• 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, 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 circumstances for their use, and the deadlines for their submission. 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. He also has the authority to clarify or detail what needs to be clarified or detailed from the provisions of those regulations.

    • 2- The Governor may, as deemed necessary for the smooth operation of work, 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 certain 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 alternative decisions.

  • Article Six

    • This decision and the attached regulations shall be published in the official gazette and shall take effect from the date specified for the implementation of the law. 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

With due regard to the provisions of Article (5) of these Regulations, the employer shall, after providing the necessary first-aid, carry the injured person, if necessary, to the treatment center already designated for him and entered into contract with the Organization or to the public hospitals or health centers belonging thereto.

• 1- In providing medical care, treatment must be offered to the injured party regardless of its type, according to what their health condition necessitates, and for the duration required to complete their treatment until they are fully healed or their condition stabilizes, as determined by the treatment authority, and with the approval of the office's physician. The relevant office must monitor the treatment, and through its physician, it may examine the patient while they are receiving treatment to reach a sound decision regarding the end of the need for treatment due to healing or stabilization of the condition.

• 2- The following is included in the treatment:

  • A- Treatment of deformities resulting from the injury in necessary cases to enable the injured party to continue their work satisfactorily, or because the deformity affects their normal social life.

  • B- Rehabilitation of the injured parties and preparing them physically and professionally if their condition requires it.

  • C- Provision of prosthetic limbs and compensatory devices and their maintenance and renewal when necessary within the Kingdom, provided that their damage or breakage is not due to the negligence of the injured party or violation of treatment instructions.

  • D- Treatment of medical conditions that must be treated to achieve the healing of the injured party from the work injury.

  • E- Treatment of medical conditions that may afflict the injured party while they are hospitalized for treatment of the injury, whether this illness is a complication of the injury or a result of the method used for their treatment, or due to a bacterial infection that occurred as a result of their hospitalization for treatment of the injury, or due to an accidental incident that occurred during their stay for this purpose. The disability resulting from the aforementioned medical conditions is not considered a work injury, except in cases where the illness is a result of complications from the injury.

  • F- Treatment of a relapse of the work injury or its complications even if the injured party was not engaged in work subject to the system at the time of occurrence.

  • G- Any of the previous paragraphs shall be applied as deemed appropriate by the treatment authority and with the approval of the office's physician.

• The Organization shall take the necessary measures for the treatment of and provision of medical care to the injured person at the hospitals, medical centers and private clinics owned by it or entered into contract with for this purpose. If the required medical treatment is not available at such places, the Organization shall provide it at the public hospitals or its own health centers, according to the available facilities.

• The Organization may agree with and private medical center or and of the employers who have special centers for the treatment of and provision of the necessary medical care to their injured workers regardless whether or not such bodies have entered into contract with the Organization. The treatment expenses shall be reimbursed to such centers as agreed under contracts concluded between them and the Organization or for each case separately as per the prices agreed with the treatment centers entered into contract with the Organization. However, where no medical facilities are available at such centers for the treatment of certain injury cases, such cases shall be referred to the Organization's contracted medical bodies where the treatment facilities are available.

• In emergency cases, the injured person may resort to a licensed private treatment body such as a physician, private medical clinic or private hospital, provided that his condition does not tolerate transporting him to the treatment body already designated by the Organization, and that the injured person or the employer shall notify the appropriate office to this effect within three days from the date of resort to the said treatment body. The Office physician shall decide whether or not an emergency case exists. The Office Director may, for justifiable reasons, forego the delay in reporting.

• The Organization shall have the right to transfer the injured person to the treatment body already designated if his condition allows such transfer.

• The Organization shall pay the expenses of the treatment of the injured person at the treatment bodies referred to in paragraph (1) above within the prices already specified by the treating body according to the Governor's decision. The Governor may set out the maximum limits which shall be taken into account in payment of the expenses of treatment of various injuries at the said treatment bodies.

• As an exception of the provisions of paragraph (3), the Organization shall only pay the treatment expenses payable under the said provisions within the expenses limits prescribed by the treatment bodies owned by or entered into contract with the Organization, in the following cases:

  a. If notice is not served within the period prescribed in paragraph (1) above, and the appropriate Office Director has not accepted the excuse for delay.

  b. If the injured person refuses to move to the treatment body designated by the Organization under the provisions of paragraph (2) above.

  c. If the Organization discovers that the injured person's condition is not an emergency case that necessitates resort to a treatment body other than those already designated by it.

• If the required medical treatment is not available at the treatment body entered into contract with the Organization where the injured person is admitted as an inpatient, he shall be transferred to such other treatment body where the required treatment is available as specified by the Office Director regardless whether the Organization has or has not entered into contract therewith, in which case the Organization shall be responsible for the cost of his treatment at the medical center to which he has been transferred. However, if he has been transferred without the approval of the appropriate Office Director, the treatment costs shall only be reimbursed by the Governor's approval and within the rates of the medical centers contracted with or owned by the Organization.

• 1- The institution is obligated to cover the expenses of the injured person's transportation to and from the workplace or their residence - as applicable - to the authorities in the following cases:

  • A- To the location where treatment is received in accordance with the provisions of this Regulation.

  • B- To the location where the prosthetic device is fitted and rehabilitation for its use is conducted.

  • C- To the place of medical examinations of any kind, whether at treatment facilities, with the institution's doctor, or with the specialized medical committees.

• 2- If the specialized medical committee decides, based on the opinion of the treatment authority, that the injured person requires a companion during treatment, the institution shall bear the expenses of the companion's transportation and accommodation for the entire period determined by the committee, even if the injured person is spending their temporary recovery period within the country where they reside, as long as the committee deems it necessary.

• 3- Notwithstanding the provisions of paragraph (2), expenses for the transportation and accommodation of the companion shall not be entitled during the period the injured person spends at the treatment facility, unless the medical committee deems it necessary for the companion to stay with them.

• 4- If the condition of the injured person necessitates treatment outside the country where they reside, they are entitled to claim accommodation expenses for themselves and their companion if they are required to stay outside the hospital or treatment center, and it is proven that they incurred these accommodation expenses.

• 5- Subject to the provisions of paragraphs (2) and (3), the disbursement of transportation and accommodation expenses in all cases is contingent upon the transportation and accommodation being based on the approval of the competent authority designated by the institution.

• 6- The governor shall determine by his decision the expenses for the transportation and accommodation of the injured person and their companion, as well as the rules and procedures for disbursing them. (1)

• 1- The individual with a permanent total disability who requires assistance from others in their mobility and daily life shall be transferred to their place of residence in accordance with the decision made by the Primary Medical Committee. The employer shall undertake the necessary procedures and bear the associated costs, and the institution shall reimburse the employer for the cost of the injured party's ticket and their companion's ticket in economy class, in addition to the cost of the medical equipment that the Primary Medical Committee deems necessary for the injured party.

• 2- In applying the provisions of Article (37) of the Law, the institution is obligated to cover the expenses of transporting the body of any participant who has died due to a work-related injury, and any participant who has died while receiving a permanent disability benefit, to their place of residence, along with the expenses for washing and embalming the body, the shroud, the costs of transporting the body to the airport, the expenses for translating and certifying the necessary documents, any notifications required for the deceased's family, and any other expenses that the governor deems appropriate for the institution to bear to ensure the safe transport of the body. (1)