Occupational disease appraisal is very different from general medical malpractice appraisal, medical malpractice appraisal is mainly to determine whether there is any medical negligence in the case, whether the negligent behavior constitutes an accident, whether there is any causal relationship with the patient’s death or disability, and if there is such a causal relationship, how great the correlation is. The identification of occupational disease is mainly to determine whether the patient has an occupational disease, i.e., whether the diagnosis is an occupational disease or not. Wuhan Union Medical College Hospital Respiratory Medicine Xin Jianbao occupational disease identification needs to make accurate judgment on the diagnosis of the disease, which is a very tricky job. Generally speaking, when the request for identification of occupational diseases, there is often a very big controversy, how to make the identification of occupational diseases to be fair, reasonable and accurate, its not a medical problem, often a non-medical problem. The diagnosis of occupational diseases should be made on the basis of the diagnostic criteria for occupational diseases, combined with the history of exposure to occupational disease hazards, testing and evaluation of occupational disease hazards in the workplace, clinical manifestations and the results of medical examinations, and other information, and make a comprehensive analysis. If the above information is perfect and complete, and the clinical manifestations are typical, the diagnosis of occupational diseases will not be difficult. However, as the identification of occupational diseases, the information is often incomplete or objectionable, so the identification of occupational diseases is quite difficult. In the process of identification of occupational diseases, there are often such phenomena, occupational disease history is not clear, such as lungs have very obvious lesions, but the patient said the occupational history of a very short period of time, the resulting signs of lesions with the occupational history of the interpretation of the insufficient; some of the patient’s occupational history of a clear, but due to the physical damage caused by the other non-occupational diseases and confusion; there are also patients with a clear occupational history of the occupationally induced damage also existed There are also patients with clear occupational history and occupationally induced damages that do not meet the national diagnostic criteria for occupational diseases; in particular, despite the occupational damages, they are acute or reversible, and the damages do not exist at the time of identification of the occupational disease, and many other phenomena, which make the identification of the occupational disease quite difficult. In the case of non-occupational diseases, diagnosis of an occupational disease may result in misdiagnosis and delay in diagnosis and treatment; in the case of occupational diseases, failure to diagnose in a timely manner may result in workers failing to receive their due compensation. Therefore, the identification of occupational diseases is very different from the general identification of medical accidents, it is not only a medical problem, or a very important social issues, to deal with the difficulties associated with not only requires a wealth of medical knowledge, but also requires a certain degree of artistic skill. Generally speaking, the diagnostic criteria for occupational diseases cannot cover all the occupational diseases caused by occupational damage, therefore, when making a diagnosis of occupational diseases, even though the basis for diagnosing occupational diseases is not sufficient, according to Article 42 of the Law of the People’s Republic of China on the Prevention and Control of Occupational Diseases, those who do not have any evidence to negate the inevitable connection between the occupational disease hazardous factors and the patient’s clinical clinical manifestations should be diagnosed after excluding other disease-causing factors (c) Occupational diseases. Although this provision does not appear to be evidence-based, it can sometimes play a very significant role in the identification of occupational diseases. For example, if a worker is exposed to a special kind of smoke at work and has certain mild respiratory symptoms, although he does not meet the diagnostic criteria of occupational acute respiratory disease, but we cannot rule out the inevitable connection between his respiratory symptoms and the exposure to smoke, so we can diagnose his bronchitis symptoms accordingly according to the Law on the Prevention and Control of Occupational Diseases. However, it would be wrong to diagnose it as chemical pneumonia, because chemical pneumonia without appropriate active treatment will often develop into acute respiratory failure and death, and even with active treatment there is still a high case fatality rate, and it would be against the law of medicine to diagnose it as chemical pneumonia. If there is a clear occupational history and clear symptoms and findings, even if the diagnostic institution fails to make a diagnosis, a diagnosis will often be obtained through an appraisal; even if an appraisal is not obtained, a more objective answer can generally be obtained through judicial consultation during the judicial process. However, if the diagnosis of an occupational disease is not met, neither the occupational disease diagnostic organization nor the appraisal organization will make a diagnosis of an occupational disease without a basis.