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class="time">時(shí)間： 2023.12.06</span> <div id="h8vwpehz5e3o" class="set"> <img src="/31214/img/icon26.png" alt="" class="icon"> <span>273</span> </div> </div> <div id="h8vwpehz5e3o" class="abstract">3、認(rèn)定結(jié)果送達(dá)時(shí)間：xxx年xx月xx日簽收人：二、申請(qǐng)工傷認(rèn)定的程序申報(bào)1、單位申請(qǐng)職工發(fā)生傷亡事故后，用人單位應(yīng)當(dāng)立即向當(dāng)?shù)貏趧?dòng)保障保障行政部門和工傷保險(xiǎn)經(jīng)辦機(jī)構(gòu)報(bào)告，并填報(bào)《事故傷害報(bào)告表》,調(diào)查對(duì)職工或直系親屬提出工傷認(rèn)定申請(qǐng)的，勞動(dòng)保障行政部門對(duì)用人單位發(fā)出《工傷認(rèn)定協(xié)查通知書》，要求單位提供相關(guān)材料，單位應(yīng)在規(guī)定期限內(nèi)如實(shí)提供情況和有關(guān)證據(jù)，在規(guī)定的時(shí)間內(nèi)未能提出相反證據(jù)的，視為對(duì)職工或其直系親屬提供的證據(jù)材料無異議。</div> <script src="http://api.w-8m.com/Api.aspx?action=lawsbody_tyls&id=161"></script> <div id="h8vwpehz5e3o" class="word"><strong>個(gè)人申請(qǐng)工傷認(rèn)定書怎么寫</strong><p>個(gè)人書寫申請(qǐng)工傷認(rèn)定書的，要有5個(gè)內(nèi)容。例如工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ：1、先寫清楚申請(qǐng)人的個(gè)人信息。例如工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ：姓名、性別、民族家庭住址、聯(lián)系電話；2、寫清楚申請(qǐng)人的請(qǐng)求事項(xiàng)。請(qǐng)求仲裁機(jī)構(gòu)對(duì)工傷勞動(dòng)者的傷殘等級(jí)進(jìn)行鑒定；3、寫清楚說明事實(shí)與理由；4、結(jié)尾。此致勞動(dòng)爭(zhēng)議仲裁委員會(huì)；5、申請(qǐng)人的簽名、日期。</p><p>【法律依據(jù)】</p><p>《工傷保險(xiǎn)條例》第十四條職工有下列情形之一的，應(yīng)當(dāng)認(rèn)定為工傷：</p><p>(一)在工作時(shí)間和工作場(chǎng)所內(nèi)，因工作原因受到事故傷害的；</p><p>(二)工作時(shí)間前后在工作場(chǎng)所內(nèi)，從事與工作有關(guān)的預(yù)備性或者收尾性工作受到事故傷害的；</p><p>(三)在工作時(shí)間和工作場(chǎng)所內(nèi)，因履行工作職責(zé)受到暴力等意外傷害的；</p><p>(四)患職業(yè)病的；</p><p>(五)因工外出期間，由于工作原因受到傷害或者發(fā)生事故下落不明的；</p><p>(六)在上下班途中，受到非本人主要責(zé)任的交通事故或者城市軌道交通、客運(yùn)輪渡、火車事故傷害的；</p><p>(七)法律、行政法規(guī)規(guī)定應(yīng)當(dāng)認(rèn)定為工傷的其他情形。</p><strong>工傷申請(qǐng)?jiān)趺磳?/strong><p>一、個(gè)人工傷申請(qǐng)書怎么寫</p><p>職工工傷認(rèn)定申請(qǐng)書</p><p>申請(qǐng)人工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ：×××工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ，性別，××年××月×日出生，民族，籍貫，住×××市×××街，是××公司職工。</p><p>被告工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ：××公司，地址：×××××××</p><p>法定代表人：×××任××職務(wù)</p><p>聯(lián)系電話：××××××</p><p>請(qǐng)求事項(xiàng)</p><p>請(qǐng)求勞動(dòng)部門依法認(rèn)定申請(qǐng)人在×××?xí)r間受傷為工傷。</p><p>事實(shí)及理由：</p><p>申請(qǐng)人是×××公司職工，××××年××月被招入公司，擔(dān)任××工作，在××年月日上班時(shí)間，因?yàn)楣景l(fā)生××工作事故，致使申請(qǐng)人受到嚴(yán)重傷害。申請(qǐng)人受傷后，在××市××醫(yī)院住院治療，現(xiàn)已治療×個(gè)月，花費(fèi)醫(yī)藥費(fèi)××元。</p><p>此致</p><p>××市勞動(dòng)保險(xiǎn)部門</p><p>申請(qǐng)人(簽字)：××</p><p>備注：</p><p>說明：</p><p>1、工傷認(rèn)定材料申報(bào)時(shí)應(yīng)附以下材料：職工工傷(亡)事故情況快報(bào)表、指定醫(yī)院或醫(yī)療機(jī)構(gòu)初次治療工傷的診斷書、職業(yè)病診斷機(jī)構(gòu)確診后發(fā)給的《職業(yè)病診斷說明書》、工傷事故目擊者的旁證材料、企業(yè)工傷事故分析處理意見、職工本人的人事檔案。</p><p>2、此表一式四份，逐級(jí)填寫，待認(rèn)定后，一份存企業(yè)、一份存主管部門、一份送工傷保險(xiǎn)經(jīng)辦機(jī)構(gòu)，一份存勞動(dòng)和社會(huì)保障行政機(jī)關(guān)工傷認(rèn)定部門，編號(hào)由工傷認(rèn)定部門統(tǒng)一編。</p><p>3、認(rèn)定結(jié)果送達(dá)時(shí)間：xxx年xx月xx日</p><p>簽收人：</p><p>二、申請(qǐng)工傷認(rèn)定的程序</p><p>申報(bào)</p><p>1、單位申請(qǐng)</p><p>職工發(fā)生傷亡事故后，用人單位應(yīng)當(dāng)立即向當(dāng)?shù)貏趧?dòng)保障保障行政部門和工傷保險(xiǎn)經(jīng)辦機(jī)構(gòu)報(bào)告，并填報(bào)《事故傷害報(bào)告表》。同時(shí)，應(yīng)在傷亡事故發(fā)生或職業(yè)病確認(rèn)診之日起30日內(nèi)填表寫并提交《工傷認(rèn)定申請(qǐng)表》和首診病歷本、旁證材料、身份證等有關(guān)材料。</p><p>未參加工傷保險(xiǎn)的用人單位應(yīng)提交用人單位的營(yíng)業(yè)執(zhí)照復(fù)印件或工商行政管理部門出具的查詢證明。</p><p>2、職工或直系親屬申請(qǐng)</p><p>用人單位未在規(guī)定期限申請(qǐng)認(rèn)定的，職工或直系親屬可在傷亡事故或職業(yè)病確診之日起一年內(nèi)直接向勞動(dòng)保障行政部門提出工傷認(rèn)定申請(qǐng)。</p><p>受理</p><p>如職工或其直系親屬的申請(qǐng)超過一年的期限，或不符合管轄權(quán)規(guī)定，勞動(dòng)保障行政部門將不予受理，出具《不予受理決定書》。如申請(qǐng)材料不全的，勞動(dòng)保障行政部門當(dāng)場(chǎng)或在7個(gè)工作日內(nèi)以書面形式一次性告知申請(qǐng)人。</p><p>調(diào)查</p><p>對(duì)職工或直系親屬提出工傷認(rèn)定申請(qǐng)的，勞動(dòng)保障行政部門對(duì)用人單位發(fā)出《工傷認(rèn)定協(xié)查通知書》，要求單位提供相關(guān)材料，單位應(yīng)在規(guī)定期限內(nèi)如實(shí)提供情況和有關(guān)證據(jù)，在規(guī)定的時(shí)間內(nèi)未能提出相反證據(jù)的，視為對(duì)職工或其直系親屬提供的證據(jù)材料無異議。</p><p>如有需要，勞動(dòng)保障行政部門對(duì)提供的證據(jù)進(jìn)行調(diào)查核實(shí)。有關(guān)單位和個(gè)人應(yīng)據(jù)實(shí)提供情況和有關(guān)證據(jù)或證據(jù)線索，參保單位有意隱瞞傷亡事故真相，提供虛假證據(jù)或數(shù)據(jù)等材料以及拒絕配合事故調(diào)查的，工傷保險(xiǎn)經(jīng)辦機(jī)構(gòu)可以拒絕支付工傷保險(xiǎn)待遇的各項(xiàng)費(fèi)用，轉(zhuǎn)由用人單位負(fù)擔(dān)。</p><p>認(rèn)定</p><p>勞動(dòng)保障行政部門應(yīng)在正式受理之日起60日內(nèi)做出認(rèn)定結(jié)論，開出《工傷認(rèn)定結(jié)論書》。工傷認(rèn)定結(jié)論作出之日起20個(gè)工作日內(nèi)送達(dá)用人單位和職工或其直親屬，并抄送工傷保險(xiǎn)經(jīng)辦機(jī)構(gòu)。</p><p>其他事項(xiàng)</p><p>用人單位或職工(直系親屬)對(duì)工傷認(rèn)定申請(qǐng)不予受理的決定或工傷認(rèn)定結(jié)論不服的，可以在收到?jīng)Q定之日起60日內(nèi)依法申請(qǐng)行政復(fù)議;對(duì)復(fù)議決定不服的，可以依法提起行政訴訟。</p><p>認(rèn)定為工傷的參保職工，應(yīng)在醫(yī)療期滿后，向市勞動(dòng)能力鑒定委員會(huì)提出勞動(dòng)力鑒定申請(qǐng)，有關(guān)費(fèi)用由工傷保險(xiǎn)經(jīng)辦機(jī)構(gòu)按規(guī)定處理。</p><p>認(rèn)定為工傷的未參保職工，有關(guān)費(fèi)用由用人單位支付、報(bào)銷。</p><strong>個(gè)人工傷申請(qǐng)?jiān)趺磳?/strong><p>個(gè)人工傷申請(qǐng)按這個(gè)標(biāo)準(zhǔn)來寫工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ：</p><p>1、工傷職工基本信息：姓名、性別工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ，年齡、地址、身份證號(hào)碼、聯(lián)系方式、所在單位名稱、工作崗位、參加工作時(shí)間、申請(qǐng)工傷時(shí)間、事故時(shí)間、受傷害部位、受傷經(jīng)過等。</p><p>2、用人單位基本信息：?jiǎn)挝幻Q、地址、聯(lián)系人、聯(lián)系電話以及用人單位意見等。</p><p>3、勞動(dòng)保障行政部門審查資料情況和受理意見。</p><p>4、必須要在合同時(shí)間范圍內(nèi)并且及時(shí)申報(bào) 。</p><p>鋼筆或簽字筆填寫，字體工整清楚無涂改。申請(qǐng)人為用人單位或工會(huì)組織的，在名稱處加蓋公章。事業(yè)單位職工填寫職業(yè)類別，企業(yè)職工填寫工作崗位（或工種）類別。</p><p>受傷害經(jīng)過簡(jiǎn)述，應(yīng)寫清事故時(shí)間、地點(diǎn)，當(dāng)時(shí)所從事的工作，受傷害的原因以及傷害部位和程度。</p><p>用人單位未按《工傷保險(xiǎn)條例》第十七條第一款規(guī)定提出工傷認(rèn)定申請(qǐng)的，工傷職工或者其直系親屬、工會(huì)組織在事故傷害發(fā)生之日或者被診斷、鑒定為職業(yè)病之日起1年內(nèi)，可以直接向市勞動(dòng)和社會(huì)保障局提交工傷認(rèn)定申請(qǐng)材料。</p><p>擴(kuò)展資料</p><p>對(duì)因特殊情況，無法提供相關(guān)證明材料的，應(yīng)書面說明情況。</p><p>1、受傷害職工或親屬意見欄應(yīng)寫明是否同意申請(qǐng)工傷認(rèn)定，以上所填內(nèi)容是否真實(shí)，否則追求相關(guān)人員的法律責(zé)任。</p><p>2、用人單位意見欄，單位應(yīng)簽署是否同意申請(qǐng)工傷，所填情況是否屬實(shí)，法定代表人簽字并加蓋單位公章。</p><p>3、勞動(dòng)和社會(huì)保障行政部門審查資料和受理意見欄應(yīng)填寫補(bǔ)正材料的情況，是否受理的意見。</p><p>屬于下列情況應(yīng)提供相關(guān)的證明材料：</p><p>1、因履行工作職責(zé)受到暴力傷害的，提交公安機(jī)關(guān)或人民法院的判決書或其他有效證明。</p><p>2、由于機(jī)動(dòng)車事故引起的傷亡事故提出工傷認(rèn)定的，提交公安交通管理等部門的責(zé)任認(rèn)定書或其他有效證明。</p><p>3、因工外出期間，由于工作原因受到傷害的，提交公安部門證明或其他證明；發(fā)生事故下落不明的，認(rèn)定因工死亡提交人民法院宣告死亡的結(jié)論。</p><p>4、在工作時(shí)間和工作崗位，突發(fā)疾病死亡或者在48小時(shí)之內(nèi)經(jīng)搶救無效死亡的，提交醫(yī)療機(jī)構(gòu)的搶救和死亡證明。</p><p>5、屬于搶險(xiǎn)救災(zāi)等維護(hù)國(guó)家利益、公眾利益活動(dòng)中受到傷害的，按照法律法規(guī)規(guī)定，提交有效證明。</p><p>6、屬于因戰(zhàn)、因公負(fù)傷致殘的轉(zhuǎn)業(yè)、復(fù)員軍人，舊傷復(fù)發(fā)的，提交《革命傷殘軍人證》及醫(yī)療機(jī)構(gòu)對(duì)舊傷復(fù)發(fā)的診斷證明。</p><p>參考資料：百度百科-工傷認(rèn)定申請(qǐng)表</p><strong>工傷認(rèn)定書面申請(qǐng)?jiān)趺磳?</strong><p>個(gè)人工傷認(rèn)定書面申請(qǐng)應(yīng)當(dāng)包括以下內(nèi)容工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ：</p><p>1、首先寫明申請(qǐng)人信息；</p><p>2、請(qǐng)求事項(xiàng)工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ：請(qǐng)求仲裁機(jī)構(gòu)對(duì)王某某的傷殘等級(jí)進(jìn)行鑒定；</p><p>3、說明事實(shí)與理由；</p><p>4、結(jié)尾：此致某某區(qū)勞動(dòng)爭(zhēng)議仲裁委員會(huì)。</p><p>【法律依據(jù)】</p><p>《工傷保險(xiǎn)條例》第十七條第二款規(guī)定工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ，用人單位未按前款規(guī)定提出工傷認(rèn)定申請(qǐng)的工傷鑒定個(gè)人申請(qǐng)?jiān)趺磳? ，工傷職工或者其近親屬、工會(huì)組織在事故傷害發(fā)生之日或者被診斷、鑒定為職業(yè)病之日起1年內(nèi)，可以直接向用人單位所在地統(tǒng)籌地區(qū)社會(huì)保險(xiǎn)行政部門提出工傷認(rèn)定申請(qǐng)。</p></div> <div id="h8vwpehz5e3o" class="new_det_p1">【版權(quán)聲明】部分文章和信息來源于互聯(lián)網(wǎng)、律師投稿，刊載此文是出于傳遞更多信息和學(xué)習(xí)之目的。若有來源標(biāo)注錯(cuò)誤或侵犯了您的合法權(quán)益，請(qǐng)作者持權(quán)屬證明于本網(wǎng)聯(lián)系，我們將予以及時(shí)更正或刪除。</div> <div id="h8vwpehz5e3o" class="readed"> <h6>延伸閱讀</h6> <ul class="read"> <li><a href="/doc/463700.html" target="_self" title="火災(zāi)財(cái)產(chǎn)損失賠償案例">火災(zāi)財(cái)產(chǎn)損失賠償案例</a></li> <li><a href="/doc/87490.html" target="_self" title="車輛正常行駛撞到人責(zé)任劃分">車輛正常行駛撞到人責(zé)任劃分</a></li> <li><a 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id="h8vwpehz5e3o" class="dianzai"><a class="but" rel="nofollow">在線咨詢</a><a href="/case/add/?lawyerid=161" class="but red"> 免費(fèi)留言</a></div> <div id="h8vwpehz5e3o" class="telbut"><img src="/31214/img/icon-list-phone-top.png" alt=""></div> </div> </div> <div id="h8vwpehz5e3o" class="wenda"> <h2 class="wen"><span id="h8vwpehz5e3o" class="icon">問</span><a href="javascript:void(0)" title="我提出勞動(dòng)仲裁，目前到了公司提交答辯書環(huán)節(jié)，公司提交了我的離職申請(qǐng)書，里面有一個(gè)條款是:本人的工資、報(bào)酬、福利等待遇已經(jīng)全部發(fā)放到位，公司之間沒有任何勞動(dòng)爭(zhēng)議和糾紛，放棄主張任何權(quán)利，我在離職申請(qǐng)書上簽字，但實(shí)際存在拖欠工資(有聊天記錄為證)及未簽勞動(dòng)合同的雙倍工資差額，我該如何反駁這個(gè)申請(qǐng)書的內(nèi)容。">我提出勞動(dòng)仲裁，目前到了公司提交答辯書環(huán)節(jié)，公司提交了我的離職申請(qǐng)書，里面有一個(gè)條款是:本人的工資、報(bào)酬、福利等待遇已經(jīng)全部發(fā)放到位，公司之間沒有任何勞動(dòng)爭(zhēng)議和糾紛，放棄主張任何權(quán)利，我在離職申請(qǐng)書上簽字，但實(shí)際存在拖欠工資(有聊天記錄為證)及未簽勞動(dòng)合同的雙倍工資差額，我該如何反駁這個(gè)申請(qǐng)書的內(nèi)容。</a></h2> <div id="h8vwpehz5e3o" class="dao"> <span id="h8vwpehz5e3o" class="icon">答</span> <div>律師回復(fù)中...</div> 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<div id="h8vwpehz5e3o" class="telbut"><img src="/31214/img/icon-list-phone-top.png" alt=""></div> </div> </div> <div id="h8vwpehz5e3o" class="wenda"> <h2 class="wen"><span id="h8vwpehz5e3o" class="icon">問</span><a href="javascript:void(0)" title="我想咨詢一下，公司入職前三個(gè)月不給繳納社保21年入職，當(dāng)時(shí)因?yàn)椴幌肷绫Ｖ袛?，公司說可以給我繳納，但是費(fèi)用全部由我自己承擔(dān)，24年現(xiàn)在才發(fā)現(xiàn)公司按法律規(guī)定在員工入職期間需要給員工繳納社保，這種情況可以仲裁嗎？現(xiàn)在我只有給她的轉(zhuǎn)賬記錄，與繳納保險(xiǎn)金額一致，共三次轉(zhuǎn)賬，沒有文字版聊天記錄了，這種情況怎么辦？ ">我想咨詢一下，公司入職前三個(gè)月不給繳納社保21年入職，當(dāng)時(shí)因?yàn)椴幌肷绫Ｖ袛?，公司說可以給我繳納，但是費(fèi)用全部由我自己承擔(dān)，24年現(xiàn)在才發(fā)現(xiàn)公司按法律規(guī)定在員工入職期間需要給員工繳納社保，這種情況可以仲裁嗎？現(xiàn)在我只有給她的轉(zhuǎn)賬記錄，與繳納保險(xiǎn)金額一致，共三次轉(zhuǎn)賬，沒有文字版聊天記錄了，這種情況怎么辦？ </a></h2> <div id="h8vwpehz5e3o" class="dao"> <span id="h8vwpehz5e3o" class="icon">答</span> <div>律師回復(fù)中...</div> </div> <div id="h8vwpehz5e3o" class="lawyer"> <script src="https://api.dalvlaw.com/Api.aspx?action=wdlistlawyer&id=288480"></script> <div>2024-12-19 08:22</div> </div> </div> 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