Louis, all of us at WCA Workers Compensation Assistance will miss you. I’m sure many, many more people outside our company will join us in saluting the enormous contribution you made to workers’ compensation in South Africa. And I would like to thank you on behalf of many thousands of employers and employees – people who have no idea that their lives were made a little easier, a little fairer, because of your passion for the work you did every day. Our condolences go out to your family and friends. May you rest in peace.

Brian Pivo, Managing Member

When someone is injured on duty in an “accident” as contemplated in section 1 of the COIDA, this accident could result in various conditions and thus different forms of compensation.  The expression “compensation” is, therefore, used in the wide sense of the word that is associated with different kinds of benefits.  The injury leads to a specific medical condition which determines the nature of the payments of compensation.  For the sake of a better understanding of what is to follow in the column let me illustrate how an injury can lead to different kind of benefits:

Temporary total or partial disablement that is the period in which the employee is receiving medical treatment and is unable to work.

• The benefit payable will be 75% of the monthly earnings of the injured taking the earning limit prescribed in item I of Schedule 4 of the COIDA into account.

How often do you read or hear reports or press releases so delusional that it sounds as if it cannot be true? A popular one is to state that they will solve their problems through the upgrading/replacement of their information technology (IT) infrastructure? I have seen and heard this promise on numerous occasions from both state departments as well as large private sector organisations. Every time an organisation is under-performing the solution seems to be to introduce hardware and software. Not long after that has been implemented it is obvious that the so-called solution was a flop and the costly exercise is repeated, usually accompanied with a change of vendor and all that goes with it. No wonder that the administration costs of especially the state departments are going through the roof. The solution to the problem is constantly overlooked.

The idea that the IT infrastructure of especially the state is a magic wand that can fix all problems is a total misconception. A computer cannot (yet) think logically like some human beings are capable of. You have heard the cliché of “garbage in, garbage out” many times; it is still appropriate.
What then is the secret to the solving of the problem if an organisation is not functioning as is expected? The best people for the job should be appointed and then they should receive on-going training. The training should never stop as the administrative environment continuously changes – the administrators of the Act who are supposed to inform the clients especially so. I experience daily the ignorance of people who are supposed to assist the client or the employer in some cases. The idea that the IT can solve the problem is a fallacy. Although it’s a must as an administrative aid, it is nothing more and nothing less.

Another common occurrence is that legislation is changed to suit the level of the expertise of the civil servants administering the Act. If the officials cannot cope with existing legislation, the Act is altered. The result is the lowering of standards. Training, once again is the solution, not a legislative amendment.

When in trouble, another approach is to decentralise the problem. Create offices where the standard is even lower than the so-called head office. I have serious doubts that the IT can be “decentralised” if the main infrastructure in the head office is in a mess; I did not guess the latter fact, the CC told the parliament committee so. What is, however, disturbing is what such a decentralisation is going to cost although money does not seem to be a problem. Decentralisation in the true sense of the word means the total service scope not a “post office” receiving forms and passing them on to the head office for adjudication and rendering the total service. If the head office’s IT is in such a state as was explained to the portfolio committee, how do they intend to create a wide area network? Putting it bluntly, it is a pipe dream.

Now verbatim quotes of some of the press releases by the Department of Labour dated 27 March 2012 to illustrate my viewpoint.

“The compensation Fund has promised a bright future for its clients free from glitches of delayed claims that have characterised the institution for decades”

“Time has come for us to move away from a paper-based institution to one that is automated and therefore quickening claims capturing, assessment and adjudication:

He said the future would see an organisation staffed with a knowledge worker who is rounded and who understands the entire value chain of the Fund”

Try to work that one out for yourself.

“.. The future Fund would be decentralised in order to bring services closer to the people once agreement with trade unions have been concluded. He said all the processes and case management would be done in provinces rather than Pretoria”

I am not sure since when trade unions are involved in the management of the Compensation Fund. What I do know is that waiting for the blessings from trade unions to administer employers’ contributions is highly irregular and ultra vires the Act.

See what I mean. It sounds familiar and a repeat of numerous previous attempts. At the risk of sounding critical I point out what the future holds for employers. That is, once the pies (in the sky) have landed.

Till next month

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I have studied the Department of Labour’s press release dated 3/2/2012 regarding their intention to decentralize the administration of the COID office with scepticism and amusement at the same time.  Amused you may ask!  Yes when this was suggested during 1995 as an alternative to closing all decentralized offices in the then ex-TBVC countries, it was met with massive opposition from the new management.  I got the idea that the central authorities feared that decentralization was tantamount to affording more power to the second level of government namely provincial authorities.  That was a total misconception as the COID Act cannot in the present form be administered by the provinces.  To put it bluntly, they are nothing but ordinary employers in terms of the Act, thus it is impossible to administer it.  Twenty odd years down the line they seem to have realised this but I am afraid to say it is too late to turn the ship around.  For those of you who have not read the press release of the Labour department, I intend to discuss their intentions.  It will start with a road show by the CC to inform all the ”stakeholders” of their intentions.  The department has stuck to the practice of calling such exercises “road shows”.  Ag please can we not find a more informative term.  Road shows sound so much like a circus or something in that category.

Decentralisation as the department sees it

I will not try to interpret their intentions and objectives with the decentralization excersice but wil rather quote from the department’s press release and comment on it for you to form your own opinion.  I have not space to deal with the whole of the document but will stick to the more relevant parts.  The main objective of the decentralization move is the following according to the department:

“Decentralisation is an initiative whereby services of the Compensation for Occupation Injuries and Diseases Act (COIDA) are now extended and rendered at provincial level, rather than be solely provided at the CF’s head office in Pretoria (Tshwane). The initiative to introduce decentralisation in the provinces is intended to bring COIDA services closer to the people and stakeholders.”
“Mkhonto said the latest initiative follows a national pilot to test the efficacy of decentralising the services of the Compensation Fund, which had proven successful. The decentralisation is expected to be implemented in the new financial year which starts in April 2012, Mkhonto said.”

I am not aware of any amendment to the COID Act but the Act defines the financial year as from 1 March of each year and not “in April” as alleged.

“He estimated that the cost of the decentralisation would be about R274-million. Mkhonto reassured employees of the Fund that no retrenchments would occur out of the unfolding process.”

“This restructuring will instead result in a number of employment opportunities including contract workers,” emphasising that the headcount would be increased from the current 711 to more than 1000 in the new structure.
“The Commissioner expects the operations at CF head office to be lean. He said the speed of rolling out decentralisation would be determined by readiness of the provinces in infrastructure in terms of accommodation and furniture among others.

Prior to the decentralisation’s pilot all information and documentation had to be sent to the national office for registration, adjudication and payment. We felt from the feedback of the stakeholders and clients that this arrangement was frustrating. Before the decentralization the turnover time for registering and adjudication was about 90 days and this has now been reduced to 60 days, and we feel that there is still room for further improvement.”

Those, dear readers are the main issues that you should take note of and for which you should prepare your own worker’s compensation procedures.

A few worrying aspects about the intended decentralization

I will be brief with my concerns because I have over the years realised that the road to hell is paved with good intentions.  So ponder the following

• The Head Office is in chaos, by their own admission, even before the portfolio committee of Parliament;
• If that is the case who will be training the personnel in the “branch” offices?;
• Decentralization is supposed to enhance the service, it is not supposed to supply the full service afforded by the Act.  I can now predict that the people in the branches will be nothing but a static courier service.  Decentralization is not an objective in itself, a complete business plan should have been drawn up before the “stakeholders” are informed;
• To state that the effort will be “about R274 million” is not sufficient.  A break down estimate should be available such as IT-infrastructure, salaries and accommodation, etc;
• The increase in staff from 711 to “more than 1000” could have been funny if it was not for a financial burden on employers.  To say that the “CF head office to be lean” is not reflected in the above figures as the 711 will remain the same; and
• I suspect this exercise has more to do with job creation than decentralization.

Decentralization which costs a large sum of money without the value that it is supposed to add is a waste.  In other words decentralization is not an end in itself; it is supposed to better the service.  You be the judge whether this will be the case

Till next month

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This is the time of the year that you must prepare for the submission of your annual Return of Earnings to the Compensation Commissioner’s office and the subsequent payment of your annual assessments.  In other words, render unto Caesar the things which are Caesar’s.  But, at the same time beware.  The State has a nasty habit of changing financial software programmes with an obvious inherent risk for you the employer.  It is for this reason that I intend to discuss the main issues that you should address in connection with the payment of assessments.

Issues relating to assessments to take note of

(a)    Maximum Earnings imit for assessment purposes
On the Return of Earnings form there are two different parts to be completed by you.  The first part is the declaration of the actual earnings of your employees for the previous financial year.  The maximum amount was published last year in the form of a Notice in the Government Gazette.  The second part will form the basis for the provisional assessment for the current financial year.  The maximum earnings on which the assessment is based will be published in the Government Gazette in the first few months of this year.  Your assessment will thus be structured as follows:
Final assessment for the previous year, plus
Provisional assessment for the current year, less
Provisional assessment for the current year that was raised the previous year.
Make sure that this credit is taken into account.

(b)    Assessment rate applicable to your business
Due to the system of industrial rating your business operations are classified under a specific subclass associated with the risk attached to the operations.  The subclass bears an assessment rate which might change from year to year depending on the performance of the group that falls under the specific subclass.  Should you wish to check on the rate applicable to your business, you can find it on the website of the Department of Labour.

(c)    Keep abreast of times
I find it strange that only a few people dealing with the workers’ compensation administration endeavour to get hold of Government Gazettes dealing with this subject.  To be able to know what the maximum earnings limits are for assessment purposes, how compensation will be calculated for a specific year, what the increases in the pensions are and many other topics can easily be obtained free of charge by accessing the internet and downloading the Government Gazettes.  The website address of this service of the South African Government Information is:
www.info.gov.za/view/DynamicAction?pageid=528
You then proceed to “Notices” on the menu and you have all the Gazettes at your disposal.  The website also makes provision for many other documents such as Acts and Bills.

(d)    Filing system
I often come across the situation, when asked to assist, that the employer has no proper filing system; the result is that the paper trail is so inadequate that the CC’s office gets away with murder.  If the Returns of Earnings and the subsequent Notices of Assessment are properly stored or electronically captured it makes it so much easier to determine the nature of the problem.  Remember the hard copy file in the CC’s office is often not available with the result that you are unable to follow the course of events and eventually land up with a loss of capital.  The noises coming from the CC’s office is that decentralization will during 2012 be accelerated, something that can aggravate your position as a client.  The solution to this threat is to keep your own house in order and at all times be able to produce the necessary evidence, even when it comes to the inevitable litigation that might follow.

Next month we will have a look at the so-called decentralization.

Till next month

I have over the past months presented you with a brief summary of the more important aspects of workers’ compensation in South Africa.  There were several Acts in this regard since the end of the 19th century and eventually culminated in the 1993 Act which came into force on 1 March 1994.  Generally speaking the different Acts improved over the years but the central theme remained unchanged and that is assisting the injured so as to avoid hardship.

Let us make it immediately clear that an Act is only as good as its administration.  Poor administration means bad legislation.  From the feedback that I receive from employers and employees a perception exist that the present administration is deficient and the purpose for the legislation, that is to assist the injured, has dismally failed.  The attitude of the CC-staff that they are doing the injured employee a favour must be changed and they should be made to understand that they are being paid handsomely to assist the persons in need.

Why Was Worker’s Compensation Legislation Necessary?

During the 19th century the economic conditions drastically changed as a result of the industrial revolution.  Greater protection and security became necessary for injuries on duty including fatalities.  To cut a long history short; three conditions arose which led to the advent of worker’s compensation, namely:

1. The employer was by law compelled to compensate the injured employee irrespective of who caused the accident;
2. The employer was obviously not always in a financial position to pay the compensation that was due as a result of the injury on duty;
3. Because of the financial burden placed on employers, the state intervened and the principle of workers’ compensation insurance was created.  The full circle in the trade-off development was now complete.  This in short meant that the employer was now compelled by law to pay an annual premium to the state to create a compensation fund.  In exchange the injured employee is prohibited to sue the employer for damages in terms of his common law delictual rights, the so-called “trade-off”.

The Workmen’s Compensation Act, 1897

This Act can be regarded as the first true workmen’s compensation statute in a common law country.  Section 1 of the Act reads as follows:

“If in any employment to which this Act applies a personal injury by accident arising out of and in the course of the employment is caused to a workman, his employer shall ……. be liable to pay compensation in accordance with the first Schedule to this Act”

For the first time the no-fault rule was introduced.  The workman was entitled to compensation irrespective whether the injury was caused through the fault of any person.  Due to the financial burden that this principle placed on the employer a state compensation fund from which the compensation was payable was established.

The Compensation for Injuries and Diseases Act, 1993 as amended

You will note from the brief history above that the main principles of the original legislation remained unchanged.  There were a few significant changes but in general it is based on the same principles.  One may ask: Should the present 1993 Act be changed at this stage, i.e. is it necessary to research and amend it now?  The fragmentation of cover for occupational diseases is a valid example.  Despite numerous commissions of enquiries and political promises occupational diseases in mines are still administered in terms of a different Act.  It appears as if the will to change this is absent.  My view, however, is that changes to the present COIDA is a definite NO mainly because of the following reasons:

1. The present level of expertise is so low that the introduction of new principles will aggravate the chaotic situation which exists.  Training of the staff is a necessity but it is also true that it takes about ten years of experience to become a claims officer.  I have seen enough to vouch for this;
2. Judging from the 1997 amendments to the COIDA the next amendments could even be a bigger disaster.  To illustrate ask yourself what the director-general of the department duties are since he became the accounting officer;  I sincerely doubt whether he knows, that is taking the many suspensions into account

Till next month

We have now reached the final column dealing with the more important issues in the COID Act.  The sections in this chapter are not something that you will deal with regularly; they are mainly procedures that the CC’s office is allowed to follow.

Section 94 allows the SA Fund to enter into arrangements with foreign states to control the payment of compensation of foreign citizens who were injured on duty in the RSA and subsequently returned to their own country.  An example is an agreement which came into force between a neighbouring state and the RSA that the compensation due to the injured will be paid to the state and not directly to the beneficiary with the idea that they will trace the employee and pay the compensation awarded by the SA Fund.  Yes you have guessed the outcome spot-on.  Only a small percentage of the amount paid over was paid to the beneficiary.  The balance remained in the state coffers, or did it?  The arrangement was immediately cancelled and I seriously doubt if any arrangement with foreign states still exist.

Section 96 is a secrecy stipulation to protect employers and employees.  The exception is amongst other if it is used for the administration of justice.  Section 97 lists the matters for which Regulations may be made to administer the Act.  The prescribed forms are contained in the Regulations, forms such as the Return of Earnings and the Report of an Accident.  Please note sections 98 and 99 which deal with false statements and penalties respectively.

Although the above sections are not that important the Schedules right at the end of the Act are indeed important to study and understand as an administrator of workers’ compensation.  These Schedules are the following:

• Schedule 2    List of percentages awarded for certain forms of permanent disablement
• Schedule 3    List of Occupational Diseases
• Schedule 4    Manner of Calculation Compensation

Schedule 2    List of percentages awarded for certain forms of permanent disablement

Against these percentages of permanent disablement an employee cannot object and request a review of the percentage permanent disablement awarded.  For example, should an employee lose a hand at the wrist, 50% disablement is awarded to calculate the compensation according to the prescriptions of schedule 4.  You cannot object to that decision as the disablement is prescribed.  There is no discretion involved from the CC’s side; the extent of disablement is cast in stone (read in the schedule).

If an injury leads to permanent disablement that is not listed the in the schedule, then the CC’s office will exercise discretion as to what the percentage should be.  In this respect they have guidelines from sources such as the Orthopaedic Associations and publications internationally accepted.  In this regard permanent disablement resulting from back injuries comes to mind.  If the affected employee is not satisfied with the decision he or she may lodge a formal objection in terms of section 91 resulting in most cases in a formal hearing by a tribunal set up in accordance with the provisions of the COIDA.  Can you see why administrators of worker’s compensation should be familiar with this Schedule 2?

Schedule 3    List of Occupational Diseases

This schedule is divided into two columns namely the name of the disease and the type of work associated with the disease.  This is a difficult schedule to work with and that is why the administrator should be familiar with the content thereof.  Compensation for occupational diseases is an aspect of worker’s compensation which is neglected in the RSA due to a lack of knowledge, not only amongst employers but even in the medical profession.  Training by experts is the answer because the layman cannot pick up the required knowledge just by studying the schedule on his own.

Schedule 4    Manner of Calculation Compensation

This is a crucial schedule for everyone to study when it comes to determining.  If you are not familiar with the content thereof I can categorically state that you have no idea of how worker’s compensation operates.  It is a must that you study it annually.  I say annually because it is amended every year and usually published in the first three months of the year as a notice in the Government Gazette.  It is your duty as employers to obtain it and study the content thereof.

We have come to the end of the year and the end of an overview discussion of the COID Act.  I sincerely hope that I have pointed you in the direction of the important aspects of the Act.

Till next month

This chapter provides for the legal remedies that are available to all the parties involved in workers’ compensation. Before I supply you with a brief summary of the more important aspects of these remedies, I must caution you that there is an enormous lack of understanding regarding the content of the sections contained in the COIDA, on the part of employers and employee on the one hand as well as in the office of the CC.  I am not going to try in the short document to speculate about the reason for this.

An aggravating factor which places especially the employees in a difficult situation is that they more often than not cannot afford an attorney familiar with the legal aspects of the COID Act.  If the employee undertakes his own case with no legal background the chances are that his objection will fail and that the original decision will stand.  I have over the years seen scores of objectors who approach me after an unsuccessful objection hearing.  All of them are surprised and cannot understand why they did not decide in his favour.  Unfortunately you cannot teach someone in a few sentences the law of evidence and related matters concerning civil law procedures.  The cases which they presented were so weak it does not help to appeal to the High Court.  A skilled legal representative is, therefore, a must if you have a valid case.

Section 90

The Director-General can review a decision taken in terms of the COID Act.  The reason for such a revised decision is usually that incorrect information was submitted to him before the decision such as an adjudication of a claim took place.  The revision of a decision can only be done after the affected party was informed of the intention to revise and to give the affected party a chance to make representations to avoid any revision.

Section 91

The legal remedy frequently used by especially injured employees is a formal objection per prescribed form W G 29 in terms of section 91.  The time limit to lodge such an objection provided for in the Act is 180 days from the date of the decision.  If the decision is late it will be out of time and will not be processed. 

The objection is heard by the CC and two assessors, one representing employers and the other representing employees.  These assessors are appointed by the minister after they have been nominated by employers’ organisations and trade unions.  The proceedings of the hearing before a tribunal are similar to that of a civil case in a court of law.  The objector can call witnesses who will give evidence on behalf of the objector.  Thereafter a representative from the CC’s office can cross-examine the witness on the evidence given.  The CC’s representative can also call witnesses with a view to proving that the original decision was correct.

Should the decision of the tribunal thereafter go against the objector he can appeal to the High Court.  The CC has no right to appeal to the High Court should the objector succeed with his objection.  (Jordaan v Oosthuisen-case)  As this last principle stems from legal technicalities I do not regard it as necessary to explain the reasons for this.

The CC may of own motion state a case to the High Court for a decision but it does not affect the decision already handed down in the objector’s case, it is simply meant to obtain clarity on the interpretation of the Act and associated matters.  (Section 92)

Before I sign off as they say on the radio I want to repeat what I have said before; if you object to a decision be sure that that you are legally qualified or represented to handle the hearing with all the procedures.  Also keep in mind that although this is not a fully- fledged court of law some intricate matters such as the onus of proof is still applicable.  If you are not familiar with that you may in serious trouble.  If you are not qualified to do it yourself I am afraid you will have to appoint a competent attorney familiar with workers’ compensation.

To the CC a friendly request; please hold the hearings not years after the objection was lodged when most of the witnesses have passed away or emigrated.  When you subpoena say 5 doctors to testify and one turn up because the rest has emigrated, it becomes a waste of time.

Till next month

Although no part of the COIDA can be said to be unimportant, this chapter is regarded by experts as particularly important when it comes to the administration of the Act.   The reason for this is mainly that the CC’s office is far more focussed on the obligations of the employers than the rights of the injured workers for whose purpose the legislation was originally established.  There appears to be no sympathy with defaulting employers whilst the CC’s obligations to injured employees leave a lot to be desired.  Late payment of benefits to the injured and medical accounts are regularly reported in the press and discussed in appropriate forums but to no avail.

Therefore, it is important for employers to be fully aware of these obligations provided for in the Act in order to avoid being penalised for every possible mistake.

Summary of the important obligations in chapter IX

The sections that are relevant relate to:

• A person or company carrying on business and who employs someone shall within the prescribed time register with the office of the CC.  The form used for registering must be in accordance with the one prescribed in terms of the Act.  The employer should be familiar with the procedures and the relevant prescribed forms;
• The employer shall for at least 4 years after the date of the last entry keep the records of the remuneration paid to employees; and
• Before or on 31 March of each year the employer must furnish the CC in the prescribed form the Return of Earnings for the previous year and the current year. (section 82 )

In section 83 provision is made for the different tariffs of assessment for different industries.  What it means in simple terms is that an employer within a specific industry is assessed according to the associated risk.  As an example it can be mentioned that a mine will be assessed at a much higher assessment rate than that of a bank.  There is also a prescribed minimum assessment for certain employers.  The big risk is where the employer fails to submit the annual Return of Earnings when the CC can then estimate the assessment and the employer will have to pay the estimated assessment which will be considerably higher than the one that would have been based on the earnings furnished as explained above.

The heading of section 84 can be very misleading.  Only the state and some licensed local authorities are exempted from paying assessments.  Every employer including the State is bound by the compensation for injured employee provisions.  There are two insurance carriers other than the compensation fund namely Rand Mutual Assurance and the Federated Employers Mutual Assurance Co.  The first registers employers and pays compensation in the mining industry and the latter caters for the building industry.  Employers in these industries pay assessments to these mutual associations so they are “exempted” from paying the CC.  They are, therefore, not in the true sense of the word “exempted” from paying assessments.

Section 85 verifies the fact that it pays financially for employers to promote safety in the workplace.  Although there is a standard rate for all employers in a specific industry, the CC can award a lower rate of assessment if it is clear that the employer’s claims cost is far less than the assessments paid.  The opposite can on the other hand lead to an increase in the assessment rate and thus a higher assessment.  Employers must apply for such a reduction as the CC will not out of own motion take the initiative.

Sections 86 to 88

These are straight forward sections and deal with the calculation and the payment of assessments.  Just a single remark, please pay the assessment before the due date to avoid hefty fines and penalties.

Section 89

Ever heard of a good standing certificate?  It is a certificate that a contractor must obtain to the effect that he has registered with the CC and that his assessments due are up to date.  The principal for whom the contractor is doing the work must insist on such a certificate.  Should the contractor fail to register and pay assessments up to date, the principal will be held liable as if he is the employer of the employees of the contractor and pay the assessments.  This is an important section and employers should always bear it in mind.

Till next month

Medical costs in terms of Chapter VIII of the COIDA were recently labelled by the CC as the biggest medical scheme in South Africa. Whether this statement is technically correct as it is not registered as such, is not relevant.  The fact of the matter is that it is a huge fund with much more benefits than that of the traditional medical schemes. It provides for a much wider spectrum of benefits. Let me give a few examples:

• When an employee meets with an “accident” the employer is legally obliged to supply transport to a hospital or doctor.  (Section 72).  The transport cost emanating from this is according to the COIDA paid by the employer.
• According to section 73 the CC shall be liable for the medical costs for a maximum of 2 years.  Thereafter the CC shall evaluate the extent of the residual injuries and if applicable award compensation for permanent disablement.  At the same time the payment of medical costs will be terminated.

The exception to the 2 year period [subsection 73(1)] is that the CC can extend the 2 year period if the CC is of the opinion that further medical treatment will reduce the disability should the medical treatment be prolonged.
Section 74 of Chapter VIII compels the medical practitioner to submit ”     within 14 days after having for the first time examined an employee injured in an accident or 14 days after having diagnosed an occupational disease in an employee furnish a medical report to the employer concerned in the prescribed manner”.  (Usually a W Cl 4 for an occupational injury).  I hope for the sake of all concerned in the medical profession to take note of this legal obligation.  If you do not get paid do not always blame the state.  (Section 74(1).  The 14 days mean exactly what was intended…Should the CC require further medical reports from the medical officer to adjudicate a claim, no further medical fees will be payable until such time as the report is submitted.  No levies or other fees may be charged as in the case of our medical schemes.  No amount for treatment can, therefore, be recovered from the injured employee or employer (subsection 76 & 77).

Cost of medical treatment for IOD’s In South Africa.
The medical aid supplied for the treatment of injured employees in terms of the COIDA is indeed as substantial as suggested by the CC.  The CC shall before determining the medical rates first consult with the Medical Association of South, the Chiropractic Association of South Africa and the Dental Association of South Africa.  Please note that no medical fee in excess of the tariffs annually published in the Government Gazette may be recovered from the patient, the doctor or the employer. (Subsections 76 and 77).
The expenditure in connection with Medical Aid
The amounts of medical aid supplied to injured employees are according to the archives from the Dept of Labour’s website for the most recent financial years published are as follows:±
                                            R million
2006/2007                        R1,415
2007/2008                        R1,287*
2008/2009                        R1,540

* How the ±11 % decrease came about for this financial year’s figures is a mystery.  Maybe one should keep in mind one of the recent disclaimers by the Auditor General who could not express an opinion on the CC’s Annual Report.
Another worrying aspect is the fact that the ratio between the compensation and the medical costs is changing every year.  Compensation was supposed to be 60% and medical costs 40%.  The last time I had a look it was the other way round (at least).  So the CC might be correct in his assumption that workers’ compensation is the largest medical aid scheme in the RSA.  It was, however, never meant to be. Due to a lack of space, I cannot give you the historical background.
There are peculiar practices concerning outstanding medical accounts.  The failure to timely pay medical accounts has lead to debateable business practices.  As there is very little that you and I can do to rectify the situation, I would leave it there with the hope that the investigations going on will produce results.

Till next time.