Industrial Accident Compensation Insurance Act

If the average salary (meaning the average amount of monthly salary of aper worker calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare based on the fixed amount of salary paid every month in the Monthly Labor Statistics prepared by the Ministry of Health, Labour and Welfare; hereinafter the same applies in this item) per a three-months period defined as January through March, April through June, July through September, and October through December (hereinafter referred to as a "quarter" in this Article and Article 42, paragraph (23)) exceeds 110 percent or below 90 percent of the average salary for the quarter of the date on which the grounds for calculation occurred (in cases where the amount calculated pursuant to the provision of this item (hereinafter referred to as the "revised daily amount" in this item) is regarded as the basic daily payment amount for loss of salary during a temporary absence from work, the quarter two quarters before the first quarter for which the revised daily amount is to be used as the basis for calculatingthe calculation of the amount of compensation payment for loss of salary during a temporary absence from work, etc.), in relation to the compensation payment for loss of salary during a temporary absence from work, etc. for which grounds for payment occurred on or after the first day of the quarter two quarters after the quarter in which the relevant increase or decrease has occurred, the basic daily payment amount for loss of salary during a temporary absence from work is the amount obtained by multiplying the amount calculated as the basic daily payment amount under the provisions of the preceding Article (in cases where a revised daily amount is regarded as the basic daily payment amount for loss of salary during a temporary absence from work, the revised daily amount) by a rate specified by the Minister of Health, Labour and Welfare based on that rate of increase or decrease.

The surviving family members who are eligible to receive a compensation pension for surviving family is a worker's spouse, children, parents, grandchildren, grandparents, and siblings who were dependent on the worker's income at the time of their death; provided, however, that in the case of those other than a wife (including a person who did not register marriage but has been in a de facto marital relationship with the worker; the same applies hereinafter)spouse, this applies only where they have satisfied the requirements prescribed in any of the following items at the time of the worker's death:

in the case of a husband (including a person who did not register marriage but has been in a de facto marital relationship with the worker; the same applies hereinafter), parents or grandparents: they are 60 years of age or older;

in the case of a husband, children, parents, grandchildren, grandparents, or siblings who do not fall under any of the requirements set forth in the preceding three items: they are disabled as specified in Order of the Ministry of Health, Labour and Welfare

Where the surviving family member who has the right to receive a compensation pension for surviving family is the worker's wife, and there are no other surviving family members eligible to receive the compensation pension for surviving family who share the cost of living with the wife, if the wife falls under any of the following items, the amount of the compensation pension for surviving family is changed from the month after the month in which the wife falls under the respective items:

when the wife turns the age of 55 (excluding cases where the wife is disabled as specified in Order of the Ministry of Health, Labour and Welfare set forth in appended table 1);

when the wife becomes disabled as specified in Order of the Ministry of Health, Labour and Welfare set forth in Appended Table 1 or such circumstances have ceased to exist (excluding cases where the wife is 55 years of age or older)

The right to receive a compensation pension for surviving family is extinguished when a surviving family member having the right falls under any of the following items. In this case, when there is no person holding the same rank in the order of priority but there is a person(s) holding a lower rank, the compensation pension for surviving family is paid to the person(s) who holds the next rank:

in the case of the worker's husband, children, parents, grandchildren, grandparents or siblings who are disabled as specified in Order of the Ministry of Health, Labour and Welfare set forth in Article 16-2, paragraph (1), item (iv), when such circumstances have ceased to exist (excluding cases where the worker's husband, parents or grandparents were 60 years of age or older at the time of the worker's death, where the worker's children or grandchildren have not experienced the first March 31 after they turned 18 years old, and where the worker's siblings have not experienced the first March 31 after they turned 18 years old or they were 60 years of age or older at the time of the worker's death).

When a surviving family member eligible to receive a compensation pension for surviving family falls under any of the items of the preceding paragraph, the member cease to be a surviving family member eligible to receive the compensation pension for surviving family.

When an association of persons set forth in Article 33, item (iii) or an association of persons set forth in item (v) of that Article has filed a claim to have this insurance apply to occupational accidents, multiple-job-related accidents and commuting accidents occurred to the persons set forth in item (iii) of that Article who are members of the association and to persons set forth in item (iv) of that Article related to those persons or to persons set forth in item (v) of that Article who are members of the association (limited to occupational accidents and multiple-job-related accidents in the case of persons specified by Order of the Ministry of Health, Labour and Welfare among those specified above in consideration of the situation while traveling between their residence and workplace or the like), and the approval of the government has been given for it as an association that conforms to the requirements specified by Order of the Ministry of Health, Labour and Welfare as those of an association capable of appropriately carrying out the affairs prescribed in Article 33, paragraph (1) of the Premiums Collection Act that pertain to the relationship with this insurance, affairs related to activities for the prevention of occupational accidents, and other affairs pertaining to the relationship with this insurance, the application of the provisions of Chapter III, Sections 1 through 3 (with regard to the persons specified by Order of the Ministry of Health, Labour and Welfare, Sections 1 through 2-2 of that Chapter) and Chapter III-2 of this Act and Chapters II through VI of the Premiums Collection Act are provided as follows:

An association that has received the approval set forth in paragraph (1) (hereinafter referred to as an "approved association") may, even after the approval set forth in that paragraph has been given, may extinguish the relationship between this insurance and the approved association, with the approval of the government.

The government may, when an association set forth in paragraph (1) violatesIf the government finds that improvement is necessary with regard to the provisionsoperation of this Act, the Premiums Collection Act, or Order of affairs of an approved association relating to the Ministry of Health, Labourrelationship between this insurance and Welfare under these Acts, the approved association, the government may extinguishorder the relationship between this insurance andapproved association to take the associationmeasures necessary for that improvement.

The right to receive insurance proceeds of persons specified in Article 33, items (iii) through (v) is not affected bygovernment may, when an approved association violates the withdrawalprovisions of the persons specified in item (iii)this Act, the Premiums Collection Act, or (v)Order of that Article from the association set forth in paragraph (1). The same applies where any of the persons specified in items (iii) through (v) of that Article cease to be a person specified inMinistry of Health, Labour and Welfare under these Acts, or violates an order under the provisions of the preceding paragraph, may extinguish the relationship between this insurance and the respective itemsapproved association.

The right to receive insurance proceeds of persons specified in Article 33, items (iii) through (v) is not affected by the withdrawal of the persons specified in item (iii) or (v) of that Article from the approved association. The same applies where any of the persons specified in items (iii) through (v) of that Article cease to be a person specified in the respective items.

A person who is dissatisfied with a decision on insurance proceeds or on the implementation of the projects listed in the items of Article 29, paragraph (1) that are specified by Cabinet Order as projects carried out for workers engaged in businesses covered by this insurance and their surviving families may file a request for administrative review with an industrial accident compensation insurance examiner, and a person who is dissatisfied with a decision by the examiner may file a request for re-examination with the Labor Insurance Appeal Committee.

The right to receive medical treatment compensation benefits, compensation payments for loss of salary during a temporary absence from work, funeral service fees, nursing care compensation benefits, medical treatment benefits for multiple-job workers, payments for loss of salary during a temporary absence from work for multiple-job workers, funeral benefit for multiple-job workers, nursing care benefits for multiple-job workers, medical treatment benefits, payments for loss of salary during a temporary absence from work, funeral benefits, nursing care benefits and payment for follow-up medical examination is extinguished by prescription when two years have elapsed from the time when it becomes exercisable, and ; provided, however, that if the right illness pertaining to receive disability compensation benefits, the accident that is the cause of those insurance proceeds (excluding payment for follow-up medical examination) is an illness specified by Cabinet Order as one for which, by its nature, it cannot easily be determined whether it falls under the cause of accident compensation benefits for surviving family, disability benefits prescribed in Article 12-8, paragraph (2) or the cause for multiple-job workers,which the benefits for surviving family prescribed in paragraph (4) of multiple-job workers, disability benefits and that Article are to be paid, whether it falls under the cause for which the benefits prescribed in Article 20-3, paragraph (1), Article 20-4, paragraph (1), Article 20-7, paragraph (1) or Article 20-9, paragraph (1) are to be paid, or whether it falls under the cause for surviving family which the benefits prescribed in Article 22, paragraph (1), Article 22-2, paragraph (1), Article 22-5, paragraph (1) or Article 24, paragraph (1) are to be paid, the term "two years" in the main clause of this paragraph is extinguished by prescription when deemed to be replaced with "five years have elapsed from" with regard to the time when it becomes exercisableright to receive those insurance proceeds.

Where, dueThe right to the revision of the average salary for each quarter under the provisions of Article 8-2, paragraph (1), item (ii) or the average salaryreceive disability compensation benefits, compensation benefits for a fiscal year under the provisions of Article 8-3, paragraph (1), item (ii), the Minister of Health, Labour and Welfare has changed the rate specified by the Ministersurviving family, disability benefits for multiple-job workers, benefits for surviving family of Health, Labour and Welfare prescribed in Article 8-2, paragraph (1), item (ii), Article 8-3, paragraph (1), item (ii) or Article 16-6, paragraph (2) (including as applied mutatis mutandis pursuant to Article 20-6, paragraph (3) or Article 22-4, paragraph (3),multiple-job workers, disability benefits and cases where that provisionbenefits for surviving family is to be followed pursuant to the provisions of Article 58, paragraph (1), Article 60-2, paragraph (1) or Article 61, paragraph (1)), or the government has changed the amount calculatedextinguished by the government prescribed in Article 8, paragraph (2), and there are insurance proceeds whose amount has been recalculated as a result of that change, the provisions of Article 31, paragraph (1) of the Public Accounting Act (Act No. 35 of 1947) do not apply to the right to receive payment of unpaid insurance proceeds underprescription when five years have elapsed from the provisions of Article 11 pertaining to those insurance proceedstime when it becomes exercisable.

Where, due to the revision of the average salary for each quarter under the provisions of Article 8-2, paragraph (1), item (ii) or the average salary for a fiscal year under the provisions of Article 8-3, paragraph (1), item (ii), the Minister of Health, Labour and Welfare has changed the rate specified by the Minister of Health, Labour and Welfare prescribed in Article 8-2, paragraph (1), item (ii), Article 8-3, paragraph (1), item (ii) or Article 16-6, paragraph (2) (including as applied mutatis mutandis pursuant to Article 20-6, paragraph (3) or Article 22-4, paragraph (3), and cases where that provision is to be followed pursuant to the provisions of Article 58, paragraph (1), Article 60-2, paragraph (1) or Article 61, paragraph (1)), or the government has changed the amount calculated by the government prescribed in Article 8, paragraph (2), and there are insurance proceeds whose amount has been recalculated as a result of that change, the provisions of Article 31, paragraph (1) of the Public Accounting Act (Act No. 35 of 1947) do not apply to the right to receive payment of unpaid insurance proceeds under the provisions of Article 11 pertaining to those insurance proceeds.

An administrative agency may, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, order a person who hires workers, a labor insurance affairs association, an association prescribed in Article 35, paragraph (1)approved association, a client entity prescribed in Article 44, paragraph (1) of the Act on Ensuring the Proper Operation of Worker Dispatching Services and Protecting Dispatched Workers (Act No. 88 of 1985; referred to as the "Worker Dispatching Act" in Article 48, paragraph (1)) (hereinafter referred to as a "client entity"), or a person who receives the services of a dispatched mariner prescribed in Article 6, paragraph (13) of the Mariners' Employment Security Act (Act No. 130 of 1948) (hereinafter referred to as a "dispatched mariner"), to make a report, submit a document or appear as necessary for the enforcement of this Act.

An administrative agency may, to the extent necessary for the enforcement of this Act, have its officials enter the workplace of the insured business, the office of a labor insurance affairs association or of an association prescribed in Article 35, paragraph (1)approved association, the workplace of the business of a client entity prescribed in Article 44, paragraph (1) of the Worker Dispatching Act, or the workplace of a person who receives the services of a dispatched mariner, question relevant persons or inspect books and documents or other items.

When an employer, a client entity or a person who receives the services of a dispatched mariner falls under any of the following items, thatthe person who committed the violation is punished by imprisonment for not more than six months or a fine of not more than 300,000 yen. When a labor insurance affairs association or an association prescribed in Article 35, paragraph (1)approved association falls under any of these items, the same applies to the representative, agent or employee or other worker of the labor insurance affairs association or the approved association, who committed the violation:

wherewhen the person fails to make a report or submit a false report, or fails to submit a document or submits a document containing any false statement, in violation of an order issued pursuant to the provisions of Article 46; or

wherewhen the person fails to answer or makes a false statement in response to a question asked by the relevant official pursuant to the provisions of Article 48, paragraph (1), or refuses, prevents or evades an inspection conducted pursuant to the provisions of Article 48,that paragraph (1).

When a person other than an employer, labor insurance affairs association, association prescribed in Article 35, paragraph (1)approved association, client entity or person who receives the services of a dispatched mariner (excluding a third party) falls under any of the following items, thatthe person who committed the violation is punished by imprisonment of not more than six months or a fine of not more than 200,000 yen:

wherewhen the person fails to make a report or notification or makes a false report or notification, or fails to submit a document or other items or submits a document containing any false statement, in violation of an order issued pursuant to the provisions of Article 47;

wherewhen the person fails to answer or make a false statement in response to a question asked by the relevant official pursuant to the provisions of Article 48, paragraph (1), or refuses, prevents or evades an inspection conducted pursuant to the provisions of Article 48,that paragraph (1); or

wherewhen the person fails to make a report or makes a false report or fails to present medical records, books and documents or other items in violation of an order issued pursuant to the provisions of Article 49, paragraph (1), or refuses, prevents or evades an inspection conducted pursuant to the provisions of that Articleparagraph.

When a representative of a juridical person (including labor insurance affairs associations and associations prescribed in Article 35, paragraph (1)approved associations which are not juridical persons; hereinafter the same applies in this paragraph) or an agent, employee or any other worker for a juridical person or an individual, with regard to the business of the juridical person or individual, commits a violation set forth in Article 51 or the preceding Article, not only the offender is punished but also the juridical person or individual is punished by the fine prescribed in the respective Articles.

Where a labor insurance affairs association or an association prescribed in Article 35, paragraph (1)approved association which is not a juridical person is punished pursuant to the provisions of the preceding paragraph, the representative of the labor insurance affairs association or approved association represents the labor insurance affairs association or approved association in conducting procedural acts, and the provisions of Acts concerning criminal proceedings in cases where a juridical person is an accused or a suspect apply mutatis mutandis to such cases.