Abstract: Work injury cases are a major type of administrative litigation in China.In practice, such cases have been characterized by extensive “procedural idling” and difficulties in resolving the disputes, which have impeded the functioning of the work-injury insurance system.Existing substantive dispute resolution methods focus on improving judicial remedies but overlook the systemic causes of the disputes, failing to address the root of the problem.A comparison of different work injury risk protection models reveals that China's current work injury insurance system has blurred public-private boundaries, fragmented procedures, and lacks effective protection of the right to payment.Improving the work injury insurance system and replacing the existing system's cumbersome procedures of labor relationship confirmation, work injury determination, work injury insurance treatment determination, and treatment payment with a single work injury insurance benefit decision will resolve the intertwined civil and administrative disputes at their source, reduce the number of disputes, and activate the potential of administrative litigation to resolve disputes, protect rights, and promote welfare administration.This exploration of dispute resolution pathways also demonstrates a new approach to substantively resolving administrative disputes.Administrative disputes are the product of specific systems, and focusing on the impact of substantive legal system design on administrative dispute resolution is the essence of the rule-of-law-based “governance of the source of litigation”.

Key words: Work Injury Determination, Social Insurance, Welfare Administration, Substantive Resolution of Disputes

摘要： 工伤认定案件是我国行政诉讼的一个主要类型。实践中,这类案件存在大面积“程序空转”、案结难以事了的现象,阻碍了工伤保险制度功能的发挥。既有的实质性争议解决方案局限于对司法救济方式的改进,忽视了纠纷产生的制度原因,无法从源头上摆脱困境。比较不同的工伤风险保障模式会发现,我国现行工伤保险制度公私界限模糊,程序碎片化,缺乏对给付权利的有效保障。改进工伤保险制度,以工伤保险给付决定替代现有制度中劳动关系确认、工伤认定、工伤保险待遇认定、待遇给付等繁冗程序,将在源头上化解争议民行交织的现象、减少争议数量,并将激活行政诉讼制度中给付判决解决争议、保障权利、推动给付行政的制度潜能。这一争议解决出路的探讨也展示了行政争议实质性解决的新路径。行政争议是特定制度的产物,关注实体法律制度设计对行政争议解决的影响,才是法治化的“诉源治理”。

关键词: 工伤认定, 社会保险, 给付行政, 行政诉讼, 实质性解决争议