Permanent Disability Benefits

The Labor Occupational Accident Insurance and Protection Act was implemented on May 1, 2022. The occupational accident insurance program has since been separated from the labor insurance. When occupational accidents occur after the implementation of the Act, should be applicable to the Labor Occupational Accident Insurance and Protection Act, for the relevant provisions on labor occupational accident insurance permanent disability benefits, please refer to "Labor Occupational Accident Insurance＼Benefits＼Permanent Disability Benefits".

【Qualification】

1. Disability Pension:
   The insured persons suffer from injury or disease but with current symptoms remain stable after the termination of the treatment. No improvement is expected even continuing the treatment. Additionally, for claiming disability pension purpose,the insured persons have to be diagnosed as permanently disabled and unable to work for the rest of the life by qualified hospitals evaluated by Bureau of National Health Insurance and the degree of the disability has to comply with the disability benefit schedule or are mental or physical disabled according to Protection Act for the Rights and Interests of (Physically and Mentally) Disabled Citizens. When the insured persons meet the above descriptions, they could apply for disability pension benefit.
2. Lump Sum Disability Benefit:
   1. If the insured persons suffer from disease but with current symptoms remain stable after the termination of treatment. No improvement is expected even continuing the treatment. Additionally, the insured persons have to be diagnosed as permanently disabled and the degree of the disability has to comply with the disability benefit schedule, but the degree of severity to disability has not reached no capability to work for life, they could apply for one lump sum disability payment.
   2. If the insured person's disability is evaluated to have no capability to work for life and has insurance seniority before January 1, 2009, he/she could choose to claim a lump sum disability benefit.

【Claim Standard】

1. Labor Insurance disability benefit is issued according to Labor Insurance Disability Benefit Schedule and the disability items, disability levels and payment days defined in the attached table of the Schedule.
2. Disability item:
   According to Labor Insurance Disability Benefit Schedule and its attachment, the disability types are divided depending on each 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.
3. The calculation of average monthly insurance salary and average daily insurance salary:
   1. Disability Pension: it is calculated using the insured persons' sixty highest average monthly Insurance Salary during insurance coverage years.
   2. Lump sum disability benefit (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.
   3. 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 ”, 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.
4. Amount of benefit:
   1. Disability Pension:
      1. 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%).
      2. For those amount less than NT$4,000, NT$4,000 shall be granted.
      3. 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%).
      4. After combining the Labor Insurance Disability Pension Benefit and National Pension Insurance Disability Pension Benefit, if the amount is less than NT$4,000, then NT$4,000 shall be granted.
      5. 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.
      6. 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.
      7. Dependent Allowance:
         • Additional Dependent Allowance: 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.

           Subject	Qualification
           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 living 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 living. 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 allowance: When the dependent does not qualified for the allowance any more, his or her allowance shall be suspended.

           Subject	Reasons for Disqualification
           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.

   2. Lump sum disability benefit: 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 benefit of 1,200 days and the lowest level is the fifteenth level with the lowest lump-sum disability benefit 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.

【Documents Required】
The following documents and certificates shall be submitted when an insured person applies for disability benefit:

1. Labor Insurance Disability Benefit Application and Payment receipts.
2. 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”).
   1. 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 hospitals which are above regional teaching hospital and graded Excellent by new hospital evaluation system of Department of Health of Executive Yuan, or national health insurance special contracted hospitals which are graded qualified by new hospital and teaching hospital evaluation system. However, insured persons who live in Penghu county, Kinmen county and Lienchiang county are not limited by this regulations.
   2. 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.
   3. Other disability type, the disability diagnosis report shall be issued by National Health Insurance special contracted hospitals or clinics.
   4. 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.
3. Labor Insurance Disability Pension with additional Dependent Allowance 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).
4. For those who have gone through medicinal examinations, the medicinal examination report and related pictures shall be enclosed.
5. In cases where the insured persons are disabled by diseases or injured caused by accidents which happened during the insured person's commute from home to work or from work to home or during business trip and apply for occupational disability benefit, the insured person shall fill in a “Certificate for evidencing that the injury was caused by an accident which occurred during the insured person's commute period (or business trip)”

【Note】

1. For those who wish to apply for disability benefit, the application shall be submitted within five years after the day the permanent disability is diagnosed by a hospital or clinic.
2. 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.
3. If the insured persons are evaluated as having no capability to work for the rest of the life, the Bureau of Labor Insurance shall withdraw from the insurance coverage when the insured persons have claimed and received the disability benefit.
4. If the degree of disability of an insured person belongs to having no capability to work for the rest of the life, and the insured person is qualified to claim both disability benefit and old-aged benefit, he/she could select either one of the benefits to apply.
5. If the insured person's degree of disability meet the regulations in the “Disability Benefit Schedule” and has reached the point of “having no capability to work for the rest of the life”, he/she could apply for disability pension benefit and receive payment every month. However, for those insured persons who have insurance coverage before January, 1, 2009, they could also choose to claim a lump-sum disability benefit. The insured persons shall select carefully, once the application has been approved by the Bureau of Labor Insurance, the benefit could not be changed.
6. 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.
7. 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 schedule and its attached tables. However, the combined disability shall not exceed the payment schedule for first level disability.
8. If the insured person has claimed disability benefit 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 benefit, the amount which already issued shall be deducted from the new benefit; 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 payment for partial disability has been completely deducted.
9. 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 payment shall be terminated in the next month after the fact was realized.

【Form Downloading】