ABSTRACT
Background and objectives: The Western Cape Provincial Medical Advisory Panel (PMAP) was established in 2004 in terms of Section 70(1) of COIDA. A primary function was to improve the efficiency of medical assessment of occupational disease claims. The PMAP was closed by the Compensation Commissioner in 2008. This audit aimed to determine the fate of claims outstanding at the time of closure. Methods: A total of 68 claims outstanding in April 2008 were followed up by telephone; email and/or internet to determine what proportion had progressed or; if accepted; had resulted in a permanent disablement compensation payment. Results: Of the 68 claims; 31 (44) were confirmed as having progressed. Of these; payment of permanent disablement awards could be confirmed in only 15 claims (22). The remaining 56 either showed no progress or no longer had a record in the COIDA system. Those stages of the claims process that had previously been aided by PMAP functioning had deteriorated in efficiency. Conclusions: Overall; the low proportion of outstanding claims finalised and awarded is consistent with inefficiency in claims handling of occupational disease; a finding echoed by recent complaints about general Compensation Fund performance from both healthcare providers and parliamentary investigation
Subject(s)
Health Care Costs , Insurance Claim Review , Occupational Diseases , Workers' CompensationABSTRACT
This paper briefly describes Noise-Induced Hearing Loss (NIHL) and proposes a formula for calculation of disability from NIHL. This has been used for compensation purposes in accordance with existing laws2 with regard to disability due to hearing loss in a mine in Botswana and could be used on a national basis. Disability from Binaural Hearing Loss (BHL) is calculated by first calculating the hearing handicap for each ear; then the Binaural Hearing Loss and finally applying a formula which takes into account the compensation allowed under the law