Workers compensation medical benefit application: A first medical-benefit claim uses KCOMWEL Form 2 for the worker’s facts and Form 3 for the medical institution’s opinion. The set starts the occupational-accident review and treatment-benefit decision.
Korea workers compensation medical benefit application: What you will finish
You will match identity and workplace records, write a dated accident narrative, disclose other compensation, authorize hospital filing if wanted, obtain the medical opinion and preserve the decision.
Korea workers compensation medical benefit application: Employer confirmation is not a filing condition on the current form. KCOMWEL notifies the insured employer and investigates facts. Submission does not itself prove that the injury or disease is occupational.
Workers compensation medical benefit application: preview, download and official source
The current official set contains two two-page HWP forms: Form 2 for the worker’s application and Form 3 for the treating institution’s medical opinion. All four official pages are previewed here before the original downloads.
Review the eight form fields
Eight checks on KCOMWEL Forms 2 and 3
- Use the two-form set: Form 2 is the worker’s application and Form 3 is the medical institution’s opinion. Download both current originals. The worker or representative completes Form 2; the treating institution completes and signs Form 3. Do not copy medical judgments yourself.
- Worker and accident facts: copy the passport/residence-card name, resident number, Korean address and reachable phones. Enter accident date and time, hiring date, arrival/departure times and occupation from records. Select the correct worker category and insured-employer relationship.
- Workplace and claim type: mark occupational accident, occupational disease or commuting accident. Enter workplace name, employer name, phone and management number when verified. If the number is unknown, use KCOMWEL’s lookup or ask the branch rather than guessing.
- Accident narrative and evidence: state where, what task you were doing, its purpose, what equipment or material was involved, the causal event, injury mechanism and immediate action in date order. Attach witness details, work orders, CCTV preservation requests, photos, shift records and accident reports when relevant.
- Other compensation and treatment: answer whether the event was reported as a traffic, assault, rescue/fire or auto-insurance case. Identify any third party and any compensation received or payer. List every medical institution visited before the current one and do not conceal overlapping payment routes.
- Submission, consent and signatures: the worker can file without employer confirmation. KCOMWEL sends notice to the employer and checks its opinion. A medical institution may submit through total.comwel.or.kr with the worker’s authorization. Read mandatory occupational-decision data consent separately from optional publicity, rehabilitation and return-to-work data uses, then date and sign.
- Medical opinion page 1: the doctor records identity, accident and first-treatment dates, route to the hospital, first symptoms, current objective symptoms, examination findings, major tests, underlying disease, prior similar treatment, diagnoses and KCD codes. Give the doctor complete prior records; do not ask for unsupported wording.
- Medical opinion page 2 and result: the doctor states expected inpatient/outpatient periods, reasons, work-treatment compatibility, surgery, intensive rehabilitation, transfer and required attachments. The application lists seven-day processing, excluding investigation or supplementation periods allowed by law. Keep the full filed set, receipt and approval/nonapproval notice.
Example only — do not submit: Arun K. copies his residence-card name and verified workplace number, then records that at 10:20 on 18 August 2026 he slipped while carrying a labeled box from the receiving area to a shelf. The example then fell on his right side and reported immediately to the supervisor. He attaches the shift record, work instruction, photos and a witness contact, lists the clinic and hospital visited. The example then reports no third-party payment, authorizes the hospital to submit, reads mandatory and optional consents separately and signs Form 2. The treating doctor independently completes Form 3 from examination, imaging and prior records. Replace every fact, medical statement and date with verified evidence.
- Official form preview

Form 2 worker, employer, event and delegation fields 
Form 2 compensation, notices and data-consent fields 
Form 3 symptoms, tests, diagnoses and medical history 
Form 3 treatment periods, surgery, rehabilitation and attachments - Official original download
Official Form 2 workers’ compensation medical-benefit application HWP · 2 pages · 70,144 bytes
Official Form 3 medical opinion for the application HWP · 2 pages · 68,608 bytes - Official source page
KCOMWEL Medical Care Work Processing Regulation — Forms 2 and 3 · Regulation Article 7 — initial medical-benefit application · Industrial Accident Compensation Insurance Act — Article 41
Verified 26 August 2026: the current KCOMWEL regulation effective 5 August 2025 provides Form 2 as a 70,144-byte two-page HWP (SHA-256 5cf3dd21…cffd) and Form 3 as a 68,608-byte two-page HWP (SHA-256 a4ead830…8fe3). OLE signatures and all four official preview images matched. BSKorean links directly to both originals.
Prepare workers compensation medical benefit application in eight steps
24 Korean phrases for workers compensation medical benefit application
Use the learner-friendly pronunciation first and RR only as a reference. Confirm difficult sounds with Korean audio or a speaker.
Each step contains three Korean phrases. Open only the step you need; learner-friendly pronunciation is shown first and Romanization stays optional.
Step 1Use the two-form set3 Korean phrases
1. Use the two-form set
Start at the official source and confirm that this form fits your case.
Use the two-form set: Form 2 is the worker's application and Form 3 is the medical institution's opinion. Download both current originals. The worker or representative completes Form 2; the treating institution completes and signs Form 3. Do not copy medical judgments yourself.
| # | Korean | How to say it | Natural meaning |
|---|---|---|---|
| 1 | 산재 요양급여를 처음 신청하려고 합니다. | sahn-jeh yoh-yahng-geu-byuh-reul chuh-eum seen-chuhng-hah-ryuh-goh hahm-nee-dah. RR: Sanjae yoyanggeubyeoreul cheoeum sincheongharyeogo hamnida. |
I want to make my first workers’ compensation medical-benefit application. |
| 2 | 요양급여신청서와 소견서가 모두 필요한가요? | yoh-yahng-geu-byuh-seen-chuhng-suh-wah soh-gyuhn-suh-gah moh-doo pee-ryoh-hahn-gah-yoh? RR: Yoyanggeubyeosincheongseowa sogyeonseoga modu piryohangayo? |
Do I need both the application and medical opinion? |
| 3 | 외국인등록증의 영문 성명을 그대로 적겠습니다. | weh-goo-geen-deung-rohk-jjeung-ui yuhng-moon suhng-myuhng-eul geu-deh-roh juhk-kkeht-sseum-nee-dah. RR: Oegugindeungrokjjeungui yeongmun seongmyeongeul geudaero jeokkketsseumnida. |
I will copy my English name from my residence card. |
Step 2Worker and accident facts3 Korean phrases
2. Worker and accident facts
Copy names, numbers and addresses from current documents instead of memory.
Worker and accident facts: copy the passport/residence-card name, resident number, Korean address and reachable phones. Enter accident date and time, hiring date, arrival/departure times and occupation from records. Select the correct worker category and insured-employer relationship.
| # | Korean | How to say it | Natural meaning |
|---|---|---|---|
| 4 | 재해 발생 일시를 확인해 주세요. | jeh-heh bahl-sehng eel-see-reul hwah-geen-heh joo-seh-yoh. RR: Jaehae balsaeng ilsireul hwaginhae juseyo. |
Please confirm the accident date and time. |
| 5 | 출근시간과 퇴근시간을 적어야 하나요? | chool-geun-see-gahn-gwah tweh-geun-see-gah-neul juh-guh-yah hah-nah-yoh? RR: Chulgeunsigangwa toegeunsiganeul jeogeoya hanayo? |
Must I enter arrival and departure times? |
| 6 | 사고 당시 직종은 무엇으로 적나요? | sah-goh dahng-see jeek-jjohng-eun moo-uh-seu-roh juhng-nah-yoh? RR: Sago dangsi jikjjongeun mueoseuro jeongnayo? |
What occupation should I write for the accident date? |
Step 3Workplace and claim type3 Korean phrases
3. Workplace and claim type
Use dates, places, people and actions; separate facts from guesses.
Workplace and claim type: mark occupational accident, occupational disease or commuting accident. Enter workplace name, employer name, phone and management number when verified. If the number is unknown, use KCOMWEL's lookup or ask the branch rather than guessing.
| # | Korean | How to say it | Natural meaning |
|---|---|---|---|
| 7 | 사업장관리번호를 확인해 주세요. | sah-uhp-jjahng-gwahn-ree-buhn-hoh-reul hwah-geen-heh joo-seh-yoh. RR: Saeopjjanggwanribeonhoreul hwaginhae juseyo. |
Please confirm the workplace management number. |
| 8 | 사업주 확인 없이도 신청할 수 있나요? | sah-uhp-jjoo hwah-geen uhp-see-doh seen-chuhng-hahl soo een-nah-yoh? RR: Saeopjju hwagin eopsido sincheonghal su innayo? |
Can I apply without employer confirmation? |
| 9 | 재해 발생 경위를 시간 순서대로 적겠습니다. | jeh-heh bahl-sehng gyuhng-wee-reul see-gahn soon-suh-deh-roh juhk-kkeht-sseum-nee-dah. RR: Jaehae balsaeng gyeongwireul sigan sunseodaero jeokkketsseumnida. |
I will write the accident sequence in time order. |
Step 4Accident narrative and evidence3 Korean phrases
4. Accident narrative and evidence
Keep originals and submit copies unless the receiving office asks otherwise.
Accident narrative and evidence: state where, what task you were doing, its purpose, what equipment or material was involved, the causal event, injury mechanism and immediate action in date order. Attach witness details, work orders, CCTV preservation requests, photos, shift records and accident reports when relevant.
| # | Korean | How to say it | Natural meaning |
|---|---|---|---|
| 10 | 어디에서 무엇을 하다가 다쳤는지 설명하겠습니다. | uh-dee-eh-suh moo-uh-seul hah-dah-gah dah-chyuhn-neun-jee suhl-myuhng-hah-geht-sseum-nee-dah. RR: Eodieseo mueoseul hadaga dachyeonneunji seolmyeonghagetsseumnida. |
I will explain where, what I was doing, and how I was injured. |
| 11 | 목격자 연락처를 첨부해도 되나요? | mohk-kkyuhk-jjah yuhn-rahk-chuh-reul chuhm-boo-heh-doh dweh-nah-yoh? RR: Mokkkyeokjja yeonrakcheoreul cheombuhaedo doenayo? |
May I attach a witness’s contact details? |
| 12 | 교통사고 신고 사실이 있습니다. | gyoh-tohng-sah-goh seen-goh sah-see-ree eet-sseum-nee-dah. RR: Gyotongsago singo sasiri itsseumnida. |
The traffic accident was reported. |
Step 5Other compensation and treatment3 Korean phrases
5. Other compensation and treatment
Mark required fields, conditional sections, signatures and representative details.
Other compensation and treatment: answer whether the event was reported as a traffic, assault, rescue/fire or auto-insurance case. Identify any third party and any compensation received or payer. List every medical institution visited before the current one and do not conceal overlapping payment routes.
| # | Korean | How to say it | Natural meaning |
|---|---|---|---|
| 13 | 자동차보험사에도 사고를 신고했습니다. | jah-dohng-chah-boh-huhm-sah-eh-doh sah-goh-reul seen-goh-heht-sseum-nee-dah. RR: Jadongchaboheomsaedo sagoreul singohaetsseumnida. |
I also reported the accident to the auto insurer. |
| 14 | 다른 보상금을 받은 사실이 없습니다. | dah-reun boh-sahng-geu-meul bah-deun sah-see-ree uhp-sseum-nee-dah. RR: Dareun bosanggeumeul badeun sasiri eopsseumnida. |
I have not received other compensation. |
| 15 | 진료받은 의료기관을 모두 적겠습니다. | jeen-ryoh-bah-deun ui-ryoh-gee-gwah-neul moh-doo juhk-kkeht-sseum-nee-dah. RR: Jinryobadeun uiryogigwaneul modu jeokkketsseumnida. |
I will list every medical institution that treated me. |
Step 6Submission, consent and signatures3 Korean phrases
6. Submission, consent and signatures
Draft a short chronology, then copy it consistently into the form.
Submission, consent and signatures: the worker can file without employer confirmation. KCOMWEL sends notice to the employer and checks its opinion. A medical institution may submit through total.comwel.or.kr with the worker's authorization. Read mandatory occupational-decision data consent separately from optional publicity, rehabilitation and return-to-work data uses, then date and sign.
| # | Korean | How to say it | Natural meaning |
|---|---|---|---|
| 16 | 병원이 신청을 대신 제출할 수 있나요? | byuhng-wuh-nee seen-chuhng-eul deh-seen jeh-chool-hahl soo een-nah-yoh? RR: Byeongwoni sincheongeul daesin jechulhal su innayo? |
Can the hospital submit the application for me? |
| 17 | 개인정보 필수 동의 내용을 읽어 주세요. | geh-een-juhng-boh peel-soo dohng-ui neh-yohng-eul eel-guh joo-seh-yoh. RR: Gaeinjeongbo pilsu dongui naeyongeul ilgeo juseyo. |
Please read the mandatory data consent to me. |
| 18 | 선택 동의를 거부해도 산재 신청은 가능한가요? | suhn-tehk dohng-ui-reul guh-boo-heh-doh sahn-jeh seen-chuhng-eun gah-neung-hahn-gah-yoh? RR: Seontaek donguireul geobuhaedo sanjae sincheongeun ganeunghangayo? |
Can I apply if I refuse optional consent? |
Step 7Medical opinion page 13 Korean phrases
7. Medical opinion page 1
Check evidence names, page order, personal data and any consent statement.
Medical opinion page 1: the doctor records identity, accident and first-treatment dates, route to the hospital, first symptoms, current objective symptoms, examination findings, major tests, underlying disease, prior similar treatment, diagnoses and KCD codes. Give the doctor complete prior records; do not ask for unsupported wording.
| # | Korean | How to say it | Natural meaning |
|---|---|---|---|
| 19 | 의사에게 요양급여신청 소견서를 요청하겠습니다. | ui-sah-eh-geh yoh-yahng-geu-byuh-seen-chuhng soh-gyuhn-suh-reul yoh-chuhng-hah-geht-sseum-nee-dah. RR: Uisaege yoyanggeubyeosincheong sogyeonseoreul yocheonghagetsseumnida. |
I will ask my doctor for the medical opinion form. |
| 20 | 최초 증상과 현재 증상을 정확히 설명하겠습니다. | chweh-choh jeung-sahng-gwah hyuhn-jeh jeung-sahng-eul juhng-hwah-kee suhl-myuhng-hah-geht-sseum-nee-dah. RR: Choecho jeungsanggwa hyeonjae jeungsangeul jeonghwaki seolmyeonghagetsseumnida. |
I will accurately describe first and current symptoms. |
| 21 | 상병명과 상병코드를 확인해 주세요. | sahng-byuhng-myuhng-gwah sahng-byuhng-koh-deu-reul hwah-geen-heh joo-seh-yoh. RR: Sangbyeongmyeonggwa sangbyeongkodeureul hwaginhae juseyo. |
Please confirm the diagnosis and diagnosis code. |
Step 8Medical opinion page 2 and result3 Korean phrases
8. Medical opinion page 2 and result
Use an accepted channel, keep a complete copy and record the receipt number.
Medical opinion page 2 and result: the doctor states expected inpatient/outpatient periods, reasons, work-treatment compatibility, surgery, intensive rehabilitation, transfer and required attachments. The application lists seven-day processing, excluding investigation or supplementation periods allowed by law. Keep the full filed set, receipt and approval/nonapproval notice.
| # | Korean | How to say it | Natural meaning |
|---|---|---|---|
| 22 | 입원과 통원 예상기간은 얼마나 되나요? | ee-bwuhn-gwah tohng-wuhn yeh-sahng-gee-gah-neun uhl-mah-nah dweh-nah-yoh? RR: Ibwongwa tongwon yesanggiganeun eolmana doenayo? |
What are the expected inpatient and outpatient periods? |
| 23 | 검사 결과와 진료기록을 첨부하겠습니다. | guhm-sah gyuhl-gwah-wah jeen-ryoh-gee-roh-geul chuhm-boo-hah-geht-sseum-nee-dah. RR: Geomsa gyeolgwawa jinryogirogeul cheombuhagetsseumnida. |
I will attach test results and medical records. |
| 24 | 접수번호와 결정 통지를 보관하겠습니다. | juhp-ssoo-buhn-hoh-wah gyuhl-juhng tohng-jee-reul boh-gwahn-hah-geht-sseum-nee-dah. RR: Jeopssubeonhowa gyeoljeong tongjireul bogwanhagetsseumnida. |
I will keep the receipt number and decision notice. |
20 words to recognize
20 words to recognize
| # | Korean | Pronunciation | Meaning |
|---|---|---|---|
| 1 | 산업재해 | sah-nuhp-jjeh-heh RR: Saneopjjaehae |
industrial accident |
| 2 | 요양급여 | yoh-yahng-geu-byuh RR: Yoyanggeubyeo |
medical benefit |
| 3 | 재해일자 | jeh-heh-eel-jah RR: Jaehaeilja |
accident date |
| 4 | 재해 발생 경위 | jeh-heh bahl-sehng gyuhng-wee RR: Jaehae balsaeng gyeongwi |
accident sequence |
| 5 | 사업장관리번호 | sah-uhp-jjahng-gwahn-ree-buhn-hoh RR: Saeopjjanggwanribeonho |
workplace management number |
| 6 | 보험가입자 | boh-huhm-gah-eep-jjah RR: Boheomgaipjja |
insured employer |
| 7 | 근로자 유형 | geun-roh-jah yoo-hyuhng RR: Geunroja yuhyeong |
worker category |
| 8 | 업무상 재해 | uhm-moo-sahng jeh-heh RR: Eommusang jaehae |
occupational accident |
| 9 | 목격자 | mohk-kkyuhk-jjah RR: Mokkkyeokjja |
witness |
| 10 | 제3자 | jeh3jah RR: Je3ja |
third party |
| 11 | 대리 제출 | deh-ree jeh-chool RR: Daeri jechul |
proxy submission |
| 12 | 필수 동의 | peel-soo dohng-ui RR: Pilsu dongui |
mandatory consent |
| 13 | 선택 동의 | suhn-tehk dohng-ui RR: Seontaek dongui |
optional consent |
| 14 | 의학적 소견 | ui-hahk-jjuhk soh-gyuhn RR: Uihakjjeok sogyeon |
medical opinion |
| 15 | 최초 증상 | chweh-choh jeung-sahng RR: Choecho jeungsang |
first symptom |
| 16 | 현재 증상 | hyuhn-jeh jeung-sahng RR: Hyeonjae jeungsang |
current symptom |
| 17 | 상병명 | sahng-byuhng-myuhng RR: Sangbyeongmyeong |
diagnosis |
| 18 | 상병코드 | sahng-byuhng-koh-deu RR: Sangbyeongkodeu |
diagnosis code |
| 19 | 입원 | ee-bwuhn RR: Ibwon |
inpatient care |
| 20 | 통원 | tohng-wuhn RR: Tongwon |
outpatient care |
Replies you may hear
Replies you may hear
- 요양급여신청서와 의료기관 소견서를 함께 준비해 주세요. – Prepare both the medical-benefit application and medical opinion.
- 사업주 확인이 없어도 근로자가 신청할 수 있습니다. – A worker may apply without employer confirmation.
- 재해 경위는 장소, 작업, 원인과 과정을 구체적으로 적으세요. – Describe the place, task, cause and sequence in detail.
- 공단이 신청 사실을 사업주에게 알리고 의견을 확인합니다. – KCOMWEL notifies the employer and checks its opinion.
- 의료기관은 근로자의 위임을 받아 대리 제출할 수 있습니다. – A medical institution may submit with the worker’s authorization.
- 필수 개인정보 동의와 선택 동의를 구분해서 읽으세요. – Read mandatory and optional data consents separately.
- 의사는 진단, 치료기간과 검사 결과를 소견서에 작성합니다. – The doctor completes diagnosis, treatment period and test results.
- 접수 후 업무상 재해 여부를 조사해 결정합니다. – After filing, occupational causation is investigated and decided.
Two form-preparation dialogues
Two form-preparation dialogues
1
재해자: 산재 요양급여를 처음 신청하려고 합니다.
공단 담당자: 별지 2 신청서와 의료기관이 작성한 별지 3 소견서를 준비하세요.
재해자: 사업주 서명을 먼저 받아야 하나요?
공단 담당자: 사업주 확인 없이 신청할 수 있고, 공단이 사업주에게 통지해 의견을 확인합니다.
재해자: 재해 경위와 증거를 사실대로 정리하겠습니다.
The worker completes Form 2 from identity, workplace and dated accident evidence; KCOMWEL—not an employer signature—tests the facts.
2
재해자: 허리 통증의 최초 증상과 현재 증상을 설명하겠습니다.
의사: 진료개시일, 상병명, 검사 결과, 입원·통원 예상기간을 소견서에 작성하겠습니다.
재해자: 기존에 치료받은 사실도 말씀드려야 하나요?
의사: 유사 상병과 기초질환, 관련 진료기록을 정확히 알려 주세요.
재해자: 완성된 소견서와 검사자료를 신청서에 첨부하겠습니다.
The treating institution completes Form 3 from examinations and records; the worker files the full set and keeps the decision.
Workers compensation medical benefit application: final form checklist
- Confirm form and deadline
- Use current official file
- Prepare ID and contact
- Write a dated chronology
- Use exact names and numbers
- Separate facts from opinion
- List every attachment
- Check signature and consent
- Keep a full copy
- Save submission proof
Scope and filing boundaries
Scope and filing boundaries
- The form does not guarantee approval
- Do not invent missing facts
- Do not alter an official file
- Protect unrelated personal data
- Use an interpreter when accuracy is at risk
- Confirm urgent deadlines with the receiving office
Do not wait for an employer signature that the form does not require, invent a management number, hide traffic or third-party compensation, alter a doctor’s opinion, or sign consent without separating mandatory from optional uses.
Prepared by BSKorean Content Studio. KCOMWEL Medical Care Work Processing Regulation effective 5 August 2025, Forms 2 and 3, and Act Article 41 were checked on 26 August 2026.
Official sources checked
Workers compensation medical benefit application: five-minute practice
Open the official form beside this guide. Draft the facts in date order, copy them into the matching fields, check the attachments and signature, then save proof of submission.
Workers compensation medical benefit application: questions foreign workers often ask
What should I confirm before using this form?
Use the two-form set: Form 2 is the worker's application and Form 3 is the medical institution's opinion. Download both current originals. The worker or representative completes Form 2; the treating institution completes and signs Form 3. Do not copy medical judgments yourself.
Which details should I check twice?
Worker and accident facts: copy the passport/residence-card name, resident number, Korean address and reachable phones. Enter accident date and time, hiring date, arrival/departure times and occupation from records. Select the correct worker category and insured-employer relationship.
Where should I get the form?
Use the official original and official source links in this guide. Check the form date again before filing.
