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Who should identify the problem of compensation dispute for installation of artificial limbs and orthoses?

In recent years, patients with amputations due to traffic accidents, electric shock injuries, work-related injuries, etc., especially those with disabled children, have been increasingly exposed. Civil lawsuits have arisen over the compensation for the cost of installing prosthetic limbs. Due to the lack of clear provisions on compensation standards for prostheses in relevant laws and regulations, and the large differences in the prices of prosthetic products across regions and manufacturers, the amount of compensation for prosthetic limbs in some claims and arbitrations is very different. As a result, both the injured party and the offending party are dissatisfied and continue to petition and appeal. In some cases, the compensation for prosthetic limb installation fees reaches millions of yuan.

In order to better handle the issue of compensation costs for prosthetic limbs caused by accidents in civil lawsuits, and to avoid the disparity in the amounts of prosthetic installation cost certificates issued by prosthetic limb factories in various places and various types (public, private, joint ventures, foreign companies) based on their own economic interests, the Ministry of Civil Affairs established a Prosthetic Orthotics Compensation Cost Appraisal Committee. The committee is based on relevant current domestic laws and regulations, starting from the actual needs of amputee patients and the current domestic prosthetic installation level, and fairly and impartially determines the types, prices, and replacement years of prosthetic limbs that should be installed for patients.

Introduction to the Prosthetics and Orthotics Compensation Appraisal Committee

Main Responsibilities:

We only accept entrusted appraisals from courts or law firms regarding compensation for the cost of installing prosthetics, orthotics and other assistive devices. The content of the appraisal: the clinical examination of patients with limb disabilities, the types of equipment that should be installed, and the required installation costs - including the unit price of the product, the replacement period and daily maintenance fees, etc., but does not include transportation, food, accommodation and nursing costs during installation.

Identification process:

The National Rehabilitation Assistive Devices Research Center organized a special compensation appraisal meeting for appraisal. Each appraisal meeting must be attended by more than 5 (including 5) members from the three units that make up the appraisal committee; after the appraisers (members participating in the meeting) listen to the introduction of the client, examine and evaluate the patient, an appraisal conclusion letter signed by each appraiser and stamped with the official seal of the National Rehabilitation Assistive Devices Research Center will be issued in the name of the appraisal committee.

Identification principles:

⑴ The prosthetics, orthotics and other auxiliary devices installed for compensation should be generally applicable products. "Ordinary" products exclude luxury products and cannot blindly pursue high quality; the requirements for "applicability" are that, firstly, they can indeed play a functional compensation role, and secondly, they must meet the requirements of "stability" and "safety". Under normal circumstances, domestic products are mainly installed. If the injury has special needs and there are no domestic substitutes, some imported mid-to-high-end materials and parts can be used as appropriate.

⑵ The product price is determined based on the "Catalogue of Special Supplies for Disabled Persons in China" attached to the "Notice of the Ministry of Finance, the State Administration of Taxation, and the Ministry of Civil Affairs on the Income Tax Exemption for Enterprises Producing and Assembling Special Servers for Disabled Persons" (Caishui [2004] No. 132), with reference to the average product price of public prosthetic limb production and assembly units in Beijing, and with due consideration to the price level in the area where the patient is located. The daily maintenance fee for prosthetic products is calculated as 10% of the total price of the required prosthesis.

⑶ The specific types of prosthetics, orthotics and other auxiliary devices that should be installed must be determined after collective research based on the specific conditions of the patient's body and residual limbs after on-site inspections by various appraisal experts. If the assembly is difficult or has special requirements, please explain.

⑷ The service life of domestic prosthetics and orthotics is based on the standard of 1 million fatigue strength tests conducted by the "National Quality Supervision and Inspection Center for Rehabilitation Assistive Devices". The service life of qualified products is generally 2 years.

⑸ The replacement period of prosthetic and orthotic products should not only be based on the service life of the product, but also consider the patient's growth and disease progression. Usually, the socket should be replaced once a year before the age of 18 (the socket should be replaced at least once a year), and every 2 years after the age of 18. If special circumstances require timely replacement (especially orthotics), a certificate from the hospital is required.

⑹ The period of compensation for installation shall be determined by the court in accordance with relevant regulations. Generally, it is from the date of disability (definition of disability) to the average life span of my country's population (70 years).

Main regulatory basis:

"Interpretation of the Supreme People's Court on Several Issues Concerning the Application of Law in the Trial of Personal Injury Compensation Cases" (Adopted at the 1299th Meeting of the Judicial Committee of the Supreme People's Court on December 4, 2003)

Article 17

… If the victim is disabled due to injury, the compensation obligor shall also compensate the necessary expenses incurred by him to increase his living needs and the loss of income caused by the loss of working ability, including disability compensation, disability assistive device expenses, dependent living expenses, as well as the necessary rehabilitation expenses, nursing expenses, and follow-up treatment expenses actually incurred due to rehabilitation care and continued treatment.

……

Article 26

The fee for assistive devices for disabled people is calculated based on the reasonable cost standards for ordinary applicable devices. If the injury requires special needs, you can refer to the opinions of the assistive device dispensing agency to determine the corresponding reasonable fee standards.

The replacement cycle and compensation period of assistive devices shall be determined with reference to the opinions of the dispensing agency.

Article 36

This interpretation will come into effect on May 1, 2004. The provisions of this interpretation shall apply to first-instance personal injury compensation cases newly accepted after May 1, 2004. If a personal injury compensation case for which an effective judgment has been made is retried in accordance with the law, the provisions of this interpretation shall not apply.

If the content of a judicial interpretation that has come into effect before this interpretation is promulgated and comes into effect is inconsistent with this interpretation, this interpretation shall prevail.

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