DA'S PLANS TO FORCE GOV TO RESOLVE PROBLEMS IN COMMISSION FOR OCCUPATIONAL INJURIES

The Commission for Occupational Injuries and Diseases (COID) was established to ensure that low-paid, unskilled workers are properly cared for if they are injured at work, and that they remain healthy and able to support their families. Since 2000, over one million workplace accidents were reported to the Commission. So it is a crucial part of South Africa's social welfare net. But, despite recent claims by the Commissioner that the Commission has improved its performance, an investigation by the DA shows that it is still failing disastrously to do its job.

At best, the Commission's ineptitude and indifference creates enormous difficulties for workers, when they are denied compensation for pay lost as a result of injuries for unreasonable lengths of time - sometimes years on end. At worst, it denies or delays proper medical treatment to injured workers, because doctors and hospitals are increasingly reluctant to offer their services to the Commission.

The solution to the Commission's problems is simple, and it is outrageous that this situation has been allowed to continue for so long. The DA will be taking a range of steps, including laying a complaint with the Public Protector and writing to the Minister of Labour, to force the government to confront this problem.

The key problems

From the complaints the DA has received, it is clear that there are three key problems with the Commission's performance.

Firstly, the rate at which medical claims are processed is unacceptably and unreasonably slow.

The legislation governing the Commission implies that claims must be paid within a maximum of three months. However, the Commission's latest Annual Report reveals that an astounding 79% of all accounts submitted were paid more than 60 days after receipt, and almost one third were paid four months or longer after they were received. Some doctors we spoke to have been waiting more than three years for payment.

A group of over 200 doctors in the Western Cape and KwaZulu-Natal, who have submitted a complaint to the Public Protector themselves, calculate that the Commissioner has collectively owed them R27m - an average of over R127 000 each - for over a year. Three of these doctors are owed over R1m.

The problem has become so serious that an entire new industry of businesses claiming to be able to expedite payments, and charging steep commissions, has been generated.

This problem has major implications for patients. For example, the DA has been told that the only orthopaedic surgeon in the Newcastle area in KwaZulu-Natal who had been willing to treat COID patients is owed approximately R1.5m by the Commission, and is now refusing to treat any more patients. Because there are no other orthopaedic surgeons in the area willing to help these patients, doctors in Newcastle are forced to send injured workers to Pretoria, 300km away.

Bizarrely, the Commission pays for the patient's trip to this doctor by ambulance, but not for the return trip. So when the patient is discharged, he or she has no way of getting home - a particularly dreadful situation as these patients are often immobilized by their injuries, and seldom have money for the return trip.

Secondly, the Commission appears to deliberately place obstacles in the way of claimants with the apparent objective of encouraging them to give up. For example.

• It is impossible to make an appointment to see a staff member, and everyone with a query or a problem must wait in a queue. One accounts manager we spoke to recently spent more than three hours waiting to be attended to at the Commissioner's office in Pretoria, and eventually had to leave without resolving his problems.
• There is no tracking process for claims. Furthermore, an enquiry about an unresolved claim may only be made after two months - and also requires filling in an enquiry form and resubmitting all the original documents.
• Claim numbers are critical in following up on payments. But the Commission has, for no logical reason, decided that no one person may be given more than five claim numbers a day, although doctors often handle dozens of cases at the same time.

Thirdly, Commission staff seem to be far more interested in minimizing their workload than in helping injured workers - even to the extent of breaking the law.

For example, in May last year the Legal Resources Centre won a law suit against the Commission after it discovered that when employers did not submit complete employers' reports on an accident, Commission employees simply placed these claims in a specially created category of "temporary claim".

Staff simply could not be bothered to make a few phone calls to follow up, so instead devised a system to place these cases on indefinite hold. The court found this to be unlawful, and ordered the Commission to immediately follow up on 250 000 of these "temporary" claims.

This neglect is a large and growing problem. Even though the number of accidents reported to the Commission remained stable between 2000 and 2004, the number of compensation awards made decreased from 60 757 to 42 668 - a drop of 20.7%.

The solution

Many of the problems that the government faces are difficult and complex, with no clear solutions. But this does not apply to the Commission. A sound and workable system is in place, and the Fund is adequately financed by employers. All the evidence suggests that the blame simply lies with poor administration and poor management.

In talking to some of the people who regularly deal with the Commission, it has become obvious that absolutely basic administrative procedures are routinely not followed. Claims frequently simply go missing (one medical accounts manager reported to us that he regularly makes five copies of an account and submits them all seperately, in the hope that one will eventually be successfully processed); phones are not answered - or are picked up and put down; faxes do not find their way to the people they are addressed to and switchboard operators are not able to put callers through to the right person.

This year the Auditor-General issued a damning report on the Fund's operation in a number of areas, to the point where he could not express an opinion on the accuracy of revenue collections or assessments.

When doctors complain about delays, Commission staff usually blame staff shortages. But the vacancy rate of just under 10% is relatively low, compared to some other government bodies. Furthermore, the Fund is in a healthy financial position. It generated a surplus of R963m in 2004, and R443m in 2005.

So solving the problem is simply a question of ensuring that basic administrative procedures are followed and that staff do the work they are employed to do. Significant progress was made towards achieving this objective when the former Commissioner was fired for non-performance and replaced by Nerine Kahn. However, she was subsequently redeployed to the CCMA. The situation at the Commission has since then quickly reverted to the status quo under the stewardship of an acting Commissioner deployed from the Department of Labour.

The COID is yet another example of a government bureaucracy whose non-performance makes the lives of the people who depend on it a misery. In the case of the Commission, these people are generally poor, blue-collar workers who do not have the means to pay for proper healthcare and insurance themselves, and who risk losing their jobs as a result of being disabled by inadequate treatment.

The DA will be taking a number of steps to compel the Commission to act according to its responsibilities. We will:

• Write to the Minister of Labour requesting an update on whether any plans have been made to deal with the problems, and if so when South Africans can expect to see the fruits of these plans.
• Write to the Public Protector to investigate the Commission's performance.
• Pose a series of Parliamentary questions about progress in addressing the problems.
• Request that the Portfolio Committees on Health and Labour to summon the Commissioner to appear before them to explain the Commission's non-delivery.

Download full document (Letter to minister of labour.doc)
Download full document (Letter to public protector.doc)