How to claim from the Compensation Fund after an injury at work

Somebody hurt at work usually asks the wrong question first. They ask whether the employer was at fault. Under this Act it does not matter, and asking it sends people down a road that leads nowhere.

The Compensation for Occupational Injuries and Diseases Act 130 of 1993, universally called COIDA, provides compensation for injuries and diseases arising out of and in the course of employment, without proof of fault. In exchange for that, it takes away the right to sue the employer.

The bargain at the centre of it

Section 35(1) provides that an employee who suffers an occupational injury has no action for damages against their employer. The employer, having contributed to the Fund, is protected from civil claims; the employee, having given up the claim, gets compensation without having to prove anybody did anything wrong.

For most workplace injuries this trade favours the employee. A worker who falls from a ladder that nobody maintained badly, in circumstances where negligence would be impossible to prove, is paid anyway. A civil claim in the same facts would fail.

Where it does not favour the employee is in the serious cases. COIDA compensation is calculated on statutory formulas and is generally considerably less than a court would award in damages for the same injury, and it does not compensate for general damages in the way a delictual claim does.

That is the bargain, and it is not optional. It applies whether you like the outcome or not.

The claim that survives

This is the part most often missed, and it is frequently worth more than the COIDA claim.

Section 35 bars a claim against your employer. It does not bar a claim against a negligent third party. So where somebody other than your employer caused the injury, that claim survives alongside the COIDA claim.

Common examples:

• a road accident while working, where the Road Accident Fund claim is unaffected. Our guide on claiming from the RAF sets out that process
• an injury caused by a contractor or another company on site
• a defective product or machine, where the manufacturer or supplier is liable under the Consumer Protection Act
• a negligent driver who is not your employer or a fellow employee

If you were hurt at work in circumstances involving anybody other than your employer, take advice, because the two claims run in parallel and the second is where the real money usually is.

Reporting: the first seven days

The obligation sits on the employer, and it is short.

The employer must report the accident to the Compensation Commissioner within seven days of having been brought to their attention (section 39). Since 1 April 2026, an employer that reports late can be made to pay a penalty equal to the full compensation payable plus interest, so the incentive to report is now strong. Our guide on what an employer must do when an employee is injured sets out the employer's side step by step.

The employee's part is to report the accident to the employer as soon as possible. Do it in writing, and keep proof. This is the single most common point of failure in the whole process: an injury reported verbally to a supervisor who never passed it on, and an employee who cannot later show that they reported it at all.

If your employer refuses or fails to report it, you can report it yourself to the Compensation Fund or to a Department of Employment and Labour office. Do not accept "we will sort it out internally" as an answer, and do not accept being paid cash to keep it off the books, which leaves you with no record when the injury turns out to be lasting.

The claim itself has a deadline. Section 43 requires a claim to be lodged within 12 months of the accident, or of the death. A claim lodged later can still be considered if the employer reported the accident under section 39. Since 23 January 2026, section 44 says the right to benefits lapses altogether only if the accident is not brought to the Commissioner's attention within three years, up from 12 months before the amendments, and regulations published on 6 March 2026 apply that three-year period to claims generally. Do not rely on the outer limit: lodge within the 12 months.

What the Fund pays

Compensation depends on what happened and on your earnings, subject to a maximum.

Medical costs reasonably necessary as a result of the injury, generally for a period after the accident, and longer where further treatment is needed.

Temporary disablement, where you cannot work for a period. This is paid as a proportion of earnings, 75% under Schedule 4. Your employer must pay it for the first three months and is then refunded by the Fund (section 47(3)). Nothing is paid for disablement that lasts three days or less (section 22(2)).

Permanent disablement, assessed as a percentage. Lower percentages are paid as a lump sum; higher percentages are paid as a monthly pension.

Death benefits, including a lump sum and a pension for a surviving spouse and children, and a contribution towards funeral costs.

Earnings are subject to a ceiling for these purposes, which is adjusted from time to time, so a higher earner is compensated on a capped figure rather than actual income.

What it does not pay

General damages. There is no award for pain and suffering as such, which is the largest single difference from a civil claim.

Full loss of earnings. Compensation is formula-based and capped.

Anything, where the injury falls outside the Act. Injuries not arising out of and in the course of employment fall outside. A road accident on your own way to or from work is the common example: section 36(6) says it gives no COIDA claim. Transport provided by or on behalf of the employer is different. Sections 22(5) and (6) treat it as part of your employment, from the pick-up point the employer designates to the drop-off point.

Your own fault is no longer a bar. Before 23 January 2026, an accident caused by the employee's serious and wilful misconduct could be excluded unless it caused death or serious disablement. The amended section 22(3)(a) now says compensation is payable even where the accident was due to the employee's serious and wilful misconduct.

Occupational diseases

The Act covers diseases as well as injuries, and this is where the claims are hardest and most valuable.

Noise-induced hearing loss, occupational asthma, dermatitis, musculoskeletal conditions and dust diseases are all capable of being compensated. Since 23 January 2026 the Act's definition of occupational disease expressly includes post-traumatic stress disorder. The difficulty is causation and timing: the disease develops slowly, employment may have ended, and the link to the workplace has to be established by medical evidence.

The clock for a disease runs from diagnosis, not from the work that caused it. Section 65(4) requires the disease to be brought to the attention of the Commissioner or the employer within 12 months of its commencement, and section 65(5) treats commencement as the date a doctor first diagnosed it, or an earlier date if that favours you. Published commentary reads the March 2026 regulations as extending the three-year outer limit to disease claims too, but report within 12 months of the diagnosis rather than test that.

If you have a condition you believe is work-related, get it assessed and reported rather than assuming it is too late because you no longer work there.

The practical sequence

Report to your employer in writing, immediately, and keep a copy.

Get medical attention, and make sure the medical records say the injury happened at work and how. A record that says "laceration to left hand" is much weaker than one that says "laceration to left hand sustained when guard on cutting machine failed at work".

Check that the employer has reported it. Ask for the claim number. An employer who cannot produce one has probably not reported.

Keep everything. The claim number, every medical report, every letter, every payslip showing what you earned before the injury.

Follow up. Compensation Fund claims are notorious for going quiet, and the people who are paid are generally the people who followed up with a reference number.

Ask about a third party. Before accepting that COIDA is your only route, work through who else was involved.

If the employer is not registered

Employers are obliged to register with the Fund and to pay assessments. Some do not.

An employee of an unregistered employer is not left without a remedy: the Fund may still pay, and since 1 April 2026 section 87(2) lets the Commissioner impose a penalty on the employer of up to the full compensation payable for the accident, on top of the assessments it never paid. Do not let an employer tell you there is no claim because they never registered, because that is their default and not your problem. Household employers are the most common offenders, and our guide on domestic workers' rights explains why a domestic worker is covered too.

If the Fund refuses or underpays

Decisions of the Compensation Commissioner are not final, and the Act provides routes to challenge them.

A claimant dissatisfied with a decision, including the percentage of permanent disablement assessed, can object and have the matter reconsidered, and there is provision for a hearing and for appeal to the High Court on a question of law. Disputes about the disability percentage are the most common, because a few percentage points can be the difference between a lump sum and a pension.

The objection deadline changed on 23 January 2026. Section 91(1) now allows 12 months after the decision to lodge an objection with the Commissioner, and section 91(8) lets the Commissioner extend that by a further six months on good cause shown. Older advice that quotes a shorter period describes the law before the amendments. Object in writing, quote the claim number and keep proof of delivery.

Where a claim has simply gone unanswered, the practical remedy is persistence with a paper trail: written enquiries quoting the claim number, addressed to the office handling it, kept in date order. As with any administrative delay, an unreasonable failure to decide is itself capable of review, and a letter from an attorney pointing that out frequently produces movement where months of telephone calls have not.

Do not let the process lapse because it is slow. Medical reports go missing, employers change payroll providers, and the evidence you need becomes harder to assemble the longer the claim sits.

Worked example

This example is illustrative. Thabo is a delivery driver. He is injured when another vehicle drives through a red light and collides with the company bakkie during a delivery.

He has two claims, and treating this as one claim is the mistake that costs the most in practice.

Against the Compensation Fund, because the injury arose out of and in the course of his employment. No fault needs to be proved. The employer must report it within seven days, and the Fund covers his medical costs and pays for his period off work and any permanent disablement.

Against the Road Accident Fund, because the injury was caused by the negligent driving of another motor vehicle. That claim is not barred by section 35, because the RAF is not his employer.

The RAF claim covers heads of damages COIDA does not, including general damages if the injury is assessed as serious and loss of earnings on an actuarial basis rather than a capped formula. Our RAF claim range indicator gives the shape of it.

There are rules about how the two interact so that he is not compensated twice for the same loss, which is a matter for an attorney. One of those rules changed on 23 January 2026: section 36(5) now says the Road Accident Fund is not a third party from which the Compensation Fund can recover what it paid. Thabo's own RAF claim is unaffected, but how the courts will treat the overlap under the new wording is not yet settled.

Change the facts: if Thabo had been hurt driving his own car to work in the morning, before any delivery, section 36(6) means he would have no COIDA claim at all, and the RAF would be his only route. But an employee in Thabo's position who claims only from the Compensation Fund, because that is what the employer's HR department told him to do, has left the larger claim entirely untouched.