07 April 2016

Radiologists take legal action against Department of Labour on breakdown of COIDA processes

Submitted by: Teresa Settas

The Radiological Society of South Africa (RSSA) together with 19 radiology practices has instituted legal proceedings in the High Court against the Compensation Commissioner and the Minister and Director General of the Department of Labour.  The action is based on long outstanding claims worth R121.5million made by radiologists under the Compensation for Occupational Injuries and Diseases Act, to  the Compensation Fund.  

Represented by law firm, Webber Wentzel, the proceedings instituted by the RSSA are born out of the near-complete breakdown and failure of the processes meant to be implemented under the Compensation for Occupational Injuries and Diseases Act, 1993. 

Under this Act, medical professionals, including radiologists, render medical services to employees who are injured while at work with no up-front payment.   The Act provides important social security protection for injured or ill employees who  often cannot afford the medical costs associated with treating their occupational injuries or diseases. The Compensation Fund is supposed to reimburse these medical service providers.

“The Fund has however almost completely failed, prejudicing not only the medical service providers, but also the recipients of such medical services. Currently, over R121.5 million is outstanding from the fund in payment of the 19 radiology practices involved in this action. Despite previous and repeated engagement with the Fund's administrators, our approaches to resolve the backlog have been to no avail, leaving litigation as the last resort to ensure that this necessary social protection does not fail completely,” explains Dr Richard Tuft, Executive Director of the Radiological Society of South Africa.

“Due to the systemic failures of the Fund, and a failure by its officers  to effectively fulfil their statutory duties, there exists a backlog of thousands of claims worth millions of Rands.  Many of these claims have not even been processed despite being lodged years ago, while many of those that have been approved have simply not been paid, timeously or at all. Moreover, the implementation of a new claims-processing system has led to certain claims not even being lodged, and introduced further difficulties on an already inefficient system. In total, claims valued at over R121.5 million remain unprocessed or unpaid. The extent of the true failure of the Fund is set out in stark relief when one considers the fact that this substantial figure represents the monies owed to a mere 19 radiology practices out of a total of nearly 90 practices, in an industry of many, where all participants are facing the same difficulties due to endemic systemic failures of the Fund and its officers,” explains Dr Tuft.

The RSSA hopes that the legal action will provide relief to the affected practices by enforcing the payment and proper processing of claims; as well as provide systemic relief to ensure the timeous discharge of statutory obligations by various designated actors under the Compensation for Occupational Injuries and Diseases Act, 1993. 

“Whilst it is unfortunate that litigation has become necessary, the RSSA and its members are forced to launch this application, not only to protect the interests of affected radiology practices, but to protect those of the South Africans workforce. Absent judicial intervention or a willingness on the part of the Fund to meaningfully co-operate and attend to the issues of non-payment, and the continued failure of the Fund can only result in one thing, and that is the withdrawal of medical services under the Act. This only serves to prejudice the thousands of workers who may suffer an injury or illness while at work, and can no longer access the necessary medical care and attention they need,” concludes Dr Tuft.

Published in Health and Medicine