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Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

Notices

Notice on Documents required to be provided by Employers to the Compensation Fund to support Injury on Duty and Occupational Disease Claims

6. Awarding a Claim and different types of benefits

 

Compensation is based on the earnings as at the time of the accident or date of diagnosis (including minimum and maximum earnings) as published in the relevant Government Gazette related to the specific date of accident and year.

 

6.1 Temporary Total Disablement (TTD and Temporary Partial Disablement (TPD)—

performing light duty during period of recuperation:

 

TTD is payable when an employee was booked off from 3 days by the treating doctor to recuperate from the injuries/condition in respect of the occupational diseases suffered at the time of the accident/diagnosis.

 

PLEASE NOTE THAT EXEMPTED EMPLOYERS ARE EXCLUDED FROM PAYING TTD/TPD BENEFITS TO THEIR EMPLOYEE'S

 

6.1.1 Documents /information required for processing TTD/TPD benefits:
• Pay slip of the employee's earnings as at the time of accident/diagnosis. In the case where the employee is earning allowances of a regular nature, these allowances should also be indicated - please refer to Section 63 of COIDA.
• Duly completed, dated and signed Resumption Report (W.CI.6) by the employer indicating the period the employee was off duty as a result of the accident/occupational disease and the amount of advances paid during this period.
• In the case where the employee is not in the service of the employer anymore or where the employer is not claiming benefits on behalf of the employee, the employee needs to submit a duly completed, dated and attested Affidavit (W.CI.132) claiming compensation. This needs to be submitted on a monthly basis until the employee's condition stabilizes.
• Progress Medical Reports (W.CI.5P) indicating the treatment administered and period(s) the employee is unfit for work, including Operation reports, if applicable.
• As soon as the employee's condition stabilizes, a Final Medical Report (W.CI.5F) indicating the date on which the employee was fit to return to work or the date on which the employee's condition has stabilised, should be submitted.
• Where the employee is off duty for a prolonged period due to injury(ies) a Progress Medical Report (W.CI.5) should be submitted on a monthly basis together with the Resumption Report (W.CI.6) until the employee's condition stabilizes.

 

6.2        Permanent Disablement: (PD)

PD is payable when the employee has a permanent anatomical defect/and or impairment of function as a result of an accident/occupational disease. It can only be assessed when employee's condition has become stabilized and on the submission of a Final Medical Report or any other medical report confirming that the employee's condition stabilized.

 

A lump sum payment is payable when the PD is between 1% and 30% and when the PD % is higher than 30 %, the employee will be entitled to the payment of a monthly pension, which will be paid until the date of death of such employee.

 

PERMANENT DISABLEMENT (LUMP SUMS AS WELL AS MONTHLY PENSIONS) FOR EXEMPTED EMPLOYEE'S ARE BEING PAID THROUGH THE GPAA, COMPENSATION FUND ISSUES AN AWARD.

 

6.2.1. Documents /information required for processing PD benefits:
• Pay slip of the employee's earnings as at the time of accident/diagnosis. In the case where the employee is earning allowances of a regular nature, these allowances should also be indicated - please refer to Section 63 of COIDA.
• Final Medical Report (W.CI.5F)
• Additional reports such as Hand Report (W.CI.31), Foot Report (W.CI.221) or an Eye Report (W.C1.52)
• Occupational Therapist Report, duly completed, dated and signed by the therapist and confirmed by the treating doctor/specialist.
• Final Medical Report by the Psychiatrist (W.CI.304) for PTSD claims
• Final Medical Report (W.CI.26) for Occupational Diseases
• Final Medical Report (W.CI.26) with the most recent lung function tests, which includes pre- and post- administration of a bronchodilator, and medication prescribed.
• Two diagnostic audiograms for claims where the employee has suffered hearing loss

 

6.2.2        Calculation of PD lump sum

PD is calculated on the earnings as at the time of the accident/death

 

6.3        Fatal Claims:

In the case where an employee dies as a result of an accident or their deaths are as a result of injuries that had been sustained from an IOD /OD, a pension becomes payable to the surviving spouse(s) and dependent children under the age of 18 at the time of death.

 

6.3.1 The following documents are required to consider payment of compensation to the dependents of the deceased:
• Pay slip of the employee's earnings as at the time of accident/diagnosis. In the case where the employee is earning allowances of a regular nature, these allowances should also be indicated - please refer to Section 63 of COIDA.
• Death certificate indicating the cause of death or the Notice of death /post modem citing the cause of death presumption of death from the Department of Home Affairs if the body could not be found
• Marriage certificate or Customary Union Certificate
• Un-abridged birth certificates of children under the age of 18 and In the case of disabled children, who can claim beyond the age of 18.
• Duly completed, dated and signed declaration by dependant Widow /widower/guardian (W.CL.32) attested by a Commissioner of Oaths,
• Notice of Accident and Claim for Compensation (W.CL.3/14), page one and two,
• Certified copy of the widow /widower's ID document,
• Specified Burial Expenses Account (W.CI.46) with receipt(s) if paid.

 

6.4 Commutation of pensions:

In terms of Section 52/60 of the Act, the DG may direct the payment of a lump sum or a portion thereof upon receipt of an application by the pensioner. This forms part of the discretionary powers of the DG and the payment of such lump sum shall be subject to the control of the DG.

 

Commutation of the pension of a child may not be considered.

 

 

COIDA BENEFITS DO NOT FORM PART OF A DECEASED'S ESTATE-SECTION 34.

 

 

 

Vuyo Mafata

Compensation Commissioner

Date: 06/09/2018