The Workmen’s Compensation is instituted by the Compensation for Occupational Injuries and Diseases Act, to provide for the compensation of disability caused by work-related injuries or disease contracted by an employee during employment, or for death which occurred from such injuries or diseases; and to provide aid for matters connected therewith.
This fund provides cover to an employee who is permanently employed, a domestic worker in a division of a boarding house, an apprentice or trainee working in the agriculture sector of farming and a worker paid by a labour agency.
This is a form of insurance which provides for lost wages, medical expenses and rehabilitation costs of an employee who has been injured or fell ill during the scope of duty. It also pays death benefits to dependants of employees who die while performing their job.
In South Africa it is compulsory to register for Workmen’s Compensation with the Department of Labour for any employer that has one or more employees.
The procedure goes as follows:
Registration of employers is done via the Department of Labour. Once the registration is complete the employer will be required to submit Returns of Earnings in terms of Section 82 of the COID Act. The deadline for submission of the returns is March 31st annually.
A yearly contribution is paid to the Workman’s Compensation Fund and this figure is determined as a percentage of how much your business spends on the annual salaries for all employees and the risk factor calculated for the particular industry.
Submission of ROE must be made to the fund once a year, every year, to be compliant with the fund.
The WCA submission will require the following:
- A summary of all Salaries paid into previous financial year – 1st March to 28th February
- An estimate of all salaries to be paid in the upcoming year – 1st March to 28th February
- Submission is done online via the Department of Labour website
- An invoice will be issued which the employer will need to pay
- Letter of Good Standing will be issued
The letter of good standing must be requested and will be issued if the company is compliant, meaning that the company has submitted all of its annual return of earnings and paid the resulting calculated liabilities due. It is often essential to provide this document when the company engages in various business activities.
There are four main claim categories for the employees and these are separated into different types of payments:
For temporary disability
This means that the worker will eventually get better, and the worker should be put off work by a doctor. If the worker is off duty for a minimum of 3 days, no compensation will be paid – the sick leave pay of the employee can be utilised for that. If the worker is off for more than 3 days, the worker received compensation which includes the first 3 days. Temporary disability can be classified as total or partial.
For permanent disability
This indicates that a worker will not fully recover from the injury or sickness, it prevents the worker from working in the long run. This may be paid monthly or as a lump sum.
This can be claimed by the widow or dependents if a worker dies due to a work-related accident or disease. However, the necessary documentation proving that you are a widow or dependent will be required.
For medical expenses
This is for a worker who is injured, dies or incurred an occupational disease due to the negligence of the employer, or a defect in operational tools and machinery used within the employment place. The worker may be entitled to additional compensation for temporary or permanent disability. There is an extra compensation for any worker who is under 26 years at the time of the injury or disease
Compensation benefits will not be paid if:
- The accident is reported to the employer more than 12 months after the accident or death, or after the disease was diagnosed
- The employee is off work for less than 3 days, only medical expenses will be paid by the fund
- The accident was due to the employee’s own negligence or wrongdoing as an employee
- The employee refuses or wilfully neglects to have medical treatment
There are various reasons claims could be denied or underpaid. It can be argued that the employee’s accident did not occur at work, especially if there were no other witnesses. It could be insisted that the injuries are due to a prior health condition. The timing could be another reason for denial. Claims are often rejected when not filed immediately after the accident, or if the employee did not file claims until after they left the job or were terminated.