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Article 135Injury and Sickness Allowance

第百三十五条(傷病手当金)

When a specially-insured day laborer receives benefits for medical treatment (including benefits in the form of medical expenses combined with treatment outside insurance coverage, medical expenses, and medical expenses for home nursing, as well as in-home long-term care service expenses, special in-home long-term care service expenses, community-based long-term care service expenses, special community-based long-term care service expenses, long-term care facility service expenses, exceptional allowance for long-term care facility services, expenses for services to prevent long-term care, and exceptional allowance for services to prevent long-term care, pursuant to the provisions of the Long-Term Care Insurance Act (limited to those equivalent to medical treatment pertaining to in-home services or equivalent services, community-based services or equivalent services, facility services, or services to prevent long-term care or equivalent services), paid to persons who have a qualified recipient card referred to in Article 129, paragraph (3) (limited to cards falling under the provisions of paragraph (5) of the same Article); the same applies in the following paragraph and following Article) and is unable to engage in labor due to the medical treatment (including in-home services and services equivalent thereto, facility services, and long-term care preventive services equivalent to medical care, and services equivalent thereto), the injury and sickness allowance is paid for the period during which the specially-insured day laborer is unable to engage in work, starting from the day on which three days elapsed after the day on which the laborer became unable to engage in work.

日雇特例被保険者が療養の給付(保険外併用療養費、療養費及び訪問看護療養費の支給並びに介護保険法の規定による居宅介護サービス費、特例居宅介護サービス費、地域密着型介護サービス費、特例地域密着型介護サービス費、施設介護サービス費、特例施設介護サービス費、介護予防サービス費及び特例介護予防サービス費の支給(これらの支給のうち療養に相当する居宅サービス若しくはこれに相当するサービス、地域密着型サービス若しくはこれに相当するサービス、施設サービス又は介護予防サービス若しくはこれに相当するサービスに係るものに限る。)であって、第百二十九条第三項の受給資格者票(同条第五項の規定に該当するものに限る。)を有する者に対して行われるものを含む。次項及び次条において同じ。)を受けている場合において、その療養(居宅サービス及びこれに相当するサービス並びに施設サービス並びに介護予防サービス及びこれに相当するサービスのうち、療養に相当するものを含む。)のため労務に服することができないときは、その労務に服することができなくなった日から起算して三日を経過した日から労務に服することができない期間、傷病手当金を支給する。

The amount of sickness and injury allowance per day is an amount prescribed in the following items, in accordance with the classifications in the following items; provided, however, that if both items are applicable, the larger of the amounts is paid:

傷病手当金の額は、次の各号に掲げる場合の区分に応じ、一日につき、当該各号に定める金額とする。ただし、次の各号のいずれにも該当するときは、いずれか高い金額とする。

with respect to the relevant specially-insured day laborer, insurance premiums had been paid for 26 days or more in the two months before the month including the day on which the laborer received the relevant benefit for medical treatment for the first time:an amount equivalent to 1/45th of the largest of the monthly total of the laborer's standard daily wages pertaining the days for which insurance premiums were paid in the period; or

当該日雇特例被保険者について、その者が初めて当該療養の給付を受けた日の属する月の前二月間に通算して二十六日分以上の保険料が納付されている場合 当該期間において保険料が納付された日に係るその者の標準賃金日額の各月ごとの合算額のうち最大のものの四十五分の一に相当する金額

with respect to the specially-insured day laborer, insurance premiums had been paid for 78 days or more in the six months before the month including the day on which the laborer received the benefit for medical treatment for the first time:an amount equivalent to 1/45th of the largest of the monthly total of the laborer's standard daily wages pertaining to the days for which insurance premiums were paid in the period.

当該日雇特例被保険者について、その者が初めて当該療養の給付を受けた日の属する月の前六月間に通算して七十八日分以上の保険料が納付されている場合 当該期間において保険料が納付された日に係るその者の標準賃金日額の各月ごとの合算額のうち最大のものの四十五分の一に相当する金額

The payment period for injury and sickness allowance pertaining to a specially-insured day laborer is not to exceed six months (one year and six months for sickness and injury designated by the Minister of Health, Labour and Welfare) from the day on which the payment started, with regard to the same sickness and injury as well as any sickness and injury caused thereby.

日雇特例被保険者に係る傷病手当金の支給期間は、同一の疾病又は負傷及びこれにより発した疾病に関しては、その支給を始めた日から起算して六月(厚生労働大臣が指定する疾病に関しては、一年六月)を超えないものとする。

If a specially-insured day laborer is, with regard to sickness or injury, unable to receive all of the benefits for medical treatment or all of the payment of medical expenses combined with treatment outside insurance coverage, medical expenses, or medical expenses for home nursing pursuant to the provisions of Article 128, or unable to receive all of the payment, pursuant to Article 20 of the Long-Term Care Insurance Act, of expenses for in-home long-term care services, expenses for special in-home long-term care services, expenses for community-based long-term care services, expenses for special community-based long-term care services, expenses for long-term facility care services, expenses for special long-term care facility services, expenses for services to prevent long-term care, or expenses for special services to prevent long-term care pursuant to the provisions of that Act (limited to payment made to those who have a qualified recipient card under Article 129, paragraph (3) (limited to cards falling under paragraph (5) of the same Article); the same applies hereinafter in this paragraph), then benefits for medical treatment or payment for medical expenses combined with treatment outside insurance coverage, medical expenses, or medical expenses for home nursing, and relevant benefits equivalent to payment of expenses for in-home long-term care services, payment of expenses for special in-home long-term care services, payment of community-based long-term care services, payment of expenses for special community-based long-term care services, payment of long-term care facility service expenses, payment of expenses for special long-term care facility services, payment of expenses for services to prevent long-term care, or payment of expenses for special services to prevent long-term care, pursuant to the provisions of the Long-Term Care Insurance Act, as well as payment of expenses for the relevant medical treatment and other medical treatment are deemed to be benefits for medical treatment or payment of medical expenses combined with treatment outside insurance coverage, medical expenses, or medical expenses for home nursing pursuant to the provisions of this Chapter, or payment of expenses for in-home long-term care services, payment of expenses for special in-home long-term care services, payment of expenses for community-based long-term care services, payment of expenses for special community-based long-term care services, payment of expenses for long-term care services, payment of expenses for special long-term care facility services, payment of expenses for services to prevent long-term care, or payment of expenses for special services to prevent long-term care, pursuant to the provisions of the Long-Term Care Insurance Act, and the provisions of paragraphs (1) and (2) apply.

日雇特例被保険者が、その疾病又は負傷について、第百二十八条の規定により療養の給付若しくは保険外併用療養費、療養費若しくは訪問看護療養費の支給の全部を受けることができない場合又は介護保険法第二十条の規定により同法の規定による居宅介護サービス費の支給、特例居宅介護サービス費の支給、地域密着型介護サービス費の支給、特例地域密着型介護サービス費の支給、施設介護サービス費の支給、特例施設介護サービス費の支給、介護予防サービス費の支給若しくは特例介護予防サービス費の支給(これらの給付のうち第百二十九条第三項の受給資格者票(同条第五項の規定に該当するものに限る。)を有する者に対して行われるものに限る。以下この項において同じ。)の全部を受けることができない場合においては、療養の給付若しくは保険外併用療養費、療養費若しくは訪問看護療養費の支給又は介護保険法の規定による居宅介護サービス費の支給、特例居宅介護サービス費の支給、地域密着型介護サービス費の支給、特例地域密着型介護サービス費の支給、施設介護サービス費の支給、特例施設介護サービス費の支給、介護予防サービス費の支給若しくは特例介護予防サービス費の支給に相当する当該給付又は当該療養若しくは療養費の支給をこの章の規定による療養の給付若しくは保険外併用療養費、療養費若しくは訪問看護療養費の支給又は介護保険法の規定による居宅介護サービス費の支給、特例居宅介護サービス費の支給、地域密着型介護サービス費の支給、特例地域密着型介護サービス費の支給、施設介護サービス費の支給、特例施設介護サービス費の支給、介護予防サービス費の支給若しくは特例介護予防サービス費の支給とみなして、第一項及び第二項の規定を適用する。

Article 136Burial Charges

第百三十六条(埋葬料)

When a specially-insured day laborer dies, insurance premiums had been paid for the laborer for 26 days or more in total in the two months preceding the month including the day of death or for 78 days or more in total in the six months preceding that month, and the laborer received benefits for medical treatment, or payment of medical expenses combined with treatment outside insurance coverage, medical expenses, or medical expenses for home nursing at the time of death, or the death was within three days since the day of loss of benefits for medical treatment, or payment of medical expenses combined with treatment outside insurance coverage, medical expenses, or medical expenses for home nursing, the amount of burial charges specified by Cabinet Order referred to in Article 100, paragraph (1) is paid to the person whose livelihood depends on the income of the laborer and who arranged the burial.

日雇特例被保険者が死亡した場合において、その死亡の日の属する月の前二月間に通算して二十六日分以上若しくは当該月の前六月間に通算して七十八日分以上の保険料がその者について納付されているとき、その死亡の際その者が療養の給付若しくは保険外併用療養費、療養費若しくは訪問看護療養費の支給を受けていたとき、又はその死亡が療養の給付若しくは保険外併用療養費、療養費若しくは訪問看護療養費の支給を受けなくなった日後三月以内であったときは、その者により生計を維持していた者であって、埋葬を行うものに対し、第百条第一項の政令で定める金額の埋葬料を支給する。

If there is no one to receive burial charges pursuant to the provisions of the preceding paragraph, an amount equivalent to the expenses required for the burial within the range of amount of burial charges referred to in the preceding paragraph is paid to the person who arranged the burial.

前項の規定により埋葬料の支給を受けるべき者がない場合においては、埋葬を行った者に対し、同項の埋葬料の金額の範囲内においてその埋葬に要した費用に相当する金額を支給する。

Article 137Lump-sum Allowance for Childbirth and Childcare

第百三十七条(出産育児一時金)

When a specially-insured day laborer gives birth and insurance premiums have been paid for the laborer for 26 days or more in total during the two months preceding the month including the day of childbirth, an amount specified by Cabinet Order referred to in Article 101 is paid as a lump-sum allowance for childbirth and childcare.

日雇特例被保険者が出産した場合において、その出産の日の属する月の前四月間に通算して二十六日分以上の保険料がその者について納付されているときは、出産育児一時金として、第百一条の政令で定める金額を支給する。

Article 138Childbirth Allowance

第百三十八条(出産手当金)

Childbirth allowance is paid to a specially-insured day laborer eligible for payment of lump-sum allowance for childbirth and childcare in the period during which the laborer does not engage in labor, starting 42 days (98 days in the case of multiple fetuses) preceding the day of childbirth (the scheduled date of childbirth if the day of childbirth is after the scheduled date of childbirth) and ending 56 days following the day of childbirth.

出産育児一時金の支給を受けることができる日雇特例被保険者には、出産の日(出産の日が出産の予定日後であるときは、出産の予定日)以前四十二日(多胎妊娠の場合においては、九十八日)から出産の日後五十六日までの間において労務に服さなかった期間、出産手当金を支給する。

The amount of childbirth allowance per day is an amount equivalent to 1/45th of the largest of the monthly total of the specially-insured laborer's standard daily wages pertaining to the days for which insurance premiums were paid in the four months preceding the month including the day of childbirth.

出産手当金の額は、一日につき、出産の日の属する月の前四月間の保険料が納付された日に係る当該日雇特例被保険者の標準賃金日額の各月ごとの合算額のうち最大のものの四十五分の一に相当する金額とする。

Article 139Coordination of Childbirth Allowance with Injury and Sickness Allowance

第百三十九条(出産手当金と傷病手当金との調整)

Injury and sickness allowance is not paid to a specially-insured day laborer during the period in which the laborer receives childbirth allowance; provided, however, that if the amount of injury and sickness allowance exceeds the amount of childbirth allowance, this does not apply to the amount in excess.

日雇特例被保険者に対し出産手当金を支給する場合においては、その期間、その者に対し、傷病手当金は、支給しない。ただし、傷病手当金の額が出産手当金の額を超えるときは、その超える部分については、この限りでない。

Article 140Dependent's Medical Expenses

第百四十条(家族療養費)

When a dependent of an insured person submits the dependent's qualified recipient card to a hospital, clinic, or pharmacy that the dependent selected from those listed in Article 63, paragraph (3), item (i) or (ii) and receives evaluation treatment, patient-requested treatment, or selective treatment from that hospital, clinic, or pharmacy, dependent's medical expenses are paid to the specially-insured day laborer for the expenses required for the treatment.

日雇特例被保険者の被扶養者が受給資格者票を第六十三条第三項第一号又は第二号に掲げる病院若しくは診療所又は薬局のうち自己の選定するものに提出して、そのものから療養を受けたときは、日雇特例被保険者に対し、その療養に要した費用について、家族療養費を支給する。

The provisions of Article 129, paragraphs (2), (4) and (5) as well as Article 132 apply mutatis mutandis to the payment of dependent's medical expenses.

第百二十九条第二項、第四項及び第五項並びに第百三十二条の規定は、家族療養費の支給について準用する。

The provisions of Article 87, paragraphs (2) and (3) apply mutatis mutandis to the calculation of the amount of medical expenses paid pursuant to the provisions of Article 132, paragraph (1) or (2) as applied mutatis mutandis pursuant to the preceding paragraph.

第八十七条第二項及び第三項の規定は、前項において準用する第百三十二条第一項又は第二項の規定により支給する療養費の額の算定について準用する。

Article 141Dependent Medical's Expenses for Home-Nursing

第百四十一条(家族訪問看護療養費)

When a dependent of a specially-insured day laborer submits the dependent's qualified recipient card to a designated home-nursing provider selected by the dependent, and receives designated home-nursing from the provider, with regard to expenses incurred in the designated home-nursing, dependent's medical expenses for home-nursing are paid to the specially-insured day laborer.

日雇特例被保険者の被扶養者が指定訪問看護事業者のうち自己の選定するものに受給資格者票を提出して、指定訪問看護を受けたときは、日雇特例被保険者に対し、その指定訪問看護に要した費用について、家族訪問看護療養費を支給する。

The provisions of Article 129, paragraphs (2) and (5) apply mutatis mutandis to the payment of dependent's medical expenses for home-nursing.

第百二十九条第二項及び第五項の規定は、家族訪問看護療養費の支給について準用する。

Article 142Dependent's Transport Expenses

第百四十二条(家族移送費)

When a dependent of a specially-insured day laborer is transported to a hospital or clinic in order to receive medical treatment to which expenses for dependent's medical treatment pertain (including medical treatment covered by special medical expenses), an amount calculated pursuant to Order of the Ministry of Health, Labour and Welfare referred to in Article 97, paragraph (1) is paid, as dependent's transport expenses, to the specially-insured day laborer.

日雇特例被保険者の被扶養者が家族療養費に係る療養(特別療養費に係る療養を含む。)を受けるため、病院又は診療所に移送されたときは、家族移送費として、日雇特例被保険者に対し、第九十七条第一項の厚生労働省令で定めるところにより算定した金額を支給する。

Article 143Dependent's Burial Charges

第百四十三条(家族埋葬料)

When a dependent of a specially-insured day laborer dies, dependent's burial charges are paid to the specially-insured day laborer.

日雇特例被保険者の被扶養者が死亡したときは、日雇特例被保険者に対し、家族埋葬料を支給する。

In order for a specially-insured day laborer to receive dependent's burial charges, insurance premiums must have been paid for the specially-insured day laborer for 26 days or more in total during the two months preceding the month including the day of death or for 78 days or more in total during the six months preceding that month.

日雇特例被保険者が家族埋葬料の支給を受けるには、死亡の日の属する月の前二月間に通算して二十六日分以上又は当該月の前六月間に通算して七十八日分以上の保険料が、その日雇特例被保険者について、納付されていなければならない。

The amount of dependent's burial charges is an amount specified by Cabinet Order referred to in Article 113.

家族埋葬料の額は、第百十三条の政令で定める金額とする。

Article 144Lump-sum Allowance for Dependent's Childbirth and Childcare

第百四十四条(家族出産育児一時金)

When a dependent of a specially-insured day laborer gives birth to a child, lump-sum allowance for dependent's childbirth and childcare is paid to the specially-insured day laborer.

日雇特例被保険者の被扶養者が出産したときは、日雇特例被保険者に対し、家族出産育児一時金を支給する。

In order for a specially-insured day laborer to receive lump-sum allowance for dependent's childbirth and childcare, insurance premiums must have been paid for the specially-insured day laborer for 26 days or more in total in the two months preceding the month including the day of childbirth or for 78 days or more in total in the six months preceding that month.

日雇特例被保険者が家族出産育児一時金の支給を受けるには、出産の日の属する月の前二月間に通算して二十六日分以上又は当該月の前六月間に通算して七十八日分以上の保険料が、その日雇特例被保険者について、納付されていなければならない。

The amount of lump-sum allowance for dependent's childbirth and childcare is the amount specified by Cabinet Order referred to in Article 101.

家族出産育児一時金の額は、第百一条の政令で定める金額とする。

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