What benefits are available to employees by government and how can they be claimed during the Coronavirus crisis?
On 20 March 2020, a notice was published by the Compensation Commissioner pursuant to the Compensation for Occupational Injuries and Diseases Act, 130 of 1993 (COIDA). This notice is applicable to employees who contract COVID- 19 during the course and scope of their employment arising from, amongst others, occupational exposure, an official business trip to a high risk area, a presumed high risk work environment or a chronological sequence between the work exposure and development of the symptoms.
The notice has categorised the work force into 4 different categories, namely:
• Very High Risk– i.e. – healthcare workers, laboratory workers and morgue workers performing autopsies;
• High risk– i.e. – Healthcare delivery and support staff, medical transport workers and morgue workers involved in preparing the bodies;
• Medium risk-i.e. – employees required in their work places to sit closer than 2 m apart, workers in contact with international travellers, workers in schools and consulting rooms;
• Low risk– i.e. – workers engaged in jobs that do not require contact with people and have more than 2m of space.
If an employee suspected of having contracting COVID-19 during the course and scope of his/her employment is recommended to self-quarantine by a medical practitioner, an employer will be liable to pay such employee for the time that he/she is off work. Such payment will be deducted from the employee’s sick leave entitlement.
In confirmed cases of COVID-19 arising during the course and scope of the employee’s employment and where the Compensation Fund has accepted liability, the Temporary Total Disablement Payment shall be paid from date of diagnosis for a period not exceeding 30 days.
In all cases accepted by the Compensation Fund, medical aid will be provided for a period not exceeding 30 days, which period may be extended by the director general. Whilst the notice states that medical aid will be provided, it is unclear how this will work in practicable terms. We envisage that it may involve the submission of proof of payment of medical expenses to the Compensation Fund, a portion of which may be recoverable from the Compensation Fund.
In addition, COIDA provides for the payment of death benefits arising from COVID-19 contracted during the course and scope of employment. The death benefits include, amongst others,the reasonable burial costs of the employee and the payment of widows and dependents’ pensions.
In order to submit a claim under COIDA, employers will be required to submit the following documentation to the Compensation Fund:
- Employer’s report of an Occupational Disease (W.CL. 1)
- Notice of an Occupational Disease and claim for compensation (W.CL. 14)
- Exposure and medical questionnaire
- First medical report in respect of an Occupational Disease (W.CL.22) indicating U07.1 as the ICD-10 code for COVID-19
- Exposure history (W.CL. 110) and any other appropriate employment history which may include any information that may be helpful to the Compensation Commissioner
- A medical report of the employee’s symptoms that details the history, establishes a diagnosis of COVID-19 and laboratory results and chest radiographs where appropriate and any other information relevant to the claim
- For each consultation, a Progress Medical Report (W.CL 26)
- Final medical report in respect of an Occupational Disease (W.CL.26) when the employee’s condition has reached maximum medical improvement
- An affidavit by the employee, if the employer cannot be traced or will not timeously supply a W.CL 1, where applicable
The COVID-19 pandemic will no doubt place an enormous strain on the resources of the Compensation Fund and we advise all employers to assist their employees who test positive for COVID-19 arising out of or during the course and scope of employment, to submit the claims as quickly as possible.