Enforcement Rules of the Labor Insurance Act Article 57

When applying for the payments of injury or sickness benefits in accordance with Article 33 or 34 of the Act, the following documents must be prepared:1.Injury or sickness benefits application form and payment Receipt.2.Written medical diagnosis of the injury or sickness. In the event that hospitalization is required, the documents prepared and issued by the hospitals concerned which contain the names of the injury or sickness and the dates of hospitalization and discharge can be served as substitutes.Instead of the “Written Medical Diagnosis of the Injury or Sickness” referred to in Subparagraph 2 of the preceding paragraph, the applicant may alternatively provide a certifying document issued by the hospital or clinic where he/she receives the medical treatment, carrying the name of the injury or sickness, the period of medical service and other details.Those who suffer from pneumoconiosis should submit their certificate of diagnosis for pneumoconiosis, a form stating previous work experience in dusty workplaces, and relevant imaging tests when claiming Occupational Disease Compensation for the first time. However, it is not necessary to submit these documents if the insurer confirms that the employee has previously been hospitalized due to pneumoconiosis.
中文原文 勞工保險條例施行細則第57條
依本條例第三十三條或第三十四條規定請領傷病給付者,應備下列書件:
一、傷病給付申請書及給付收據。
二、傷病診斷書。
前項第二款所定傷病診斷書,得以就診醫院、診所開具載有傷病名稱、醫療期間及經過之證明文件代之。
罹患塵肺症,初次請領職業病補償費時,並應附送塵肺症診斷書、粉塵作業職歷報告書及相關影像圖片。
但經保險人核定以塵肺症住院有案者,得免再附送。

English translation for reference only; the Chinese text prevails. Not legal advice.