Claiming Compensation for Occupational Injuries or Diseases
Workers who are injured or contract a disease through their work are able to claim money from the Compensation Fund. Families can also claim if their breadwinner died through work related disease or injury.
WHO CAN CLAIM WORKER'S COMPENSATION?
The Compensation Fund covers workers who:
You can claim if you were injured or contracted a disease while
There are certain categories of worker who cannot claim from the fund. For example, you cannot claim if you are:
You can claim if you are:
Claims will only be paid if they are submitted in the correct way in the proper time. Claims will not be paid if:
WHO PAYS INTO THE FUND?
Employers pay into the Compensation Fund once a month. Workers do not pay anything to the Fund. Employers cannot deduct money from workers' wages as contributions to the Fund.
WHAT INJURIES AND DISEASES ARE COVERED?
The Fund covers occupational diseases and workplace injuries.
Occupational diseases are illnesses caused by substances or conditions that the worker was exposed to at the workplace. You can claim compensation if you are exposed to these working conditions and then get the related disease.
The working conditions and diseases caused by these conditions that are covered by the Compensation Fund are set out in Schedule 3 of the Act.
You can claim for other disease if you can prove using medical evidence and reports that the disease was caused by conditions at work.
The Fund also covers injuries that were sustained as a result of work or at the workplace.
WHAT CAN BE CLAIMED?
There are five kinds of compensation:
The Compensation Fund does not pay for pain and suffering, only for loss of movement or use of your body.
The amount of compensation that will be paid to the worker depends on how much the worker was earning when the injury was sustained or the disease diagnosed. If you are have stopped working by the time a disease is diagnosed, the compensation will be worked out according to what you would have been earning.
What is temporary disability?
Temporary disability is when you are unable to work or cannot do all your work because of an injury or disease but you will get better.
To claim for this, you need to be put off work by a doctor for more than three days. If you are put off work for longer than three days, you will get paid out for the whole time that you are unable to work (including the first three days).
What do you get paid?
If you cannot work at all, you will get paid out 75% (¾) of your normal monthly or weekly wage.
If you can only do some of your work, you will still get paid some wages by your employer. The Fund will pay you 75% (¾) of the difference between what you got paid and what you would have been paid before the injury.
All medical expenses are also paid if the accounts are submitted to the Commissioner.
How long can you claim for?
You can claim compensation for temporary disability for 12 months. This can be extended to 24 months. After 24 months the Commissioner may decide that the condition is permanent and grant compensation on the basis of permanent disability.
What is permanent disability?
A permanent disability is an injury or illness that the worker will never recover from, for example, losing an eye. The serious of the disability will determine whether the worker will never be able to work again or whether they will find work more difficult.
Disabilities are rated from 100% to 1% depending on the seriousness. For example, a 100% would be the loss of both your hands or the loss of your sight. The loss of your small toe is a 1% disability.
Your doctor will write a medical report about the disability. The Commissioner and various other doctors will then decide how serious the disability is.
How much compensation do you get?
If the disability is more than a 30% disability, you will get paid a monthly pension. The size of the pension depends on what your wages were and on the seriousness of the disability. If you have a 100% disability you will get paid 75% (¾ ) of your wages. If the disability is less serious, the following formula is used to work out the monthly payment: [wages * (75 ÷ 100)] * (disability% ÷ 100).
If the disability is less than a 30% disability, you will get paid a lump sum.
How long will the compensation be paid for?
The lump sum payment is a once off payment. The monthly payment will be paid for the rest of the worker's life.
If the bread-winner in your family was killed by an occupational injury or disease, you can claim from the Fund.
How much can you claim?
The amount of compensation that you will be paid depends on your relationship to the deceased. The total amount paid to the family cannot be more than the pension the deceased worker would have received if he/she was ¾ of the worker's wages per month.
The spouse will be paid:
The worker's children under the age of 18 (including illegitimate, adopted and step children) are entitled to a monthly pension of 20% x ¾ of the worker wages. This is paid every monthly until the child is 18 years old. This pension can continue for longer if the child is mentally or physically handicapped.
If there is no spouse or children, other dependents will be paid compensation (for example, parents). People who were fully dependent on the worker get the same as the widow. People who were partially dependent on the worker get a once off payment that depends on how dependent they were on the worker.
The person who pays for the funeral expenses will be paid expenses up to R6 970.
To claim compensation for the death of a family member, you need to provide certified copies of:
All the medical expenses of a worker will be paid for up to two years from the date of the accident or the diagnosis of the disease. All medical accounts should be submitted to the Commissioner. This includes fees for transporting an injured employee to a hospital or to their home.
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 a machine. Any worker who is under 26 years will get extra compensation.
HOW DO YOU CLAIM?
The worker and the employer should keep copies of all the forms.
When the first doctor's report has been submitted with the accident report, the Compensation Commissioner will consider the claim and make a decision. A claim number will also be allocated. This number should be used for all paperwork relating to a claim.
If the worker disagrees with the decision, they can appeal the decision within 90 days by submitting form W929 to the Commissioner.
All forms that need to be submitted to the Commission can be sent to:
You can contact the Commissioner or any Regional Office of the Department of Labour for more information and for assistance. Forms are available from:
Western Cape Office of the Department of Labour
WHO PAYS THE CLAIM?
The Compensation Commissioner is appointed to administer the Fund and approves workers' claims. The worker gets money from the Fund and not from the employer.
BUT the employer has to pay the injured worker for the first 3 months after the injury was sustained. The Compensation Fund will pay the employer back.
If the worker is off for more than 3 months, the Compensation Commissioner takes over the monthly payments.
If the employer has insurance against workplace injuries then the insurance company will pay the compensation. In these cases, claims are still made to and decided by the Compensation Commissioner.
NB: Payment of claims can take a long time to process.
|Government Body:||(The Government of South Africa)|
- Occupational Health and Safety Act, 85 of 1993 (Act) (File type: pdf; size: 114.47 KB)
- Compensation for Occupational Injuries and Diseases Act, 130 of 1993 (Act) (File type: pdf; size: 182.58 KB)
- Compensation for Occupational Injuries and Diseases Amendment Act, 61 of 1997 (Act) (File type: pdf; size: 194.11 KB)