PSIber (Pty) Ltd

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. The Government Notice on Compensation for Occupationally Acquired Novel Corona Virus Disease, which was signed by the Compensation Commissioner on the 20th March 2020, deals with occupationally-acquired COVID-19 resulting from single or multiple exposures to the confirmed case(s) of the virus in the workplace or after an official trip to high-risk countries or areas in a previously COVID-19-free individual.

A claim for occupationally-acquired COVID-19 shall clearly be set out as contemplated in and provided for in sections 65 and 66 of the COID Act.

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 work exposure and the development of symptoms.

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 not for a period exceeding 30 days.

Suspected and Unconfirmed Cases

For self-quarantine recommended by a 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 the 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:

  • Employer’s 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 the 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 – U07.1:

  • 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 011359430

Claims Processing

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 the medical assessment of the claim and for the confirmation of the acceptance or rejection of the claim.

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