Compensation for Occupational Injuries and Diseases (COID) is a government body that compensates workers who have been injured at work or who have contracted a disease at work. One can think of it as a large insurance policy. Employers pay a set tariff (similar to a premium on and insurance policy) and it “activates” when an employee suffer an injury at work or become ill related to their work, safeguarding employees when they are injured or ill and making sure that businesses support their compensation by paying tariffs to COID.
When it comes to claiming from COIDA on behalf of an employee, many employers find the prospect and the expected processes quite daunting. This is problematic as it can discourage employers from making use of the provisioned funds and put themselves at risk of fines for not reporting occupational injuries.
The process can be grouped into 5 stages:
Stage 1: Accident and reporting
- Any accident that occurs during working hours must be reported to the employer and/or safety officer. This will establish a timeline should the injury develop into something more serious later.
- The employee must give a written or verbal notice of the injury at work to the employer before end of the shift.
- The employer must compile a list of all the witnesses to the accident.
- The Notice of Accident and Claim for Compensation, W.Cl 2, must be completed as soon as the accident is reported. If the employee needs medical attention or the accident resulted in a death, the form must be submitted to the Compensation Commissioner within 7 days.
Completing the W.Cl 2 form:
- Part A on Page 1 must be completed when the incident is reported.
- Part B must be detached and given to the employee to take with him/her to the hospital or doctor should medical attention be required. In the case of serious injury, Part B must be handed to the emergency services personnel that responded to the accident.
- The Doctor or Medical Practitioner must complete a W.Cl 4 form (first medical report in respect of an accident). This report must include the details of the seriousness of the injury and the estimated time the employee will likely be absent from work for recovery.
- Part A, Page 2 must then be completed and sent to the Compensation Commissioner with a certified copy of the employee’s ID and an initial medical report (W.Cl 4) where necessary.
Stage 2: Acknowledgement of claim
- When the office of the Compensation Commissioner receives the claim, they will issue a W.Cl 55 postcard to the employer. It contains the claim reference number that must be used in all communication and paperwork relating to the claim.
- Once the first medial report is received, the Compensation Commissioner will consider the claim and decide whether to accept or deny the claim.
- If the Compensation Commissioner accepts the claim, a W.Cl 56 postcard will be sent to the employer. If a W.Cl.56 is not issued, it normally indicates that the claim has been denied.
- A worker can appeal a denied claim within 90 days by submitting a W929 form to the office of the Compensation Commissioner.
Stage 3: Progress Medical Report
- A medical report detailing the progress made in the recovery must be sent by the medical practitioner if there is a prolonged absence from work– a Progress Medical Report form (W.Cl 5).
- This report must be submitted on monthly basis until the employee can return to work to keep the Compensation Commissioner updated on the status of the employee’s recovery.
Stage 4: Final Medical Report
- A final W.Cl 5 must be sent to the Compensation Commissioner when the employee is fit to return to duty or is declared permanently disabled.
- The doctor or medical practitioner must send this report to the employer who must forward it to the Commissioner.
Stage 5: Return to duty
- A Resumption Report, W.Cl 6, must be completed and submitted to the Compensation Commissioner when the employee returns to work.
- The case will only be closed, and final payments made if all these stages are completed.
The compensation office will send a payment either to the worker, or to the employer who must forward the payment to the worker. The employer must pay 75% of the employees’ salary for the first three months after an incapacitating injury or illness. The employer will be reimbursed through the Compensation Fund when the fund starts paying the claim for the worker.