An injured worker with a percentage disability greater than 30% and above OR calculated pension should be more than the gazetted minimum pension.

· WCIF 14

· Medical Report

· Copy of ID/Valid passport

· Payslip for the month of injury

· Bank Statement

· Decision sheet for pneumoconiosis cases

Widow should be married to the injured worker on or before the date of accident. Workers cause of death should be work related or worker should have been receiving Worker’s Pension at time of death

.WCIF 14

· Copy of Death Certificate/Medical report

· Marriage Certificate/Affidavit

· Copy of ID/Valid passport

· Payslip for the month of injury

· Bank Statement

· Decision sheet for pneumoconiosis cases

Children below the age of 19 and should be born before date of accident or not more than 10 months from the date of accident.

Disabled Children are paid for life.

· WCIF 14

· Medical Report

· Copies of Birth certificates

· Disability certificate for disabled children

· Certificate of Adoption

· Letter of Guardianship when both parents are deceased and when widow has remarried

· Copy of ID for guardian

· Copies of worker or widow’s death certificates

· Guardian’s bank statement

· Decision sheet for pneumoconiosis cases

A trained aide for the grossly disabled workers

· Copy of ID for Aide

· Bank Statement

· Certificate of training from WCRC

Any dependent besides surviving spouse and children

· WCIF 14

· Dependence certificate/Form

· Copy of worker’s Death Certificate

· Copy of Dependent’s ID

· Bank Statement

An injured worker with a percentage disability of equal or less than 30% OR calculated pension should be less than the minimum pension applicable.

· WCIF 14

· Medical Report

· Copy of ID/Valid passport

· Payslip for the month of injury

· Bank Statement

· Decision sheet for pneumoconiosis cases

Widow/widower should be married to the injured worker on or before the date of accident.

Paid to Widows receiving Widow’s Pension who have remarried

· WCIF 14

· Copy of Death Certificate/Medical report

· Marriage certificate or Affidavit stating the remarriage status

· Copy of ID/Valid passport

· Payslip for the month of injury

· Bank Statement

· Decision sheet for pneumoconiosis cases

· Confirmation of marital status form

An injured worker with two or more assessments of disability with different ratings.

• WCIF 14

• Two or more Medical Reports with different assessments

• Copy of ID/Valid passport

• Payslip for the month of injury

• Bank Statement

• Decision sheet for pneumoconiosis cases

Whoever meets the funeral expenses of the deceased worker.

· Death of certificate and or confirmation of cause of death

· Funeral expenses claim Form

· Copy of ID for the claimant

· Bank statement for the claimant

An injured worker invited to NSSA offices.

 Proof of travel in the form of bus tickets

The injured worker treated for work related injuries.

• WCIF 14
• Medical Aid claim form
• Invoices and receipts

· WCIF 14

· Off duty slip

· Medical certificate of incapacity

· Copy of worker’s ID

· Banking details

Industrial clinic

 Registered Clinic completes WCIF 22 obtained from NSSA Office