How to Claim Korean Industrial-Accident Disability Benefits

Korea Forms in Real Life · Episode 12/24
Quick answer

Industrial accident disability benefit claim: Industrial-accident disability benefits concern a disability that remains after the work injury or disease is legally healed. Filing a form does not establish a grade or guarantee payment.

Korean industrial accident disability benefit claim: What you will finish

You will separate claimant and physician fields, report the accident, account, prior disability and same-cause compensation, then prepare diagnosis, imaging and medical records.

Korean industrial accident disability benefit claim: This guide covers KCOMWEL Form 11 and the linked Form 12 diagnosis. It is not a diagnosis, legal opinion, grade prediction, or guide to pneumoconiosis benefits.

Industrial accident disability benefit claim: preview, download and official source

The official bundle has a two-page Form 11 and five-page Form 12. Form 11 combines disability-benefit and complication-prevention routes; this episode marks disability benefits only. Form 12 has a general page plus specialty pages, so use the page KCOMWEL and your physician identify.

Review the eight form fields

Eight checks on disability-benefit Forms 11 and 12

  1. Claim type and identity: mark disability benefits, not preventive management, and copy the claimant’s name and birth date exactly. Enter the work-accident date from the accepted case record.
  2. Receiving account: answer whether the account changes, then use an ordinary account or benefit-only account in the claimant’s name. Recheck bank, number and holder.
  3. Prior disability: disclose any disability that existed before this accident or arose from another cause. Do not decide yourself whether it changes the grade.
  4. Same-cause compensation: answer whether money was received under the Civil Act or another law for the same reason and attach the settlement, judgment, receipt or other proof requested.
  5. Submission and consent: sign the claim. Medical-institution proxy filing is a separate consent route; refusing it does not prevent you from filing directly. Promotional personal-data consent is optional and separate.
  6. Physician-only Form 12: the attending physician records first-treatment and healing dates, diagnosed condition, affected part, treatment, tests, detailed remaining disability, prognosis and specialty measurements. The claimant must not invent these medical findings.
  7. Attachments and examination: the rules identify Form 12, radiology data, medical records and other material showing the disability. KCOMWEL may ask for the relevant specialty page, identity confirmation, consultation or an in-person examination.
  8. Grade and payment choice: KCOMWEL decides the grade. Grades 1–3 are pension routes, 4–7 may choose pension or lump sum, and 8–14 are lump sum under the rules. Make any permitted choice only after the official explanation; a completed choice may be irreversible.

Example only — do not submit: Minh P. marks disability benefits on Form 11 after the accepted treatment is closed. He copies the accident date, keeps his own receiving account, answers that he has no pre-existing disability and no same-cause civil compensation, declines medical-institution proxy filing and files directly. His orthopaedic physician—not Minh—completes the applicable Form 12 page and supplies medical records and imaging. KCOMWEL, not the example, decides the grade and payment route. Replace every fact with your records.

Official Korean form preview for How to Claim Korean Industrial-Accident Disability Benefits
Official form preview. Tap to enlarge, then use the official original link below.
  1. Official form preview
  2. Official original download

    Official Form 11 disability-benefit claim HWP · 2 pages · 76,800 bytes
    Official Form 12 disability diagnosis HWP · 5 pages · 71,168 bytes

  3. Official source page

    Korean Law Information Center — KCOMWEL compensation rules and forms · Industrial Accident Compensation Insurance Act — Article 57

Verified 26 August 2026: official Form 11 is a 76,800-byte, two-page HWP (SHA-256 5cc285e0…c796); Form 12 is a 71,168-byte, five-page HWP (SHA-256 0d09c0c2…c59b). Both OLE/HWP signatures and official preview images matched. BSKorean links directly and does not mirror them.

Prepare industrial accident disability benefit claim in eight steps

24 Korean phrases for industrial accident disability benefit claim

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 1Claim type and identity3 Korean phrases

1. Claim type and identity

Start at the official source and confirm that this form fits your case.

Claim type and identity: mark disability benefits, not preventive management, and copy the claimant's name and birth date exactly. Enter the work-accident date from the accepted case record.

# Korean How to say it Natural meaning
1 장해급여를 청구하려고 합니다. jahng-heh-geu-byuh-reul chuhng-goo-hah-ryuh-goh hahm-nee-dah.
RR: Janghaegeubyeoreul cheongguharyeogo hamnida.
I want to claim disability benefits.
2 치료가 종결된 날짜를 확인해 주세요. chee-ryoh-gah johng-gyuhl-dwehn nahl-jjah-reul hwah-geen-heh joo-seh-yoh.
RR: Chiryoga jonggyeoldoen naljjareul hwaginhae juseyo.
Please confirm the treatment-completion date.
3 치료가 끝난 뒤 장해가 남았습니다. chee-ryoh-gah kkeun-nahn dwee jahng-heh-gah nah-maht-sseum-nee-dah.
RR: Chiryoga kkeunnan dwi janghaega namatsseumnida.
A disability remained after treatment ended.
Step 2Receiving account3 Korean phrases

2. Receiving account

Copy names, numbers and addresses from current documents instead of memory.

Receiving account: answer whether the account changes, then use an ordinary account or benefit-only account in the claimant's name. Recheck bank, number and holder.

# Korean How to say it Natural meaning
4 장해급여 항목에 표시하겠습니다. jahng-heh-geu-byuh hahng-moh-geh pyoh-see-hah-geht-sseum-nee-dah.
RR: Janghaegeubyeo hangmoge pyosihagetsseumnida.
I will mark disability benefits.
5 재해 발생일을 정확히 적겠습니다. jeh-heh bahl-sehng-ee-reul juhng-hwah-kee juhk-kkeht-sseum-nee-dah.
RR: Jaehae balsaengireul jeonghwaki jeokkketsseumnida.
I will enter the accident date accurately.
6 수령 계좌를 변경하지 않겠습니다. soo-ryuhng gyeh-jwah-reul byuhn-gyuhng-hah-jee ahn-keht-sseum-nee-dah.
RR: Suryeong gyejwareul byeongyeonghaji anketsseumnida.
I will not change the receiving account.
Step 3Prior disability3 Korean phrases

3. Prior disability

Use dates, places, people and actions; separate facts from guesses.

Prior disability: disclose any disability that existed before this accident or arose from another cause. Do not decide yourself whether it changes the grade.

# Korean How to say it Natural meaning
7 본인 명의 계좌를 적겠습니다. boh-neen myuhng-ui gyeh-jwah-reul juhk-kkeht-sseum-nee-dah.
RR: Bonin myeongui gyejwareul jeokkketsseumnida.
I will enter an account in my name.
8 보험급여 전용계좌를 사용하려고 합니다. boh-huhm-geu-byuh juh-nyohng-gyeh-jwah-reul sah-yohng-hah-ryuh-goh hahm-nee-dah.
RR: Boheomgeubyeo jeonyonggyejwareul sayongharyeogo hamnida.
I want to use a benefit-only account.
9 같은 사유로 받은 보상금이 있습니다. gah-teun sah-yoo-roh bah-deun boh-sahng-geu-mee eet-sseum-nee-dah.
RR: Gateun sayuro badeun bosanggeumi itsseumnida.
I received compensation for the same reason.
Step 4Same-cause compensation3 Korean phrases

4. Same-cause compensation

Keep originals and submit copies unless the receiving office asks otherwise.

Same-cause compensation: answer whether money was received under the Civil Act or another law for the same reason and attach the settlement, judgment, receipt or other proof requested.

# Korean How to say it Natural meaning
10 기존 장해가 있는지 확인해 주세요. gee-john jahng-heh-gah een-neun-jee hwah-geen-heh joo-seh-yoh.
RR: Gijon janghaega inneunji hwaginhae juseyo.
Please check whether I have a pre-existing disability.
11 장해진단서는 의사가 작성하나요? jahng-heh-jeen-dahn-suh-neun ui-sah-gah jahk-ssuhng-hah-nah-yoh?
RR: Janghaejindanseoneun uisaga jaksseonghanayo?
Does the doctor complete the disability diagnosis?
12 초진일과 치유일을 확인해 주세요. choh-jee-neel-gwah chee-yoo-ee-reul hwah-geen-heh joo-seh-yoh.
RR: Chojinilgwa chiyuireul hwaginhae juseyo.
Please confirm the first-treatment and healing dates.
Step 5Submission and consent3 Korean phrases

5. Submission and consent

Mark required fields, conditional sections, signatures and representative details.

Submission and consent: sign the claim. Medical-institution proxy filing is a separate consent route; refusing it does not prevent you from filing directly. Promotional personal-data consent is optional and separate.

# Korean How to say it Natural meaning
13 장해의 원인이 되는 상병명을 적어 주세요. jahng-heh-ui wuh-nee-nee dweh-neun sahng-byuhng-myuhng-eul juh-guh joo-seh-yoh.
RR: Janghaeui wonini doeneun sangbyeongmyeongeul jeogeo juseyo.
Please write the diagnosed condition causing the disability.
14 장해 부위를 자세히 기록해 주세요. jahng-heh boo-wee-reul jah-seh-hee gee-roh-keh joo-seh-yoh.
RR: Janghae buwireul jasehi girokae juseyo.
Please record the affected body part in detail.
15 검사 결과와 진료기록을 준비했습니다. guhm-sah gyuhl-gwah-wah jeen-ryoh-gee-roh-geul joon-bee-heht-sseum-nee-dah.
RR: Geomsa gyeolgwawa jinryogirogeul junbihaetsseumnida.
I prepared test results and medical records.
Step 6Physician-only Form 123 Korean phrases

6. Physician-only Form 12

Draft a short chronology, then copy it consistently into the form.

Physician-only Form 12: the attending physician records first-treatment and healing dates, diagnosed condition, affected part, treatment, tests, detailed remaining disability, prognosis and specialty measurements. The claimant must not invent these medical findings.

# Korean How to say it Natural meaning
16 방사선 검사 자료도 제출해야 하나요? bahng-sah-suhn guhm-sah jah-ryoh-doh jeh-chool-heh-yah hah-nah-yoh?
RR: Bangsaseon geomsa jaryodo jechulhaeya hanayo?
Must I also submit radiology data?
17 의료기관 대행 제출에 동의합니다. ui-ryoh-gee-gwahn deh-hehng jeh-choo-reh dohng-ui-hahm-nee-dah.
RR: Uiryogigwan daehaeng jechure donguihamnida.
I consent to medical-institution proxy filing.
18 대행 제출에 동의하지 않고 직접 제출하겠습니다. deh-hehng jeh-choo-reh dohng-ui-hah-jee ahn-koh jeek-jjuhp jeh-chool-hah-geht-sseum-nee-dah.
RR: Daehaeng jechure donguihaji anko jikjjeop jechulhagetsseumnida.
I do not consent to proxy filing and will file directly.
Step 7Attachments and examination3 Korean phrases

7. Attachments and examination

Check evidence names, page order, personal data and any consent statement.

Attachments and examination: the rules identify Form 12, radiology data, medical records and other material showing the disability. KCOMWEL may ask for the relevant specialty page, identity confirmation, consultation or an in-person examination.

# Korean How to say it Natural meaning
19 개인정보 홍보 이용 동의는 선택 사항인가요? geh-een-juhng-boh hohng-boh ee-yohng dohng-ui-neun suhn-tehk sah-hahng-een-gah-yoh?
RR: Gaeinjeongbo hongbo iyong donguineun seontaek sahangingayo?
Is promotional use of personal data optional?
20 연금과 일시금은 언제 선택하나요? yuhn-geum-gwah eel-see-geu-meun uhn-jeh suhn-teh-kah-nah-yoh?
RR: Yeongeumgwa ilsigeumeun eonje seontaekanayo?
When do I choose pension or lump sum?
21 선택을 나중에 변경할 수 있나요? suhn-teh-geul nah-joong-eh byuhn-gyuhng-hahl soo een-nah-yoh?
RR: Seontaegeul najunge byeongyeonghal su innayo?
Can the choice be changed later?
Step 8Grade and payment choice3 Korean phrases

8. Grade and payment choice

Use an accepted channel, keep a complete copy and record the receipt number.

Grade and payment choice: KCOMWEL decides the grade. Grades 1–3 are pension routes, 4–7 may choose pension or lump sum, and 8–14 are lump sum under the rules. Make any permitted choice only after the official explanation; a completed choice may be irreversible.

# Korean How to say it Natural meaning
22 장해등급은 근로복지공단이 결정하나요? jahng-heh-deung-geu-beun geun-roh-bohk-jjee-gohng-dah-nee gyuhl-juhng-hah-nah-yoh?
RR: Janghaedeunggeubeun geunrobokjjigongdani gyeoljeonghanayo?
Does KCOMWEL decide the disability grade?
23 추가 진찰을 받아야 하나요? choo-gah jeen-chah-reul bah-dah-yah hah-nah-yoh?
RR: Chuga jinchareul badaya hanayo?
Do I need an additional examination?
24 접수증과 결정 통지서를 보관하겠습니다. juhp-ssoo-jeung-gwah gyuhl-juhng tohng-jee-suh-reul boh-gwahn-hah-geht-sseum-nee-dah.
RR: Jeopssujeunggwa gyeoljeong tongjiseoreul bogwanhagetsseumnida.
I will keep the receipt and decision notice.
20 words to recognize

20 words to recognize

# Korean Pronunciation Meaning
1 장해급여 jahng-heh-geu-byuh
RR: Janghaegeubyeo
disability benefit
2 치유일 chee-yoo-eel
RR: Chiyuil
healing date
3 장해 jahng-heh
RR: Janghae
disability
4 장해급여 청구서 jahng-heh-geu-byuh chuhng-goo-suh
RR: Janghaegeubyeo cheongguseo
disability-benefit claim
5 재해 발생일 jeh-heh bahl-sehng-eel
RR: Jaehae balsaengil
accident date
6 수령 계좌 soo-ryuhng gyeh-jwah
RR: Suryeong gyejwa
receiving account
7 보험급여 전용계좌 boh-huhm-geu-byuh juh-nyohng-gyeh-jwah
RR: Boheomgeubyeo jeonyonggyejwa
benefit-only account
8 동일 사유 보상 dohng-eel sah-yoo boh-sahng
RR: Dongil sayu bosang
same-cause compensation
9 기존 장해 gee-john jahng-heh
RR: Gijon janghae
pre-existing disability
10 장해진단서 jahng-heh-jeen-dahn-suh
RR: Janghaejindanseo
disability diagnosis
11 초진일 choh-jee-neel
RR: Chojinil
first treatment date
12 상병명 sahng-byuhng-myuhng
RR: Sangbyeongmyeong
diagnosed condition
13 장해 부위 jahng-heh boo-wee
RR: Janghae buwi
affected body part
14 검사 소견 guhm-sah soh-gyuhn
RR: Geomsa sogyeon
test finding
15 진료기록부 jeen-ryoh-gee-rohk-ppoo
RR: Jinryogirokppu
medical record
16 방사선 검사 자료 bahng-sah-suhn guhm-sah jah-ryoh
RR: Bangsaseon geomsa jaryo
radiology data
17 대행 제출 동의 deh-hehng jeh-chool dohng-ui
RR: Daehaeng jechul dongui
proxy-filing consent
18 장해등급 jahng-heh-deung-geup
RR: Janghaedeunggeup
disability grade
19 장해보상연금 jahng-heh-boh-sahng-yuhn-geum
RR: Janghaebosangyeongeum
disability pension
20 장해보상일시금 jahng-heh-boh-sahng-eel-see-geum
RR: Janghaebosangilsigeum
disability lump sum
Replies you may hear

Replies you may hear

  • 치유된 뒤 장해가 남아야 청구할 수 있습니다. – You may claim after healing if a disability remains.
  • 별지 제11호와 장해진단서를 함께 제출하세요. – Submit Form 11 with the disability diagnosis.
  • 의학적 소견은 주치의가 작성합니다. – The attending doctor completes the medical opinion.
  • 기존 장해와 같은 사유의 보상을 사실대로 적으세요. – Report pre-existing disability and same-cause compensation truthfully.
  • 진료기록과 검사 자료가 추가로 필요할 수 있습니다. – Medical records and test data may also be required.
  • 대행 제출 동의와 홍보 동의는 서로 다른 항목입니다. – Proxy-filing consent and promotional consent are separate.
  • 장해등급과 지급 방식은 공단 결정 후 안내됩니다. – KCOMWEL explains the grade and payment method after its decision.
  • 접수 뒤 본인 확인이나 추가 진찰을 요청할 수 있습니다. – Identity confirmation or another examination may be requested.
Two form-preparation dialogues

Two form-preparation dialogues

1

청구인: 장해급여를 청구하려고 합니다.

담당자: 치유일과 재해 발생일을 먼저 확인하세요.

청구인: 장해진단서와 진료기록을 준비했습니다.

담당자: 기존 장해와 동일 사유 보상도 사실대로 표시하세요.

청구인: 본인 계좌를 적고 직접 제출하겠습니다.

The claimant checks healing, accident, claimant fields, account, prior disability, attachments and filing route.

2

청구인: 연금과 일시금 중 지금 선택하나요?

담당자: 장해등급 결정 뒤 선택 대상이면 설명을 받습니다.

청구인: 의사가 제 등급을 정하는 건가요?

담당자: 의사는 소견을 쓰고 최종 등급은 공단이 결정합니다.

청구인: 접수증과 결정 통지서를 보관하겠습니다.

KCOMWEL explains the grade and any permitted pension or lump-sum choice after medical review.

Industrial accident disability benefit claim: 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 fill medical opinions yourself, hide prior compensation, assume a grade, or publish identity, bank or medical data. Ask KCOMWEL which diagnosis page fits your body part.

Prepared by BSKorean Content Studio. Official KCOMWEL compensation rules, Forms 11 and 12, and Article 57 were checked on 26 August 2026.

Official sources checked

Industrial accident disability benefit claim: 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.

Practise these phrases in the BSKorean app →

View all 24 episodes

Industrial accident disability benefit claim: questions foreign workers often ask

What should I confirm before using this form?

Claim type and identity: mark disability benefits, not preventive management, and copy the claimant's name and birth date exactly. Enter the work-accident date from the accepted case record.

Which details should I check twice?

Receiving account: answer whether the account changes, then use an ordinary account or benefit-only account in the claimant's name. Recheck bank, number and holder.

Where should I get the form?

Use the official original and official source links in this guide. Check the form date again before filing.