Up to 40 percent of workplace injuries go uncompensated, according to an analysis of patients arriving at National Taiwan University Hospital's emergency rooms that was performed by the Department of Environmental and Occupational Medicine.
Even though labor insurance is required by law, many find themselves falling through the gaps in the system. Those who are working in the most dangerous jobs are also most likely to be unprotected, according to the department's doctors.
The analysis included 176 patients received in the last four months at the hospital's emergency rooms.
"We found 30 percent of the patients we sampled to be without labor insurance, which is high compared to the national average," said Lin Ching-hua (林慶華), a physician at the center. "We think our sample might be skewed because we used emergency-room arrivals."
"Those who suffer massive physical trauma are more likely to be employed at dangerous work places like construction sites and be less aware of their rights," Lin said.
Another 10 percent of workers in the study were not covered because they worked multiple jobs while only being insured for one or were insured with their union and did not update their insurance policies after changing jobs, Lin said.
In one case, a patient was insured under a taxi drivers' union but also worked in construction. When he fell from scaffolding and became unable to walk properly, his injuries were not covered by his insurance.
Under current labor insurance policies, workers can only be insured under one workplace, leaving workers injured at a second, unrelated job without coverage.
Rule changes are under discussion to allow insurance that covers multiple jobs and total wages -- instead of just the wages earned at the primary workplace -- according to Meng Ai-lun (孟藹倫), director of the Council of Labor Affair's Bureau of Labor Insurance.
Lin said another problem was that psychological damage incurred while at work was not compensated under labor insurance rules unless the medical damage sustained was so severe that the worker qualifies as disabled.
One patient was working on an underground construction site when he was buried by a cave-in. The worker had recurring nightmares of being trapped underground and was fired when he failed to return to work.
"Many workers suffer high levels of anxiety after a traumatic incident and need time to adjust before returning to their job, even if they are physically capable," Lin said.
Although medical costs are covered by National Health Insurance regardless of whether or not it is job-related, labor insurance still plays an important role.
"Workers covered by labor insurance do not have to pay any out-of-pocket expenses [related to their treatment], which can add up for serious injuries," said Lin. "Secondly, they can apply for some compensation for time they have to take off from work."
"There is also the issue of which fund is used," he added. "If a condition is work-related, it is supposed to be treated with money from the Labor Insurance pool and not the National Health Insurance pool."
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