Connect Class XIII September 2016 Use of correct RMA forms RMA streamlines Let RMA its document cover you management from end- process to-end

Transcription

1 Connect Class XIII September 2016 Issue 3 Use of correct RMA forms RMA streamlines its document management process Let RMA cover you from endto-end

2 Use of correct RMA forms It is important that when submitting forms to RMA that they be submitted on the correct RMA form and not on a Department of Labour (DoL) form in order to avoid delays. RMA has different processes and thus has different requirements to the Compensation Fund, which means that the RMA forms may contain fields that differ from those of the DoL. RMA, however, encourages its clients to report and capture claims directly onto C-Filing, RMA s online claims management portal. The advantage of this is that should you require a hard copy of the claim details, once captured the form can be printed off for your files. How to print an accident form off C-Filing: STEP 1: Click on the print icon as circled in red below. STEP 2: Select the print icon for the form you want to print, in this case RMD01 - Accident Claim Form. 02

3 In addition, for all medical reports completed by the healthcare provider, it is important that these be RMA branded. RMA has a network of healthcare providers with whom it has a good working relationship and it is important that they recognise the RMA branded forms to ensure that your injured staff member receives the best possible service when they need it most. All RMA forms are available under the Downloads tab on the RMA website click here: Correct: Examples of frequently used forms: RMA First, Progress and Final medical reports 03

4 Incorrect: Accident: W.CL.4 - First Medical Report in Respect of an Accident W.CL.5 - Final/Progress Medical Report in Respect of an Accident Disease: W.CL.22 - First Medical Report in Respect of an Occupational Disease W.CL.26 - Final or Progress Medical Report in Respect of an Occupational Disease 04

5 COIDA vs the POPI Act While the Protection of Personal Information (POPI) Act is not yet fully enforced within South Africa, RMA is already cognisant of the future requirements and is putting measures in place to ensure that it will be fully compliant with the requirements of the Act well in advance of it being implemented. POPI seeks to regulate the collection, storing and processing of personal information which can identify a natural or juristic person. The POPI Act requires there to be a legitimate reason for obtaining and processing personal information, such as for a justifiable reason or a requirement by another Act. RMA s obligation under COIDA: It is important to note, however, that in terms of section 63 of COIDA, RMA is required to calculate the earnings of an employee in such a manner that is deemed best to determine the monthly rate at which the employee was being remunerated at the time of the accident. In order to achieve this, RMA requires the injured employee s earnings to accurately determine the compensation payable to the employee, or his beneficiaries in the event of his death. Employers should further note that in terms of section 81 of COIDA they are expected to keep a record of earnings and other particulars of all employees, and should at all reasonable times be able to produce this record on demand for inspection. Some employers have raised concerns regarding their obligations in terms of COIDA, or in particular, RMA s requests for personal information versus POPI obligations. We need to emphasise that the information requested by RMA is required in order to speedily and adequately adjudicate claims received. It is RMA s view that the requested information is required to protect and pursue the interest of the employee and their beneficiaries and thus justified in accordance with section 11 (c), (d) and (f) of the POPI Act, 4 of Employers therefore remain responsible to submit the required information regarding the injured person and event to RMA, including earnings. Please be assured that RMA uses the information solely for the purpose for which it is requested, and protects the information in accordance with standards set by the POPI Act. At RMA we have a zero tolerance for non-compliance and strive to be a trusted partner to our clients. The POPI Information Regulator was appointed by Parliament on 7 September 2016, and Adv. Pansy Tlakula will oversee this positon. If there are any changes to the above view once the regulator has released her interpretation of the POPI Act, RMA shall communicate this to all employers. Current indications are that the commencement date of the POPI Act will likely be May 2017, and there will be a one-year grace period until May 2018 for the industry to comply with the Act. 05

6 Let RMA cover you from end-to-end Has your company opted for section 78 but is now suffering under the burden of heavy medical and administration costs? Section 78 of the Compensation for Occupational Injuries and Diseases Act (COIDA) gives employers the option to choose to cover all their employee s medical costs - both chronic and acute - which are offset against the COID premium. Many companies that have chosen this option are carrying onerous costs with an additional administration liability; administering something that is not core to their business or even taking on an extra burden by outsourcing the administration to an external company. A number of these companies are thus opting to dispose of section 78 for this very reason. Instead they are taking up day one cover with RMA, ensuring they are covered from end-to-end. We continue to receive numerous requests in this regard. Through economies of scale and a network of healthcare providers around the country, RMA is in a better position to manage medical costs through negotiated tariffs with hospitals and cost management of the COIDA tariffs for medical doctors. RMA has a number of clinical and medical experts in-house that manage its hospital, disease and pharmacy benefit management programmes which ensure that the most appropriate clinical treatment is rendered at the best possible time and cost. These cost-reducing measures mean that your premium will not be severely affected should you choose to replace section 78 with day one cover from RMA. In addition, our strong relationships with the medical industry ensure that your injured employees are attended to timeously and with care. If you are currently covered by section 78, contact RMA for a quote. 06

7 How to submit a fatal claim to RMA In the unfortunate event that one of your staff members die as a result of an occupational accident or disease, first think RMA. The Compensation for Occupational injuries and Diseases Act (COIDA) requires employers to report accidents to RMA within 7 days, and diseases within 14 days. However, reporting as soon as possible within the legislated timelines means that the deceased employee s dependants get quicker access to the benefits due to them in their time of need. The following fatal benefits are payable: a) Spouse s lump sum payment b) Spouse s monthly pension c) Dependent children s monthly pension/s d) Funeral benefit When reporting the fatality to RMA, the information and documents listed below must be submitted for speedy adjudication of the claim: 3. Details of the deceased employee, as follows: a. Nomination forms by the employee listing his/her dependants (if available); b. Certified copy of the employee s ID; c. Certified copy of the death certificate; d. Payslips from the six months prior to the date of the accident; and e. Certified copies of the employee s marriage certificate/s. 4. Details of the deceased s dependants, as follows: a. Name/s and contact details of the employee s dependants; b. Certified copy of the widow(er)/s ID; c. Birth certificate/s of the employee s children; and d. Banking details of the spouse/guardian. 5. RMA may also request proof of guardianship, SAPS reports, witness statements, road accident reports or post-mortem reports where applicable, and any other documents that may assist in adjudicating the claim. 6. RMA may appoint an investigator to confirm that the accident or disease is work-related A comprehensive statement by the employer of how the accident occurred and what transpired, together with the date and time of the accident and witnesses to the event Confirmation of the employee s employment i.e. contract, salary slip, time sheets, or payroll information to confirm that the employee was employed by your company and that the accident occurred while on duty and in the execution of his/ her duties. If these details are not readily available, talk to us. RMA is about caring and client-centricity, so we believe jointly we can find a solution. Clearly then paying your COIDA premiums makes good business sense. RMA mobile clinic helps Malawi pensioners Fulfilling its promise of Caring, Compassionate Compensation, RMA s mobile prosthetic unit assisted 86 disabled RMA pensioners with prosthetic reviews on a recent trip to Malawi. The mobile clinic is totally self-sufficient with electricity and a back-up water supply, and is fully equipped for prosthetic repairs and manufacturing. The pensioners were seen in both Blantyre and Lilongwe where they had their prosthetics refitted and repaired, or new prosthetics manufactured and fitted where required by prosthetics partner, Marissa Nel and Associates. 07

8 In addition to the prosthetic reviews, RMA clinical staff provided medical screening, blood pressure and glucose tests, as well as reviews of spinal cord injuries. The team was happy to meet up again with RMA pensioner, Hammy Phiri, who previously received assistance from RMA to invest in a self-sustaining community vegetable project. He continues to provide food for eight women, their families and communities through his food security programme. Our mobile clinic staff even got to enjoy the fruits of his labour during their long night shifts in Lilongwe. In addition, an ex-miner arrived at the clinic, who had not previously been reviewed by the clinic. He was injured in 1969 and had a home-made prosthesis constructed out of steel, which was cutting into his skin and damaging his shin. He was fitted with a brand new prosthesis and received a pair of grasshopper shoes donated by RMA. He left the clinic happy and much more comfortable. On average, the life span of a new prosthesis is around three to five years before it needs to be replaced, so hopefully we will see this gentleman again in three years, Our mobile unit brings much needed care to our pensioners in far-reaching areas and we are always filled with a deep sense of purpose and humility when we are able to assist and support our pensioners in this way, says General Manager: Medical, Dr Deodat Kritzinger. The RMA team is not the only one to relish this opportunity, the pensioners look forward to it too. This is caring and compassion in action. Our mobile unit brings much needed care to our pensioners in far-reaching areas and we are always filled with a deep sense of purpose and humility when we are able to assist and support our pensioners in this way, 08