(From May 1, 2022, the “Labor Occupational Accident Insurance and Protection Act” was implemented; the labor occupational accident insurance was separated from the labor insurance. Occupational accidents that occur after implementation shall be subject to the "Labor Occupational Accident Insurance and Protection Act" and for the relevant provisions on the payment of occupational accident insurance permanent disability benefits, please visit "Labor Occupational Accident Insurance \ Insurance Benefits \ Permanent Disability Benefits.")
- Qualification
- Disability pension: An insured person who has incurred injury or illness and become stabilized after treatment but unable to recover fully with further treatment, as well as diagnosed to be permanently disabled by an National Health Insurance-authorized hospital and meets the standards for receiving disability benefits or as the physical or mental disabled by the People with Disabilities Rights Protection Act, and has also been assessed to loss of lifetime working capability (meaning an individualized conforms to one of the following stipulations), may file to collect the disability pension payout.
- An insured person who meets the “permanent inability to work” requirement under the “Disability Conditions” column of the Disability Benefit Payment Schedule, for a total of 20 items.
- In filing for the disability pension, an insured person needs to be assessed with a disability level conforming to levels 1 to 7, and has also undergone the individualized professional assessment to suffer loss of working capability by 70% or more, and who also can no longer return to the workplace.
- Lump-sum Disability Benefits:
- An insured, when encountering injury or contracting disease, and upon undergoing treatment, exhibits stable symptoms, and when further treatment can no longer expect the treatment yield, who has been diagnosed by an National Health Insurance-authorized hospital as permanently disabled, and whose disability conditions conforming to the criteria stipulations of the disability benefit payout, but not yet reaching the “permanent inability to work” payout item, may file for the lump-sum disability benefits payout.
- An insured whose disability conditions confirming to the “permanent inability to work” payout item, and also has insured seniority prior to January 1, 2009, may also choose to file for the lump-sum benefits payout.
- Disability Benefit Payment Schedule
- Labor Insurance disability benefit is issued according to Labor Insurance Disability Benefit Payment Schedule and the disability items, disability levels and payment days defined in the attached table of the Schedule.
- Disability item:
According to Labor Insurance Disability Benefit Payment Schedule and its attachment, the disability types are divided depending on the part of a body which are: mental, neuropathic, eyes, ears, nose, mouth, viscera in chest and abdomen, trunk, head, face, neck, skin, upper limbs, and lower limbs, a total of 12 types, 221 disability items and 15 disability levels.
- The calculation of Average monthly Insurance Salary and average daily Insurance Salary:
- Disability Pension: it is calculated using the insured persons' sixty highest average monthly Insurance Salary during insurance coverage years.
- Lump-sum disability benefits (including lump sum occupational disability benefit): It is calculated by averaging the actual monthly Insurance Salary six months before the month when the insurance accident occurred to the insured person (which is the date the insured person is diagnosed as permanently disabled); the average daily Insurance Salary is calculated by dividing the average monthly Insurance Salary by 30.
- For insured persons who are concurrently employed by more than two insurance coverage units, the monthly Insurance Salary for issuing benefit for ordinary accident could be jointly calculated but it shall not exceed the highest level in the “Table of Grades of Insurance Salary for Labor Insurance”, however, if the continuous insurance coverage days are less than 30 days, the wages could not be jointly considered in the calculation of Insurance Salary.
- Amount of benefit:
- Disability Pension:
- It is calculated according to insured persons' insurance coverage years, 1.55% of the average monthly Insurance Salary is issued for every one full year of insurance seniority. (that is Average Monthly Insurance Salary × Coverage Years × 1.55%).
- For those amount less than NT$4,000, NT$4,000 shall be granted.
- If the insured persons have National Pension Insurance coverage seniority, for every one full year of insurance seniority with insurance premium paid, 1.3% of the insurance amount of National Pension Insurance shall be granted (that is Monthly Insurance Amount of National Pension Insurance × Coverage Years of Insurance Premium Paid × 1.3%).
- After combining the Labor Insurance Disability Pension Benefits and National Pension Insurance Disability Pension Benefits, if the amount is less than NT$4,000, then NT$4,000 shall be granted.
- For those who have suffered from occupational injuries or disabled caused by occupational diseases, a lump-sum payment of 20 months occupational disability compensation shall be granted in addition to the pension.
- For those whose insurance coverage year is less than one year, it would be calculated proportionally according to the actual insurance coverage month; for those which is less than 30 days, it shall be calculated as one month.
- Dependent Allowances:
- Additional Dependent Allowances: For those who apply for disability pension benefit and have spouse or dependent children who meet the following qualification, 25% of the amount calculated according to Article 53 shall be granted as dependent allowance for each dependent, a maximum of 50% will be granted.
- Spouse:
Those who meet one of the following conditions:
(1)Spouse aged 55 or above and the marriage relationship with the insured person lasts more than one year. However, if the spouse has no capability of earning a livelihood or raising children as stipulated in the below shall not be limited by this regulation.
(2)Spouse aged 45 or above, the marriage relationship with the insured person lasts more than one year, and the monthly income of the spouse does not exceed the first grade in Table of Grades of Insurance Salary.
- Children:
Those who meet one of the following conditions (For Adopted children, the adoption relationship shall last for more than 6 months):
(1)Under age or minor children.
(2)No capability of earning a livelihood .
(3)Under the age of 25 and still go to school with monthly income not exceeding the first grade in Table of Grades of Insurance Salary.
- Suspension of dependent allowances: When the dependents do not qualified for the allowance any more, the dependent allowance shall be suspended.
- Spouse:
(1)Remarried.
(2)Do not meet the qualification indicated above for claiming dependent allowance by spouse.
- Children
Do not meet the qualification indicated above for claiming dependent allowance by children.
- Spouse and Children
(1)Serving sentences in a prison, or, being detained or kept in custody because of criminal offenses. (2)Disappearance.
- Lump-sum disability benefits: For those who suffer from general injuries or are disabled caused by general diseases, the highest disability level is the first level with the highest lump-sum disability benefits of 1,200 days and the lowest level is the fifteenth level with the lowest lump-sum disability benefits of 30 days. An extra of 50% of the original lump-sum payment shall be granted if the insured persons have occupational injuries or are disabled caused by occupational diseases, which means the highest benefit days would be 1,800 days and lowest benefit days shall be 45 days.
- Disability Benefits Application Procedures
- Labor Insurance Disability Benefits Application and Payment receipts
- Labor Insurance Disability Diagnosis Report (the insured person shall contact hospitals or clinics for diagnosing and issuing such report, the report shall be sent directly by those hospitals or clinics to Bureau of Labor Insurance within five days after it is issued, the insured persons shall send “Certificate of Proof for sending Labor Insurance Disability Diagnosis Report directly to Bureau of Labor Insurance”).
- For those who have eyes, ear, mastication, deglutition and speaking disability, viscera in chest and abdomen disability (functional disability), rachis deformity and moving disability, upper and lower limbs functions or skin disability, their disability diagnosis report shall be issued by national health insurance special contracted hospital, which is rated as excellence or better in Hospital Accreditation, or as qualified in Hospital Accreditation(for medical center and regional hospital), or as qualified in Hospital Accreditation and Teaching Hospital Accreditation by the Ministry of Health and Welfare. However, insured persons who live in Penghu county, Kinmen county and Lienchiang county are not limited by this regulations.
- For those who are mentally disabled, the report shall be issued by Psychiatrists; for those who have neuropathic disability, the diagnosis report shall be issued by medical specialists from neurology, neurological surgery or rehabilitation department; for those who have bladder disability, the diagnosis report shall be issued by Urologist.
- Other disability type, the disability diagnosis report shall be issued by National Health Insurance special contracted hospitals or clinics.
- For those who are disabled outside the effective area of this Act, the diagnosis report shall be issued by the original diagnosis hospitals or clinics.
- Labor Insurance Disability Pension with additional Dependent Allowances Application and Payment receipts (it is limited to those who have applied pension payment and are spouse or dependent children who meet the criteria for claiming additional dependent support allowance).
- For those who have gone through medicinal examinations, the medicinal examination report and related pictures shall be enclosed.
- In cases where the insured persons are disabled by diseases or injury caused by accidents which happened during the insured person's commute from home to work or from work to home or during a business trip and apply for occupational disability benefits, the insured person shall fill in a “Labor Insurance Insured Person Proof of Injury Resulting from Accident on the Way to or from Work or during a Business Trip”
- Points for Attention
- An insured person filing for the disability benefits needs to present whose filing within a five-year period from the date the hospital diagnosed the individualized with permanent disability.
[Explanation]: Of the Presidential Decree No. 10100279771 order announcement of the amended provision of “Article 30 of the Labor Insurance Act”, which the Article 13 of the Central Regulation Standard Act stipulates for implementation effective December 21, 2012. Also per an abstract of the Council for Labor Affairs, Executive Yuan’s directive, Reference number Labor Insurance Er Zi No. 1010140557, dated on December 26, 2012:
- Following the foresaid provision amendment takes effect, the insurance payout requesting right shall be implemented per the post-amendment regulations, where the valid time of the requesting right is set to 5 years.
- At the time when the provision amendment takes effect on December 21, 2012, the valid time of individuals whose requesting right has not exceeded 2 years, in a bid to safeguard the claimant’s insurance payout equity, is to be heed to the post-amendment regulations, and the requesting right is to cease to exist over a five-year period from the eligible fling date due to the non-exercise of the requesting right.
- Prior to the article amendment takes effect on December 21, 2012, individuals who have not filed for an application exceeding two years of whose insurance payout requesting right, or who have been declined of the payout by the bureau due to the valid time, due to the non-retroactive legal principle, shall heed to the pre-amendment regulation, and the insurance payout requesting right shall cease to exist over a two-year period for non-exercise of the requesting right.
- If the insured persons are still in treatment for the disability and the symptoms are not stable, it is advised not to apply for disability benefit under such condition.
- Of an insured being reviewed with a disabled status conforming to the “permanent inability to work” payout item who collects the disability payout, or an insured upon undergoing the individualized professional assessment as loss of lifetime working capability who claims the “disability pension payout”, the individualized shall be cancelled of whose insurance by the Labor Insurance Bureau, effective from the date the individualized has been diagnosed with permanent disability.
- Of insured people with a disability level falling under the “permanent inability to work” payout item, or having undergone the individualized professional assessment as losing lifetime working capability who claim the “disability pension payout”, an individualized who concurrently holds the eligibility for filing for the disability benefits and the old age benefits may choose to collect one of the payout schemes.
- An insured person who has been reviewed with the “Disability Conditions” column of the Disability Benefits Payment Schedule has enlisted of “permanent inability to work”, may collect the disability pension payout by month. However, individuals with insured seniority prior to January 1, 2009 may also choose to collect the lump-sum disability benefits. The insured person shall select the scheme stringently, as it can no longer be changed once the Bureau of Labor Insurance approves and releases the payout.
- For those who claim for disability pension benefit due to occupational diseases or injuries, a lump-sum of 20 months occupational disability compensation would be issued additionally.
- If the insured person's body was originally disabled partially, and the partial disability was aggravated or different body part was disabled by diseases or injuries, the issuance of disability benefit shall consider the degree of disability aggravated and calculate the disability benefits according to disability benefit payment schedule and its attached tables. However, the combined disability shall not exceed the payment schedule for first level disability.
- If the insured person has claimed disability benefits due to partial disability on his/her body parts and the degree of disability was aggravated again due to diseases or injuries, and has selected to claim for a lump-sum disability benefits, the amount which already issued shall be deducted from the new benefit payment; however, if the insured person has selected monthly pension payment, then 80% of the disability pension amount shall be issued monthly until the half of the original lump-sum disability payments for partial disability has been completely deducted.
- If the insured persons who have applied for disability pension benefit and later found themselves not qualified for the benefits, they shall submit related documents and inform the Bureau of Labor Insurance within 30 days after they found out the fact and the pension payments shall be terminated in the next month after the fact was realized