What is a compensation fund and how do I claim it

What is a compensation fund and how do I claim it

Do you know all the rights and provisions that a South African worker is entitled to? One of the provisions that all workers need to know is the compensation fund. This is a special fund that is set aside in case a worker gets injured or dies while in the course of duty. Typically, the affected parties have to file for claims before the compensation money is disbursed. Having this information is essential because it could save you or your loved ones from hefty bills should a workplace mishap happens.

What is a compensation fund and how do I claim it
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Source: UGC

What is compensation fund South Africa? This is an endowment that reimburses a worker who is injured or falls sick while on duty. In the case of mortality, the family members are compensated. In South Africa, this is provided for in the 1993 Compensation for Occupational Injuries and Diseases Act (No 130) as well as the 1997 Compensation for Occupational Injuries and Diseases Amendment Act (No. 61). The money is awarded directly from this account and not from the employer. One is reimbursed only if they contract an occupational disease, an accident occurs while at work, or the worker dies from the disease or from an industrial accident.

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Who qualifies for workers compensation?

In case of an industrial accident, industrial-related disease or fatality, the following groups of people are entitled to workers’ reparation:

  • Persons who have permanent employment status
  • Domestic workers in boarding houses or those working in business institutions
  • Trainees or apprentices in farms
  • All workers listed under a labour agency’s remuneration folder

On the flipside, these people are NOT permitted to claim from the Compensation fund South Africa:

  • Domestic workers working in private households
  • Members of the National Defense team
  • Members of the South Africa Police Service
  • Workers who do not fall directly under a specific employer such as subcontractors
  • South African workers serving abroad for more than 12 months and are yet to establish a contract with the relevant officials in the Department of Labor

NB: In case of road carnage while on duty, the Road Accident Fund Act is responsible for the reimbursement process.

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How does workman's compensation work in South Africa?

According to the Act, the injury on duty employer responsibility is to pay a specified monthly amount into the compensation endowment. The employee is not required to pay any amount. If an injury, disease or fatality occurs, the employer is required to provide the compensation amount to the affected person or the relatives of the deceased for 3 months after the catastrophe. The endowment fund repays the employer the total amount that is sent out during the period and takes over the workers’ reimbursement after this period.

Once the disease, injury, or fatality is ascertained, the affected party is required to file a claim. One can only make a compensation fund registration claim if their disease is a result of the working conditions. Medical substantiation of this must be provided. In some instances, getting the medical report as proof can be complex and costly. There are institutions to help in such scenarios. Claims may be made long after one leaves a specific workplace if the ailment takes long to manifest.

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What is a compensation fund and how do I claim it
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The relevant officials have to approve the claim only after the assertion is verified. In situations where the disease or injury worsens, the worker places an application to have the reimbursement increased. Typically, the four classifications of compensation are:

  • Payments for temporary incapacitation- These are instances where the worker makes a full recovery
  • Payments for enduring disability- The worker cannot make a full recovery
  • Payments for mortality
  • Payments for access to medical care

How do I claim compensation fund?

All workers must understand that claims are only made for physical body injuries and not for pain and anguish. The process of filing for claims is as follows:

  1. The worker should report an injury or disease as soon as possible to the employer either in writing or verbally. They must also note and indicate any witnesses of the incident.
  2. They should fill in the WCL 2 form that gives notice of the accident and issues claim for the same.
  3. The employer then reports the incident to the chief compensation official. If there are any doubts, further verification is done by filling the WCL 3 form, that is, the employer makes a report of the mishap. The employer must report within 1 week of the injury or 2 weeks of being diagnosed with a workplace-related illness.
  4. A qualified medical expert should explain the severity of the injury or disease and the period that one will be away from work in the WCL 4 form. The form is sent to the employer who then delivers it to the Fund’s offices. For harm that takes longer to recover, the medic should send periodic WCL 5 forms to explain the recovery process.
  5. A final report by the doctor is issued using the WCL 5 form explaining whether one is fit to resume work or not in case of a permanent disability.
  6. After resumption of regular duties, the employer fills in the WCL 6 form to the Compensation Fund’s officials to inform them about the return to work and to state the total reimbursement money that was offered to the hurt worker.

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When all the information that is needed to ascertain the compensation fund claim status is available, the chief commissioner either approves or rejects the claim. All the involved parties should retain copies of all the above documents. If a claim is considered redundant, the worker may petition the pronouncement using the W929 form. Claims are usually rejected if:

  • They are made over 12 months after the diagnosis, accident or death.
  • The worker is off work for 3 days or less.
  • The worker intentionally induced the accident, except when one is seriously disabled or dies.
  • The worker fails to seek medical attention.
What is a compensation fund and how do I claim it
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Source: UGC

In cases where an employee who meets all criteria dies, the relatives claim the money. The amount that is disbursed is dependent on the relationship with the deceased. Spouses and children below 18 years of age have a right to make claims. In the absence of a spouse or children, parents are allowed to file the claim.

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For successful filing of claims, certified copies of these documents must be presented:

  • Certificate of marriage
  • The birth certificate of each child
  • The certificate of death
  • Form WCL 32- the spouse’s declaration
  • A report by the employer
  • Form WCL 46- the funeral details
  • A form detailing the applicant’s assets and income

How compensation is calculated?

The actual amount that is reimbursed varies depending on the amount of salary that the injured party was making before the physical damage or diagnosis. If one is no longer an employee, the workmen’s compensation calculation is based on the amount they would be earning if they still held their positions.

The compensation fund South Africa is a scheme that was established to reimburse workers who suffer from work-induced diseases, physical damage, or death. The affected persons must file for claims before any amount is released. The endowment protects them from wallowing in a financial crisis when catastrophic events strike.

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