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Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

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Annual Increase in Medical Tariffs for Medical Service Providers - 2020

Renal Care, Wound Care and Social Workers Psychology

Rules for payment of wound care accounts in terms of COIDA


1. In terms of Sec 73(1) of COIDA, the Compensation Fund shall pay reasonable medical costs incurred by or on behalf of an employee in respect of medical aid necessitated by such accident or disease.


2. Referral letter with clinical indications for wound treatment should be submitted by the referring doctor and medical accounts from wound care practitioners should be accompanied by such motivation.


3. A regular medical report should b submitted to the Fund indicating progress of the wound.


4. The treatment of the wound should be directly related to the nature of injuries sustained by the employee.


5. Wound treatment within four months post operatively must be motivated according to rule 2 otherwise rules G(d) will apply. Rule G(d) of the General Practitioners and specialist Government Gazette stipulates that the fee in respect of a procedure shall include normal aftercare for a period not exceeding four months. If normal aftercare is delegated to any other health professional and not completed by the surgeon it shall be a surgeon's responsibility to arrange for the service to be rendered without extra charge.


6. The Surgeon should refer to the specific procedure code as outlined in the gazette for General Practitioners and specialist for a specific aftercare period.


7. After 10 conservative wound treatments the employee should be referred back to the treating doctor who should write a progress or final medical report. If further wound treatment is indicated the Compensation Fund should be furnished with motivation for further wound care treatment.


8. Wound treatment and cost of materials in the hospital is only payable to the hospital as a per diem tariff.