GUIDE IN RESPECT OF CLAIMS
Who is an employee ?
Any person who has entered into a contract of service with an employer. The service contract can be in writing, expressed or implied and applies to temporary, permanent and under aged workers and is defined in section 1 of the Act.
This Act is not applicable to domestic employees employed as such in a private household.
Who is an employer ?
Any person including the State, who employs an employee.
What is an Occupational Injury (ACCIDENT)
It is an occurrence of which a date, time and place can be determined
that arises out of and in the course of an employee’s employment and
resulting in personal injury.
Which Occupational Injuries (ACCIDENTS) must be reported ?
All occupational injuries or alleged occupational injuries that entail medical expenses and/or
absence from work for more than three days must be
reported within seven days in the prescribed manner.
For procedure, refer to paragraph 5
The delay to report an accident or alleged accident is a criminal
offence.The Commissioner may also impose a penalty on the employer
which could be the full amount of the claim.
Procedure when reporting an Occupational Injury (ACCIDENT)
Step 1: Complete “PART A” of form W.Cl.2 “Employer’s report of an Occupational Injury” , sign it and provide date where indicated.
Step 2: Detach “PART B” where perforated and forward it without delay to the doctor or hospital concerned. In minor cases, “PART B” must accompany the employee.
Step 3: Complete “PART A”, page 2 in full.
Step 4: Forward the completed form W.Cl.2 “PART A”, pages 1 and 2 without delay to :
P.O. Box 955
The employer is liable for the payment of compensation for the first three months from the date of the occupational injury.
The compensation paid by the employer shall be reimbursed by the Commissioner.
Recording of Occupational injuries (ACCIDENTS) by the Commissioner
Upon receipt of the Employer’s Report of an Occupational injury , W.Cl. 2
and a First Medical Report W.Cl. 4 the claim will be considered
and if liability is accepted , a postcard W.Cl. 56 will be addressed to the
employer.The claim number allocated will appear on this card.
If liability cannot at that stage be accepted an acknowledgement card
W.Cl. 55 will be addressed to the employer ,providing the claim number allocated.
N.B. EMPLOYERS ARE REQUESTED TO QUOTE THIS NUMBER IN ALL CORRESPONDENCE WITH THE COMMISSIONER RELATING TO OCCUPATIONAL INJURY,
as this will greatly facilitate the filing of correspondence and relevant documents on
the appropriate file and will expedite finalisation of the claim.
The basic information to identify a claim is as follows :
The registered trade name and registration number as registered with the Commissioner.
The full names and surname of the injured employee (not nicknames).
The employee’s identity number/personnel number and date of birth.
The date the occupational injury was sustained.
The above mentioned information is captured on the computer and any discrepancies
can result in duplication of claims , or that documents cannot be associated with an existing claim.
What is an occupational disease
It is a disease arising out of and contracted in the course of an employee’s employment and which is listed in Schedule 3 to the Act.
Procedure when reporting an Occupational Disease
An employer must within 14 days after he gained knowledge of an alleged occupational disease complete an “Employer’s Report of an Occupational Disease” , W.Cl.1 and forward it to the
P.O. Box 955
The commencement of the disease shall be the date on which the doctor first diagnosed the illness.
The occupational disease will be recorded in the same way as discussed in paragraphs 6.1-6.4.
Dispatch of further documents
Occuppational Injuries (ACCIDENTS)
When the First Medical Report ( W.Cl.4 ) was not posted together with the employer’s report of an occupational injury, it must be obtained without delay and submitted to the Commissioner.In cases of prolonged absence, a Progress Medical report (W.Cl.5) must be obtained monthly from the practitioner and submitted.When the employee resumes work , a Resumption Report ( W.Cl.6 ) must be completed and submitted to the Commissioner together with the Final Medical Report ( W.Cl.5 ).
The Employer’s Report of an Occupational Injury must not be kept in abeyance awaiting the medical report.
The medical reports must not be kept in abeyance until the employee’s condition has stabilized or when he has resumed work.
Fatal Occupational Injuries (ACCIDENTS)
If the accident resulted in the employee’s death the following documents must be submitted without delay : Documentary proof indicating the cause of death.
If the employee leaves a widow/widower and/or children under the age of 18 years as dependants :
A marriage certificate.
Birth certificates/baptismal certificates/sworn statements regarding the age of the widow/widower.
Birth certificates/baptismal certificates/sworn statements regarding the ages of all the children.
A Claim for Compensation ( W.Cl.3 ) (page 1) and (page 2).
A statement by the dependant widow/widower of the deceased employee ( W.Cl.32 ).
A specified burial account and if paid also a receipt.
In the case of an alledged occupational disease , the employer must irrespective of the W.Cl.1 also submit the following documents :
A First Medical Report for an Occupational Disease ( W.Cl.22 ).
A Claim for Compensation for an Occupational Disease ( W.Cl.14 ).
A Progress medical report (W.Cl.26) must be submitted monthly until the employee’s condition has become stabilised, where after a Final medical report (W.Cl.26) must be submitted.
In cases of deafness as a result of excessive noise at the employee’s workplace , audiograms must also be submitted.
All reasonable medical expenses incurred by or on behalf of an employee in respect of medical treatment necessitated is defrayed by the Compensation Commissioner or the carrier of the risk , provided the accident/occupational disease was reported by the employer in the prescribed manner.Under no circumstances should employers pay the accounts themselves.
Transport of an injured employee
The reasonable expenses incurred for the conveyance of an employee injured in an accident necessitates his conveyance to a hospital or to his residence , will be refunded from the Compensation Fund or by the carrier of the risk.
The Commissioner or any Regional Office of the Department of Labour may be contacted for any information and assistance regarding matters within the scope of the Act.
Forms that are required for accidents/occupational diseases can be obtained from the above mentioned offices.
Important aspects which should be considered
The employer in whose service the employee was at the time of the accident is liable for the payment of compensation for the first three months from the date of accident and will be refunded by the Commissioner.
No payments will be made for temporary total disablement or temporary partial disablement which lasted for three days or less.