Workman Compensation Dilemma: How Should Employers Handle Unexpected Claims?

How to Move in the Matter of Workman Compensation

The information is given below as has been briefed to me.

One workman was lying in his residence in a bad condition due to sickness. Some fellow workmen of the group requested their contractor to help the sick person. The contractor, on humanitarian grounds, admitted the sick workman to a hospital. The sick person was diagnosed with a neuro-disorder due to high blood pressure. The workman was discharged from the hospital once he recuperated.

The workman remained on the rolls of the contractor until the closure of the contract. Now, the contractor received a notice from the WC Commissioner after a span of 23 months through the principal employer for payment of compensation amounting to 16 lakhs. The workman filed a copy of the hospital papers with the WC Commissioner. The Principal Employer has already informed the authority that no accident had occurred on the particular date mentioned in the petition. However, the principal employer withheld the payment that was due to the contractor and stated that the payment could only be released after the matter is resolved.

Workmen's Compensation and Employer's Responsibility

The Workmen's Compensation Commission cannot issue an order without giving the employer (the contractor) an opportunity to be heard. The incident has nothing to do with employment, and as such, no compensation can be awarded in such cases. To be eligible for compensation under the WC Act, the incident should have occurred during employment. In this case, the employee had the neurological disorder while at his residence.

Calculation of Compensation

Coming to the compensation part, I am not sure if the calculation of compensation is correct. Even if we take the age of the employee to be 18 and the wages of the employee to be the maximum under the Act, i.e., Rs 8000, the compensation for permanent disablement will be 60% of wages (or 60% of Rs 8000) multiplied by the factor relevant to the age of 18 years, i.e., 226.38, or Rs 10,86,624.

Role of the Principal Employer

The step taken by the principal employer cannot be blamed because, for him, whatever is available in hand only can be taken as right, and if the Workmen's Compensation Commissioner has issued a notice of recovery, he has to obey it. It is for the contractor to take necessary steps to get out of this.

Mr. TK, your apprehension is correct. No order was passed; rather, a notice was issued based on the information provided by the workmen, including medical expenses amounting to 4 lakhs. The contention is that the case lacks merit as it does not fulfill the following criteria:

1) "It must have been the result of an accident arising out of and in the course of the worker's employment."

2) The complainant was absent until the date of his hospitalization.

3) However, the complaint refers to the last date on which he was present as the date of the accident.

I will say that the contractor should appear before the Commission and describe the entire story. The Commissioner will be convinced.

Whatever the facts of the case may be, since notice is received from the concerned government authorities, the employer has to reply in a legal manner.

From the facts described regarding the nature of the illness - no accident at the site, no occupational disease - no liability attaches to the employer for compensation.

Thank you, Mr. TK and Mr. Nathrao. However, the reply has already been provided. The advocate appeared and requested the submission of various documents through the WC Commissioner to support the case, such as workmen biometric attendance, first aid reports, accident reports from the Factory Inspector, Ambulatory pass from CISF, etc. The workmen were unable to provide the requested documents as they were fabricated. Subsequently, the workmen's advocate filed an application under the Right to Information (RTI) to obtain the aforementioned information but did not receive any documents.

Dear colleagues,

I would like to supplement some more development that took place in the recent past, as updated by the contractor. The contractor has been asked to act as per the suggestions received and after due discussion with the advocate.

Advocate's Involvement

The contractor appointed an advocate who appeared before the WC Commissioner and submitted the reply. The advocate pressed the authority to provide proof of the accident by which this case has been registered. The advocate pleaded before the authority to drop the case as it does not fall within the ambit of WC, stating that "it must have been the result of an accident arising out of and in the course of the worker's employment," which is missing in the instant case.

Burden of Proof

The contractor's advocate pleaded that the burden of proof is the obligation of the party. Since the onus of proof lies on the part of the complainant to prove his claim, he may be directed to provide the following documents to rely upon: the wage slip, biometric attendance report, first aid report, accident report from the Office of the Inspector of the Factory, Ambulatory pass from CISF, etc. The advocate of the workmen filed an application under RTI to obtain the above information. The WC authority provided a three-week time limit to submit the information, which ended on 15.01.2019. The claimant could not produce any document that could help him establish the case. The claimant's advocate requested another two weeks' time. Simultaneously, the contractor approached the authority to issue a notice to the insurance company as a party to the case, as the contractor holds a valid WC policy.

Mr. TK and Nathrao are worthy of praise for shedding light on the topic and are also requested to provide further insight since the case has not yet ended.

PE is taking steps as a matter of abundant precaution. From facts discussed, it is apparent that the illness or injury was not due to employment. A self-contained case needs to be placed on record with details of his work and last attendance or work done in the factory. Documents regarding his illness need to be shown, as the type of illness and work are not related. The procedure of proof takes time but can be done, as the facts do not justify workers' compensation in mind.