DOL- PRESENTATION TO DOH- SCIENTIFIC WORKSHOP ON RISK ASSESSMENT SUNNYSIDE PARK HOTEL 31 JULY 2013

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1 DOL- PRESENTATION TO DOH- SCIENTIFIC WORKSHOP ON RISK ASSESSMENT SUNNYSIDE PARK HOTEL 31 JULY 2013

2 Overview of the presentation Compensation Fund in South Africa Governance of the Fund Mission of the Fund Revenue generation COIDA Benefits Guiding principles Objections Rehabilitation and re-integration Proposed social security reforms Challenges 2

3 THE COMPENSATION FUND Social insurance within the social security system in South Africa Administered under the Compensation for Occupational Injuries and Diseases Act, 130 of 1993, as amended in 1997 (COIDA) It is a schedule 3 Public Entity i.t.o the Public Finance Management Act- in the Department of Labour Minister is Executive Authority The Director-General is the Accounting officer The Compensation Commissioner (DDG) reports to the DG 3

4 Governance of the Compensation Fund- Compensation Board The Compensation Board is an advisory body The CF Board consists of organised business, organised labour, government and medical fraternity The Board advises Minister of Labour on policy matters, amendments to the Act, annual increases in benefits, appointment of assessors Director-General (DG) may request the board to investigate any issue relating to the operations of COIDA The Compensation Commissioner is delegated by the DG to administer COIDA 4

5 Mission To compensate employees for disablement caused by occupational injuries/diseases sustained/contracted in the course of their employment or their dependents for death resulting from such injuries/diseases and to pay the reasonable medical expenses incurred. 5

6 The Revenue of the Compensation Fund All employers must register with the Compensation Fund, over active at present The revenue of the Compensation Fund consists mainly of annual assessments paid by the registered employers on the basis of a percentage of the annual earnings of their employees. This rate is fixed per industry subclass Levies calculated based on the earnings (salaries) submitted by employers multiplied by standard rate per subclass The Act makes provision for a minimum assessment to ensure that the assessment is not less than the administration costs Employers pay direct into CF accounts Employers are obliged to pay within prescribed time frames (30 days of invoice date), which qualifies them for Letters of Good standing 6

7 Revenue Conti Definition: any person, including the State, who employs an employee State is exempted from paying assessments however, they pay administration costs Obligations of employers: Register as an employer Keep record of employee s earnings Furnish annual Return of Earnings Pay annual Assessment Report all alleged accidents/occupational diseases on duty Furnish all requested outstanding documents/information. Failure to comply: penalties 7

8 MUTUAL ASSOCIATIONS Rand Mutual Assurance Company Ltd mining industry. Federated Employers Mutual Assurance Company Ltd construction and building industry. Operates under license from the Minister of Labour Permission is given for employers to register/transfer to mutual associations 8

9 High level business process Revenue generation process Register employer Issue return of earnings Receive return of earnings Assess employer Issue invoice Employer pays 9

10 COIDA BENEFITS Benefits are paid to employees, employers (refunds), dependents, medical providers Definition: Employee is any person who has entered into or works under a contract of service with an employer. The contract of service can be in writing or oral, expressed or implied. Temporary/casual workers, employed for the purpose of the business covered. Domestic workers in a private household- NOT covered (will be with amendments) Benefits are for both occupational injuries and diseases 10

11 Temporary Total Disablement (TTD) 75% x(minimum/maximum salary) Section 47(3)(a) Employer liable for payment of compensation for the first 3 months. After 3 months Fund pays employee until he is declared fit 11

12 Permanent Disablement (PD): Up to 30% - lump sum-15 x (minimum/maximum salary) 1 29% - calculated proportionally 100% Pension 75% x (minimum/maximum salary) 31-99% PD: 75% x (minimum/maximum salary) calculated proportionally Payable for life Increased annually based on CPI 12

13 Widow/er: Lump sum Children Min/max salary x 75% x 40% (more than one widow/er, they share) 2 x monthly pension the deceased employee would have Monthly Pension Monthly pension 20% x 75% x (min/max salary) Until 18 years old Extended secondary or tertiary education Maximum : 60% (three cildren) W.Ac. 22 life certificate to be submitted annually Also increased annually 13

14 Burial expenses 2012 R R Assistive devices Need for such medical aid is determined by the CF Chronic medication Constant Assistance Allowance 14

15 MEDICAL BENEFITS Employee has free choice of doctor Doctor determines nature and extent of treatment Compensation Fund pays reasonable medical aid related to injuries sustained for a maximum of two years Need for, nature and sufficiency of medical aid decided by the Compensation Fund 15

16 High level business process Claims processes Register claim Adjudicate Assess compensation payable Calculate award Employee objects Review Hearing 16

17 Main guiding principles of COIDA No fault workrelatedness Risk based to improve OHS standards No damage are recovered by employees against employers Employees covered even for willful misconduct if serious injuries resulted in death Employee can claim from employer if the accident was due to employer s negligence All injuries or diseases must be caused by employment COIDA is the exclusive remedy for occupational injuries/diseases in SA unlike in N. Zealand; Switzerland, Netherlands etc. Similar to Germany, USA; Canada; Israel and others Employers are rated according to their risk profiles Incentive for employers to improve occupational health and safety standards Compliance by employers to OHS results in less accidents 17

18 Objections to Decisions taken by the Commissioner Any person affected may lodge an objection Should use prescribed form WG 29 Lodge objection within 180 days of date of decision Objection heard by Presiding officer and two assessors-one representing employees and one representing employers If dispute is medical, a medical assessor sits in COIDA tribunal decisions are appealable to the Supreme court having jurisdiction 18

19 Rehabilitation, Re-Integration and Return to Work Policy Framework Currently, the CF is working on Rehabilitation, Re-integration and Early Return to Work policy. PROGRESS The policy framework has been developed The amendment of the current COID Act is underway to make provision for the policy on rehabilitation, a chapter has been added A policy is being developed to support the new chapter in the Act 19

20 Social Security Reforms Compensation Fund, thus DoL, is a member of the Inter Departmental Task Team (IDTT) on social security reforms in the country CF has given inputs to RABSA and NHI COIDA amendments is also meant to accommodate these reforms There are benefits in ensuring alignment of entities dealing with social security 20

21 COIDA Key challenges Fragmented compensation systems ODMWA and COIDA Under-reporting of accidents/ diseases/ or delays Inadequate enforcement of COIDA Centralised system- no direct examination of patients Over servicing by some health care providers Exorbitant medical costs Exploitation of injured employees receiving assistive devices Portability of compensation benefits for non-citizens is still a challenge 21

22 COIDA STATISTICS AS IN 2010 Registers an average of to per annum Paid R1.8 billion for medical expenses Paid a total of benefits worth R801m Had employers in the database R29 billion in assets for 2010 financial year 22

23 Industries with highest number of compensation claims Air and transport compensation claims- Agriculture and forestry claims Iron; Steel and metal Building and construction claims Food drinks and tobacco Personal services and Hotel claims Trade and Commerce claims 23

24 Thank you 24

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