COIDA Medical Reports: The Doctor's Guide to W.Cl.4, W.Cl.5 and Injury-on-Duty Claims

Updated 2026-07-05 · Written for South African healthcare practitioners by Sphygmos.

When a patient arrives with an injury on duty (IOD), the consultation is only half the work. The claim lives or dies on the medical report. Under the Compensation for Occupational Injuries and Diseases Act (COIDA), the Compensation Fund adjudicates on paper: the W.Cl.4 first medical report establishes what happened clinically, whether it is work related, and how long the employee will be off. This guide sets out the statutory framework of a COIDA claim: which form applies to which claim type, what the Act requires each report to state, who reports what and by when, and how the practitioner's account is paid.

What COIDA covers and why the medical report carries the claim

The Compensation for Occupational Injuries and Diseases Act 130 of 1993 (as amended, including by Act 61 of 1997) provides no-fault compensation for employees who are injured in accidents arising out of and in the course of their employment, or who contract occupational diseases, and for dependants where the injury or disease causes death. It is administered by the Compensation Fund under the Compensation Commissioner, within the Department of Employment and Labour. In general, employees covered by the Act claim from the Fund rather than suing their employer.

For the treating practitioner, the key point is that the Fund never examines the patient. It adjudicates the claim on the documents. The medical report is the clinical evidence on which liability is accepted, temporary disablement payments are calculated, permanent disablement is assessed, and the practitioner's own account is paid.

Who does what: the employer lodges the claim, the doctor writes the report

A common misconception is that the doctor submits the claim. Under COIDA the claim is lodged by the employer: the employee reports the accident to the employer, and the employer must report it to the Compensation Fund within seven days of gaining knowledge of an accident, and within fourteen days of learning of an alleged occupational disease. Most employers lodge through CompEasy, the Fund's online claims system. Since the COIDA Amendment Act 10 of 2022, a claim prescribes three years after the date of the accident or diagnosis (previously twelve months).

The medical reports are the treating practitioner's responsibility. The W.Cl.4 is a first medical report, completed at the first treatment, and it does not depend on the employer having lodged the claim.

Employee: reports the accident or diagnosis to the employer as soon as possible.
Employer: lodges the Notice of Accident and Claim for Compensation (W.Cl.2) within 7 days of an accident, or the occupational disease report within 14 days of diagnosis, usually via CompEasy.
Treating practitioner: completes the medical reports. W.Cl.4 and W.Cl.5 for injuries; W.Cl.22 and W.Cl.26 for occupational diseases.
Compensation Fund / Commissioner: registers the claim, decides liability, determines disablement awards and pays medical accounts.

The forms, by claim type

COIDA claims run on two tracks, injury on duty and occupational disease, each with its own set of forms. Injury claims use the W.Cl.4 and W.Cl.5 medical reports; occupational disease claims use the W.Cl.22 and W.Cl.26. The forms are available from the Department of Employment and Labour's Document Centre, and medical reports can be uploaded to CompEasy.

W.Cl.2 (Notice of Accident and Claim for Compensation): the employer's report of an injury on duty.
W.Cl.4 (First Medical Report in respect of an Accident): completed by the treating practitioner at first treatment, with a detailed clinical description of the injury.
W.Cl.5 (Progress / Final Medical Report in respect of an Accident): covers further treatment and, ultimately, the final outcome.
W.Cl.1 (Employer's Report of an Occupational Disease) and W.Cl.14 (Notice of an Occupational Disease and Claim for Compensation, completed by the employee).
W.Cl.22 (First Medical Report in respect of an Occupational Disease): the practitioner's first report on the disease track.
W.Cl.26 (Progress / Final Medical Report in respect of an Occupational Disease): submitted until the condition has stabilised, then as the final report, supported by the relevant objective investigations.

What the W.Cl.4 first medical report must contain

The W.Cl.4 is completed at the first treatment and is the medical foundation of an injury-on-duty claim. The Fund adjudicates on the documents, and the form requires the following, completed in full and signed by a registered practitioner.

Patient and employer details, with the date of the accident and the reported mechanism of injury.
A clinical description of the injuries and the examination findings: site, side, nature and severity, with relevant special investigations.
The diagnosis, with the applicable ICD-10 code(s).
An opinion on whether the clinical findings are consistent with the reported accident: the causal link between the injury and the employment.
Treatment given and planned, including referrals, procedures and expected further management.
The period of temporary total or partial disablement: how long the employee is unfit for work, and the expected date fit to resume duties.
Whether any permanent disablement is anticipated.
The practitioner's HPCSA registration details and practice number, signature and date. The Fund requires reports from a registered practitioner with a practice number.

Progress and final reports: W.Cl.5 and W.Cl.26

The first report opens the clinical record; the progress and final reports close it. For injuries, the W.Cl.5 records further treatment, changes in the off-duty period and, once the condition has stabilised, the final outcome: whether the employee has recovered fully, the date fit to return to work, and any permanent impairment found on examination. The Commissioner uses the final report to assess permanent disablement.

On the occupational disease track, W.Cl.26 progress reports are submitted until the condition has stabilised, followed by a final W.Cl.26 supported by the relevant objective investigations. For respiratory disease, the Fund expects current lung-function tests performed pre- and post-bronchodilator.

Causation and disablement: what the report states and what the Fund decides

The causal relationship between the diagnosis and the employment is central to every COIDA claim, and the medical report must state the practitioner's opinion on it. The Fund adjudicates that opinion together with the reported mechanism or exposure, the examination findings and the investigations recorded on the form.

The percentage of permanent disablement, and the award that follows from it, is determined by the Compensation Commissioner, not the treating doctor. The report states whether permanent disablement is anticipated and, after the condition has stabilised, the objective impairment findings. A disablement percentage is never the treating practitioner's to invent.

Getting paid for COIDA work

Where the Fund accepts liability for a claim, it pays the medical accounts at the tariffs prescribed for COIDA in the Government Gazette, so accounts are claimed according to the gazetted tariff codes. The account goes to the Fund or, where the employer is insured through a licensed mutual association such as Rand Mutual Assurance or FEM, to that association. An injured employee should not be billed for accepted injury-on-duty treatment, and the employer may not recover it from the employee's wages. Reasonable medical aid is payable for up to two years from the date of the accident or diagnosis, and can be extended where further treatment will reduce the extent of the disablement.

Treating practitioners register on CompEasy as medical service providers and can submit medical reports and accounts directly on the portal. The claim number is quoted on every report and invoice once it has been issued.

What an inadequate report costs

The Compensation Fund cannot register, accept or pay a claim it cannot adjudicate, and it adjudicates on the medical report. A missing or inadequate first medical report leaves the claim unregistered or under query: the employee waits for temporary disablement payments, the employer carries an open incident, and the practitioner's account sits against a claim that has not been accepted.

Queries from the Fund can arrive months or years after the consultation, and they are answered from the report on file. A W.Cl.4 that does not establish the clinical findings, the causal link and the disablement period leaves the Fund unable to adjudicate, and an unadjudicated claim pays no one.

How Sphygmos helps

Sphygmos drafts COIDA medical reports with the statutory framework built in: the W.Cl.4 and W.Cl.5 structure, the causal relationship statement and the disablement fields the Compensation Fund requires. It never invents an impairment or disablement rating. Where a judgement is clinically the practitioner's to make, the draft marks it clearly, and every report arrives as a draft ready for the treating practitioner's review and signature.

See Sphygmos, the clinical operating system for South African doctors

Frequently asked questions

Who completes the W.Cl.4 first medical report?

The treating medical practitioner completes the W.Cl.4 (First Medical Report in respect of an Accident) at the first treatment of an injury on duty. The practitioner must be HPCSA registered and include a practice number, because the Compensation Fund will not process reports without them. The employer lodges the claim itself; the medical report is the treating practitioner's responsibility.

What is the difference between the W.Cl.4 and the W.Cl.5?

The W.Cl.4 is the first medical report for an injury on duty, completed at first treatment with the clinical description, diagnosis, causal opinion and off-duty period. The W.Cl.5 is the progress and final medical report: it records further treatment, changes to the disablement period and, once the condition has stabilised, the final outcome and any permanent impairment findings. Both belong to the injury track; occupational diseases use the W.Cl.22 and W.Cl.26 instead.

Which COIDA forms apply to occupational disease claims?

On the disease track the practitioner completes the W.Cl.22 (First Medical Report in respect of an Occupational Disease) and thereafter the W.Cl.26 (Progress / Final Medical Report) until the condition stabilises. The employer must report an alleged occupational disease to the Compensation Fund within fourteen days of learning of it. Disease claims also require the relevant objective investigations; for respiratory disease, current lung-function tests performed pre- and post-bronchodilator.

Who pays the doctor for treating an injury on duty, the Fund or the patient?

Once the Compensation Fund accepts liability for the claim, it pays the medical accounts at the COIDA tariffs prescribed in the Government Gazette; where the employer is insured through a licensed mutual association, the association pays instead. The injured employee should not be billed for accepted injury-on-duty treatment. Reasonable medical aid is payable for up to two years from the accident or diagnosis, and longer where further treatment will reduce the extent of the disablement.

How quickly must an injury on duty be reported?

The employee must report the accident to the employer as soon as possible, and the employer must report it to the Compensation Fund within seven days of gaining knowledge of it, or within fourteen days for an alleged occupational disease. Failing to report is an offence and can leave the employer liable. The W.Cl.4 first medical report is completed at the first treatment, whatever stage the employer's report has reached.

Can I state a permanent disablement percentage on the first medical report?

No. The W.Cl.4 asks whether permanent disablement is anticipated; the assessment itself happens after the condition has stabilised, on the final report, and the percentage and award are determined by the Compensation Commissioner. The treating practitioner's report supplies the objective findings on which that determination is made.

What is CompEasy?

CompEasy is the Compensation Fund's online claims management system, hosted by the Department of Employment and Labour at compeasy.labour.gov.za. Employers use it to register injury-on-duty and occupational disease claims, and registered medical service providers can submit medical reports and accounts directly on the portal. Step-by-step manuals for employers and healthcare providers are published on labour.gov.za.

Sources

This guide is general information for healthcare practitioners, not medical or legal advice. Compensation Fund forms and processes change; verify current requirements with the Department of Employment and Labour.