Training Workers Compensation Administrators


Subsequent to the April 2010 column which amongst others addressed the lack of understanding of the COID Act, I would like to briefly discuss the essence of the training problem that exists. This is one of the aspects which is absolutely necessary and is suggested as one of the solutions to change the organisational problems.  Unfortunately the perception is that training comprises of memorising legislation and procedures. That is also important but unless the administrator understands what the meaning or the intention of the legislator is it will not be effective enough to be successful. The crux of the matter is to be able to interpret what the section of the Act really means and how to apply it as such.

An Example to Illustrate the Above Statement

An “accident” is defined in section 1 of the COID Act. You will be able to memorise this definition in a short period of time. After all claims administrators are supposed to report these accidents to the office of the Compensation Commissioner (CC) per prescribed form. Do the administrators, however, know that there are three elements contained in the definition?  Are they also aware of the following issues associated with the concept of an “accident”:

  • If one of the elements is absent, are they aware that it cannot be labelled as an “accident” as defined in section 1 of the COID Act?  It can, therefore, not be accepted as a claim for an injury on duty by the CC;
  • What action should the claims administrator take when he or she is of the opinion that the facts surrounding the incident cannot conform to the requirements to establish an “accident”?
  • What action should the claims administrator take where the injured employee insists that he or she was injured in a work related “accident” and the administrator is convinced that it is not the case?  I refer specifically to the question of reporting to the CC’s office;
  • What is the time limit in which the employee can report an accident to the employer?  It is an important issue as serious disputes have arisen between the employer and employee on this point and has lead to many tribunals. The bottom-line to this question is when does the employee’s claim prescribe? and
  • At some stage the administrators must become familiar with the case law relating to what an “accident” is. There are numerous cases that the administrators should be familiar with to be able to fulfil their duties; the logic of the interpretation must be part and parcel of their training. Learning like a parrot to repeat, is not learning in the proper sense of the word.

These are a few examples emanating from one definition in one section of the COID Act. Can you imagine what the position should be if you want to interpret all 101 sections of the COID Act, however, I must concede some of them are easier than the one used as an example. But, the others are not as important as that of an “accident”.  The fact of the matter is that the COID Act is one of the most difficult Acts to deal with. Not only must your knowledge of medical matters such the human anatomy and pharmaceutics and medical jargon in general be up to standard, it will also be required of you to know the law of wrong doing (see section 56). So be prepared and train your staff dealing with these matters.

The South African Situation

For some unknown reason there is a serious lack of literature in South Africa to assist the administrator of workers’ compensation. The information in the available handbooks can under no circumstances be sufficient to assist the administrator. It is mostly simplistic summaries of the legislation. Even the website of the Department of Labour cannot be said to be of real assistance. The main reason for the absence of a proper handbook, I presume, is that there is not a big enough market to make it a financially viable proposition.  I have over the years drafted several formats intended for publication but it soon became clear that finding a publisher is not going to happen.

In the meantime the expert knowledge of workers’ compensation is getting scarcer by the day. It is not only happening from the employer’s side but also in the office of the CC. I see decisions taken there that are, to say the least, scary. As far as I know nobody with the expertise in workers’ compensation is training them.

Who will eventually have to pay the price for this laissez faire attitude? The injured employee, obviously.

Till next time.