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Compensation for occupationally-acquired novel corona virus disease (covid-19)

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NOTICE ON COMPENSATION FOR OCCUPATIONALLY-ACQUIRED NOVEL CORONA VIRUS DISEASE (COVID-19) UNDER COMPENSATION FOR OCCUPATIONAL INJURIES AND DISEASES ACT, 130 OF 1993 AS AMENDED

 

The Notice for compensation of occupationally-acquired novel Corona virus disease (COVID-19) came into effect on the publication date of Gazette no. 43126.

 

Occupationally-acquired COVID-19 is a disease contracted by an employee as defined in the COID Act arising out of and in the course of his or her employment as well as after official trips to high-risk countries or areas in a previously COVID-19-free individual.

 

All employers and medical service providers must follow stipulated prescripts when submitting claims and supporting medical reports for COVID-19.

 

Diagnosis

 

COVID-19 can be reliably diagnosed by:

Sputum, nasopharyngeal or oropharyngeal swab specimen collected from all patients at admission, tested by real time polymerase chain reaction (PCR) for SARS-CoV-2 RNA performed within three hours of collection.

 

Occupationally-acquired COVID-19 diagnosis relies on:

 

Occupational exposure to a known source of COVID-19;
A reliable diagnosis of COVID-19 as per the WHO guidelines;
An approved official trip and travel history to countries and/or areas of high-risk for COVID-19 on work assignment;
A presumed high-risk work environment where transmission of COVID-19 is inherently prevalent; and
A chronological sequence between the work exposure and the development of symptoms.

 

Occupations at risk

 

Very high exposure risk occupations:

 

Very high exposure risk jobs are those with high potential for exposure to known or suspected sources of COVID-19 during specific medical, post mortem, or laboratory procedures.

 

Medium Exposure risk occupations:

 

Medium exposure risk jobs include those that require frequent and/or close contact with (i.e. within 2 meters of) people who may be infected with SARS-CoV-2, but who are not known or suspected COVID-19 patients. In areas without ongoing community transmission, workers in this risk group may have frequent contact with travelers who may return from international locations with widespread COVID-19 transmission.

 

In areas where there is ongoing community transmission, workers in this category may have contact with the general public (e.g. in schools, high-population-density work environments, such as labour centres, consulting rooms, point of entry personnel and some high-volume retail settings),

 

Low Exposure risk occupations:

 

Lower exposure risk (caution) jobs are those that do not require contact with people known to be, or suspected of being infected with COVID-19, nor frequent close contact with (i.e. within 2 meters of) the general public. Workers in this category have minimal occupational contact with the public and other co-workers.

 

The Medical Officers in the Compensation Fund will determine whether the diagnosis of COVID-19 was made according to acceptable medical standards.

 

Impairment

 

Assessment of permanent impairment shall be determined three months after diagnosis and when Maximum Medical Improvement (MMI) has been reached.

The degree of impairment will be evaluated based on the complications of the Covid-19 from the affected body system(s).

 

Benefits

 

Temporary total disablement (TTD):

Payment for temporary total disablement shall be made for as long as such disablement continues, but nor for a period exceeding 30 days.

 

Suspected and Unconfirmed Cases:

For self-quarantine recommended by registered Medical Practitioner in accordance with the DOH/WHO/ILO guidelines, the employer will be liable for remuneration for days of absence.

 

Confirmed Cases:

For confirmed cases and where the Compensation Fund has accepted liability, temporary total disablement shall be paid from the date of diagnosis up to 30 days. In an event where there are complications, the Commissioner has a right to review the case.

 

Permanent Disablement:

In an event where there are complications the Commissioner has a right to assess each case on merit and determine if there is any permanent disablement.

 

Medical Aid:

In all accepted cases of COVID-19, medical aid shall be provided for a period of not more than 30 days from the date of diagnosis. If in the opinion of the Director-General further medical aid will reduce the extent of disablement this shall be considered.

 

Death Benefits:

Reasonable burial expenses, widow’s and dependent’s pensions shall be payable, where applicable, if an employee dies as a result of the complications of COVID-19.

 

Reporting

 

The following documentation should be submitted to the Compensation Commissioner or the employer individually liable or the mutual association concerned.

 

When submitting reports online through the CompEasy system or Mutual Association Claims systems, medical service providers must use the emergency COVID-19 ICD-10 code: U07.1 as proposed.

 

Employers’ 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/or any other appropriate employment history which may include any information that may be helpful to the Compensation Commissioner.
A Medical Report on the employee’s symptoms that details the history, establishes a diagnosis of COVID-19 and laboratory results and chest radiographs where appropriate or 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 (MMI).
An affidavit by the employee if employer cannot be traced or will not timeously supply a W.CL.1, where applicable.

 

Online claims for COVID-19 must be made through the following channels, indicating the correct ICD-10 code.

 

Compensation Fund: CompEasy (www.labour.gov.za)

Rand Mutual Assurance: CompCare (www.randmutual.co.za)

Federated Employers Mutual: IMS (https://roe.fem.co.za)

 

Submission of manual claims for COVID-19 must be sent to these email addresses:

 

Compensation Fund: covid19claims@labour.gov.za or phone 0860 105 350

Rand Mutual Assurance: contactcentre@randmutual.co.za or phone 086 022 2132

Federated Employers Mutual: FEM-Registry@fema.co.za or phone 011 359 4300

 

The office of the Compensation Commissioner shall consider and adjudicate upon the liability of all claims. The Medical Officers in the Compensation Commissioners’ Office are responsible for medical assessment of the claim and for the confirmation of the acceptance or rejection of the claim.

 

Guide:

 

We have put a guide together including the necessary documentation to be completed for Compensation for occupationally-acquired novel corona virus disease (covid-19).

 

Click here to view the guide.

 

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