ENGLISH
Industrial Accident Compensation Insurance
Definition of Nursing Benefits
Definition of nursing benefits- The term "nursing benefits" pertains to industrial accident compensation insurance benefits (hereinafter referred to as "insurance benefits") paid to any beneficiary of medical care benefits who is in need of medically constant or frequent nursing care after their cure and is actually receiving nursing care (Article 61 (1) of the Industrial Accident Compensation Insurance Act).
※ The term "cure" pertains to reaching a state in which an injury or disease has been completely cured or there are no further expected effects of treatment with its symptoms remaining unchanged (Subparagraph 4 of Article 5 of the Industrial Accident Compensation Insurance Act).
Those Eligible for Nursing Benefits and Standards for Payment Those eligible for nursing benefits- Those eligible for nursing benefits shall be as follows (Article 61 (2) of the Industrial Accident Compensation Insurance Act and Article 59 (1) and Attached Table 7 of the Enforcement Decree of the Industrial Accident Compensation Insurance Act):
· Permanent nursing benefits
1. Any person who has a disability with their nervous system, mental functions or thoracoabdominal organs corresponding to Disability Grade 1 and always needs the nursing care of other people for actions required for their daily life;
2. Any person who has a disability in any of their 2 eyes, 2 arms or 2 legs corresponding to Disability Grade 1 and a disability in any other body part corresponding to Disability Grade 7 or higher, and always needs nursing care of other people for actions required for their daily life;
· Occasional nursing benefits
3. Any person who has a disability with their nervous system, mental functions or thoracoabdominal organs corresponding to Disability Grade 2 and needs nursing care of other people frequently for actions required for their daily life;
4. Any person who has a disability corresponding to Disability Grade 1 (including cases where their disability grade is changed to Grade I under Article 53 (2) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act) and needs nursing care of other people frequently for actions required for their daily life.
Claims for Nursing Benefits Claims for nursing benefits- Any person who intends to claim nursing benefits shall file a written claim for nursing benefits and a doctor's note assessing the degree of need for nursing care, attached by documents stating the following, with the Korea Workers' Compensation & Welfare Service [Article 61 (2) of the Industrial Accident Compensation Insurance Act, Article 59 (6) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act, Article 50 of the Enforcement Rule of the Industrial Accident Compensation Insurance Act and Article 30 (1) and Forms 12-2 and 12-3 of the Regulations of Compensation Affairs].
1. Name and address of the nursing facility or the place of receiving nursing care
2. Name and resident registration number of the care giver and his/her relationship with the benefit recipient (only when no nursing care is received from nursing facility)
3. Actual period of receiving nursing care
4. Cost of nursing care and details thereof
Extinctive prescription of the right to claim nursing benefits- If the right to claim nursing benefits is not exercised for 3 years after the next day of receiving nursing care, it shall become extinctive by prescription (Subparagraph 1 of Article 112 (1) of the Industrial Accident Compensation Insurance Act).
- Extinctive prescription of the right to claim nursing benefits shall be interrupted by a request for nursing benefits filed by the beneficiary. In such cases, where the request for nursing benefits is the first request requiring a judgment on whether the case concerns an occupational accident, the interruption of prescription resulting from the request shall affect the other insurance benefits (Article 113 of the Industrial Accident Compensation Insurance Act).
Payment of Nursing Benefits Payment of nursing benefits- Nursing benefits shall be paid for days when a person eligible for nursing benefits actually receives nursing care (Article 61 (2) of the Industrial Accident Compensation Insurance Act and Article 59 (2) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
- No public charges of the State or local governments shall be imposed on any money or valuables offered as nursing benefits (Article 91 of the Industrial Accident Compensation Insurance Act).
Due date for payment and payment standard of nursing benefits- Nursing benefits shall be paid within 14 days after the decision for payment thereof (Article 82 (1) of the Industrial Accident Compensation Insurance Act).
- The standard amount for payment of nursing benefits under the Industrial Accident Compensation Insurance Act shall be as the following (「Standard for payment of nursing benefits under the Industrial Accident Compensation Insurance Act」).
|
Classification |
Full-time nursing benefits |
Frequent nursing benefits |
|
Professional caregiver |
KRW 44,760 |
KRW 29,840 |
|
Family or other type of caregiver |
KRW 41,170 |
KRW 27,450 |
- If a person eligible for nursing benefits incurs no nursing expenses because they enter a complimentary nursing home, etc., or spends less than the standard amount, the amount actually spent shall be paid as the nursing benefits (Article 61 (2) of the Industrial Accident Compensation Insurance Act and Article 59 (4) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
- If a beneficiary of nursing benefits receives additional medical care, no nursing benefits shall be paid during such additional medical care (Article 61 (2) of the Industrial Accident Compensation Insurance Act and Article 59 (5) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
Claims for and payment of unpaid nursing benefits- If a beneficiary of nursing benefits dies, their survivor shall file a written claim for unpaid insurance benefits with the Korea Workers' Compensation & Welfare Service in order to receive such benefits instead of the dead beneficiary (Article 81 of the Industrial Accident Compensation Insurance Act, Article 49 and Form 29 of the Regulations of Compensation Affairs).
- Unpaid nursing benefits shall be paid within 14 days after the decision for payment thereof (Article 82 (1) of the Industrial Accident Compensation Insurance Act).
Prohibition, etc. of transfer and seizing of entitlement to nursing benefits- Each worker’s entitlement to nursing benefits shall not be extinguished by their retirement (Article 88 (1) of the Industrial Accident Compensation Insurance Act).
- Entitlement to nursing benefits may not be transferred, seized or offered as collateral (Article 88 (2) of the Industrial Accident Compensation Insurance Act).
Collection of unjust gains- Where any person receives nursing benefits by fraud or other improper means, an amount equivalent to double the nursing benefits shall be collected from him/her (The former part of Article 84 (1) of the Industrial Accident Compensation Insurance Act).
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