Module 3: Toxicology - Section 7: Legal Aspects

TOX 7.3: COIDA Lecture

COMPENSATION FOR OCCUPATIONAL INJURIES AND DISEASES ACT, 130 of 1993

Contents:

1. History
2. Administration
3. Coverage
4. Benefits
5. Claims procedure: injuries
6. Claims procedure: diseases
7. Occupational diseases - general
8. Third Schedule - some examples
9. Recourse
10. Problems with the system

History:

Six laws, many amendments since 1914.

Historical shifts over time:

• common law ® statute
  
  * "historical compromise"
• voluntary ® compulsory
• private ® state
  
  * 2 private assurers: mining (Rand Mutual) and building (Fedsure)
• injuries ® diseases

Administration:

• Administered by: Dept of Labour: Compensation Commissioner
  
  Note: distinguish from "Compensation Commisioner for Occupational Diseases" under ODMWA (Dept. of Health)
• Funded: Premiums on employer wage bill, risk rated by class of industry
  
  *Average (1999): R0.85 / R100 (down from R1.14 in 1995)
  
  
• Governance: Tripartite Compensation Board and technical committees.

Coverage:

Yes:

• Casual labour
• Employees in employer's vehicle
• Farmworkers
• Employees of unregistered employers ( 1 m.+ ,mainly small employers)

No:

• Domestic workers in private homes
• Defence, police while on "defence" service

Benefits:

• Yes:
1. Medical expenses
2. Wage replacement:
• Temporary disablement (if > 3 days)
  (NB: Employer must pay 75% of wages up front for 3 months and claim back. After 3 months, employee must receive directly from Commissioner)
• Permanent disablement
3. Death expenses (widow pension; funeral)


• No:
1. Pain and suffering
2. Unemployment

Claims procedure: injuries

Worker, supervisor informs employer of injury

Employer completes Employer's Report of an Accident

Employee gets (private) medical care

Doctor completes First Medical Report of an Accident

Employer sends forms to Compensation Commissioner

Doctor completes Progress Reports and/or Final Report, sends to Commissioner (or employer)

Employer completes Resumption Report

Commissioner (or insurer) pays medical expenses and disablement if any

Claims procedure: occupational diseases

Doctor makes diagnosis, informs employee

Doctor completes First Medical Report of an O.D., informs employer

Employer completes Employer's Report of an O.D., sends with First Medical to Compensation Commissioner

Employee gets (?private) medical care

Doctor completes Progress Reports and/or Final Report of an O.D., sends to Commissioner

Commissioner decides on acceptance and disablement, pays medical expenses and disablement if any

Occupational diseases - general:

1. Third Schedule

2. Unscheduled:

   • AIDS following needlestick injury - if incident recorded
   • Post-traumatic stress disorder - if meets criteria
   • Carpal tunnel syndrome - sometimes - unclear
   • Chronic back pain - unlikely if no incident
   • Stress induced heart attack - ?untested

3. Differences from injury which make compensation difficult:
• Diagnostic uncertainty regarding cause - often multicausal
• Exposures in past - latency period until disease appears
• Exposures mixed or obscure - no single agent
• Doctor, not employer, initiated

Third schedule: some examples

Refer: Third Schedule of COIDA

• Occupational asthma
• Tuberculosis of the lung
       - silica exposed      - health care workers
• Hearing impairment (Instruction 71)
• "Any disease or pathological manifestation due to"
  • Metals
  • Solvents
  • Hydrocarbons
  • Any compound of above
• Any disease due to overstraining of muscular tendonous insertions due to repetitive movements

Recourse

1. Objections (sec. 91)

   • Within 90 days of receiving decision.
   • In writing

2. Re-opening claim

   • Deterioration
   • AND treatment will assist rehabilitation

3. Extra compensation (sec. 56)

   • Negligence must be shown
   • Administrative, not judicial hearing

Problems with the system

1. Commissioner' s office

   • Inefficient - delays, mislaid documents
   • Unresponsive
   • Lacks expertise
   • Lack of criteria for most diseases
   • Injury oriented

2. Injuries

   • Injury not recorded or reported (12 month expiry) by employer
   • Inadequate medical reports, e.g. Final Report too early, or doesn’t fully reflect disability

3. Diseases
   • Underdiagnosed
   • Not worked up properly - inadequate medical reports
   • Uncooperative employers

Postgraduate Diploma in Occupational Health (DOH) - Modules 3: Occupational Medicine & Toxicology (Basic) by Profs Mohamed Jeebhay and Rodney Ehrlich, Health Sciences UCT is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 2.5 South Africa License. Major contributors: Mohamed Jeebhay, Rodney Ehrlich, Jonny Myers, Leslie London, Sophie Kisting, Rajen Naidoo, Saloshni Naidoo. Source available from here. For any updates to the material, or more permissions beyond the scope of this license, please email healthoer@uct.ac.za or visit www.healthedu.uct.ac.za. Last updated Jan 2007.
Disclaimer note: Some resources and descriptions may be out-dated. For suggested updates and feedback, please contact healthoer@uct.ac.za.