December Festivities
This is the time of the year to which all of us who have battled for the last 11 months have been looking forward. Some will be staying at home with family and others will be going away. Deservedly you will have time to relax and forget about your daily routine of the past year. But before you go on leave please consider for a moment whether you have indeed completed your duties.
Injured employees already on leave (incapacitated leave)
Before locking the filing cabinet and your office door just consider for a moment whether you have done everything possible for your injured employees. These are the people who will be off-duty as a result of an accident on duty. Yes I realize that some employers are paying the full remuneration whilst an injured employee is incapacitated. I take my hat off to you who do that. The COID Act requires that you only pay for three months from date of injury and then only the compensation due to him and not the full remuneration. Thereafter it becomes the sole duty of the Compensation Commissioner to compensate the employee as long he or she is incapacitated. That sounds fine so what is the problem?
The problem for the incapacitated employee
There are many parties involved in the claims process with the result that one or all of the relevant parties can be responsible to some extent for problems that may arise. I will discuss only a few of these parties.
1. Your own contribution to the problems
If, before leaving, you have submitted the Progress Reports (W Cl 5) filled out by the doctor treating the injured employee, the Compensation Commissioner will be in a position to compensate the injured employee. See however the content of paragraph 3 hereunder in connection with the Compensation Commissioner’s new method of paying “clients”, this could have serious repercussions for the beneficiaries.
The Compensation Commissioner will only compensate for the injured employee’s temporary total disablement in cases where the doctor has confirmed the period for which the employee will still be unable to work. So if for example the Progress Report submitted at the beginning of December confirms that the employee is unable to work for at least another 60 days to come, the Compensation Commissioner can pay compensation in cases where the employer is not paying the usual remuneration. So in fact the Progress Report is the substantiating medical evidence necessary to pay compensation. If you have failed to submit this document the employee will probably be looking forward to a festive season without any income;
2. The treating medical practitioner’ role in the problems.
Medical practitioners are not famous for doing paper work. Where they fail to complete the Progress Report, the Compensation Commissioner cannot pay compensation. The periods between seeing the patient must be covered in the Report, it will enable everybody to arrange for the injured persons compensation;
3. The buck stops at the Compensation Commissioner (or does it?).
When all the parties concerned have done their duties as good citizens should, the onus is now on the Compensation Commissioner’s office to pay the compensation. When all the documents are in the hands of the Compensation Commissioner’s office nothing stands in the way of paying the employee. The fact that section 47(4) of the COID Act provides that:
“Payment of compensation in terms of subsections (1) and (2) shall take place in the form of periodical payments at such times and intervals, but not exceeding one month, as the Director-General may determine.” (My underlining) is, however, not always a priority with the Compensation Commissioner’ office.
The word “shall” makes it an imperative provision for the Compensation Commissioner, not a friendly request. Payment must be made at least once a month. If both the employer and the doctor have done their duties before going on leave, judge for yourself whether the officials who are employed by the state specifically to assist employees in need whether they have fulfilled their part of the deal.
There is, however, a word of warning. Judging from the notice by the Compensation Commissioner in the press during the past two weeks (according to this information it also appears on the department’s website, something I have failed to detect so let me know if you have been able to find it) it will now take some effort to obtain money from the Compensation Commissioner. Firstly, the claimant must supply the Compensation Commissioner with the claimant’s bank statements!! for three months. Then there are various other procedures which will make it extremely difficult to obtain the rightful compensation. In the case of service providers, outstanding accounts will not be paid unless these absolutely user-unfriendly instructions are adhered to. (What do they do with the bank statements? Check the overdrafts?). This totally disregards the statutory rights of the injured employee and other persons who are obliged by law to insure with the state – with absolutely no choice in the matter. The notice at the end makes it abundantly clear that unless the procedures are followed, no payments will be made.
It might not be an important issue for the Compensation Commissioner but all these intricate prerequisites for payment all in the name of preventing fraud sound very noble.
That is why the buck to some extent is now again with you as the employer. Are you willing to assist the employee to adhere to these stringent measures to obtain compensation? Are you willing to assist with the prescriptions? Are you willing to point out to the Compensation Commissioner what reasonableness in administrative law means? Give it a thought and prepare for the uphill battle for 2008.
Enjoy the festive season. Will see you next year.