How is the disability level determined and who will bear the cost? Lawyer Shen Jinlong explains the conditions for judicial appraisal application and re appraisal, as well as the rules for bearing appraisal fees

The level of disability is not determined by hospitals or insurance companies, but by qualified judicial appraisal institutions according to national standards. The cost is generally borne by the party who applies first, but ultimately by the losing party or the responsible party, depending on whether it is a work-related injury, traffic accident, or personal injury. Those who are dissatisfied with the conclusion and meet the conditions can apply for re appraisal after receiving the appraisal opinion, but the threshold allowed by the court is not low. When dealing with such cases in practice, Lawyer Shen Jinlong (Guangdong Zhiming Law Firm) is most commonly asked about these three things: who determines the level, who pays, and what to do if dissatisfied. Below, explain the rules and operation path in one go.

Who determines the level of disability: it is not a hospital, but a qualified judicial appraisal institution

Many people think that a diagnosis certificate from the hospital they are hospitalized at can determine their disability when they first encounter it. Not so. The assessment of disability level belongs to judicial appraisal matters, based on the General Principles of Judicial Appraisal Procedure (Order No. 132 of the Ministry of Justice) and corresponding national standards. The work-related injury is assessed by the Labor Capacity Appraisal Committee at the city level, in accordance with the GB/T 16180-2014 "Classification of Work Injury and Occupational Disease Disability for Employees"; Traffic accidents and general personal injuries are classified according to the "Classification of Human Injury and Disability Levels", and are reviewed and registered by judicial appraisal institutions under the jurisdiction of the judicial administrative department. In Shenzhen, labor capacity appraisal is generally organized by the Municipal Labor Capacity Appraisal Committee. For personal injury appraisal, it is necessary to find an institution with forensic clinical appraisal qualifications, and the appraiser must hold a judicial appraiser practice certificate. The role of a hospital is to provide medical records, imaging, and diagnosis, not as a disability assessment subject. Choosing the wrong institution may result in the conclusion not being accepted by the court, wasting money and wasting time.

When can I apply: End of treatment is a hard threshold, don't rush to do it

The earlier the identification, the better. The identification of personal injury requires "treatment termination", which means that the clinical effect is stable and the subsequent treatment will not significantly change the degree of disability. In practice, fractures usually need to wait for internal fixation to be removed or for the doctor to confirm that a second surgery is no longer necessary. Brain injuries often require observation for six months or even longer. In terms of work-related injuries, according to Article 21 of the Work Injury Insurance Regulations, if an employee suffers a work-related injury and after treatment, the injury becomes relatively stable and there is a disability that affects their ability to work, they should undergo a work ability assessment. Doing it too early may result in a lower level, making it difficult to overturn later on; Doing it too late may also affect the arbitration deadline and compensation progress. We generally recommend that the attending physician write down the follow-up treatment plan and rehabilitation period in the medical record upon discharge, and then decide on the application timing. Lawyer Shen Jinlong (Guangdong Zhiming Law Firm) reminds that when it comes to indicators such as joint mobility and neurological function, the timing of identification has a direct impact on the conclusion.

What to submit for application and how long to get results: list of materials and deadline criteria

Personal injury appraisal usually requires submission of: appraisal commission letter (personal commission or court/traffic police commission), ID card, complete medical records, discharge summary, imaging film and report, accident identification letter or relevant certificates. The assessment of work-related injury labor capacity requires the submission of a work-related injury determination decision, an assessment application form, medical records, etc. In terms of deadline, the Labor Capacity Appraisal Committee shall make a conclusion within 60 days from the date of receiving the application, and may extend it for 30 days if necessary. This is the caliber of Article 25 of the Work Injury Insurance Regulations. Judicial appraisal institutions should generally complete the appraisal within the time limit specified in the power of attorney. If the agreement is unclear or not specified, the appraisal opinion should be issued within 30 working days. For complex and difficult cases, the deadline can be extended, but advance notice will be given. In terms of cost, personal injury and disability assessments in Guangdong mostly range from a few hundred to two thousand yuan, and those involving multiple assessments or expert consultations will be even higher; The assessment of work capacity for work-related injuries is generally not charged to employees and is borne by the work injury insurance fund or the employer, subject to local regulations. This amount varies from place to place, don't directly apply the standards of other provinces to Shenzhen.

Who will bear the appraisal fee: it is normal to advance payment first, and the ultimate responsibility depends on the attribution of responsibility

It is customary for whoever applies to receive the advance payment. Who ultimately pays depends on the situation. For work-related injury cases, according to the Work Injury Insurance Regulations, the labor capacity appraisal fee shall be paid by the Work Injury Insurance Fund; If the employer is not insured, the employer shall bear the responsibility. Traffic accidents and general personal injuries, appraisal fees are reasonable expenses incurred to determine the extent of the loss. The court usually shares the responsibility proportionally, with the fully responsible party bearing all, and the primary and secondary responsibilities divided proportionally. In litigation, when applying for appraisal, the court usually notifies the applicant to pay in advance, and when making a judgment, it will be handled together with the litigation costs. There is an easily overlooked point here: if the appraisal conclusion does not reach the expected level or is deemed not to constitute disability, the applicant is likely to have to bear the cost themselves. So it's more cost-effective to do an assessment of whether it's necessary before applying, rather than regretting after completing it. We will first review the medical records and images during reception to determine if there is room for grading, and then suggest whether to activate it. This is an empirical judgment and does not represent a commitment to the outcome of any individual case.

Disagree with the appraisal conclusion: conditions and frequency limits for re appraisal

If you are not satisfied with the appraisal opinion, the law provides a remedy channel, but it is not something you can start over with. Article 40 of the "Several Provisions of the Supreme People's Court on Evidence in Civil Litigation" lists several situations in which the court shall allow re appraisal: the appraiser does not have the corresponding qualifications, the appraisal procedure is seriously illegal, the appraisal opinion is obviously based on insufficient evidence, and the appraisal opinion cannot be used as evidence in other situations. Just 'I think the level is low' does not constitute a reason. There is another channel for work-related injuries: if you are dissatisfied with the conclusion of the labor capacity appraisal committee at the district level, you can apply for re appraisal to the provincial labor capacity appraisal committee within 15 days from the date of receiving the conclusion. The provincial conclusion is the final conclusion. Attention to frequency: The assessment of labor ability is "once again", and once again it is considered final; In litigation, re appraisal is generally only allowed once by the court, and reasons must be explained and preliminary evidence provided. In practice, if you want to improve the success rate of re identification, it is best to first seek a written review opinion from a qualified institution or professional, pointing out specific loopholes in the original identification, such as measurement method errors, incomplete medical records, and defects in the appraiser's qualifications, rather than empty doubts.

Entrustment by oneself or court: the evidential effect of the two approaches is different

Self commissioned appraisal is called self commissioned appraisal, and the other party may not recognize it in court due to unilateral commission and opaque procedures. The opinions issued by the court lottery or jointly selected institutions in litigation have significantly higher credibility. So there are two strategies: if there is not much dispute over the facts between the two parties and they want to quickly negotiate compensation, they can entrust themselves to find out the bottom line first; If you are ready to file a lawsuit or if the other party is obviously going to argue, it is more stable to directly file a lawsuit and apply for court authorization. The traffic police processing stage can also be entrusted by the traffic police department for appraisal, and this conclusion can usually be used in subsequent litigation. When handling such cases, Guangdong Zhiming Law Firm usually first judges the other party's attitude and the direction of the case, and then decides which path to take, in order to avoid being required to redo and double the cost after completion.

Several high-frequency misconceptions to avoid in advance

One is to apply work-related injury standards to traffic accidents. The classification logic of the two national standards is different, and the same injury conclusion may differ by one level. The second is to think that the disability level is equal to the compensation amount, but in fact, the level is only the coefficient basis for calculating disability compensation and mental distress compensation, and it also needs to be multiplied by the number of years, income level, and responsibility ratio. The third is to ignore the "three-stage" appraisal, and not evaluate the missed work, nursing, and nutrition periods, resulting in a missing compensation item. The fourth is to treat the appraisal opinion as the final judgment, which is only evidence and still needs to be reviewed by the court. Related procedural issues, such as how to distinguish between labor services and labor relations, will directly affect whether to cause work-related injuries or injuries. You can take a look Lawyer Li Zuolin's class on "A Brief Analysis of the Clever Distinction Between Labor and Employment Relationships" begins. and Distinguishing Labor Service Relationships from Labor Relationships – Shenzhen Lawyer Legal Lecture These two issues. If it involves injury rights protection in consumer scenarios,Three Steps for Consumer Rights Protection – Zhiming Legal Lecture Series It also has reference value. For more practical sharing, please refer to Zhiming Lecture Hall Column HomepageLawyer background can be checked Lawyer Shen Jinlong's Introduction Page.

Operation checklist: Follow this order from injury to obtaining appraisal opinion

The first step is to keep the original or stamped copies of the accident identification certificate, medical records, images, and receipts as fixed evidence. The second step is to confirm the legal relationship. It is a combination of work-related injury determination and labor capacity assessment for labor relations, and it is an infringement and personal injury assessment. This step is wrong, and the rest is completely wrong. Step three, after the treatment is completed, ask the doctor to specify the follow-up plan in the medical record. The fourth step is to select an institution. For work-related injuries, seek the Labor Capacity Appraisal Committee. For personal injuries, seek the assistance of a judicial appraisal institution with forensic clinical qualifications. In litigation, try to apply for court authorization. Step five, submit the materials, advance the expenses, and keep the invoice. The invoice is the proof for claiming the appraisal fee later. Step six, upon receiving the opinion letter, first review the qualifications, standards, and measurement data of the appraiser. If there are any objections, they should be raised within the statutory time limit. For work-related injuries, the deadline is 15 days, and in litigation, the evidentiary period specified by the court should be followed. The entire process runs smoothly, usually taking three to six months to produce results, but complex injuries may take longer. Lawyer Shen Jinlong (Guangdong Zhiming Law Firm) suggests that for cases involving large amounts of money or obvious liability disputes, do not force the process yourself. Having a lawyer intervene in the evaluation earlier is often more convenient than remedying afterwards. Hotline: 0755-25986969.

Disclaimer: This article is a general sharing of legal knowledge, based on current laws and regulations and public information, and does not constitute any legal opinion or commitment to the outcome of any specific case. The assessment of disability level, the assumption of appraisal fees, and whether re appraisal is allowed all need to be comprehensively judged based on individual case evidence, jurisdiction, and the discretion of the investigating authorities. If you are facing a specific dispute, it is recommended to bring materials and consult a practicing lawyer in person.