Answer #1:

Yes. Whenever a diagnosis of TB is made in a worker, the possibility that it is work-related and compensable must always be explored. A detailed occupational history is therefore necessary.

(Back to Exercises)

Answer #2:

TB is compensable if the worker performed at least 200 risk shifts and has clinically "active" TB during employment or contracted TB within 12 months of working the last risk shift. The following steps are therefore recommended:

• Contact previous employer/s to obtain full employment details

• If the worker qualifies for compensation, submit the following materials to the MBOD:

  • Occupational history (Annexure to G24/64 or GW 24/16);
  • Medical history and physical examination including age, height and weight (Medical form: GW 24/56).
  • Recent Chest Xray (postero-anterior);
  • Microbiology results (sputum).
  • Worker identification and fingerprints: GW 24/17 (duplicate).

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Answer #3:

• Compensation (75% of wages) will only be paid for loss of earnings while temporarily incapacitated - for up to 6 months.
• Re-assessment will be done after 6 months.
• Information on DOTS programme and compliance.
• Information on nutrition and smoking.
• Information and possible counseling on TB and HIV/AIDS.
• Possibility of being in gainful employment on treatment.

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Answer #4:

• Importance of completing 6 months of treatment.
• Importance of confidentiality.
• Discuss benefits of TB Treatment Programme at work (See new WHO/ILO Workplace TB Guidelines). (See the reference below.)
• TB not infectious after 2 weeks on treatment.

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Answer #5:

The ODMWA provides for lump sum payments for first or second degree occupational disease, this includes chronic cardio-respiratory TB that leaves permanent impairment after healing. If the worker has both Pneumoconiosis (silicosis in this exercise) and Pulmonary Tuberculosis, second degree compensation is payable. The following steps are therefore recommended:

• Re-submit (after 6 months treatment)to MBOD with materials as per answer to question 2.
• Include Lung Function Test and repeat Chest X-ray.
• Advise worker that should he be diagnosed with both silicosis and TB he will be compensated for second degree which is the maximum payment for occupational lung disease.
• Depending on the physical demands of current employment worker may decide to continue to work.

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REFERENCE:

1. Alli B O, Maher D, Boldini F, Pathania V, Gabriel P, Kisting S, Norval P. Guidelines for Workplace TB Control Activities. The contribution of workplace TB control activities to TB control in the community. WHO, ILO.WHO/CDS/TB/2003. http://www.who.int/gtb/publications/communityTBcare
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