• Title/Summary/Keyword: Workers' compensation insurance

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Review of 2013 Major Medical Decisions (2013년 주요 의료 판결 분석)

  • Lee, Dong Pil;Jeong, Hye Seung;Lee, Jung Sun;Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.263-302
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    • 2014
  • The court handed down meaningful rulings related to medical sectors in 2013. This paper presents the ruling that the care workers could be the performance assistants of the care-giving service although the duties of care worker are not included in the liability stipulated in the medical contract signed with the hospital for reason of clear distinction of duties between care workers and nurses within the hospital in connection with the contract which was entered into between the hospital and patients. In relation to negligence and causal relationship, the court recognized medical negligence associated with the failure to detect the brain tumor due to the negligent interpretation of MRI findings while rejecting the causal relationship with consequential cerebral hemorrhage. The court also recognized negligence based on the observation on the grounds of inadequate medical records in a case involving the hypoxic brain damage caused during the cosmetic surgery. In terms of the scope of compensation for damages, this paper presents the ruling that the compensation should be estimated based on causal relationship only in case the breach of the 'obligation of explanation' is recognized, however rejecting the reparation for de factor property damages in the form of compensation, and the ruling that the lawsuit could be instituted in case that the damages exceeded the agreed scope despite the agreement that the hospital would not be held responsible for any aftereffects of surgery from the standpoint of lawsuit, along with the ruling that recognized the daily net income by reflecting the unique circumstances faced by individual students of Korean National Police University and artists of Western painting. Many rulings were handed down with respect to medical certificate, prescription, etc., in 2013. This paper introduced the ruling which mentioned the scope of medical certificate, the ruling that related to whether the diagnosis over the phone at the issuance of prescription could constitute the direct diagnosis of patient, along with the ruling that required the medical certificate to be generated in the name of doctor who diagnosed the patients, and the ruling which proclaimed that it would constitute the breach of Medical Act if the prescription was issued to the patients who were not diagnosed. Moreover, this paper also introduced the ruling that related to whether the National Health Insurance Service could make claim to the hospitals for the reimbursement of the health insurance money paid to pharmacies based on the prescription in the event that the hospitals provided prescription of drugs to outpatients in violation of the laws and regulations.

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An Analysis on the Employment Duration of the Workers Injured in Industrial Accidents (요양종결 이후 산재근로자의 취업기간 분석)

  • Yee, Seung-Yeol
    • Journal of Labour Economics
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    • v.27 no.3
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    • pp.25-52
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    • 2004
  • The work history of the workers injured in industrial accidents was recomposed by combining the database on compensation for industrial accidents with the database on employment insurance among those who were newly classified as disabled during the period from 1998 to 2000. It shows that the injured workers mainly returned to the original workplaces, and such workers had higher job retention rate. It is in contrast with the higher separation rate of the workers who started to work at the new workplace after medical recuperation. And it is found that 61% left or lost their jobs out of the injured workers who returned to work, and 77% of the job separators had job tenure less than one year. The analysis based on competing risks model shows that the workers at the smaller workplace have the shorter the employment duration, and the longer job-searching period has the negative effect on the employment duration of the job losers. In addition, the longer employment duration at the first job after medical recuperation is more effective on the reemployment and job stability after separation.

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The Effects of Occupational Stress and Musculoskeletal Symptoms on Health-Related Quality of Life in Female Labor Workers (생산직 여성근로자의 직무스트레스와 근골격계증상이 건강관련 삶의 질에 미치는 영향)

  • Lee, Young-Mee;Phee, Young Gyu
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.26 no.2
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    • pp.210-218
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    • 2016
  • Objectives: The objectives of this study were to investigate female labor workers' occupational stress and musculoskeletal symptoms and to identify the effects of their occupational stress and musculoskeletal symptoms on their health-related quality of life. Methods: A survey was conducted through direct interviews using a musculoskeletal symptoms questionnaire, the Korean Occupational Stress Scale(KOSS), and the Short-Form 36-Item Health Survey(SF-36). Subjects were 112 female labor workers in three factories in D city who were selected by convenience sampling. Results: Factors significantly affecting health-related quality of life were found to be: occupational stress(${\beta}$=-.36); degree of pain, with medium pain(${\beta}$=-.31) and extremely severe pain(${\beta}$=-.24); duration of pain, with more than 1 week-less than 1 month(${\beta}$=-.25) and more than 6 months(${\beta}$=-.16); frequency of pain, with once per 2-3 months(${\beta}$=-.22); responses to pain such as medical leave, use of worker's compensation insurance, task change, etc.(${\beta}$=-.16), and Slightly difficult(${\beta}$=-.16) versus Not hard at all. These variables demonstrated that health-related quality of life is 48%(F=11.72, p<.001) in female workers. Conclusions: To improve female labor workers' health-related quality of life based on the above results, occupational health managers should reduce the workers' occupational stress, develop and apply health interventions regarding musculoskeletal symptoms, prevent the early onset of musculoskeletal symptoms, and protect and promote the workers' health.

A Study on the Characteristics of Injured Workers Rate and Work Environment of Male Workers for over 40 years (산업재해 남성 근로자의 작업환경의 특성에 관한 연구: 산재보험패널조사)

  • Choi, Kil-Yong;Yang, Kyung-Soo
    • The Korean Journal of Health Service Management
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    • v.10 no.1
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    • pp.131-142
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    • 2016
  • Objectives : Using several waves of the Panel Study of Worker's Compensation Insurance(PSWCI), this study analyzed the effect of work hours on health and lifestyle of Korean workers in a sample from the 2013~2014 year (The first survey was completed in August-October 2013; the second survey was completed in August-October 2014). Methods : The research subjects were 1,312 men from among employees who responded to a 2013 PSWCI panel report. Statistical analyses were done with SAS version 9.3 (SAS Institute Inc., Cary, NC, USA). Results : According to the results of the analysis, the male subjects had differences in economic activity and health conditions based on the length of working hours. There was a significant relationship among working hours and life satisfaction, and the correlation coefficients were statistically significant. The results show that workplace conditions has a direct positive effect on life satisfaction as we anticipated in the hypothesis. Conclusions : Management should focus on the factors identified in this study when developing employment interventions programs to improve the the promotion of healthy lifestyles for adults over the age of 40.

Health Related Quality of Life Among Herniation of Nucleus Pulposus Patients Caused by Occupational Accidents (산업재해 추간판탈출증 환자의 삶의 질에 관한 연구)

  • Shin, Na Young;Lee, Se-Hoon
    • Korean Journal of Occupational Health Nursing
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    • v.16 no.2
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    • pp.168-176
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    • 2007
  • Purpose: This study was to investigate the factors influencing on the quality of life (QOL) among herniation of nucleus pulposus (HNP) patients caused by occupational accidents. Method: 203 patients of HNP were recruited. 106 patients were occupationally injured workers who benefited from workmen's compensation scheme (PWCS group), and 43 patients were non-occupationally injured workers benefiting from national health insurance (PNHI group). Questions of QOL items were used by Korean version of SBQOL (SmithKlein Beecham's Qality of Life). Result: The quality of life of PWCS group measured by SBQOL was significantly lower than that of PNHI group. In PWCS group, SBQOL was significantly lower in patients with 40s of their age, 5 years or longer of treatment duration, no expectation of return to work, no expectation of recovering subject's health, and with loss of employment than rest of the patients in each category. Expectations of recovering subject's health showed to be affect factors on QOL both the PWCS and PNHI groups. Conclusion: It suggested that betterment of expectation of recovering patient's health and an administrative system for returning to work of the occupationally injured HNP patients during treatment be necessary for improvement of their quality of life.

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Relationship between Occupational Accident Service, Pain, and Life Satisfaction of Industrial Accident Compensation Insurance Beneficiaries (산업재해보험 급여수급자의 통증과 산업재해서비스 및 생활만족간의 관계)

  • Jang, Yu Mi
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.4
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    • pp.45-51
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    • 2022
  • This study aims to provide basic data on socioeconomic and social activities from the point of view that disability or disease accompanying the suffering of industrial accident subjects is directly related to individual socioeconomic activity and is a major variable affecting current health and daily life satisfaction. The purpose of this study is to investigate the relationship between pain and life satisfaction and to suggest basic data for economic and psychological rehabilitation of industrial accident insurance beneficiaries by linking factors affecting life satisfaction with industrial accident services. As a result of the study, it was found that workers' compensation insurance benefit recipients had an effect on their daily life satisfaction after becoming an industrial accident patient due to industrial accident pain. There was a positive(+) relationship between rehabilitation services and medical counseling services. Occupational accident pain lowers self-esteem, which is a characteristic of an individual, and even if current health improves, satisfaction with daily life decreases. The importance of industrial accident-related services can be seen in that the satisfaction of daily life is increased through rehabilitation services and medical consultation services. In addition, it was indirectly confirmed that satisfaction with rehabilitation services and health can be improved as a result of continuing attempts to improve self-esteem suitable for patients in various problems and situations after an industrial accident.

A Study on the Characteristics of Labor Market Transition and Factors Influencing Labor Market Transition of Injured Workers (산업재해근로자 노동시장이행의 성격과 영향요인 연구)

  • Bae, Hwa Sook
    • Korean Journal of Social Welfare
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    • v.69 no.3
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    • pp.193-212
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    • 2017
  • This study is purposed to explain the characteristics of injured workers' labor market situation and to analyze the factors influencing labor market transition of those workers. Using the Worker's Compensation Insurance Panel Data ver.1~3 which was surveyed by the Korean Workers' Compensation & Welfare Service in 2013-2015, this study analyzed 1,668 injured worker cases. The study shows that workers who have experience job retention at least once are 36.8% of all, 51.5% of them have experienced re-employment, and 36.9% have done unemployment. One result of the longitudinal analysis is that socio-demographic factors including gender, age, education years, convalescence period, ability on job performance, company size, term of service, temporary employment, daily-workers status before job accident and job training were associated with return to pre-injury job. The other result is that statistically significant factors affecting the probability to be the unemployed are gender, age, levels of disability, convalescence, ability on job performance, term of service before job accident, job rehabilitation service utilization. These findings indicate that we need to develop efficient intervention programs for supporting return-to-work and labor market transition of injured workers.

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The Trends and Status of Work-related Musculoskeletal Diseases under Korean Worker's Compensation System (업무상 근골격계질환 산업재해판정자에 대한 현황 분석)

  • Kim, Kyung Ha;Hwang, Rah Il;Suk, Min Hyun
    • Korean Journal of Occupational Health Nursing
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    • v.22 no.2
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    • pp.102-111
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    • 2013
  • Purpose: This study was conducted to analyze the characteristics of work-related musculoskeletal diseases (MSD) and the factors for approving MSD by the parts of the body. Methods: The analysis was done using the data which were drawn from the Industrial Accident Compensation Insurance that is operated by the Korea Worker's Compensation & Welfare Service. The data were composed of total cases related to the work-related diseases from 2006 to 2009. In addition, MSD data input by an investigator were collected. The factors associated with MSD were analyzed using ${\times}2$ and multiple logistic regression. Results: MSD approved cases have increased since 2006 and the proportion of the approved work-related MSD cases in the workers with work-related diseases in 2009 were 33.4%. Spinal approved cases were the highest percentage and upper and lower extremities cases gradually increased. The factors for approving upper extremity were found to be age, company size, type of industry, working duration, and in the case of spine to be company size and heavy lifting. Conclusion: Work-related MSD have increased and the factors that affected MSD by the parts of the body varied. Management strategy must be established to prevent MSD by the parts of the body.

The Renewal of Cognizance Criteria for Work Compensated Disease in Spondylolisthesis (척추전방전위증의 업무상질병 인정기준 개선)

  • Cho, Joon;Yoon, Do Heum;Park, Young Gou
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1600-1605
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    • 2000
  • Objective : World Health Organization and International Labour Organization, in June 8, 1999, requested that working conditions should be reformed ethically right and economically solid for 2.7 billion world labour force. The purpose of this study is to request compensable surgical therapeutic options and to suggest the renewal in cognizance criteria for worker's compensation, especially in spondylolisthesis. Methods : Regarding spondylolisthesis, we obtained data from Korea Labor Welfare Corporation(KLWC). Spinal disease occurrence incidences and medical fees of National Federation of Medical Insurance(NFMI) were analysed. The compensated 122 spinal instrumented cases included 117 male and 5 female patients, aged from 23 to 72 years old(mean : $45{\pm}9.85$). We compared Korean and Foreign Workers Compensation Law. Results : Numbers of herniated nucleus pulpus(78 cases), spinal fractures(34 cases) and dislocations(4 cases) were claimed after spinal interbody fusion operation and were compensated. These compensated degenerative diseases, work related illness, occurred in the course of work. A case of 52-year old spondylolisthesis patient with Disability Grade 8 was compensated by KLWC, according to its occurrence at work by accident. With exception of trauma at work by accident, current cognizance criteria were too narrow to be compensable, especially in surgical therapeutic option, for worker's spondylolisthesis. Conclusion : Considering both worker's compensation law and clinical pathologic progress, we believe that spondylolisthesis should be regarded as a compensable occupation related disease if and when aggravates rapidly in the course of work. We suggest a new cognizance standard to KLWC for labour welfare and proper worker's compensation.

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Trends of Industrial Injuries among Long-Term Health Care Workers in Korea (한국 요양보호사 산업재해의 연도별 변화추이)

  • Son, Mia;Jeon, Geo-Song;Bae, Dong-Chul;Son, Byungchang;Kim, Taeun;Yun, Jae-Won
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.31 no.2
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    • pp.156-172
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    • 2021
  • Objectives: To investigate the trends of industrial injuries among long-term health care workers in Korea Methods: T7866 injuries were selected from the total industrial injuries approved by the Industrial Accident Compensation Insurance Act(Occupational Safety and Health Act) among long-term health care workers between 2007 and 2016 in Korea. We analyzied the trends of industrial injuries according to work process, occurrence type, and causes. Results: The industrial injuries among long-term health care workers increased since 2012. The mostly occurred area for industrial injuries were low back areas, which is related that the most serious industrial injuries occurred when the one long-term healthcare worker lift manually the recipient, from bed(ondol, Korean floor heating system) to a wheelchair, bed to bath bed, and wheelchair to bath chair. In addition to this, lack of workforce, increased work intensity due to overwork contributed the increasing of occupational injury. Conclusions: This study suggests that the main causes of industrial injuries were Lack of facilities and equipment for small private long-term care institutions, The physical load that goes into lifting the recipient directly, work intensity such as excessive workload and increased work speed. We suggest that the social publicization of long-term care service for the elderly, avoiding ways to lift recipients directly, introducing lifting machines as well as improving working methods, and reducing the workload of caregivers are required.