1. What is the qualification and benefit standard for claiming disability benefits?
- Eligibility:
(1) 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.
A. 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.
B. 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.
(2) Lump-sum disability benefits:
A. 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.
B. 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.
- Benefit Standards
(1) Labor Insurance Disability Benefits are to be conducted and issued according to the disability type, disability level and payment days defined in labor insurance disability benefit standard.
(2) Disability type:
According to Labor Insurance Disability Benefit standard and its attachment, the physical disability is categorized into 12 disability types including mental, neuropathic, eyes, ears, nose, mouth, viscera in chest and abdomen, trunk, head-face-neck, skin, upper limbs and lower limbs, 221 disability items and 15 disability levels.
(3) Calculation of Average monthly insured salary and average daily insured salary:
A. Disability Pension: it is calculated using the insured persons’ sixty highest average monthly Insured salary during insurance coverage years.
B. Lump Sum Disability Benefits (including lump sum benefits for occupational injury and sickness compensation): it is calculated using the actual average monthly insured salary for the 6 months prior to the insurance accident happened to the insured person (meaning the date the insured person is diagnosed as permanently disable); average daily insured salary is calculated using the average monthly insured salary divided by 30.
C. For insured persons who are concurrently employed by more than two insurance coverage units, the monthly Insured salary for issuing benefits for general accident could be jointly calculated but it shall not exceed the highest level in the “Table of Grades of Insurance Salaries 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 Insured salary
(4) Amount of Benefits:
A. Disability Pension:
a. It is calculated according to insured persons’ insurance coverage seniority, 1.55% of the average monthly Insured salary is issued for every one full year of insurance seniority. (That is Average Monthly Insured salary × Coverage Years × 1.55%).
b. For those amount less than 4,000 NT dollars, 4,000 NT dollars shall be granted.
c. 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 × seniority of Insurance Premium Paid × 1.3%).
d. After combining the Labor Insurance Disability Pension Benefits and National Pension Insurance Disability Pension Benefits, if the amount is less than 4,000 NT dollars, then 4,000 NT dollars shall be granted.
e. For those who have suffered from occupational injuries or disabled by occupational diseases, a lump-sum payment of 20 months occupational disability compensation shall be granted in addition to the pension.
f. 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 are less than 30 days, it shall be calculated as one month.
g. Dependent Support Allowance:
※ Additional Dependent Support Allowance: For those who apply for disability pension benefits 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 support allowance for each dependent, a maximum of 50% will be granted.
※ Suspension of dependent support allowance: When the dependents do not qualified for the allowance any more, the dependent support allowance shall be suspended
B. Lump-sum Disability Benefits:
For those who suffer from general injuries or are disabled 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 by occupational diseases which mean the highest benefit days would be 1,800 day and lowest benefit days shall be 45 days.