The Administrative Process for Recognition and Compensation for Occupational Diseases in Korea

In the Workers' Compensation Insurance (WCI) system in Korea, occupational diseases (ODs) are approved through deliberation meetings of the Committee on Occupational Disease Judgment (CODJ) after disease investigations when workers or medical institutions requested the Korea Workers' Compensation and Welfare Service (COMWEL) for medical care benefits. Insufficient data presented by employers or workers or lack of objective evidence may increase the possibility of disapproval. The expertise of accident investigation staff members should be reinforced and employers' and related institutions' obligations to cooperate and submit data should be specified under the law. The deliberation meetings of the CODJ are held separately for musculoskeletal, cerebro-cardiovascular, and medical diseases, and the judgments of ODs are made by the chairperson of COMWEL and six committee members by majority vote by issue. To reinforce the expertise of the members of the CODJ, periodic education and a system to accredit the committee members after appropriate education should be introduced. To fairly and quickly compensate for diseases that occur in workers, the criteria for the recognition of occupational diseases should be continuously amended and the systems for disease investigations and judgments should be continuously improved.

Work-Related Musculoskeletal Diseases and the Workers' Compensation

The Industrial Accident Compensation Insurance Act (IACIA) regulates the workers' compensation insurance system and the standards for the recognition of occupational diseases (ODs). Since its establishment in 1994, the IACIA has been amended several times. Before 2008, the approval of compensation for work-related musculoskeletal diseases (WMSDs) was decided based on the recommendation of consultants of the Korea Workers' Compensation and Welfare Service (COMWEL). The IACIA was amended in 2008, and since then, the approval of compensation for occupational injuries has been decided based on the recommendation of COMWEL consultants, whereas the approval of compensation for ODs was decided based on the judgment of Committee on Occupational Diseases Judgment (CODJ) which was established in 2008. According to the 2013 amendment to the IACIA, degenerative musculoskeletal diseases among workers engaged in musculoskeletal-burdening work should be considered compensable ODs. Despite some commendable changes to the workers' compensation insurance system, other significant issues persist. To resolve these issues, related organizations including the associations of orthopedic surgery, neurosurgery, and occupational and environmental medicine; Ministry of Employment and Labor; and COMWEL need to work cooperatively.

Compensation for Occupational Injuries and Diseases in Special Populations: Farmers and Soldiers

Some types of workers such as farmers and soldiers are at a higher risk of work-related injury and illness than workers from other occupations. Despite this fact, they are not covered under the Industrial Safety Health (ISH) Act or the Industrial Accident Compensation Insurance (IACI) Act. The Safety Aid System for Farmers (SASF) is a voluntary insurance scheme, and it is the only public compensation plan for self-employed farmers. Fifty percent of SASF premiums are subsidized by the Korean government. Soldiers are compensated by the Veterans' Pension (VP) Act. The approval standard of and procedure for the VP Act are provided in the Decree of VP Act, and the Council for VP Benefits determines work-relatedness in the claimed cases. Meanwhile, SASF applies the insurance clause automatically without any expert advice or additional procedures. Furthermore, compared with IACI, these programs pay fewer benefits to workers. Thus, a stronger institutional strategy is needed to maintain a safe work environment, to protect workers' health in unavoidably hazardous environments, and to compensate for work-related injuries and diseases.

The Scope and Specific Criteria of Compensation for Occupational Diseases in Korea

The range of diseases covered by workers' compensation is constantly expanding. However, new regulations are required for the recognition of occupational diseases (ODs) because OD types evolve with changes in industrial structures and working conditions. OD criteria are usually based on medical relevance, but they vary depending on the social security system and laws of each country. In addition, the proposed range and extent of work-relatedness vary depending on the socio-economic conditions of each country. The Labor Standards Act (LSA) and the Industrial Accident Compensation Insurance Act (IACIA) of Korea employ lists based on their requirements without listing causes and diseases separately. Despite a considerable reshuffle in 2003, the basic framework has been maintained for 50 yr, and many cases do not fit into the international disease classification system. Since July 1, 2013, Korea has expanded the range of occupational accidents to include occupational cancers and has implemented revised LSA and IACIA enforcement decrees. There have been improvements to OD recognition standards with the inclusion of additional or modified criteria, a revised and improved classification scheme for risk factors and ODs, and so on.

Previdência Social e Seguro Público contra Acidentes e Doenças do Trabalho: estudo metodológico da definição das alíquotas para contribuição patronal nas dimensões coletiva e individual / Social Security and Public Insurance against accidents and diseases of work: study on methodological for definition of employer contribution aliquots on individual and collective dimensions

Este estudo faz um relato breve sobre a formação do sistema brasileiro de previdência social e sobre a evolução do seguro público de acidentes e doenças do trabalho neste sistema, contextualizando-a no âmbito das políticas públicas de atenção à saúde do trabalhador e segurança nos ambientes laborais, com enfoque especial nas ações e programas adotados pela política previdenciária. Considerando a expressiva evolução dos sistemas de informação acerca da acidentalidade, tanto no tocante aos registros de acidentes como nos respectivos desdobramentos, e a formação da agenda de Governo que conferiu relevância ao tema Saúde e Segurança no Trabalho – SST, a Previdência social promoveu a revisão do enquadramento dos graus de risco segundo as atividades econômicas, atualizando esta correlação de acordo com o cenário real dos padrões de acidentalidade. Em seguida, a implementação da individualização da tarifação para a formação do custeio para o pagamento dos benefícios de natureza acidentária e das aposentadorias especiais, para cada empresa, surge como um instrumento com forte potencial para estimular a adoção ou o aperfeiçoamento dos sistemas de gerenciamento de riscos laborais, pelos empregadores. Observando que alguns aspectos necessitam de atenção especial, tais como o estabelecimento de uma metodologia própria para os enquadramentos dos graus de risco, a definição de temporalidade e a extensão da cobertura do seguro aos trabalhadores de todas as categorias profissionais, propostas para tratamento e solução destas questões são apresentadas nesta dissertação.

This study is a brief account about the formation of the Brazilian social security system and the evolution of public insurance against accidents and occupational diseases in this system, contextualizing it within the public policy for worker health and safety, with special focus on actions and programs adopted by Social Security. Due to significant evolution of information systems about accidentality, and the relevance the topic Health and Safety at Work - OSH had achieved in the Government agenda, the Social Security had promoted the revision of degrees of risk according to economic activities using real scenarios patterns accidentality. The implementation of individual fare for contribution to financing the benefits related to workplaces risks appears as an instrument with strong potential to stimulate the adoption of better management systems workplace risks, by employers. Some aspects need special attention, such as the establishment of a proper methodology for framing degrees of risk, the definition of temporality and extent of insurance coverage to workers of all professional categories, and some proposals are presented for them in this dissertation.

Current Situation and Issue of Industrial Accident Compensation Insurance

Industrial Accident Compensation Insurance (IACI) has a history of about 50 yr, and is the oldest social insurance system in Korea. After more than 20 times of revision improvements in benefits, its contents and claim systems have been upgraded. It became the protector of injured workers and their families, and at the same time became the system which could cope with both financial burden of employers and their responsibilities. However, there are some issues to be reformed to upgrade the IACI: 1) the problems in the approval system of occupational diseases, 2) quality improvement of workers' compensation medical care, 3) vocational rehabilitation and return to work, 4) workers' compensation premiums and out-of-pocket money of injured workers, 5) issues in application of IACI. Growth of IACI cannot be achieved by an effort of an individual. Efforts by workers, owners, and government, in addition to physicians and welfare professionals toward the same goal are required for the next level improvement of IACI.

O novo seguro de acidente e o novo FAP / The new accident insurance and the new accident prevention factor

O que é o FAP – Fator Acidentário de Prevenção (tarifação individual por empresa)? O que é o RAT – Risco de Acidente de Trabalho (tarifação coletiva por setor econômico)? O que muda para as empresas e para os trabalhadores com o FAP? Como faço para calcular o FAP da empresa? Como essa política de prevenção funciona em outros países? Qual é a legislação básica do novo Seguro de Acidente e do novo FAP? Estas são algumas perguntas que clamam por respostas desde o lançamento do FAP, em setembro de 2009. Esta obra traz amplas informações sobre ambos: o FAP, que incidirá ano a ano para as empresas a partir de 2010, e o RAT, que é o ponto de partida para o FAP. Juntos, esses dois instrumentos orientarão as políticas de saúde e segurança no trabalho e, portanto, precisam ser amplamente conhecidos por empresários, trabalhadores, advogados, médicos, gestores públicos, engenheiros, pesquisadores, técnicos na área de saúde ocupacional e por todos os que atuam no campo da saúde e segurança no trabalho. Tornar conhecidos o FAP e o RAT é o objetivo deste livro. Aqui, estão descritos a metodologia do FAP e do RAT e o histórico da legislação previdenciária que deu origem a esses instrumentos e também é feita uma comparação com o que acontece em outros países, quanto à tarifação coletiva e individual para o financiamento do custo da acidentalidade no trabalho. Os resultados do RAT e do FAP também são apresentados, mostrando o impacto desses instrumentos em cada um dos grandes setores da economia: indústria, comércio, construção, saúde, transporte, bancos, serviços... Como está cada uma dessas atividades econômicas quanto aos acidentes de trabalho? Como o FAP altera as alíquotas das empresas nos diversos setores? Que impactos são esperados para o campo de saúde e segurança no trabalho a partir das mudanças efetuadas? As respostas para essas e outras perguntas podem ser obtidas pela leitura deste livro.