July 30

How to Get Paid Out by COIDA When an Employee Is Injured at Work (Step-by Step Guide)

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Workplace injuries happen — often when you least expect them. One moment, everything is routine. The next, someone is bleeding, broken, or shaken, and people are asking: "What now?"

In that moment, knowing the COIDA process isn’t just a compliance issue — it’s a business-critical skill.

The Compensation for Occupational Injuries and Diseases Act (COIDA) exists to protect both employers and employees when someone gets hurt on the job. It ensures workers receive the care and compensation they need — and it protects businesses from direct liability, provided the correct process is followed.

But here’s the problem:
Most employers only learn the process when it’s too late. And when an employee is sitting in a waiting room, being refused care, or forced to pay out of pocket, lack of preparation turns into legal and reputational risk.

This guide outlines the exact steps, forms, and responsibilities involved — with verified timelines and real-world advice — so you can handle a workplace injury with clarity and confidence.


Who Can Claim Under COIDA

COIDA applies to nearly every person who performs work for remuneration in South Africa — regardless of their employment status, nationality, or job title.

Here’s who qualifies for cover:

  • Permanent, part-time, fixed-term, and casual employees

  • Apprentices, interns, and learners

  • South African citizens, foreign nationals, and — in many cases — undocumented workers

As long as the injury or disease arises “in the course and scope” of employment, the employee is entitled to compensation.

That includes:

  • Accidents on-site or in the workplace

  • Injuries sustained while traveling for work

  • Occupational diseases caused by the working environment

  • Events that aggravate a pre-existing condition during working hours

It’s important to note:
Employees do not claim directly from the Compensation Fund — the employer is responsible for initiating the claim and submitting the paperwork. However, the benefits — medical care, compensation for lost income, and permanent disability payments — are ultimately paid to or on behalf of the injured worker.

This means the employer’s role is not optional. It’s a legal duty.

Who Gets Paid Out (and For What)

COIDA is designed to take the financial sting out of workplace injuries — but it’s not a blank cheque. It pays for specific things, and it pays them to specific parties.

What COIDA Covers:

  • Medical expenses — doctor visits, hospital treatment, X-rays, CT scans, medication, surgery, and rehabilitation.

  • Temporary disablement compensation — a percentage of wages if the employee is booked off work due to the injury.

  • Permanent disablement compensation — a lump sum or pension if the injury leaves lasting damage.

  • Death benefits — including funeral costs and ongoing support for dependents.

Who Receives the Money:

  • Medical service providers — if they bill the Compensation Fund directly.

  • Employers — if they’ve paid for medical treatment or temporary wages upfront; they are reimbursed after claim approval.

  • Dependents — in cases of death benefits.

  • Never the employee directly — even if the employee pays for treatment, the employer must reimburse them and claim from the Fund.

The employer’s prompt submission of forms and supporting documents is what unlocks these payments. No forms, no payout.

What If the Employee Is Foreign or Undocumented?

This is one of the most misunderstood aspects of COIDA — but the law is clear:

If someone is injured while performing work for pay, they are covered under COIDA.
Even if they are a foreign national. Even if they do not have a valid work permit.

COIDA is a “no-fault” system. It doesn’t ask whether the employee was legally employed — it only asks whether they were injured in the course and scope of their work.

So what does the employer need to do?

  • Submit the injury as normal using the W.CL.2 form.

  • Attach a certified copy of the employee’s passport or any official ID.

  • If there is no work permit, note this clearly. Do not fabricate documentation.

The Compensation Fund may still process the claim, especially for medical expenses. However, employers who hire undocumented workers still face immigration and labour compliance risks — including fines and prosecution under the Immigration Act.

But here’s the key:

You cannot “opt out” of COIDA by pretending the worker doesn’t exist.
If they were hurt while working for you, you are responsible for reporting the incident — and they are entitled to treatment.

What Happens If the Employer Hasn’t Done the Admin?

Accidents don’t wait for paperwork. If an employee is injured and your COIDA admin isn't in place — no registration, no CompEasy login, no forms ready — things can unravel quickly.

But here’s what you need to know:

You still have a legal duty to act, and you still have options — even if you're not registered yet.

If you’re not on CompEasy:

  • You must still complete the W.CL.2 form manually (PDF available online).
  • Tear off Part B of the form and give it to the injured employee immediately.
  • The employee must present this when visiting a hospital or doctor — it confirms the injury is work-related and covered under COIDA.
  • You can register on CompEasy afterward and upload the documents within the 7-day reporting window.

What if the employee already went for treatment?

  • If they paid, you (the employer) should reimburse them and then submit the claim to the Compensation Fund for reimbursement.
  • If you paid, submit proof of payment and all forms to claim it back.
  • If the provider refuses to treat the employee without COIDA paperwork, escalate to hospital management or contact the Department of Labour.

Reminder:

The W.CL.2 form is not just a reporting tool — it’s also the key that unlocks medical treatment.

Failing to act can result in:

  1. The employee being refused care
  2. You losing the right to reimbursement
  3. Possible fines or penalties for non-compliance

The Step-by-Step Process (Most Accurate and Up to Date)

This is the exact, legally verified sequence of what to do from the moment an employee is injured:

Immediately After the Injury:

  1. Ensure the employee receives first aid or emergency care.
      – If urgent, call emergency services or transport them to the nearest hospital.

  2. Complete the W.CL.2 form (Employer’s Report of Accident)
      – Fill out Part A (pages 1–2).
      – Tear off Part B and give it to the injured employee.
      – This slip must accompany them to the doctor or hospital.

  3. Send the employee for treatment.
      – Ideally to a provider familiar with COIDA claims.
      – They must hand over the W.CL.2 Part B at reception.

Within 1–2 Days:

  1. Collect the W.CL.4 (First Medical Report) from the treating doctor.
      – This confirms the nature and cause of the injury.
      – It is essential for submitting the claim.

  2. Gather all required documents:
      – Completed W.CL.2 (Part A)
      – W.CL.4 (Medical Report)
      – Certified copy of employee’s ID or passport
      – Medical invoice and proof of payment (if employer paid)
      – Your company’s verified banking details (if claiming reimbursement)

Within 7 Days of the Injury:

  1. Submit the full claim to the Compensation Fund
      – Register or log in via https://compeasy.labour.gov.za
      – Upload the required documents and track the claim online
      – If not yet registered, you may also submit manually at your nearest Department of Labour office

After Submission:

  1. Track progress and respond to any queries from the Fund.
      – If the employee is booked off for a long period, obtain W.CL.5 (Progress Medical Report) monthly.
      – Once they return to work, submit a W.CL.6 (Resumption Report).
      – If the injury results in permanent impairment, the doctor will issue a final W.CL.5 with impairment rating.

This process protects your employee — and it protects you.
It ensures that medical costs are covered, time off is compensated, and you're reimbursed properly.

What Forms to Submit and Where

The COIDA claim process relies on a small number of standard forms. Each one has a specific purpose, and submitting the right forms to the right place is the key to getting paid.

Here’s what to use and when:

Primary COIDA Forms

 Form  Purpose  Completed By  Submitted To 
 W.CL.2 – Employer’s Report of Accident Officially reports the incidentEmployerCompensation Fund via CompEasy or Labour Centre
 W.CL.4 – First Medical Report Confirms injury, diagnosis, and causeTreating doctorEmployer submits with claim
 W.CL.5 – Progress / Final Medical Report Updates Fund on recovery status or permanent disabilityDoctor (monthly if needed)Employer uploads
 W.CL.6 – Resumption Report Confirms return to workEmployerFund via CompEasy or manual

Additional Documents to Include (if applicable)

  • Certified copy of employee’s ID or passport

  • Medical invoices and proof of payment (if employer paid upfront)

  • Company banking details (if claiming reimbursement)

  • Proof of earnings (e.g. payslip) if the employee was booked off work

Where to Submit

  • Preferred: https://compeasy.labour.gov.za
      → Create an account or log in as an employer
      → Upload all forms, track claim status

  • Alternative (if not registered yet):
      → Submit manually at your nearest Department of Labour or Compensation Fund office
      → Or email forms to provincial COIDA contact if permitted (check with Fund)

Tip: Always keep a full copy of every form and receipt submitted. Delays and lost documentation are common — your paper trail is your protection.

Who Pays First — and Who Gets Reimbursed?

This is where many employers and employees get confused — and where mistakes cost real money.

What COIDA Pays For:

  • Medical expenses (consultations, scans, treatment, rehab)

  • Temporary disablement compensation (if the employee is booked off work)

  • Permanent disability compensation (if applicable)

  • Funeral and dependency benefits (in cases of death)

But the key question is: who pays first, and who gets the money back?

Who Pays First?

It depends on the situation:

SituationWho Pays FirstWho Gets Reimbursed
Medical provider agrees to bill COIDANobody (the Fund pays directly)Medical provider
Medical provider demands upfront paymentEmployer (or employee if urgent)Employer (not the employee)
Employee paysEmployer must reimburse the employee, then claim from COIDAEmployer

Important:

COIDA only reimburses registered medical providers or the employer.
It does not pay the employee directly, even if they paid for treatment out of pocket.

Reimbursement Conditions:

To be reimbursed, the employer must:

  • Submit W.CL.2 (accident report)

  • Submit W.CL.4 (medical report)

  • Provide original medical invoices

  • Provide proof of payment (EFT slip, stamped invoice, etc.)

  • Submit a certified copy of the employee’s ID or passport

Reimbursement is subject to COIDA tariff limits — so if a private doctor charges more than the tariff allows, the excess might not be covered.

⚠️ Tip: Always ask medical providers upfront if they accept COIDA cases. If not, prepare to pay and claim — but document everything.

Common Mistakes (and How to Avoid Them)

Even well-meaning employers run into trouble with COIDA claims — usually because they miss a simple but critical step. Here are the most frequent mistakes, and how to stay clear:

❌ Mistake 1: Not submitting W.CL.2 within 7 days

COIDA requires that workplace injuries be reported to the Compensation Fund within 7 calendar days.
→ Always complete and submit W.CL.2 immediately — even if you’re still waiting for medical reports.

❌ Mistake 2: Forgetting to give W.CL.2 Part B to the employee

Part B is the tear-off section the employee must hand to the doctor or hospital.
→ Without it, they may be refused care or charged private rates.

❌ Mistake 3: Assuming employees can claim on their own

Employees do not log their own COIDA claims. It’s the employer’s legal duty.
→ Failure to act can result in penalties — and delayed or denied benefits for the employee.

❌ Mistake 4: Going to a provider who doesn’t know COIDA

Some hospitals and doctors refuse to treat COIDA patients — or charge full private rates upfront.
→ Call ahead and confirm the provider accepts COIDA billing. If they don’t, be prepared to pay and claim.

❌ Mistake 5: Expecting the employee to be reimbursed

COIDA does not reimburse employees directly — only employers or registered medical providers.
→ If the employee pays, the employer must refund them, then claim back from the Fund.

✅ Bonus Tip: Keep Copies of Everything

Never send originals without keeping copies. Paperwork goes missing. Claims get delayed. Documentation is your insurance policy.

Case Study: When Things Go Wrong (and How to Fix Them)

Let’s walk through a real-world example that highlights the most common pitfalls — and how the correct COIDA process helps fix the situation.

🚗 The Situation:

Two employees at a mining consultancy firm are returning from a site visit. They’re involved in a car accident while traveling between the client location and head office.

One suffers minor injuries and is shaken. The other has back pain and is sent for scans.

🔥 The Complication:

The employer isn’t registered on CompEasy. They have no forms ready. The employee goes to a public hospital — and is turned away.

He’s told COIDA patients must go to a private facility, and without a medical aid or cash, he leaves untreated.

✅ The Solution:

  • The employer quickly downloads and completes the W.CL.2 form.

  • They tear off and hand the Part B slip to the employee, who returns to the hospital and is now treated.

  • The company pays for the CT scan and X-rays upfront (approx. R10,000).

  • Within 3 days, they gather the medical report (W.CL.4), the invoice, and proof of payment.

  • They register on CompEasy and upload the full claim within the 7-day deadline.

Eight weeks later, the Compensation Fund reimburses the employer in full — less a small adjustment due to tariff limits.

💡 Lesson:

Even if you're not fully set up, you can — and must — act fast to support your employee and protect your business.
COIDA works, but only if you follow the process.

Frequently Asked Questions (FAQ)


Can the employee go to a public hospital?

✅ Yes. COIDA allows the employee to be treated at any reasonable public or private facility.
Public hospitals are legally required to provide emergency treatment and must not refuse care for work-related injuries.

What if the hospital refuses to treat them?

🛑 That’s unlawful.
The employee must be given the W.CL.2 Part B slip from the employer to show that it’s a COIDA case.
If care is still refused, escalate to hospital management or the Department of Labour.

What if the employee is a foreign national or undocumented?

✅ They are still covered.
COIDA applies to anyone injured “in the course and scope” of their employment — regardless of immigration status.
Use their passport or any available ID for the claim. Legal risks for immigration remain separate.

Can an accountant or third party submit claims on our behalf?

✅ Yes.
A service provider can register on CompEasy as a third-party representative with a signed authorisation letter and supporting documents. They can then handle claims on behalf of the employer.

How long does reimbursement take?

⏳ It varies — typically 6 to 12 weeks, sometimes longer depending on the Fund’s backlog.
Ensure all documents are submitted completely and correctly to avoid delays.

What if we missed the 7-day reporting deadline?

⚠️ Submit the claim anyway — better late than never.
Include a letter explaining the delay. The Compensation Fund may still accept the claim, especially if the injury is serious or medical costs were incurred.

Resources & Downloads

Here are the official forms, tools, and links you’ll need to manage a COIDA claim properly:

COIDA Forms

- 📄 W.CL.2 – Employer’s Report of an Accident (with Part B for hospital)
 Download: Form W.CL.2 PDF (labour.gov.za)

- 📄 W.CL.4 – First Medical Report in Respect of an Accident (completed by the doctor)
 Download: Form W.CL.4 PDF (labour.gov.za)

- 📄 W.CL.6 – Resumption Report (when employee returns to work)
 Download: Form W.CL.6 PDF (labour.gov.za)

Online Tools

- 💼 Submit claims and track progress via the official CompEasy portal:
https://compeasy.labour.gov.za/

- 📞 Contact the Compensation Fund directly:
 Call Centre: 0800 321 322
 Email: cfenquiries@labour.gov.za

Like this guide?

If you found this article helpful, please share it with your network on social media — your colleagues, clients, or fellow employers might need it too.


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COIDA


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