• The Minister of Labor and Social Affairs

• After reviewing the Social Insurance Law issued by Royal Decree No. (M/33) dated 3/9/1421 AH.

• And the executive regulations of the previous Social Insurance Law in the areas of registration rules and procedures, determining and collecting contributions, classifying establishments, and the principles of submitting objections, rules and procedures for applying the pensions branch, rules and procedures for applying the occupational hazards branch, rules and procedures for organizing work in inspection bodies, and rules and procedures for the work of medical committees issued by the decisions of the Minister of Labor and Social Affairs No. (2/Insurance) dated 11/9/1392 AH, No. (15/Insurance) dated 28/1/1395 AH, No. (19/Insurance) dated 7/11/1395 AH, No. (61/Insurance) dated 6/4/1402 AH, No. (104/Insurance) dated 12/3/1411 AH, and the amended decisions thereto.

• In light of the requirements of the new law for the necessity of issuing new executive regulations that take into account the provisions it has introduced and the amendments it has made.

• Based on the decision of the Board of Directors of the General Organization for Social Insurance No. (735) dated 25/10/1421 AH regarding the executive regulations it approved as a replacement for the aforementioned regulations.

• The following is decided:

  • Article One

    • The attached regulations regarding the implementation of the provisions of the Social Insurance Law issued by Royal Decree No. (M/33) dated 3/9/1421 AH shall be enforced as follows:-

      • 1- Registration and Contributions Regulation.

      • 2- Pensions Branch Compensation Regulation.

      • 3- Occupational Hazards Branch Compensation Regulation.

      • 4- Medical Committees Regulation.

  • Article Two

    • In the context of defining the terms mentioned in the regulations referred to in the previous article, reference is made to their meanings as stated in Article Two of the law in addition to the definitions included in each of the attached regulations for the terms unique to them, in addition to the meanings specified next to the following terms:-

      • 1- The Law: The Social Insurance Law issued by Royal Decree No. (M/33) dated 3/9/1421 AH.

      • 2- The Previous Law: The Social Insurance Law issued by Royal Decree No. M/22 dated 6/9/1389 AH.

  • Article Three

    • The provisions of these executive regulations are considered complementary, explanatory, and detailed to the provisions of the law.

  • Article Four

    • 1- The Governor of the General Organization for Social Insurance shall determine the form and specifications of the necessary models and certificates for implementing the attached regulations, the conditions and terms of their use, and the deadlines for their submission, and he has the authority to make any changes regarding them, whether by amending them through deletion or addition, or by merging some with others, or canceling any of them, or creating any new models or certificates, and he may clarify or detail what needs to be clarified or detailed from the provisions of those regulations.

    • 2- The Governor may, as required by the interest of the smooth operation, require all or some employers to comply with electronic dealings with the organization.

    • 3- The Governor may dispense with the requirement to submit the documents stipulated in the attached regulations if the organization has the data of those documents by any other means whenever it is easier for the organization’s work system, especially what is compatible with the automated methods for registration and disbursement of compensations.

    • 4- The Governor may delegate some of his powers stipulated in the attached regulations to those he designates from the organization’s employees.

  • Article Five

    • 1- In application of the provisions of paragraph (2) of Article (68) of the law, the executive regulations of the previous law issued by the ministerial decisions referred to in the introduction of this decision are canceled.

    • 2- The decisions issued previously that include special treatments for cases of categories of employers or categories of participating workers shall remain in effect, provided they do not conflict with the provisions of the law and the attached regulations.

    • 3- The decisions issued in the areas of organizing work or its implementation procedures shall remain in effect as long as they do not conflict with the provisions of the law and the mentioned regulations until they are amended or replaced by new decisions.

  • Article Six

    • This decision and the attached regulations shall be published in the official gazette, and shall take effect from the specified date for the implementation of the law, and the Governor of the General Organization for Social Insurance shall take the necessary measures for its implementation.

•  

• Minister of Labor and Social Affairs

• Ali bin Ibrahim Al-Namlah

1- The primary medical committees referred to in paragraph (1) of Article (53) of the Law shall consist of at least two doctors, one of whom shall represent the institution whenever possible, with one committee in each office of the institution in the regions and governorates. The governor of the institution may merge the functions of two or more committees into one committee based on the volume of work and its needs.
2- The appellate medical committee referred to in paragraph (2) of Article (53) of the Law shall be formed at the main center from at least three doctors who are outside the institution.
3- Without prejudice to the provisions of the previous two paragraphs, the governor shall select the members of the primary and appellate medical committees from among the doctors of the institution, doctors of the Ministry of Health, or other qualified medical professionals, either through secondment or contracting, provided that there is a specialist in occupational medicine among these doctors in each committee as much as possible.

• Appeal Medical Committee meets at GOSI office, and may, if necessary, to take place in another place with the consent of the Governor. 

• Primary medical committee meets at the headquarters of the competent office, and may, if necessary, to take place in another place with the consent of the competent manager.

• Primary medical committee meets once a month at least as long as any of the cases offered her. 

• Competent Director determines the dates of the Medical Committee in coordination with the Physicians Committee members. 

• If one of the members of the Medical Committee of Appeal fails to appear for any reason, and resulted in his absence that the number of members of the Committee became less than three doctors governor laments another doctor to be replaced at his absence who should not be member of the Committee, which issued the challenged decisions. 

• In the event of default by one of the members of the medical committee for elementary attendance for any reason, and resulted from his absence that the number of members of the Committee became smaller than two doctors, competent manager replace him during period of his absence. 

The following procedures shall be followed upon receiving a request for establishment of an occupational or non-occupational disability state of a contributor:

• The contributor’s cases shall be presented to the Office physician who may medically examine the contributor of refer him to the appropriate medical body for undergoing the necessary medical examinations before being presented to the Board. The contributor shall submit his medical reports to the said Office physician.

• Where all the medical reports and examinations deemed to be necessary by the Office physician are completed, the Secretary to the Medical Board shall refer to the contributor to the Board on the date fixed by the Office Director for the session and shall notify the contributor of the fixed time of the session. 

• As an exception of the provisions of the preceding two paragraphs, there shall be no consideration of the employment injury cases for which five or more years have elapsed without submission of an application and receipt of an injury notification, unless Governor’s approval of the tolerance of the delay is issued.

Board members or the one the Board authorizes to do so and submit thereto a report, if the Board or Office physician is of the opinion that the physical condition of the contributor or beneficiary does not enable him to appear before the Board.

2. For the purposes of determining the jurisdiction of the Primary Medical Board, if the contributor or beneficiary is present in a place falling within the jurisdiction of another Medical Board, his case may be examined by the Medical Board operating in the place where he is present. 

3. As an exception of the provisions of paragraph (1), the Medical Board may consider the medical reports and laboratory tests as sufficient for the purposes of establishment or continuity of the disability state in the following cases:

a. If the case is appealed against to the Appeal Medical Board, the contributor has left the Kingdom and the Board is satisfied with the adequacy of the report submitted in respect of this case. 

b. In case the medical reports required by the Medical Boards for the establishment of the state of the disability are submitted after the contributor’s departure from the Kingdom as supplementary to previous medical examination by the Medical Board.

c. If the contributor, who is afflicted with a non-occupational disability, is only entitled to lump sum compensation.

d. In case of submission of the medical reports required by the Medical Boards for periodical re-examination of the contributor or beneficiary.

e. Where the case of any family member is considered for the establishment of his earning incapacity.

f. Such other cases as the Governor may permit the Board to be satisfied with the medical reports without the requirement of the contributor to appear before the Board. 

4. In all cases referred to in sub-paragraphs (a), (b), (d) and (e) of paragraph (3), the Governor may require to have the contributor or beneficiary subjected to medical examination under the supervision of the Organization, if he deems such action to be necessary in any of the cases.

5. The Governor shall determine the conditions that shall be satisfied by the medical reports and the tests that shall be made outside the Kingdom in order to be considered as reliable.

1- Without prejudice to the provisions of paragraph (2) of Article (39) of the Law, in order to prove non-professional disability for the insured, the conditions for establishing disability as defined in the insurance context in paragraph (6) of the aforementioned article must be met. The medical committee, when examining the insured after leaving the work subject to the Law, must determine the date of the onset of disability from the date on which all legal and medical conditions were met.
2- The primary medical committees must not declare a permanent disability status for the injured party - if any - except after completing all treatment requirements and stabilizing the condition of the injured party. These committees may examine the injured party while they are still in the treatment facility and issue their decision regarding the establishment of permanent disability before the injured party leaves the treatment facility if they are assured that the injured party has completed all treatment requirements and their condition has stabilized.
3- If it becomes apparent to the treatment facility or the office physician that the health condition of the non-Saudi injured party does not allow them to return to work and that they must leave the hospital to return to their country directly, the medical committee may issue its decision before the injured party leaves the treatment facility in accordance with the provisions of paragraph (2) of this article. In this case, the office must coordinate with the employer to arrange the injured party's travel procedures to their country, ensuring that compensation is paid to them in a timely manner before their departure. The receipt of compensation by the injured party shall terminate all their rights against the institution, and the governor shall put in place the necessary arrangements and controls to ensure that the institution does not bear the costs of treatment or additional allowances after the date set for the injured party's travel.