Industrial Accident (Workers' Compensation) Standards in Korea – Recognition Requirements and Application Process

What Are Industrial Accident (Workers' Compensation) Processing Standards?

The Industrial Accident Compensation Insurance Act (산업재해보상보험법; hereinafter "the Act") provides compensation when a worker suffers injury, illness, disability, or death due to work. The key is being recognized as an occupational accident (업무상 재해), and the criteria for that recognition are commonly referred to as the industrial accident processing standards (산재처리기준). Article 37 of the Act (산재보험법 제37조) classifies occupational accidents into three categories: ① occupational accidents (업무상 사고), ② occupational diseases (업무상 질병), and ③ commuting accidents (출퇴근 재해).

Note for foreign workers: These are the statutory minimum standards. Your employment contract may provide additional protections, but it cannot fall below these legal requirements.

1. Occupational Accidents (업무상 사고)

To be recognized as an occupational accident, two requirements must be met: work performance (업무수행성) and work causation (업무기인성).

• Work performance (업무수행성): The accident must have occurred while the worker was performing duties under the direction and supervision of the employer.
• Work causation (업무기인성): There must be a substantial causal relationship between the accident and the work.

Examples include getting caught in machinery during work, falling from a height, or being involved in a traffic accident during a work-related outing. Conversely, accidents that occur during private activities — even while on duty — are in principle not recognized.

2. Occupational Diseases (업무상 질병)

For occupational diseases, the causal relationship between work and the disease is the core issue. Annex Table 3 of the Enforcement Decree of the Act (산재보험법 시행령 별표 3) lists recognized occupational disease criteria; even if a disease is not listed there, it may still be covered if a medical causal relationship with work is established.

Common occupational diseases include noise-induced hearing loss, pneumoconiosis, musculoskeletal disorders, and cerebrovascular/cardiovascular diseases (including death from overwork). In particular, cerebral hemorrhage or myocardial infarction caused by overwork or stress is more likely to be recognized if it can be shown that the worker performed an average of more than 52 hours per week over the 12 weeks before onset, or was under an extreme short-term work burden (based on Ministry of Employment and Labor guidelines).

3. Commuting Accidents (출퇴근 재해)

Since 2018, commuting accidents have also been covered under industrial accident insurance. Accidents that occur while commuting via the ordinary route and method are recognized. However, deviations from or interruptions of the normal route are in principle excluded. Exceptions apply when the deviation or interruption was for an act necessary for daily life (such as eating, visiting a hospital, or dropping off/picking up children).

Industrial Accident Application Procedure

1. File a medical care benefit application (요양급여 신청): The worker (or bereaved family) submits an application form to a branch of the Korea Workers' Compensation & Welfare Service (근로복지공단). The application can be filed without the employer's confirmation.
2. Investigation by the Service: The Service investigates the circumstances of the accident, medical records, and workplace conditions.
3. Approval or denial decision: A decision is typically issued within 30–60 days.
4. Appeal process: If denied, the worker may appeal in the following order: request for review (심사청구; within 90 days) → request for re-examination (재심사청구) → administrative litigation (행정소송).

Points Frequently Overlooked in Practice

• Securing witnesses and on-site photographs: Gathering evidence immediately after the accident is critical for proving causation.
• Content of the medical certificate (진단서): It is advantageous if the medical certificate explicitly states a connection to work.
• Statute of limitations (소멸시효): The right to claim medical care benefits expires 3 years from the date of the accident, so you should apply without delay.
• Workplaces not enrolled in the four major social insurance programs: Even if the employer has not paid insurance premiums, the worker is still entitled to insurance benefits.

If you need to confirm the number of regularly employed workers (상시근로자 수) at a workplace before determining industrial accident eligibility, try the regularly employed worker count calculator at Byro (workbylaw.com). If you need help preparing industrial accident-related documents or submitting a complaint, you can get quick assistance through Byro's AI search and complaint drafting features.

This article is for informational purposes only and does not constitute legal advice. For specific cases, consult a certified labor attorney (노무사) or lawyer.