WHEN TO CLAIM COMPENSATION BENEFITS
Compensation benefits are claimable when you experience an occupational accident or disease which results in temporary disability, permanent disability or death of workers. Employers are required to report accidents and diseases within three days of gaining knowledge of the occurrence. Accident and disease Report Forms are available at all Compensation Offices and on the website under Statutory Forms.
HOW COMPENSATION BENEFITS ARE CALCULATED
Compensation benefits are calculated according to loss of earning capacity or degree of disablement suffered by a worker as a result of an occupational accident or disease. According to the present Workers’ Compensation Act, earning capacity means K800,000 per month or K9.6 million per year. The Act provides for calculation of benefits subject to 50% of earning capacity.
WHAT TYPE OF BENEFITS ARE CLAIMABLE FOR INJURY & DISEASE
Compensation benefits claimable under the present Workers’ Compensation Scheme include the following;
The Workers’ Compensation Fund Control Board provides medical refunds to employers on all expenses incurred as a result of hospitalization and treatment of workers disabled by occupational accidents and diseases at public and private health institutions.
Treatment at local health institutions
The Board encourages employers to utilize public and private health institutions available within the country for the purpose of hospitalization and treatment of workers. All medical expenses incurred at such institutions are refunded upon submission of necessary documentation and receipts to the Commissioner.
In circumstances, where there are no specialized health facilities locally and upon recommendation by medical experts, employers can seek approval from the Commissioner to evacuate injured workers abroad to receive treatment. Without prior approval by the Commissioner to evacuate injured workers no reimbursement of costs incurred on treatment can be made to employers.
The Workers’ Compensation Fund Control Board compensates workers disabled by occupational accidents and diseases through the following:
1. CASH BENEFITS
The Board awards life pension, a benefit drawn monthly until death, to workers for static or permanent injuries or diseases assessed by a Medical Assessment Board at more than 10 percent degree of disablement.
The Board provides lump sum payments (one off payments) to workers for static or permanent injuries assessed by a Medical Assessment Board at 10 percent or less degree of disability. A medical Assessment Board consists of a registered medical practitioner, employee’s representative, injured employee and a Board official.
WIDOW’S OR WIDOWER’S PENSION
Surviving spouses of workers who die as a result of occupational accidents and diseases are granted widow’s or widower’s pension, a benefit drawn monthly until death or remarriage of the surviving spouse. In the event of remarriage, the spouse is granted gratuity and the case is closed. Where a disabled worker in receipt of monthly pension dies, the surviving spouse is granted monthly pension at 80 percent of the amount payable to the deceased worker.
CHILDREN & GUARDIAN ALLOWANCES
In addition to monthly pension granted to surviving spouses of workers who die as a result of occupational accidents and diseases, children’ allowances are paid to children below the age of eighteen. While guardian allowances are paid to single deceased workers survived by person’s other than spouses.
COMMUTATIONS OF PENSION
The Board through the Commissioner ‘s discretion grants commutations of pension to workers in receipt of monthly pension to enter into a business venture or any undertaking considered to be of lasting benefit in line with the provisions of the act. Normally these are:
(a) Part commutation - certain amount of his/her pension is reduced to yield a lumpsum for the purpose so required leaving a reasonable residual monthly pension;
(c) Total commutation - where the Commissioner feels pension is very minimal, the whole amount is commuted if the pensioner is agreeable and the case is closed thereafter.
These are payments of compensation in cash or in kind to the injured worker. These periodical payments are claimed by employers upon submission of form No. 18 and final medical form No. 21. The Board provides periodical payments subjec to a maximum of 18 months to workers disabbled by, duly hospitalization or treatment.
The Board re-inburses medical expenses incures by employers on treatment and hospitalization of injuresd or disabled workers subject to provision of medical receipts.
This is when a pensioner/employer has paid for their medical services and needs to be reimbursed and so a refund is given.
2. NON-CASH BENEFITS
This is the restoration of the disabled worker to the fullest physical, mental, social, vocational and economic usefulness of which he is capable. Under Rehabilitation, the following services are offered:
Post Accident counseling
The Board through its Rehabilitation Section in the Directorate of Claims and Pensions provides mobility aid to permanently disabled workers such as artificial limbs, surgical shoes, crutches, wheel chairs and hearing aids. The Board works in close collaboration with the Italian Hospital in Lusaka and Arthur Davison Hospital in Ndola to manufacture and supply artificial limbs to disabled workers.
The Board provides vocational training to pensioners in various courses such as industrial sewing, metal-work, carpentry, typing, to mention a few, through sponsorship at the National Vocational Rehabilitation Centre and other training providers in the country.
CONSTANT ATTENDANCE ALLOWANCE
The Board pays constant attendance allowance to persons taking care of paraplegic (bed ridden) pensioners.
PERIODICAL MEDICAL EXAMINATIONS
The Board meets costs associated with arrangements for pneumoconiosis pensioners to undergo periodical examinations at the Occupational Health & Safety Research Bureau in Kitwe.
Workers’ Compensation Fund in addition to mitigations through Health & safety, and life pension it also provides rehabilitation services such as:
(a) Constant Attendance Allowances to both paraplegics and highly disabled pensioners on a quarterly basis in addition to the monthly pension in order to cushion the effects.
(b) Provides mobility aid such as wheelchairs, armpit & elbow crutches, pulpit walkers, walking sticks,
(c) Surgical kits to paraplegics such as: Inco sheets( linen savers), urine bags, catheters, KY jell, diapers, talcum powder, Dettol, Vaseline gauze, strappings, syringes, needles, deep heat spray, normal saline, cotton wool, gauze swabs etc.
(d) Facilitates pensioners to commute either in total or part as provided for in Workers Compensation Act No. 10 of 1999
(e) Facilitates provision for physiotherapy to improve pensioners well being
(f) Counseling services: post-accident counseling, pre & post commutation counseling, nutritional counseling.
(g) Provides artificial limbs
(h) Community Based Rehabilitation
(i ) Vocational training for pensioners in various fields.