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Form - COID - W Cl 304 - Final or Progress - Department of Labour

Form - COID - W Cl 304 - Final or Progress - Department of Labour 2025

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The document is a Final/Progress Medical Report for an employee suffering from Post Traumatic Stress Disorder, required under the Compensation for Occupational Injuries and Diseases Act of 1993 in South Africa. It includes sections for detailing the employee's treatment, prognosis, fitness for work, stabilization of condition, and any permanent impairment. A psychiatrist or medical practitioner must certify the report and submit progress reports monthly until the employee's condition stabilizes.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Claim Number at the top of the form. This is essential for tracking your submission.
Fill in the employee's full name and surname, along with their identity number and address, including postal code.
Provide the employer's name and address, followed by the date of the accident.
In section one, describe any treatments or tests conducted, including dates. Be thorough to ensure clarity.
For prognosis and further treatment, detail any ongoing care required for recovery.
Indicate when the employee was fit for normal work and when they are expected to return.
Confirm if the employee's condition has stabilized and provide a final diagnosis across all five axes.
Describe any permanent impairment resulting from the condition, referencing relevant scales like GAF or SOFAS.
Finally, ensure that a qualified professional certifies the report by signing and providing their details.

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