You and Your Rights: COIDA
- Even an employee being trained by the employer can claim compensation
- A domestic worker employed in a household, as opposed to a hotel or other business, cannot claim compensation under the Act
- Only the employer, not the employee, must contribute to the Compensation fund and do so without deducting wages
- Extra compensation is awarded in the event that disability was caused by negligence on the part of the employer
- When a workplace injury occurs, it is important to take note of witnesses as well as report the incident to your employer immediately
What is COIDA?
COIDA stands for the ‘Compensation for Occupational Injuries and Diseases Act’. If you are injured whilst you are doing your work or become sick as a result of your work, you can claim compensation from the Compensation Fund. Families or dependants can also claim if their breadwinner dies as a result of a work-related accident or disease.
Who can claim compensation?
Any employee who is permanently or casually employed, or being trained by an employer can claim from the compensation fund.
The Compensation Fund covers employee's who:
- were hurt in an accident while busy with their work;
- contracted an occupational disease or illness through their work;
- died from a workplace accident or occupational disease.
There are some categories of employee's that CANNOT claim because they are not covered by the fund.
For example, you CANNOT claim if you are:
- a domestic worker in a private home (BUT you can claim if you are a domestic worker employed by a business such as a hotel or guest house);
- a member of the South African National Defence Force or South African Police Services (they have their own fund);
- an employee who works outside South Africa for more than 12 months at a time, unless there is a special agreement with the Commissioner.
Who contributes to the Fund?
Employers pay into the Compensation Fund once a month. Employee's do not pay anything into the Fund. Employers cannot deduct money from the employee's wages as contributions to the Fund.
When will the Fund NOT pay Compensation?
Claims will only be paid if they are submitted in the correct way within the proper time limit.
The claim will NOT be paid if:
- the claim is made more than 12 months after the injury or death, or more than 12 months after the disease is diagnosed;
- you are off work for 3 days or less. This is not covered by the Compensation Fund, but it may be covered by the employee's own medical aid or sick leave fund;
- the accident or injury is a result of your own wrong doing or misconduct, unless the employee was seriously disabled or died as a result of the accident;
- you unreasonably refuse to have medical treatment.
What Compensation can be claimed?
There are five main types of compensation:
- Temporary disability
- Permanent disability
- Medical Expenses
- Additional Compensation
Compensation is worked out as a percentage of the wage the employee was earning at the time the injury occurred or disease was diagnosed.
The Compensation Fund does not pay for pain or suffering, only for loss of movement or use of your body.
Temporary disability means that the employee will eventually get better.
- If you are off work for 3 days or less, no compensation will be paid.
- However if you are off for more than 3 days, you will receive compensation that also covers the first 3 days.
- Temporary disability can be total or partial.
- If you have a total temporary disability and cannot work at all, you will receive 75% of your normal weekly or monthly wage. If you have a partial temporary disability and are able to do some of your work or light duties at less than your normal wage, you will be paid 75% of the difference between what you got paid and your normal wage from before the injury.
- You can claim compensation for temporary disability for 12 months. If the condition has not improved after 12 months, the Commissioner may agree to continue payments for up to 24 months. After 24 months the Commissioner may decide that the condition is permanent and grant compensation on the basis of permanent disability.
A permanent disability is an injury or illness that you will never fully recover from.
Disabilities are rated from 100% to 1% depending on the seriousness.
Your doctor will need to write a medical report about your permanent disability, which the Commissioner, together with a panel of doctors, will use to work out the percentage of disability set out in Schedule 2 of the Compensation for Occupational Injuries and Diseases Act.
- Loss of two limbs……………………………..100%
- Loss of hearing in both ears…………….50%
- Loss of sight in one eye…………....…..30%
- Loss of small toe………………………………..1%
If the disability is measured at more than 30%, you will receive a monthly pension for the rest of your life. The amount of pension you receive will be worked out from your wages at the time of the injury as well as the percentage of disability.
If the injury is 30% or less, you will receive a once off lump sum payment.
Death Benefits Compensation can be claimed by the widow or dependants if an employee dies as a result of an occupational injury or disease.
The amount of compensation you will be paid depends on your relationship to the deceased, but the total amount paid to the family cannot be more than the pension the deceased employee would have received if he or she was 100% disabled (i.e. 75% of the monthly wage).
The spouse will receive a lump sum of 2 X 75% of the employees wages plus a monthly pension for life of 40% X 75% of the employee's wages.
The employee's dependent children under the age of 18 are entitled to a monthly pension of 20% X 75%. This pension will stop once the child is 18 years old, but may continue for longer if the child has a mental or physical disability.
If there is no spouse or children, the compensation may be paid to other dependent family members (for example, the employee's parents).
The amount of compensation paid will depend on whether the claimant was fully or partially dependent on the employee.
You will need to submit certified copies of the following documents to apply for death benefits:
- Marriage certificate
- Children’s birth certificates
- Death Certificate
- Declaration by the Spouse (form WCL32)
- The Employer’s incident report
- Funeral accounts (form WCL46)
- Details of your income and property
All medical expenses of an employee will be paid for up to two years from the date of the accident or diagnosis of the disease.
These medical accounts should all be submitted to the Compensation Commissioner.
In addition to the general compensation, you can get extra compensation if the injury or disease was caused by the employer’s negligence or a fault with your work equipment or machinery.
Any employee who is under 26 years will receive extra compensation. An application for additional compensation must be made on form W930 within 24 months of the injury or disease being diagnosed.
How do you claim Compensation?
- You must report your injury to your employer or supervisor immediately. Make a note of anyone who witnessed the accident. The form that must be completed is a WCL 2: Notice of Accident and Claim for Compensation.
- Your employer is then legally responsible for reporting your injury to the Compensation Commissioner by submitting a Form WCL 3: Employer’s Report of the Accident.
- The employer must report a workplace injury within 7 days or within 14 days of finding out that the employee has an occupational disease. The employer has a duty to report it, even if they don’t believe the accident or disease is work-related.
- Within 14 days of seeing the employee, the doctor must fill in a WCL 4 first medical report stating how serious the injury was and how long the employee is likely to be off work. This form should be sent to the employer to send to the Commissioner. The employee does not pay the doctor’s fees, unless you want a second medical opinion in which case the employee would have to pay for this.
- If the injury will take a long time to heal, the doctor must send regular progress reports (WCL 5) to the Commissioner every month to advise how long the employee will be off work.
- The doctor must submit a final doctor’s report stating that the employee is fit to go back to work or that the employee is permanently disabled. This report is sent to the employer to send to the Commissioner.
- When the employee goes back to work, the employer must send a resumption report (WCL 6) to the Commissioner stating when the employee went back to work and how much the employee has been paid in compensation.
- When the first doctor’s report has been submitted with the accident report, the Compensation Commissioner will consider the claim and make a decision as to whether it is a work-related injury or disease or not.
- A claim number will also be allocated and this claim number should be quoted when dealing with the Compensation fund.
- If the employee disagrees with the decision, you have the right to appeal the decision within 90 days by submitting form W929 to the Compensation Commissioner, at PO Box 955, Pretoria, 0001.
Who pays the compensation claim?
The Compensation Commissioner is appointed to administer the Fund and approves employee’s claims.
The employee gets money from the Fund and not from the employer. BUT for the first three months or less that you are off work, the employer must pay you 75% of your normal monthly or weekly wage. Your employer can claim this back from the Compensation Fund.
If you are off for more than 3 months, the Compensation Commissioner takes over the monthly payments.