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42. Accident compensation of workers
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An employer must make the utmost effort to prevent workers from being injured, diseased, or killed as a result of their activities during business operations.
However, in cases where the worker unfortunately encounters an industrial accident, and suffers an injury or illness in the course of duty, the employer is obligated to compensate the worker for his/her wages for the period during which he/she cannot work, and for the expenses necessary for medical care, etc., according to the provisions of the Labour Standards Law.
On the other hand, Japan has the Workmen's Accident Compensation Insurance System, and the insurance uses the insurance premium levied from employers as funds, and grants various compensation benefits for industrial accidents, on behalf of the employers. Furthermore, the insurance also grants compensation benefits for commuting accidents that are closely related to jobs, although this is not the responsibility of employers under the Labour Standards Law.
In addition to insurance benefits, the Workmen's Accident Compensation Insurance System secondarily operates a system for promoting the welfare of workers and their bereaved families, such as promoting social rehabilitation and assisting those who are suffering.
(The Labour Standards Law, the Enforcement Ordinance of Labour Standards Law, the Workmen's Accident Compensation Insurance Law, the Enforcement Order of Workmen's Accident Compensation Insurance Law, the Enforcement Ordinance of Workmen's Accident Compensation Insurance Law, and Ordinance on the Payment of Special Supplements of Workmen's Accident Compensation Insurance)
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| 1. Relation to the Labour Standards Law, etc. (Labour Standards Law, Article
84; Workmen's Accident Compensation Insurance Law, Articles 12-5 and 12-6) |
| a. |
Employers are exempt from the responsibility of compensation in cases where
compensation has been made based on the Workmen's Accident Compensation
Insurance Law (hereinafter called Insurance Law). |
| b. |
In cases where compensation has been made according to the provisions of
the Labour Standards Law, the employer concerned is exempt from the responsibility
of compensation for damage based on the Civil Law, up to the extent of
the compensated value. |
| c. |
The right to receive an insurance benefit cannot be transferred, mortgaged
or seized. |
| d. |
Neither taxes nor public charges can be imposed on the granted insurance
benefit, such as money or articles as a standard. |
|
| 2. Types of insurance benefits (Insurance Law, Article 7) |
|
The Insurance Law grants the following insurance benefits: |
| a. |
Insurance benefits covering occupational injury, disease, physical handicap,
or death of a worker |
| b. |
Insurance benefits covering injury, disease, physical handicap, or death
of a worker due to commutation |
| c. |
Benefits such as secondary health examinations |
| 3. Persons to be benefited (Insurance Law, Articles 1 and 32 to 36; Enforcement
Ordinance of the Law, Articles 46-16 to 46-18) |
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The persons to be compensated for industrial accidents are the workers
employed by employers, according to the Labour Standards Law, but under
the Insurance Law, the following specially admitted persons also receive
benefits: |
| a. |
Employers who regularly employ fewer than 300 workers (generally called
small and medium-sized employers; fewer than 50 workers in the case of
financial, insurance, real estate, retail, or service industries, or fewer
than 100 workers in the case of the wholesale industry) |
| b. |
Persons who are engaged in the undertakings of employers of a.
|
| c. |
Persons who are regularly engaged in any of the following undertakings without employing any workers:
| · |
Transporting passengers or cargo using a motor vehicle |
| · |
Constructing, modifying, repairing, or dismantling buildings or other structures
|
| · |
Gathering or catching marine animals or plants using a fishing boat
|
| · |
Forestry work |
| · |
Arranging or selling medicine |
| · |
Collecting, transporting, sorting, or dismantling waste for the purpose
of recycling |
|
| d. |
Persons who are engaged in any of the undertakings of employers of c. |
| e. |
Persons who are engaged in the following work:
| · |
Agriculture (limited to work using machines, hazardous work in oxygen-deficient
air, or work using pesticide sprays, etc.) |
| · |
Home workers (using a press machine, using an organic solvent, manufacturing
pottery using a lead compound, using a weaving machine, etc., manufacturing
household Buddhist altars using woodworking machines, etc.) |
|
| f. |
Working in labor unions such as assemblies of full-time directors of labor
unions or being involved in collective bargaining) |
| g. |
Nursing care, for example, work involving patients' bathing, excretion,
eating, etc., functional training, etc. |
| h. |
Persons dispatched abroad |
| 4. Types and outline of insurance benefits |
| a. |
Benefits for occupational accidents |
|
| · |
Medical compensation benefit (herein called medical compensation as in
the Labour Standards Law) (Insurance Law, Article 13; Labour Standards
Law Article 75)
In cases where a worker is occupationally injured or diseased, the expenses
necessary for medical care (operation expenses, drug expenses, nurse expenses,
etc.) will be paid. |
| · |
Compensation benefit for temporary disability (compensation for temporary
disability) (Insurance Law, Article 14; Labour Standards Law, Article 76)
In cases where a worker cannot work because of the necessity of medical
care, 60/100 of the basic per diem amount will be paid as compensation
for temporary disability beginning with the fourth day of medical care.
| Note |
1: |
The employer is obligated to pay the amount up to the third day of abstention
from work according to the provisions of the Labour Standards Law. |
| Note |
2: |
The basic per diem amount is approximately the average wage (daily amount),
as provided in the Labour Standards Law. |
|
| · |
Compensation benefit for a physical handicap (compensation for a physical handicap) (Insurance Law, Article 15; Labour Standards Law Article 77)
In cases where an injured or diseased worker remains with a physical handicap, a physical handicap compensation pension (1st grade to 7th grade) or physical handicap lump sum (8th grade to 14th grade) will be paid according to the grade of the physical handicap.
. (Grades of physical handicaps and days of compensation)
| Grade |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
∼ |
13 |
14 |
| Days |
313 |
277 |
245 |
213 |
184 |
156 |
131 |
503 |
∼ |
101 |
56 |
Note: Physical handicap states (examples)
| Physical handicap |
1st grade |
a person who has lost the sight of both eyes; a person who has lost both
upper limbs above the elbow joints, etc. |
| 2nd grade: |
a person who has lost the sight of one eye and has acuity of 0.02 or less in the other eye; a person who has lost both upper limbs above the wrist joints, etc.
|
| 3rd grade: |
a person who has lost the sight of one eye and has acuity of 0.06 or less
in the other eye; a person who has lost ten fingers, etc. |
| 14th grade: |
a person who remains with a scar as large as a palm on the exposed surface of a upper limb; a person who has lost the function of the little finger of one hand, etc.
|
|
| · |
Bereaved family compensation benefit (bereaved family compensation) (Insurance
Law, Article 16; Labour Standards Law, Article 79)
In cases where a worker dies, a bereaved family compensation pension or
bereaved family compensation lump sum will be paid to the bereaved family.
| : |
If there is one pension recipient |
basic per diem amount for 153 days |
| If there are two pension recipients |
basic per diem amount for 201 days |
| If there are three pension recipients |
basic per diem amount for 223 days |
| If there are four pension recipients or more |
basic per diem amount for 245 days |
| : |
Lump sum for 1,000 days (the amount may be decreased depending on the situation of the bereaved family) |
|
| · |
Funeral expenses (funeral expenses) (Insurance Law, Article 17; Labour
Standards Law, Article 79)
For a person presiding at a funeral, the amount obtained by adding 30 days'
basic per diem amount to ¥315,000 will be paid. (60 days' basic per
diem amount, if the amount is less than 60 days' basic per diem amount) |
| · |
Injury and disease compensation pension (Insurance Law, Articles 12-8,
18 and 19) |
|
If an occupationally injured or diseased worker does not recover from his/her injury or disease by one year and six months after the start of medical care, or corresponds to any grade specified as a degree of physical handicap, the injury and disease compensation pension corresponding to the physical handicap grade will be paid while the physical handicap state continues. (The physical handicap grades, physical handicap states, and annual benefit amounts are almost the same as those of the 1st to 3rd grades of physical handicap compensation pensions.)
In cases where an injury and disease compensation pension has been paid, it is deemed that the compensation for discontinuance provided in the Labour Standards Law has been paid. |
| · |
Nursing care compensation benefit (Insurance Law, Article 19-2)
A nursing care compensation benefit is paid monthly to a person who has a 1st grade physical handicap, remains remarkably physically handicapped in the nervous system or at an organ in the chest and abdominal cavity, and is constantly in need of care, or a person who has a 2nd grade physical handicap, remains remarkably physically handicapped in the nervous system or at an organ in the chest and abdominal cavity, and is occasionally in need of care.
The payment is the amount of expenses disbursed for care in the month concerned
(maximum ¥108,300). |
|
|
| b. |
Types and amounts of benefits for commuting accidents (Insurance Law, Article
21)
The types of benefits for commuting accidents are as follows, and the amounts
of benefits are the same as those for occupational accidents:
|
· Medical care benefit · Temporary disability benefit
· Physical handicap benefit · Bereaved family benefit · Funeral benefit
· Injury and disease pension · Nursing care benefit |
|
| c. |
Benefit for secondary health examination, etc. (Insurance Law, Articles
26 to 28)
In cases where a worker undergoes a health examination according to the
Industrial Safety and Health Law, Article 66, Paragraph 1, the expenses
paid for sphygmomanometry blood tests and other tests concerning cerebral
or cardiac disease for an occupational reason will be borne as a benefit. |
5.Labour welfare services (Insurance Law, Article 29)
In addition to various benefits for industrial accidents and commuting
accidents as described above, the Workmen's Accident Compensation Insurance
presents the following services for promoting the welfare of workers and
their bereaved families: |
| a. |
Construction and management of medical care facilities and rehabilitation
facilities, and services necessary for promoting the smooth social rehabilitation
of workers suffering from industrial and commuting accidents |
| b. |
Services such as assistance to the medical care of suffering workers and assistance to the nursing care received by suffering workers, etc.
As part of labor welfare services, there is a special supplementary system. (Ordinance on the Payment of Special Supplements of Workmen's Accident Compensation Insurance)
The special supplements are granted for industrial accidents and commuting accidents, and include the following: (Payment Ordinance Article 2)
|
·Temporary disability special supplement
·Physical handicap special supplement
·Bereaved family special supplement
·Injury and disease special supplement
·Physical handicap special pension
·Physical handicap special lump sum
·Bereaved family special pension
·Bereaved family special lump sum
·Injury and disease special pension |
As for the amount of payment, for example, because 20/100 of the basic
per diem amount is paid as a temporary disability special lump sum, 80/100
will be paid together with 60/100 granted as a temporary disability compensation
benefit or temporary disability benefit (for commuting accidents).
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6. Labour Insurance premiums
The funds for various benefits and special supplements under the Workmen's
Accident Compensation Insurance are the Labour Insurance premiums levied
from employers. (Law Concerning the Collection of Labour Insurance Premiums,
etc.)
Labour Insurance premiums are the premiums of both Workmen's Accident Compensation Insurance and Employment Insurance (insurance concerning the payment of allowances, etc. for the unemployed) levied together. However, all of the premiums to the Workmen's Accident Compensation Insurance are levied from employers.
The premium rates concerning the Workmen's Accident Compensation Insurance depend on the degree of danger in the industry, past benefit conditions, etc., and their examples are enumerated below. (A premium is "insurance premium rate" × "total amount of wages paid to the workers of each workplace".) |
|
| Lumber industry |
134/1000 |
······ |
Highest premium rate |
| Hydraulic power facilities or new tunnel construction |
134/1000 |
|
|
| Metal mining or coal mining, etc |
89/1000 |
|
|
| Quarry industry |
72/1000 |
|
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| Sea fishery |
59/1000 |
|
|
| Port cargo handling |
38/1000 |
|
|
| New road construction |
33/1000 |
|
|
| Ceramic industry or earth and stone product manufacturing industry |
26/1000 |
······ |
Highest premium rate among manufacturing industries |
| Timber or wood product manufacturing industry |
23/1000 |
|
|
| Shipbuilding or repair work |
22/1000 |
|
|
| Agriculture or fishery other than sea fishery |
11/1000 |
|
|
| Other undertaking |
6/1000 |
······ |
Lowest premium rate |
Note: For a terminable undertaking in the building industry, the rate is
calculated by multiplying a contract amount by a specific labor ratio (for
example, 20% for hydraulic power facilities or new tunnel construction). |
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7. Restriction of payment (Insurance Law, Article 12-2-2)
The Workmen's Accident Compensation Insurance restricts payment in the
following cases:
|
| a. |
When a worker has intentionally injured, diseased, physically handicapped,
or killed himself/herself, or has caused an accident that has directly
resulted in injury, disease, physical handicap, or death (all benefits) |
| b. |
When a worker has injured, diseased, physically handicapped, or killed
himself or caused an accident that has directly resulted in injury, disease,
physical handicap, or death, by an intentional criminal act or serious
error or by not following the instructions for medical care without good
reason, or when a worker has increased the degree of injury, disease, or
physical handicap, or has disturbed the recovery from it (all or partial
benefits) |
8. Collection of expenses (Insurance Law, Articles 12-3 and 31)
The government will collect all or part of the expenses paid as a benefit
in any of the following cases: |
| a. |
When a recipient has received an insurance benefit by false or any other
illegal means (to be collected from the recipient) |
| b. |
When an employer has made a false report or certificate concerning illegal
receipt of benefits (to be collected from the employer and the recipient
jointly) |
| c. |
When an industrial accident has occurred because of an intentional or serious
error of an employer (to be collected from the employer) |
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(This series has been completed.)
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