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Operation Directions for Conducting the Individualized Professional Evaluation for the Permanent Disability Pension of the Labor Insurance Commissioned by the Bureau of Labor Insurance, Ministry of Labor

Letter No. Lao-Bao-San-Zi-1020140362 issued by the Council of Labor Affairs, Executive Yuan on May 27, 2013 for future reference.
Order No. Bao-Ji-Can-Zi-10260317801 issued by the Bureau of Labor Insurance on June 13, 2013.
Letter No. Lao-Dong-Bao-San-Zi-1030006700 issued by the Ministry of Labor on March 26, 2014 for future reference.
Through Order No. Bao-Zhi-Shi-Zi-10360067571 promulgated by the Bureau of Labor Insurance, Ministry of Labor on April 10, 2014, Points 1 and 9 amended and the title changed to “Operation Directions for Conducting Individualized Professional Evaluation for the Permanent Disability Pension   of the Labor Insurance Commissioned by the Bureau of Labor Insurance, Ministry of Labor,” which shall take effect as from the date of promulgation.
The amendment is announced by the Bureau of Labor Insurance, Ministry of Labor on November 18, 2015 by BLI directive Bao-Zhi-Shi-Zi No. 10460427631, taking effect that day.
 
  1. These Operation Directions are enacted by the Bureau of Labor Insurance, Ministry of Labor (hereinafter called “BLI”) in order to implement Article 4-1 of the Labor Insurance Disability Benefit Payment Standards.
  2. Among the insured persons who apply for the labor insurance disability pension benefits, except for those whose disability status is classified as “loss of work capacity for the rest of their lives” according to the standards specified in the Labor Insurance Disability Benefit Payment Standards, others whose overall disability status is classified as Level 1 to Level 7 in the Standards shall be sent to the hospitals commissioned by BLI (hereinafter called “commissioned hospitals”) to receive an individualized professional evaluation (hereinafter called “evaluation”).
  3. The following documents are required when BLI sends such an applicant to a commissioned hospital for evaluation:
    (1)The labor insurance disability benefit payment application form and the disbursement receipt,
    (2)The labor insurance medical certificate of disability,
    (3)Medical record, pathological test reports, or information related to the evaluation, and
    (4)Record of changes in the insured person’s enrollment in the labor insurance program and the jobs and positions that he/she has ever had.
  4. For the purpose of evaluation, the commissioned hospital may request BLI to provide necessary documents and information or to have the insured submit further information or receive re-examination by a deadline.
  5. The commissioned hospital shall, based on the requirements of the Standard, organize a team to conduct the evaluation and complete the evaluation report using the format specified by the BLI. The evaluation report shall be returned to BLI along with the original file. 
    The aforementioned evaluation report shall include the following items:
    (1)General information of the insured,
    (2)Case history,
    (3)Occupational history (including the occupations and positions),
    (4)Physical examination report,
    (5)Primary diagnosis,
    (6)Impairment rating according to the American Medical Association’s Guides to the Evaluation of Permanent Impairment,
    (7)Adjustment to the percentage of impairment of work capacity,
    (8)Date of evaluation,
    (9)Seal of the evaluating hospital,
    (10)Seals of the members of the evaluation team,
  6. Listed below are the payment standards for the evaluation fees, which are subject to adjustment by BLI when necessary:
    (1)An evaluation fee of NT$7,000 will be paid for each case on which the commissioned hospital has finished an evaluation report pursuant to the preceding point, and an evaluation fee will be paid more according to the status of the evaluation team, up to the maximum of NT$15,000.
    (2)If an evaluation cannot be completed due to the insured’s failure to cooperate by the deadline or other reasons which cannot be blamed on the commissioned hospital, but the hospital has done part of the evaluation and explains in writing the evaluation situations and the reasons for incompletion, then a partial evaluation fee of NT$3,500 will be paid for each case.
    (3)An evaluation fee of NT$2,500 will be paid for each case when it is necessary for the insured to provide additional related information to be evaluated by the commissioned hospital or when BLI asks the same hospital to re-evaluate the case because the applicant raises an objection after completion of the evaluation. However, this shall not apply to the re-evaluation which is not made by the same commissioned hospital.
    BLI shall not make any payment to the commissioned hospital if the evaluation report is not finished and the situations described in Subparagraph 2 of the preceding paragraph do not exist.
  7. After complete evaluation reports or evaluation situations are submitted for a certain number of cases, the commissioned hospital shall apply to BLI for evaluation fees every month by submitting an evaluation fees application form and a billing document such as an invoice.
  8. When a hospital is commissioned by BLI to make individualized professional evaluations, it shall sign a contract with BLI.
  9. (Deleted)
Last Update:2018-11-12
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