Appraisal standard for the degree of industrial injury and occupational disease disability of employees (for Trial Implementation)
Classification number l35301199221
Notice of the Ministry of Labor, the Ministry of Health and the All-China Federation of Trade Unions on Printing and Distributing the Appraisal Standard of Occupational Injury Disability of Workers (for Trial Implementation)
Effective timeliness
Promulgated by the Ministry of labor, etc.
Promulgated on 19920309
Implementation date: 19920309
valid period
Classification of insurance benefits for cadres
The document number is Laoxianzi (1992) No.6.
The research results of "Appraisal Standard of Injury and Occupational Disease Disability Degree (Trial)" have been appraised and are hereby issued for trial implementation.
The appraisal standard of workers' injury and occupational disability (for Trial Implementation) is based on the ten-year plan for national economic and social development and the first
The requirements of establishing and perfecting the social security system put forward in the Eighth Five-Year Plan meet the needs of the reform of the industrial injury insurance system.
The Ministry of Sports and the Ministry of Health organize relevant experts to study and formulate. The degree of disability and loss of working ability of employees is divided into ten levels, including one, two, three,
The fourth level is complete loss of working ability; Grade five or six means that most of them lose their ability to work; Grade seven, eight, nine and ten are partial incapacity.
Force. Please all provinces, autonomous regions and municipalities directly under the central government to try out the reform of the industrial injury insurance system, carry out labor appraisal work according to this standard, and pay attention to
Sum up experience. This standard can be used as a reference when identifying the degree of disability of employees who are disabled due to illness or non-work-related injuries.
Reason. If there is any problem in the trial process, please inform us in time so as to modify it and provide a basis for the formation of national standards.
1. This standard is formulated to adapt to the reform of industrial injury insurance system, protect the legitimate rights and interests of employees, strengthen production safety and safeguard the overall interests of the country.
It worked.
Two, this standard is applicable to the local labor department identified as work-related injuries, or approved by the health administrative department has the right to diagnose occupational diseases.
After being diagnosed as an occupational disease by a medical and health institution, the medical unit needs to carry out disability medical examination and labor ability appraisal when determining the end of medical treatment.
Three, this standard is based on the organ damage and dysfunction of the wounded and sick at the end of medical treatment and their dependence on medical care, due consideration.
Due to the influence of social and psychological factors caused by disability, the degree of disability is graded.
1. Organ damage is the direct result of industrial injury, but occupational diseases do not necessarily have organ defects.
2. Dysfunction The degree of dysfunction after work-related injuries is related to the location and severity of organ defects, and organ dysfunction caused by occupational diseases.
It is related to the severity of the disease. The judgment of dysfunction should be based on the medical examination results at the end of medical treatment, according to the disabled objects one by one.
A sure. The definitions of some disability categories in Appendices A, C, E, G and I, and the grading judgment basis of the dysfunction caused by this standard.
Yes, I made an account and explanation.
3. Medical dependence refers to the person who can't leave treatment at the end of medical treatment after injury or illness.
4. Nursing dependence refers to those who are injured or disabled and need to be cared for by others because they can't take care of themselves. The scope of self-care mainly includes the following five items:
(1) Eat; (2) turn over; (3) defecation; (4) dressing and washing; (5) self-movement.
Nursing dependence is divided into three levels:
A. Complete care and dependence refers to those who need care in the above five aspects.
B. Most nursing dependence refers to people who need nursing care for three of the above five items.
C. Partial nursing dependence refers to the person who needs nursing in one of the above five items.
5. Psychological disorders Some special residual feelings, on the basis of organ defect or dysfunction, do not cause medical dependence, but do cause psychological disorders.
If the quality of life of disabled people is hindered or impaired, these consequences should be properly considered when assessing disability.
Four, according to the above principles, the disability caused by work-related injuries and occupational diseases is divided into ten levels, listed in Table 1. ..
Due to the complexity of disability types, some types can be graded from the heaviest (1 level) to the lightest (1level) to cover ten levels, while others may not be enough.
Ten, still empty. Individual disabilities not listed in this standard can be evaluated according to the above principles and with reference to the corresponding grades in this standard.
Settings.
Five, this standard is divided into five parts according to the disability categories of different systems and organs, and each part contains the standard text (work injury and job)
Classification table of occupational diseases and disabilities), supplementary part (classification basis or judgment standard) and reference part (explanation of correct use standard), as shown in table B.
As shown in the figure. For ease of use, a grading series is attached.
If the injury caused by occupational factors outside Innecco belongs to the list of occupational diseases published by the Ministry of Health, there shall be a disability grade at the end of medical treatment.
According to the corresponding residual feelings in table 1 ~ 4, the residual feelings caused by occupational tumor surgery refer to the corresponding main damaged organs.
Evaluate the project.
Six, in the use of this standard, we should strictly follow the classification basis or judgment benchmark of all kinds of disabilities in the supplement, and use it correctly according to the reference.
The description of the standard, according to the specific situation of disability, master the classification of this standard, and identify the degree of disability of work-related injuries and occupational diseases.
Eight, such as the original disability and disease history of organs damaged by work-related injuries, the assessment of disability level is based on the actual disability outcome at the end of medical treatment.
Foundation.
Table A: Grade Table of Workers' Occupational Injury and Occupational Disease Disability
grade
According to classification
Level a
Organ loss or complete loss of function, other organs can not be compensated, need special medical dependence and complete nursing dependence to maintain life and basic life.
assistant
Serious organ defect or deformity, serious dysfunction or complications require special medical dependence and most nursing dependence.
Three levels
Serious organ defects or deformities, serious dysfunction or complications require special medical dependence and nursing dependence.
Totally good.
Serious organ defect or deformity, serious dysfunction or complications, need special medical dependence, and can take care of themselves.
Piati
Most organs are defective or obviously deformed, have serious dysfunction or complications, need general medical dependence, and can take care of themselves.
College English Test Band-6
Most organs have defects or obvious deformities, moderate dysfunction or complications, need general medical dependence, and can take care of themselves.
Seven grades
Most organs have defects or deformities, mild dysfunction or complications, which require general medical dependence and can take care of themselves.
Grade?Eight
Partial organ defects, abnormal morphology, mild dysfunction, medical dependence, and self-care.
Grade?Nine
Partial organ defects, abnormal morphology, mild dysfunction, no medical dependence, and self-care.
Ten grades
Partial organ defects, abnormal morphology, no dysfunction, no medical dependence, self-care.
Table 1 Appraisal Standard of Occupational Injury Disability Degree of Employees (Neurology, Neurosurgery, Psychiatry)
-
Disability category | one | two | three | four | five
- | - | - | - | - | - |
| | | | ||
Mental retardation | extremely severe | severe | moderate | severe
| | | | ||
- | - | - | - | - | - |
Mental illness mental illness mental illness mental illness mental illness mental illness mental illness
||||| Lack of formal reasons |||||
Psychotic symptoms ||||| Lack of life | Danger or lack of social skills ||
|||| Capable | Dynamic | Powerful ||
- | - | - | - | - | - |
Epilepsy ||||||||||||
- | - | - | - | - | - |
Dyskinesia |||||||
1. Tetraplegia | Tetraplegia | Triplegia | 1. Paraplegia | 1. Paralysis | 1. Tetraplegia |
(Brain, spinal cord and | Force 3 or | Force 3 or | Force 3 muscle strength 2 muscle strength 4 |
Nerve injury) | Tripplegia | Hemiplegia | 2. Hemiplegia | 2. Biped animal | 2. Paralysis |
Force 2 | Force 2 | Force 3 | Muscle strength of muscle paralysis | Muscle strength 3 |
|||||| or hands | 2 | 3. Hands |
||||||||| Muscle paralysis||| Muscle strength. Muscle paralysis of both hands
|||||| Level 3 Paralysis muscle strength Level 3 Strength Level 2
|||||| Level | 4. Almighty |
Muscle paralysis | muscle strength | muscle strength
|||||| Level II |
|||||||| 5. biped |
Muscle paralysis | muscle strength | muscle strength
||||||| Level 3 |
| | | | ||
| | | | ||
2. Non-limb paralysis |||||| Moderate ||
||||||| | | |
- | - | - | - | - | - |
A4 personality change
Personality is the sum of individual psychological characteristics, which has obvious consistency and constancy and represents a person's consistent behavior tendency.
And a constant way of reaction is a person's usual behavior pattern. Generally speaking, personality refers to the process of individual development.
The psychological attribute gradually developed in middle school is generally considered to be 18 years old maturity, which is an innate quality and acquired environment.
It's over. Early childhood, especially before the age of 6, is very plastic, and the environment and education have great influence on it.
Influence, but once it is mature and stereotyped, it has strong stability and is often retained for life and is not easy to change. Overall personality characteristics
It affects a person's adaptation to the environment and reaction to specific things, and determines a person's unique behavior and way of thinking.
It also includes your own understanding and attitude.
In the process of individual development, personality abnormality caused by innate quality or acquired environmental factors is called personality disorder;
Organic personality abnormality caused by work-related injury or occupational poisoning affecting the brain is called personality change.
Organic personality changes, with significant and lasting changes in behavior patterns and interpersonal relationships as the main clinical manifestations, have at least the following types.
One of the following situations:
A. Emotional instability, such as sudden change from normal to depression, or anxiety, or irritability;
B. Repeated rage attacks or aggressive behaviors are obviously not commensurate with the inducing factors;
C. the sense of social responsibility is declining, the work is irresponsible, and people are not trusted; Emotional indifference, lack of response to the surrounding things.
Some care, but they can't maintain normal interpersonal relationships with others;
D. Instinct hyperactivity, lack of self-control, obvious damage to ethics, lack of self-esteem and shame; oneself
I am self-centered and impulsive;
E. the social adaptation function is obviously impaired.
A5 criteria for diagnosis and frequency classification of epilepsy
A5. 1 epilepsy diagnosis: there must be an exact history of work-related injury or occupational disease, which is described or proved by doctors or other witnesses.
The EEG showed abnormality, which was divided into mild, moderate and severe according to the seizure frequency and drug control.
A5.2 Frequency classification of epilepsy
A. mild
The authors of various types of epilepsy can only be controlled by systematic drug treatment.
B. mild
After two years of systematic medication for various types of seizures, the average number of grand mal and psychomotor seizures per month was 65438 0.
Or 1 time or less, and minor attacks and other types of attacks are below 1 time per week on average.
C. severe
After two years of systematic medication for various types of seizures, the average number of grand mal and psychomotor seizures per month was 65438 0.
Above, minor seizures and other types of seizures exceed 1 time per week on average.
B 1 scope of application of this standard
This standard is applicable to those who are disabled due to work-related injuries or occupational diseases, have neuropsychiatric dysfunction, and need to be identified at the end of medical treatment.
Disabled people.
B5 Schizophrenia and bipolar disorder are endogenous mental diseases, the onset of which mainly depends on the biological quality of patients.
Endogenous mental illness accompanying work-related injury or occupational disease should not be confused with mental illness directly caused by work-related injury or occupational disease.
Confused. Schizophrenia and bipolar disorder do not belong to work-related injuries or occupational psychosis.
Table 2 Appraisal standard of disability degree of industrial injury and occupational disease (orthopedics, plastic surgery, burn department)
-
Disability category | 1 | 2 | 3
- | - | - | - |
| 1. Severe facial disfigurement | Severe facial disfigurement
||| Attached in Table 2.
||||||| One of the two disabled people |
| 2. Severe systemic scar |||||
The head and face were destroyed and the spine and limbs were destroyed.
Capacity ||||||| Large joint function
|||||| |
| | | |
| | | |
- | - | - | - |
| | | |
| | | |
Spinal injury ||||||
| | | |
| | | |
- | - | - | - |
| Double elbow amputation | Bilateral wrist amputation or | 1. One hand amputated and the other |
Total loss of limb or function | Total loss of function of both hands | Loss of thumb and hand |
||||| 2. Missing thumb and forefinger of both hands |
||||| Loss of function or complete loss |
||||| Lost |
|||||| 3. One elbow amputated |
||||| (beneficial party) |
Upper limb ||||||
| | | |
| | | |
| | | |
| | | |
| | | |
| | | |
| | | |
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D 1 This standard is only applicable to the appraisal of the degree of disability of spine and limbs injuries caused by work-related injuries and occupational diseases. This standard is not applicable to other congenital malformations or degenerative changes with age, such as osteoarthritis.
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D 15 Facial foreign body pigmentation refers to that various foreign bodies (including stones and iron particles) remain on the face due to work-related injuries such as explosion injury, or appear pigmentation in different degrees after foreign bodies are taken out. However, it is difficult to accurately classify the number and area of facial foreign body pigmentation in clinic, and it is even more difficult to summarize the psychological effects caused by factors such as gender and age. Considering all kinds of complicated situations that may be encountered in practical work, the standard divides facial foreign body pigmentation into mild and severe levels, with 1/4 and 1/2 exceeding the total area of the face as the criteria for judging the severity (see C2).
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Table 3 Appraisal standard of disability grade for work-related injuries and occupational diseases (ophthalmology, otolaryngology and stomatology)
-
Disability category | 1 | 2 |
- | - | - |
| No light perception in both eyes or only one eye with or without light perception |
| Light perception but inaccurate light positioning | The other eye corrects vision |
| | ≤ 0.02 or field of vision |
||| ≤ 8% (or radius ≤5 ×
| | |
| | |
| | |
| | |
Eye injury and visual function |||||
Obstacle |||
| | |
| | |
| | |
| | |
- | - | - |
| | |
Hearing impairment |||||
- | - | - |
Vestibular balance disorder |||
- | - | - |
| | |
Laryngeal dyspnea
Dysphony |||||
- | - | - |
||||| After esophageal atresia or resection |
Dysphagia | Feeding-dependent gastrostomy
- | - | - |
Auricular defect |||
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Evaluation of visual impairment in E3 aphakic eyes
Removal of lens due to work-related injury or occupational disease not only leads to visual impairment, but also affects patients' visual field and stereoscopic vision function. Therefore, the calculation of the effective value of central vision (after correction) in aphakic eyes is lower than that in normal lens eyes. The calculation method can compare the number of aphakic eyes and aphakic eyes with normal aphakic eyes according to the best vision correction (including wearing glasses or contact lenses and putting this value into intraocular lens), and determine the degree of visual damage of aphakic eyes according to the percentage of visual decline.
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Diagnostic criteria and calculation method of E5 hearing impairment
E5. 1 Hearing threshold measuring equipment and methods must comply with relevant national standards; Audiometer (GB 7341-87); Calibrate the standard zero level of pure tone audiometer (GB 4854-84); Acoustics-Determination of pure tone air conduction hearing threshold for hearing protection (GB 7583-87).
E5.2 When calculating the hearing threshold of subjects over 30 years old, the age correction value should be deducted from the measured value, and the latter should be taken from the national standard GB 7582-87 "The Relationship between Normal Popularity Hearing Threshold and Age and Sex in Acoustics-Otology".
E5.3 calculation method of binaural hearing loss: the average value of the air conduction hearing threshold of the ear with good hearing is the average value of toasting, and the sum is divided by 5, that is
PTA (good ear) wishes? Check the margins.
- dB .
five
If the cause of deafness with poor hearing has nothing to do with work-related injury or occupation, it is not counted, and the average hearing threshold of language frequency of good ears shall prevail directly. When calibrating the average hearing threshold, the mantissa after the decimal point is rounded to an integer by the method of 4 to 5. Age correction value of pure tone air conduction threshold (dB)
-
male
Age (years) |-
Frequency (Hz) | 500 | 1000 |
- | - | - | - |
30 | | 1 | 1 |
40 | | 2 | 2 |
50 | | 4 | 4 |
60 | | 6 | 7 |
70 | | 10 | 1 1 |
-
-
woman
-
2000 | 500 | 1000 | 2000
- | - | - | -
1 | 1 | 1 | 1
3 | 2 | 2 | 3
7 | 4 | 4 | 6
12 | 6 | 7 | 1 1
19 | 10 | 1 1 | 16
-
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F 1 This standard is only applicable to the identification of the degree of disability caused by eye, ear, nose, throat and mouth injuries caused by work-related injuries and occupational diseases, and is not applicable to non-work-related injuries and occupational diseases such as night blindness, color blindness, stereoblindness and otosclerosis.
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The visual damage caused by F2 employees' work-related injuries and occupational diseases is not only the damage or destruction of eyes, but also the damage of visual function and related anatomical structures and functions, such as eyelids. Therefore, the identification of visual impairment includes: (1) the identification of the anatomical structure and function of eyelid, eyeball and orbit; (2) Visual function appraisal (vision, visual field, stereoscopic vision, etc.). ).
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F6 eye can be identified with reference to Article 8 of the General Rules for Non-work-related Disability Identification. However, in the clinical identification of non-work-related injuries, there may be many complicated situations, such as (1) one eye or both eyes being injured and one eye being disabled; (2) There are three kinds of single disabled eye injuries, namely (1) disabled eye injuries; (2) Normal eye trauma; (3) Both normal eyes and disabled eyes were injured at work. In view of the above situation, the legitimate interests of the state, the collective and the individual should be taken into account when finally evaluating the degree of industrial injury disability of non-industrial injury disabled eyes.
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F 15 employees who have been diagnosed with functional vision impairment and deafness due to work-related injuries or occupational-related factors should apply corresponding special examination methods to make a definite diagnosis, and disability assessment can only be carried out after determining organic vision impairment and hearing loss. Pseudodeafness should also be ruled out before disability assessment.
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Table 4 Criteria for Grade Appraisal of Industrial Injury and Occupational Disease Disability (General Surgery, Thoracic Surgery, Urogenital Department)
-
Disability category |/kloc-0 | 2 |
- | - | - |
||||| Unilateral pneumonectomy with chest |
|||| Contour, dyspnea |
Chest wall, trachea and branches | difficulty level III | difficulty
Trachea and lung ||||
| | |
- | - | - |
| | |
Heart and blood vessels | Cardiac insufficiency | Grade III |
| | |
- | - | - |
||||| Esophageal atresia or resection |
After esophagus ||||, eating depends on gastrostomy.
||||| Fistula |
- | - | - |
Stomach |||
- | - | - |
| | |
||||| Small bowel resection > 3/4, not implemented |
More than 90% resection | reverse peristalsis anastomosis |
- | - | - |
| | |
Colon |||||
- | - | - |
| orthotopic liver metastasis after hepatectomy | 1. 3/4 hepatectomy with |
| Plants | The routine liver function is seriously damaged |
|||| Injury |
Liver ||| 2. Portal vein after liver trauma |
||| Pulse hypertension or hair | trilogy
|||| Original cloth-plus synthesis |
|||| Complications |
- | - | - |
||||| Severe liver caused by biliary tract injury |
|||| Functional injury of biliary tract |
-
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Table 5 Appraisal Standard of Industrial Injury and Occupational Disease Disability Grade (Occupational Disease Internal Medicine)
-
Disability category | one | two | three | four | five
- | - | - | - | - | - |
||||| 1. Severe lung function |1. Pneumoconiosis ⅲ| | | 1. Pneumoconiosis Ⅱ |
|||| Injury degree | 2. Pneumoconiosis stage Ⅱ | lung function stage |
|||| 2. Dyspnea|||| Slightly impaired lung function |
|||| Level 4 or Level 3 Injury or Breathing | Level 4 Injury or Breathing
|||| pao 2 4.1~| difficulty level 3 ||| difficulty level 2 |
||| 8kpa or pa-| 3. Pneumoconiosis Ⅰ and Ⅱ ||| 2. Pneumoconiosis Ⅰ |
7.9 ~| Stage joint activities |||| Stage and lung function ||
|||||| 6 kPa |||| Tuberculosis ||| Moderately damaged tuberculosis
Lung disease ||| 3. Pneumoconiosis Ⅲ | 4. Radiation | lung | injury | breathing | or
|||| Lung function ||| Inflammation of Shuang Ye lung ||| Difficulty | Level 3 |
||||||||||||||||||||
|||||||||| | |
|||| 4. Radiation lung|||||
||||| After inflammation, two leaves are |||||| | | | | | | | | | | | | | | | | |
||||||||||| Upper pulmonary fibrosis
- | - | - | - | - | - |
||||||| Cardiac insufficiency | Ⅲ atrioventricular block | Sick sinus | 1. Mohs Ⅱ |
|||||| Three Depression Syndrome||| Type II Room| Three Depression Syndrome
Heart |||||| (Ventricular block needs to be installed |
||||||| Musician) | 2. Cardiac function |
|||||||| Incomplete Level II |
- | - | - | - | - | - |
||||1.Leukemia||||1. Mild recurrence |
|||||||||||||||||||||||||||||||||||||||||||
||||||||||| Obstructive anemia |
|||| (Type I and Type II) ||| 2. Platelets |
Blood |||||||
|||||||| Reduce and own |
|||||||||| Bleeding tendency |
| | | | | 10 |
|||||| (4 Zhu Bao/|
| | | |L) |