In an industrial accident (산재) claim, the account of the accident in the application and the first medical record greatly affect whether the claim is approved. A labor lawyer can help you document the link between the work and the accident from the start. If your claim is denied, you must appeal within 90 days.
When an Accident Is Recognized as Work-Related
| Type | Typical examples | Main point of dispute |
|---|---|---|
| Work-related accident | Falls or being caught in machinery during work, accidents on a business trip, accidents at a company event | Whether the accident happened during a private activity |
| Work-related illness | Cerebral hemorrhage or myocardial infarction, musculoskeletal disorders, noise-induced hearing loss, occupational cancer, mental illness caused by harassment | The relationship between the work burden or exposure to harmful substances and the onset of the illness |
| Commuting accident | An accident while commuting by the usual route and method | Whether the worker left the usual route, and whether the act was necessary for daily life |
A causal link does not have to be proven clearly in a medical or natural-science sense. The court recognizes it if, considering the worker's health condition, the content and intensity of the work, and how the illness developed, it can be inferred that the work caused the onset or worsening of the illness. Even if you had a pre-existing condition, it can be a work-related injury or illness if the work made the condition worse faster than its natural course.
Insurance Benefits You Can Receive
| Benefit | Details |
|---|---|
| Medical care benefit (요양급여) | Treatment costs. Paid when the medical care period is 4 days or more (the employer bears the cost for 3 days or less) |
| Temporary incapacity benefit (휴업급여) | 70% of the average wage (평균임금) for the period you could not work |
| Sickness compensation annuity (상병보상연금) | Paid instead of the temporary incapacity benefit if you have not recovered after 2 years of medical care and are in severe care condition grades 1 to 3 |
| Disability benefit (장해급여) | If a disability remains after treatment, an annuity or lump sum according to grades 1 to 14 |
| Survivors' benefit and funeral expenses (유족급여·장례비) | For a work-related death, an annuity (as a rule) or lump sum to the bereaved family, and funeral expenses to the person who held the funeral |
| Nursing care benefit (간병급여) | When nursing care is still needed after treatment has ended |
Industrial accident insurance benefits are not reduced even if the worker was at fault. However, they do not include compensation for emotional distress (위자료). If the company or a third party is responsible, you can separately claim the difference through a civil damages claim.
How to File and the Employer's Cooperation
You or your bereaved family file the medical care benefit application directly with the Korea Workers' Compensation and Welfare Service (근로복지공단). The employer's confirmation or seal is not required, and you can apply even if the company refuses to treat the case as an industrial accident. The Service asks the employer for its opinion but is not bound by it.
For a work-related illness, the Service branch refers the case to the Occupational Disease Determination Committee (업무상질병판정위원회) for review. The committee decides based on the submitted documents and the accident investigation results, so it is important to submit enough materials at the application stage that concretely show your working hours and job duties.
- Accident report: date, time, place, work being done, witnesses
- First medical record and diagnosis: check that it states the injury happened during work
- Working hours records: commuting records, work schedules, PC logs, work messenger
- Job content records: photos and videos of the work, substances handled, statements from coworkers
Appeal Procedure After a Denial
- Check the reason for denialReview the decision notice and determination document, and the accident investigation report and advisory physician's opinion obtained through an information disclosure request
- Request for review (심사청구)Within 90 days of learning of the decision, to the Korea Workers' Compensation and Welfare Service (reviewed by the Industrial Accident Review Committee, 산재심사위원회)
- Request for re-examination (재심사청구)Within 90 days of learning of the review decision, to the Industrial Accident Compensation Insurance Re-examination Committee (산업재해보상보험재심사위원회)
- Administrative lawsuit (행정소송)Within 90 days of learning of the disposition or ruling, to the Administrative Court (행정법원). You can file directly without a request for review
If you dispute the decision again with the same materials, the result is unlikely to change. You need materials suited to the reason for denial: if the reason is insufficient working hours, find the missing working hours; if the medical causal link is insufficient, supplement it with an opinion from your treating doctor or a court appraisal. In an administrative lawsuit, a court medical record appraisal gives you a chance to obtain a medical judgment different from that of the Service's advisory physician.
Dismissal Ban During Recovery and Your Relationship with the Company
A worker cannot be dismissed during the period of medical care for a work-related injury or illness and for 30 days afterward (Labor Standards Act (근로기준법) Article 23(2)). Treating a worker unfavorably because they filed an industrial accident claim can also be a problem.
Concealing an industrial accident is subject to a separate sanction against the employer. If the company proposes handling the case as a private settlement (공상) and discourages you from filing, you should first consider that if your after-effects become worse after you agree to the private settlement, it may become difficult to receive insurance benefits.
Industrial Accident Benefits and Appeal Deadlines
| Item | Legal basis | Summary |
|---|---|---|
| Recognition of a work-related accident | Industrial Accident Compensation Insurance Act (산업재해보상보험법) Article 37 | Where a work-related accident, work-related illness, or commuting accident has a reasonable causal link with the work |
| Temporary incapacity benefit | Industrial Accident Compensation Insurance Act Article 52 | 70% of the average wage (평균임금) per 1 day of the period you could not work because of medical care |
| Funeral expenses | Industrial Accident Compensation Insurance Act Article 71 | 120 days' worth of the average wage (within the maximum and minimum amounts) |
| Request for review | Industrial Accident Compensation Insurance Act Article 103 | Within 90 days of learning of the insurance benefit decision, to the Korea Workers' Compensation and Welfare Service (근로복지공단) |
| Request for re-examination | Industrial Accident Compensation Insurance Act Article 106 | Within 90 days of learning of the review decision, to the Industrial Accident Compensation Insurance Re-examination Committee (산업재해보상보험재심사위원회) |
You can also file an administrative lawsuit directly without going through a request for review. In that case, you must file the lawsuit within 90 days of learning of the disposition. The right to receive insurance benefits expires if not exercised for 3 years (5 years for disability benefits, survivors' benefits, and similar benefits).
What to Check Before Filing
- At your first medical visit, tell the doctor accurately that you were injured during work.
- Record the work you were doing on the day of the accident and any witnesses.
- Secure your working hours records for the 12 weeks before the onset of the illness.
- Even if the company refuses to treat the case as an industrial accident, you can apply directly to the Service.
- Before signing a private settlement agreement (공상 합의서), consider future treatment costs and the possibility of a disability.
- Record the date you received the denial notice and keep track of the 90-day deadline.
Industrial accident claims & appeals: frequently asked questions
My company will not file an industrial accident claim for me.
Are part-time and daily workers covered by industrial accident insurance?
My industrial accident claim was denied. Can I apply again?
If my claim is approved, can I no longer seek damages from the company?
Applicable law: Industrial Accident Compensation Insurance Act (산업재해보상보험법). Written based on the laws in force on 2026-09-17. This page provides general legal information and is not legal advice on a specific case. Labor laws and court decisions change often, so decide how to respond after consulting a lawyer who has reviewed your documents, such as your contract and any notices you received.
This page is an English translation of the Korean original. If the two differ, the Korean version prevails. Korean page ›