The social security fund that compensates workers for occupational diseases and injuries suffered at work is expecting more Covid-19 related claims due to the opening up of the economy.
So far the statutory Compensation Fund has mostly received medical costs and hospital admission claims for health workers but expects to receive more income-replacement claims as workers return to work and the infection spreads.
However, the DA does not believe the fund which has been plagued by financial mismanagement and delays in finalising claims for years will be able to cope with the expected deluge of claims. It has called on employment and labour minister Thulas Nxesi to outsource the processing and payment of claims to the private sector to prevent what it says will be a disaster.
Tim Hughes, the spokesperson of the Injured Workers Action Group — a lobby group representing medical practitioners, health providers, hospital groups and workers — believes only about 7% of claims submitted under the Compensation Fund’s new computer system, which was introduced in October last year, have been paid.
“Any added burden on the Compensation Fund arising out of Covid-19 related claims could collapse what is an already profoundly dysfunctional system. I think it is potentially a national crisis,” Hughes said, though he cautioned that it would be difficult to prove that a worker became infected with the disease in the workplace as is required.
Compensation Fund commissioner Vuyo Mafata told SABC News on Friday that the turnaround time for Covid-19 related claims so far was about seven days but as more claims were received this was likely to rise to 30 days.
If the volume of claims rose significantly, capacity would also be increased, he added to prevent compromising on the turnaround time.
So far the fund has received 941 claims on behalf of workers who were treated medically or admitted to hospital because of Covid-19. A total 356 claims have been accepted and about R200,000 paid out.
Of the claims received about 30% have been repudiated because the disease was not contracted in the workplace or because the information provided was insufficient.
More than 80% (533) of the claims have been lodged by women, which Mafata attributed to the fact that they were health workers who were on duty during the first phase of the lockdown. The claims received so far emerged from this period.
“As other sectors of the economy open up we should see these numbers change to the normal claims patterns,” Mafata said. No income-replacement claims have been paid so far but Mafata expects these to come in. There have also been no fatality claims.
Explaining the reason less than half of the existing claims had been accepted, Mafata said many claims were in the adjudication process to determine whether the infection was contracted in the workplace. Often this was not the case and the claim was repudiated.
DA labour spokesperson Michael Cardo said at a media briefing that as “increasing numbers of employees return to the workplace with the easing of lockdown levels, cases of occupationally acquired Covid-19 are going to soar and then persist until a vaccine becomes widely available.
“The Compensation Fund, which has a long and undistinguished history of inefficiency, maladministration and financial mismanagement is going to buckle under the weight of claims.
“The huge challenges faced by the Unemployment Insurance Fund (UIF) in administering the Covid-19 Ters [temporary employer/employee relief scheme] benefit over the past three months — which challenges the UIF still hasn’t overcome — tell a cautionary tale,” Cardo said.
“The Compensation Fund is in a much worse state of health than the UIF. Institutionally, it is far less robust than the UIF. In fact, compared with the Compensation Fund, the UIF runs like a Swiss watch. Without private sector assistance, the Compensation Fund is likely to drop the ball spectacularly on Covid-19 claims.”
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