In terms of section 22 of the Compensation for Occupational Injuries and Diseases Act (COIDA), an employee has a right to compensation.
The Compensation Fund, a division of the Department of Labour, have their own medical section with assessors to evaluate all claims submitted by employers/employees.
If in their opinion, the claim does not warrant compensation, a Medical Officer (from the Compensation Fund Department) will issue a M O Recommendation and request certain information regarding full Medical Report and other supporting documentation for review. Whilst awaiting the requested documents there will be no payment, this can be very frustrating.
COIDA however provide recourse in a simplified manner namely “Objections and Appeals” as per section 91.
- “Any person affected by a decision of the Director-General or a trade union or employer’s organisation of which that person was a member at the relevant time may within 180 days after such decision, lodge an objection against that decision with the commissioner in the prescribed manner.
- (a) An objection lodged in terms of this section shall be considered and decided by the Presiding Officer assisted by two Assessors designated by him, of whom one shall be an Assessor representing employees and one an Assessor representing employers. (b) If the presiding officer consider it expedient, he may, notwithstanding paragraph (a), call in the assistance of a Medical Assessor”.
In a nutshell, COIDA provides that, without being legalistic, an injured employee is afforded an opportunity to convince a Director-General to relook a rejected claim.
MISA is just a phone call away!