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Permanent Disability Benefits

【Qualification】

  1. Lump-sum Disability Benefits:
    1. For the insured suffers from occupational injury and disease, if the symptoms lasts after the treatment and further treatment cannot improve the conditions, the insured is diagnosed as having permanent disability by the NHI hospital or clinic, and meets the provisions of the permanent disability benefits distribution standard for labor occupational accident insurance. Those who are insured may apply for the distribution of lump-sum permanent disability benefits based on their average monthly insured salary and the prescribed distribution standard.
    2. For the insured having seniority in labor insurance before the implementation of the labor insurance pension system on January 1, 2009 and having been evaluated as incapable of working for lifetime and is eligible for permanent disability pension, he/she may choose to claim the lump-sum permanent disability benefits.
  2. Permanent disability pension:
    If the degree of permanent disability of the insured complies with the definitions of complete, severe or partial permanent disability, the insured may apply for permanent disability pension.
    1. Complete permanent disability: comply with the disability item of Level 1 or 2 disabilities specified in the Attachment of the Labor Insurance Disability Benefit Payment Standards, and the disability status of such item is listed as lifelong incapacity for work.
    2. Severe permanent disability: For those meeting one of the following conditions:
      1. Comply with the disability item of Level 3 disability specified in the Attachment of the Labor Insurance Disability Benefit Payment Standards, and the disability status of such item is listed as lifelong incapacity for work.
      2. The overall degree of disability complies with Levels 1 to 9 of the permanent disability and after customized professional assessment, it is determined their working capability has been reduced by more than 70% and they are unable to resume to work.
    3. Partial permanent disability: the overall degree of disability complies with Levels 1 to 9 of the permanent disability and after customized professional assessment, it is determined their working capability has been reduced by more than 50%.

【Claim Standard】

  1. Occupational accident insurance permanent disability benefits shall be reviewed and handled in accordance with the Standards for Disability Benefits of Labor Occupational Accident Insurance and the disability items and levels specified in the Attachment of the Labor Insurance Disability Benefit Payment Standards.
  2. 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.
  3. The calculation of Average monthly Insurance Salary and average daily Insurance Salary:
    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.
  4. Amount of benefit:
    1. Lump sum disability benefits: The benefits will be distributed according to the average monthly insured salary for the 6 months before the month when the insured is diagnosed with actual permanent disability, and calculated according to the number of days for the payment level specified in the Standards for Disability Benefits of Labor Occupational Accident Insurance. The highest Level 1 has 1,800 days for distribution and the lowest Level 15 has 45 days for distribution.
    2. Permanent disability Pension:
      • If the degree of permanent disability of the insured complies with the definitions of complete, severe or partial permanent disability, the standard for distribution of permanent disability pension is as follows.
      • Complete permanent disability: 70% of the average monthly insured salary will be distributed for the 6 months preceding the month when the insured is diagnosed with actual permanent disability.
      • Severe permanent disability: 50% of the average monthly insured salary will be distributed for the 6 months preceding the month when the insured is diagnosed with actual permanent disability.
      • Partial permanent disability: 20% of the average monthly insured salary will be distributed for the 6 months preceding the month when the insured is diagnosed with actual permanent disability.
      • Dependent Allowances:
        Additional Dependent Allowances: If the insured claiming permanent disability pension has a spouse or child(s) who is eligible for additional family allowance, each of such persons will receive an additional 10% of the amount calculated according to the above-mentioned permanent disability pension distribution standard, with the maximum amount of 20%.
        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 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.
        Subject Qualification
        Spouse
        1. Divorced.
        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.

【Documents Required】

  1. Labor occupational accident insurance permanent disability benefits application form and payment receipt
  2. Labor Insurance / Labor Occupational Accident Insurance Permanent Disability Diagnosis Certificate (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 / Labor Occupational Accident Insurance Permanent Disability Diagnosis Certificate 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 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.
    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 / Labor Occupational Accident Insurance Permanent Disability Pension and Family Allowance Application Form and Payment Receipt (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 benefits, the insured person shall fill in a “Labor Occupational Accident Insurance Insured Person Report of Injury Resulting from Accident on the Way to or from Work or during Business Trip”.

【Note】

  1. 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.
  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. 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 “permanent disability pension payout”(that is the level of permanent disability accord with full permanent disability or serious permanent disability), 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.
  4. If the insured applies for the permanent disability pension benefit from the labor occupational accident insurance and the pension benefit for the surviving family members of the same insurance or other social insurance pension benefits, if the total amount of all pension benefits exceeds the average monthly insured salary, the amount of permanent disability pension benefit shall be reduced and adjusted in accordance with the "Regulations for Adjustment on Combined Collection of Pension Benefits of Labor Occupational Accident Insurance ".
  5. For the insured having seniority in labor insurance before the implementation of the labor insurance pension system on January 1, 2009, and having been evaluated as incapable of working for lifetime and is eligible for permanent disability pension, he/she may choose to claim the lump-sum permanent disability benefits. The Applicant is not allowed to change the benefit item after the application has been approved by the insurer. 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.
  6. The insured's body is already partially disabled, and the degree of severity of disability of the same part is aggravated due to occupational injury or disease, or the disability of different parts occurs. After comprehensive evaluation, if the following conditions are met, it can be determined as the degree of severity of disability is aggravated, and an application may be made in accordance with the regulations.
    1. Lump-sum permanent disability benefits: distributed when the level of permanent disability approved by the comprehensive evaluation of all disability status is higher than the original disability level of partial disability.
    2. Permanent disability pension: distributed when the level of permanent disability approved by the comprehensive evaluation of all disability status is higher than the original disability level of partial disability, or the disability items are increased compared with the original partial disability.
  7. The insured’s body is already partially disabled: after claiming the lump-sum permanent disability benefits for labor occupational accident insurance or labor insurance, and the degree of disability of the same part is aggravated due to occupational injury or disease or the disability occurs in different parts. If you choose to claim lump-sum permanent disability benefits, it will be distributed according to the difference in the number of days before and after the disability level is aggravated; if you choose to claim permanent disability pension, 80% of the pension will be distributed monthly until half of the originally received payment has been deducted.
  8. The insured is already partially disabled before applying for the labor occupational accident insurance or during the period of suspension of insurance, and the disability of the same part of the body is aggravated due to occupational injury or disease after applying for insurance or the disability occurs in different parts. If you choose to claim lump-sum permanent disability benefits, it will be distributed according to the difference in the number of days before and after the disability level is aggravated; if you choose to claim permanent disability pension, 80% of the amount of permanent disability pension will be paid on a monthly basis until the original partial disability benefits is distributed according to the permanent disability benefits of labor and occupational accident insurance and half of the standard lump-sum permanent disability benefits amount is deducted.
  9. If the insured persons who have applied for permanent 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.

【Form Downloading】

Public Service>Table Download>Labor Insurance>Insurance Benefits> Labor Occupational Accident Insurance Disability Benefit Application Form and benefit receipt

Last Update:2022-09-16
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