PRESENTATION ON COID ACT NO 130 of 1993 TRAINING 2018 PRESENTER CHIEF AVHATAKALI TSHIVHASE 083 757 7643 : E-mail. avhatakali.tshivhase@labour.gov.za
Definition of an accident Arising out of and in the Course of his employment and resulting in a personal injury, illness or the death of employee .
FOUR ELEMENTS OF AN ACCIDENT 1. ACCIDENT It is an untoward incident/accident/occurence/event of which the specific date, time and place can be determined . 2. ARISING OUT OF Means that an employee was doing what he/she was employed to do when accident occurred.
3. IN THE COURSE OF The employee must be busy doing his work during normal hours. 4. PERSONAL INJURY/ILLNESS OR DEATH Injuries could be visible or invisble. If there is no personal injury the claim will be repudiated.
WHO IS AN EMPLOYEE A person who has entered into a or works under a contract of service or of apprenticeship or learner ship, with an employer, whether it is express or implied, oral or writing and whether the remuneration is calculated by time or work done, or is in cash or in kind.
REPORTING PROCEDURES Employee 1. Must report the accident as soon as possible. Sect 38 of the Act. Must be done within 12 months after date of accident. Sect. 44 2. Should the employer failed to report employee has to complete a Notice of a claim and Claim for Compensation (W.Cl 3) . Rule 5 of the Act 3. Employee must assist employer to obtain the medical reports.
Employer 1. Has to report the accident by completing the Employers Report of an Accident (W.Cl 2) and with in 7 days. Sect 39 if the employer can not submit it electronically. 2. Obtain First Medical Report (W.Cl 4) 3. Progress Medical Reports (W.Cl 5) 4. Final Medical Reports (W.Cl. 5 F) 5. Resumption Report (W.Cl 6)
Medical Practitioner 1. Complete the First Medical Report (W.Cl 4) electronically or hard copy. Must be furnished with in 14 days after examination. Sect 74 (1). 2. Regular Progress Medical Report (W.Cl 5) 3. Final Medical Report (W.Cl. 5F)
ACCEPT LIABILITY To accept liability of a claim we need the following: 1. Employers Report of an Accident (W.Cl 2) duly completed 2. First Medical Report (W.Cl 4) with a full clinical description 3. All 4 elements of an accident must be indicated.
BENEFITS The following types of compensation can be paid out of the Compensation Fund 1. Temporary Total Disablement (TTD) 2. Permanent Disablement (PD) 3. Death benefits 4. Medical Costs.
What is Temporary Total Disablement or TTD? The time span from when an employee was injured and unable to work until he recovers or recuperates. It is temporary as employee will be fit to resume duties after a period of time .
PERMANENT DIABLEMENT (PD) What is PD If the injury results in a permanent anatomical defect, loss of function or disfigurement, which causes disablement for employment, the employee will be entitled to PD When is the degree of PD assessed When the employees condition became stabilised and the doctor completes the Final Medical Report. Some time the Commissioner may decide to postpone the assessment. eg. Loss of movement of the joint.
What do we need to assess and pay PD The Final Medical Report (W.Cl 5) The employee does not have to complete any additional form. The Medical doctor should not assess but only describe the PD Additional report may also be required eg. Hand Report (W.Cl 31), Eye Report (W.Cl 52), Photos if the is scars No compensation is payable for pain and suffering
How is PD assessed Schedule 2 of the Act prescribes the % of PD to be awarded for specific anatomical losses eg. amputations, lost of vision etc. The degree of the PD is assessed in the open labour market and does not take into consideration the occupation of the injured person or whether he is working or not. It is assessed i.r.o. anatomical loss and/or impairment of function only. Boarding is a matter between employee and employer. Employee is still allowed to work. It will not influence his PD assessment.
How is PD calculated In a lump sum. 30% PD or less Monthly pension. 31% and more. The amount of 30% is calculated as follows 15 times of an employee’s earning as at the time of the accident to a maximum and minimum of such earning. Less than 30% calculation 15 X earnings X PD% ÷ 30 PD i.r.o. 100% is calculated as follows 75% of the earnings subject to a maximum and minimum of such earnings. 31% - 99% PD is calculation proportionally
Pro rata pension: Should the employee be involved in more than one accident in respect of which small % of PD were assessed and lump sums paid a monthly pension will be awarded if the total degree of PD i r o all injuries amount to 31% and more. Additional pension: An additional pension is awarded when an employee has already been awarded a monthly pension.
If the employee was under the age of 26 or an apprentice at the time of the accident he will be compensated on his future probable earnings. Constant attendance allowance (CAA) If the injury of which compensation is payable causes disablement of such a nature that the employee is unable to perform the essential actions of life without the constant help of another person we can grant an allowances towards the costs of such help. Normally it is 100% PD CAA is 10% of the monthly salary or minimum or R1659
FATALS Compensation is payable to the dependants when an employee dies as a result of and accident or occupational desease. Who can be regarded as a dependant? A widow/widower as at the time of the accident A widow/widower who was party to a marriage according to indigenous law and customs, if neither the husband nor the wife was a party to a subsisting marriage If no widow/widower as above, a person with whom the employee was living together as husband and wife.
A child under the age of 18 years, except where such child is unable to earn an income owing to a physical or mental disability, or dies or marries before reaching the age of 18 years, or until the child completes secondary education, or while the child is undergoing tertiary education and it could reasonably have been expected that the employee would have contributed to the maintenance of that child, whichever occurs last; If no widow/widower or child, a parent or any other person who was wholly or partially financially dependant upon the employee.
What do we need W.Cl 2/1 Death certificate The following must be submitted by the dependants/claimants o Notice of Accident and Claim for Compensation (W.C.l 3) o Declaration (W.Cl. 32) o Certified copy of marriage certificate or any other proff of marraige or that they were living together as husband and wife at time of the accident. o Certified copy of ID/Birth certificate of widow/widower
the pension payable to a child referred to in paragraph (d) of the said definition shall lapse at the end of the month in which such child reaches the age of 18 years, except where such child is unable to earn an income owing to a physical or mental disability, or dies or marries before reaching the age of 18 years, or until the child completes secondary education, or while the child is undergoing tertiary education and it could reasonably have been expected that the employee would have contributed to the maintenance of that child, whichever occurs last;
o Burial expenses account (W.Cl. 46) o If employee was not married but had a child/children we required and Affidavit by the mother of the child or guardian of the child declaring herself that they are responsible for the upbringing of those children. o A letter from a person of authority confirming that the children are indeed under the care of that person. o Certified copy of ID of mother/guardian. o Certified copy of the children.
How is compensation calculated i.r.o. fatal cases The wife will receive a preliminary award in the form of a lump sum payment twice the monthly pension the deceased would have received if 100% permanent disabled. Widow/widower is entitled to a monthly pension of 40% of what the deceased would have received if 100% permanent disabled. A child receive 20% of what the deceased would have received if 100% permanent disabled. Three children will thus receive 60%. If there are more than 3 children they will share equally in the pension i r o 60%. Total pension can not be more than 100%.
If a child is mentally and/or physically disabled, the pension is paid for a period based on the life expectancy of the deceased employee. Pension is payable form the date of death of the employee. More than one wife the wives will share the 40% equally. Pensions are increased annually.
QUESTIONS
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