights of a person who has received the insurance benefits, to exercise the claim for damages against the third person, within the limits of the amount of such benefits: Provided, That this shall not apply where at least two business owners as policyholders portion out one line of business at the same place and operate their own portion of the business respectively, and, in the course of operation, an accident occurs due to an act committed by an employee of the other business owner.

(2) In cases falling under paragraph (1), if a beneficiary has been paid damages equivalent to insurance benefits under this Act from a third person for the same reason, the Service shall not pay insurance benefits under this Act, within the limits of the amount of the damages converted by the method prescribed by Presidential Decree.

(3) If any accident occurs by an act of a third person, the beneficiary and policyholder shall report such accident to the Service without delay.

Enforcement Ordinance

Article 81-2 (Prohibition against seizure of insurance benefits)

“the amount prescribed by Presidential Decree” under Article 88 (3) refers to the whole amount deposited in the insurance benefits account pursuant to Article 82 (2).

Article 87-2 (Indemnification Consultation and Arrangement Council etc.)

(1) If an agency claims indemnification with an insurer etc. (hereinafter referred to as “insurer etc.” in this article) as prescribed in Article 2 paragraph (7) of the Guarantee of Automobile Accident Compensation Act in accordance with Article 87, the agency may constitute and operate an indemnification consultation and arrangement council to consult and determine the amount of indemnification to be paid out.
(2) Agencies and insurers etc. may request information from each other as necessary for consultation and management as prescribed in paragraph (1). Such requests shall be granted unless there is justifiable reason not to do so.
(3) Matters necessary for organization and operation of the indemnification consultation and arrangement council as prescribed in paragraphs (1) and (2) shall be determined by the agency.

Enforcement Ordinance

Article 81 (Adjustment of Insurance Benefits for Person Receiving Damages from Third Person)

If a person entitled to insurance benefits receives damages from a third person, the provisions of Article 76 shall apply mutatis mutandis with regard to the method of converting the damages into an amount in which insurance benefits are not paid pursuant to the proviso of Article 87 (2) of the Act.

Article 88 (Protection of Right to Benefits)

(1) The right of a worker to receive insurance benefits shall not be extinguished by his/her retirement.
(2) The right to receive insurance benefits shall not be transferred, seized or offered as collateral.
(3) A deposit into the insurance benefits account designated in accordance with Article 82 (2) shall not be seized if the amount of money is less than the amount prescribed by Presidential Decree.

Article 89 (Exercise by Proxy of Right to Benefits)

In case an insurance subscriber (including the subcontractors prescribed in subparagraph 5 of Article 2 of the Insurance Premium Collection Act;hereinafter the same shall apply) pays an entitled person money or valuable goods equivalent to the insurance benefits pursuant to the Civil Act or other Acts and subordinate statues for his/her worker’s work-related accident for the same reason for which insurance benefits are paid in accordance with this Act, and the money or valuable goods are considered as a substitute for the insurance benefits, the insurance subscriber may subrogate the right of the entitled person to receive the insurance benefits as prescribed by the Presidential Decree.

Enforcement Ordinance

Article 82 (Exercise by Proxy of Right to Benefits)

(1) If an insurance subscriber (including subcontractors referred to in subparagraph 5 of Article 2 of the Insurance Premium Collection Act;hereinafter in this Article, the same shall apply) intends to receive insurance benefits by exercising by proxy the right of a person entitled to insurance benefits pursuant to Article 89 of the Act, he/she shall file the claim with the Corporation, together with documents certifying the fact that he/she has paid the entitled person money or other valuable goods equivalent to the insurance benefits for the same cause as insurance benefits should be paid under the Act.
(2) If an insurance subscriber files a claim to receive insurance benefits by exercising by proxy the right pursuant to paragraph (1), the Corporation shall check whether the person entitled to the insurance benefits has received money or other valuable goods equivalent to the amount of insurance benefits concerned.
(3) If an insurance subscriber has provided a person entitled to insurance benefits with money or other valuable goods equivalent to his/her disability benefits or survivors’ benefits pursuant to Article 89 of the Act, he/she shall be considered to have been provided money or other valuable goods equivalent to the lump sum disability compensation or lump sum survivors compensation.

Article 90 (Settlement of Accounts of Medical Care Benefit Costs)

(1) In case where the National Health Insurance Corporation under Article 13 of the National Health Insurance Act or the head of a Si, Gun or Gu (hereinafter referred to as “the National Health Insurance Corporation, etc.”) under Article 5 of the Medical Benefit Act has paid medical care benefits, etc., under health insurance to a person entitled to the medical care benefits prescribed by this Act and then claims the costs, the Corporation may pay an amount equivalent to the medical care benefits if the medical care benefits, etc., under health insurance are deemed equivalent to the medical care benefits payable under this Act. [Amended by Act No. 11141, Dec. 31, 2011]
(2) In case where the Corporation has paid an entitled person medical care benefits and then the decision on such payment is cancelled, the Corporation may claim an amount equivalent to the medical care benefits, etc., under health insurance from the National Health Insurance Corporation if the paid medical care benefits are deemed equivalent to the medical care benefits, etc., under health insurance, which are payable under the National Health Insurance Act or the Medical Benefit Act.

Article 90-2 (Settlement of Medical Care Benefit Costs of the National Health Insurance)

(1) Where the person who received the medical care benefits or additional medical care under Article 40 is entitled to the medical care benefits pursuant to Article 41 of [the National Health Insurance Act] within two years from the end of medical care (Provided that the person received the medical care benefits in compensation for an occupational injury or an occupational disease that was the object of the terminated medical care), the Service may pay an amount equivalent to the medical care benefits that the National Health Insurance Corporation had defrayed.
(2) The procedures for payment of the medical care benefits referred to in paragraph (1) shall be prescribed by ordinance of the Ministry of Employment and Labor.
[This Article Newly Inserted by Act No. 13045, Jan. 20, 2015]

Article 91 (Exemption of Public Charges)

Public charges of the State or a local government shall not be imposed on money or valuable goods provided as insurance benefits.

Enforcement Ordinance

Article 83 (Preparation of Benefit Ledger)

(1) The Corporation shall, when paying insurance benefits, prepare and keep a benefit ledger by worker who has received the benefits.
(2) The Corporation shall, at the request of a person related to insurance benefits, allow him/her to inspect the benefit ledger and if necessary, may issue a certificate.

For further questions, please
call (+82) 2-539-0098 or email bongsoo@k-labor.com

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