Work-related accidents are risks that no one wishes for, yet they occur quite frequently in practice. When an accident happens, employees not only suffer health damage but also worry about insurance benefits, compensation, and legal procedures. What are the conditions to receive work-related accident benefits? What documents are required? How are benefits calculated? The following content provides a comprehensive overview of the procedures for settling work-related accident benefits in accordance with current regulations.
Pursuant to Clause 8, Article 3 of the Law on Occupational Safety and Health 2015, a work-related accident is an accident that causes injury to any part or function of the body or results in death, occurring in the course of employment and in connection with the performance of assigned work or duties.
When an employee unfortunately suffers a work-related accident, the employer (enterprise or household business) is required to fully perform its obligations under Article 38 of the Law on Occupational Safety and Health 2015, including:
Providing timely first aid and emergency care;
Paying medical expenses during treatment;
Paying full salary during the employee’s treatment period;
Paying compensation or allowances as prescribed by law;
Preparing and submitting a dossier to claim work-related accident benefits from the Work-Related Accident and Occupational Disease Insurance Fund.
Employees participating in work-related accident and occupational disease insurance are entitled to benefits if they fully meet the conditions stipulated in Article 45 of the Law on Occupational Safety and Health 2015.
An accident is deemed work-related if it occurs in one of the following circumstances:
At the workplace and during working hours, including when performing necessary personal activities permitted by law and internal regulations, such as breaks, meals, personal hygiene, bathing, breastfeeding, or using restrooms;
Outside the workplace or outside working hours while performing tasks at the request of the employer or an authorized manager;
On a reasonable route and within a reasonable time while traveling from home to work or from work back home.
The employee must suffer a reduction in working capacity of 5% or more due to a work-related accident.
Benefits from the insurance fund will not be paid if the accident results from:
Personal conflicts unrelated to work duties;
Intentional self-inflicted injury by the employee;
Illegal use of drugs or other prohibited addictive substances.
Depending on specific circumstances, the required dossier varies in accordance with Article 57 of the Law on Occupational Safety and Health 2015 and guidance from the social insurance authority.
Typically includes:
Application for settlement of work-related accident benefits (Form No. 05A-HSB);
Hospital discharge certificate or medical record extract after treatment (for inpatient cases);
Medical assessment record on the reduction of working capacity issued by the Medical Assessment Council;
Medical indication for assistive devices (if any);
Invoices and receipts for medical assessment expenses (if reimbursement is requested).
In addition to basic documents, the employee must provide:
Social insurance book (if data is incomplete);
Work-related accident investigation report or traffic accident documents (if a traffic accident is recognized as a work-related accident);
Previous and reassessment records of working capacity reduction.
Includes:
Application for settlement of work-related accident benefits for the subsequent accident;
Medical records and discharge papers from the most recent treatment;
Combined medical assessment record on working capacity reduction;
Documents related to medical assessment and assistive devices (if any).
For employees already receiving work-related accident benefits and requesting continued provision of assistive devices, the dossier includes purchase invoices and relevant travel receipts (if any).
Within 30 days from receiving a complete dossier from the employee, the employer must submit it to the social insurance authority;
Within 10 days from receipt of a valid dossier, the social insurance authority must resolve the benefits. In case of refusal, a written explanation must be provided.
Benefit levels depend on the assessed percentage of working capacity reduction.
Applicable when the reduction ranges from 5% to 30%:
5% reduction: 5 times the statutory base salary;
Each additional 1%: an extra 0.5 times the base salary;
Plus an additional allowance based on years of contribution to the insurance fund.
Applicable when the reduction is 31% or more:
31% reduction: 30% of the base salary;
Each additional 1%: an extra 2% of the base salary;
Plus a supplementary allowance based on years of contribution.
Employees with a working capacity reduction of 81% or more, suffering from severe conditions such as spinal paralysis, total blindness, loss or paralysis of both limbs, or mental illness, are entitled to an additional monthly attendance allowance equal to the base salary.
If an employee dies due to a work-related accident or during treatment, their dependents are entitled to:
A lump-sum allowance equal to 36 times the base salary at the time of death;
Survivor benefits in accordance with the law.
If you encounter difficulties in settling work-related accident benefits or are unclear about procedures, documentation, or entitlements, consulting a lawyer or professional legal advisor can help minimize risks and ensure your rights are fully and promptly protected.
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