Compensation Fund still failing to pay up - SAMA

Association says, as a result, private practitioners unable to bear costs of injured workers who approach them for treatment (July 13)

Continued failure of the Compensation Fund

13 July 2015

The South African medical Association expresses its dismay at the continued maladministration of the Compensation Fund and its failure to discharge its lawful obligations under the Compensation for Occupational Injuries and Diseases Act.

All employers in South Africa are required to contribute to the Compensation Fund on behalf of their employees to provide medical cover for their workers who are injured or contract occupational diseases while on duty. The Compensation Fund therefore receives hundreds of millions in contributions annually and workers have the right and a legitimate expectation that claims made against the Fund will be paid by the Fund. Tragically, the converse is true.

Despite repeated assurances by the various officials who have occupied the position of the Compensation Commissioner, to address the maladministration and backlog in claims processing, the position has not improved. Claims that are literally decades old have not been paid and the backlog shows no signs of abating.

While SAMA advocates for the rights and interests of its members, being medical doctors, it is, in this instance gravely concerned by the impact of the failures of the Compensation Fund on workers. These failures to process and pay legitimate claims create a barrier to the access to healthcare by injured workers and infringe upon their Constitutional right to healthcare services.

Private practitioners are increasingly and justifiably unable to continue to personally bear the healthcare costs of those injured workers who approach them for treatment. The result is that these workers are forced to seek treatment and rehabilitative services from an already under-resourced public health sector. The consequence for these workers is that they experience significant delays in accessing treatment and rehabilitation, which often prevents a full recovery.

SAMA has previously and repeatedly engaged with the Compensation Commissioners and the Fund to address this problem, but to no avail. The promises and assurances received by the Fund and the alleged interventions that the Fund has allegedly put in place have shown no improvement and the backlog of claims now spans decades. While the Compensation Commissioner has made statements to the Parliamentary Portfolio Committee, he has not addressed the fundamental issue of the extreme backlogs at the Fund

SAMA is now compelled to find other avenues, including, but not limited to, calling for a judicial review of this issue, not only in the interests of its members but for the benefit of the South African public at large.

About the South African Medical Association (SAMA)

The South African Medical Association (SAMA) is a non-statutory, professional association for public and private sector medical practitioners.  Registered as an independent company, SAMA acts as a  champion for doctors, patients and as a Trade Union for its public sector members 

Statement issued by Dr Mzukisi Grootboom, Chairperson: SAMA, July 13 2015