Lesson 10A: Forms & Fraud

Legal Report Forms

The OHaSA and COIDA require specific forms be completed and submitted by the employer and medical practitioner to the Dept of Labour and Compensation Commissioner respectively. They include:

Copies of these forms must:

• Be circulated to and retrieved from the relevant parties.
• Archive Annexure 1 for a period of at least three years.
• Archive W.Cl.2 for a period of at least 40 years.
• Be kept by the HR and the OH&S department.

Annexure 1

When recording and investigating incidents, it is important to capture detailed information to ensure accurate reporting and analysis. Annexure 1 outlines the necessary steps and details to be recorded during the process.

1. Name of employer – The employer’s full name.
2. Name of affected person – The name of the individual affected by the incident.
3. Identity number of affected person – The affected person’s identity or ID number.
4. Date of incident – The specific date on which the incident occurred.
5. Time of incident – The exact time the incident took place.
6. Part of body affected – Which part of the body was affected by the incident (e.g., arm, head, etc.).
7. Effect on person – Description of the injury, such as sprains or strains.
8. Expected period of disablement – How long the person is expected to be unable to work due to the injury.
9. Description of occupational disease – If applicable, describe any occupational disease that resulted from the incident.
10. Machine/process involved/type of work performed/exposure – Details of the equipment or process involved, the type of work being performed, and any potential exposures contributing to the incident.
11. Was the incident reported to the Compensation Commissioner and Provincial Director? – Indicate if the relevant authorities were notified.
12. Was the incident reported to the police? – If so, document this.
13. SAPS office and reference – The police station and reference number, if applicable.

B. Investigation of the Incident by a Designated Person

When investigating the incident, the following details should be documented:

1. Name of Investigator – The person responsible for investigating the incident.
2. Date of Investigation – The date the investigation was carried out.
3. Designation of Investigator – The job title or position of the investigator.
4. Short description of incident – A brief summary of the incident.
5. Suspected cause of incident – The possible causes that led to the incident.
6. Recommended steps to prevent a recurrence – Suggestions to avoid similar incidents in the future.

1. Signature of Employer – The employer’s signature confirming the actions taken.
2. Date – The date the actions were taken.

D. Remarks by Health & Safety Committee

The Health & Safety Committee may provide feedback or suggestions related to the incident:

1. Remarks – Any additional comments or observations from the committee.
2. Signature of Chairperson of Health & Safety Committee – The chairperson’s signature acknowledging the remarks.
3. Date – The date the remarks were made.

The definition of fraud is the:

• Unlawful and intentional.
• Misrepresentation of facts.
• Calculated to harm another person or party.

Indicators that fraud [a criminal offence] may be planned or committed:

• Not reported promptly.
• No witnesses
• Details are vague.
• Witnesses contradict the reported facts.
• Incident not consistent with assigned job.
• Occurred shortly after start of work.
• After announcement of layoffs, cut-backs or shut-down.
• Disciplinary procedure prior to incident.
• Report is through a lawyer’s letter.
• Casualty is in financial difficulty.