Who's responsible for your employees occupational disease medical expenses?
You have to know that your company, the Director General or a mutual association are liable for paying reasonable costs of medical assistance for your employee.
According to Section 73.1 of COIDA
, the medical assistance will be paid for a period of not more than two years for a disease. The Commissioner will tell you who must pay and what the reasonable costs are. This is usually in the form of a letter.
When it comes to decisions for payment of medical assistance, these will be decided by the Director General (Section 75 of COIDA) and the cost of medical assistance is calculated according to the tariff of fees. This is also decided by the Director General.
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Provided that your company or a mutual association is liable for paying medical assistance costs, and you need to recover these costs from the Commissioner, your recovery can only be claimed if:
• It's larger than the tariff of fees;
• The amount for that particular medical assistance hasn't been determined by the Commissioner; and
• It's larger than what the Director General decides to be reasonable.
Bear in mind that you can't demand or receive payment from your employee as a contribution to the cost of medical assistance. Also, if you're convicted for non-compliance because you made your employee pay, the Director General will order you to repay the amount you took from the employee, as section 77.2 of COIDA states.
Moreover, if you provided employees with medical assistance that complies with COIDA, the Director General may approve your arrangements, according to sSection 78.1 of COIDA).
Note that if you've made arrangements to pay occupational disease medical expenses and it's approved by the Director General, the following conditions apply (Section 78.2, 3 of COIDA):
• Your employees are entitled to the medical assistance you've arranged;
• You'll only have to pay for that medical assistance;
• The Director General may reimburse you if you aren't individually liable or reduce your tariff of assessment; and
• The Director General can withdraw his approval or change these conditions at any time.
There you have it. These are the surrounding conditions that makes you liable for paying the costs in case of occupational disease!