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Five rules to remember when claiming compensation for injuries

by , 30 March 2015
When it comes to claiming compensation for workplace injuries and accidents, the rules of the game are simple. There are things you can do and there are things you can't do, otherwise you'll be outside the law.

Here are the five rules you need to follow to claim compensation for injuries.

Five COID compensation rules

1. Your employee still has a right to compensation even if he doesn't tell you about the accident himself and you found out about it from another source

2. If your employee doesn't report the accident or makes mistakes in the details he provides about it, he's entitled to compensation. Allow him to correct any mistakes he's made about the details of the accident

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Avoid getting your claims denied...

COID statistics show that the fund denies 80% of all claims outright!

Why?

For two reasons:
1.    The employee either didn't report the claim properly.
2.    Or the incident they reported is something the COID Fund doesn't cover.

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3. Report the accident to the Commissioner within seven days of finding out about it

4. Report all accidents to the COID Commissioner. Note that you don't have the authority to decide if an injury or disease occurred during working hours or not. Only the Commissioner has that authority.

5. Also, in case you don't report an injury or disease to the Commissioner within seven days, the Director General can fine you and you could face other penalties. The fine includes:

• The cost of medical assistance;
• Any amount paid or payable, including ambulance fees, doctor fees or any specialist fees;
• The value of a pension (lump sum or portion); and
• Allowances (for transportation, ambulance, treatment at home etc.) (See also sections 38-39 of COIDA for further examples on all of the above).

But that's not all – you also need to provide these five pieces of information when claiming from COID

We wanted to also provide you with the necessary information on the five steps to take to support your compensation claim:

1. Ask your employee to give you any information or documents that the Commissioner may need to support the compensation  claim, such as medical reports, copies of sick notes, copies of prescriptions for medicines etc. (Section 41.1 of COIDA);

2. After you get the information, documents and medical report, submit these to the Commissioner within seven days of receiving these (Section 41.2 of COIDA);

3. Your employee may have to be examined by a medical practitioner. Note that medical practitioner is designated by the Director General, the employer or a medical association (Section 42.1of COIDA);

4. The cost of the examination will be paid directly to the medical practitioner by the Director General. If your employee isn't able to go to the medical practitioner, arrange for the medical examination to take place at another agreed time and place (Section 42.2 of COIDA, 3); and

5. If your employee wants to have his own medical practitioner or chiropractor present at the examination, he'll be responsible for that cost (Section 42.4 of COIDA).

Analyse the situations and make sure you understand when your responsibilities end and when the Commissioner gets involved.

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