WORKERS’ COMPENSATION ACT: INDEX TO SUBSIDIARY LEGISLATION

PNEUMOCONIOSIS (FORMS) REGULATIONS

SCHEDULE

FORM 1

FORM 2

FORM 3

FORM 4

FORM 5

FORM 6 B.1

FORM 7 B.2

FORM 8 B.3

FORM 9 B.4

FORM 10 B.5

FORM 11 B.6

FORM 12 B.7

FORM 13 B.8

FORM 14 B.9

FORM 15 B.9a

FORM 16 B.10

FORM 17 B.11

FORM 18 B.12

FORM 19 B.13

FORM 20 B.14

FORM 21 B.15

FORM 22 B.16

FORM 23 B.17

FORM 24 B.B

NOTICE AND RULES MADE UNDER THE WORKERS’ COMPENSATION ACT

WORKERS’ COMPENSATION REGULATIONS

FIRST SCHEDULE

FORM 1

FORM 2

FORM 3

FORM 4

FORM 5

FORM 6

FORM 7

FORM 8

FORM 9

FORM 10

FORM 11

FORM 12

FORM 13

FORM 14

FORM 15

FORM 16

SECOND SCHEDULE

THIRD SCHEDULE

WORKERS’ COMPENSATION (LUMP SUM COMPENSATION CALCULATION BASIS) ORDER

WORKERS’ COMPENSATION (PNEUMOCONIOSIS) (CHARGES AND FEES) REGULATIONS

SCHEDULE

WORKERS’ COMPENSATION (PERMANENT DISABLEMENT) (COMMUTATION OF PENSION) REGULATIONS

SCHEDULE

WORKERS’ COMPENSATION (CAPITALISED VALUES) REGULATIONS

FIRST SCHEDULE

SECOND SCHEDULE

THIRD SCHEDULE

FOURTH SCHEDULE

FIFTH SCHEDULE

WORKERS’ COMPENSATION (DOMESTIC WORKERS) REGULATIONS

SCHEDULE

In any case where a worker is entitled to compensation both under the law of Zambia and under the law of Zimbabwe, such worker or his dependants shall be entitled to recover compensation under the law of one country only.

[Am by 156 of 1965.]

4. Law of Zambia to apply to Zambian worker temporarily in Zimbabwe

In the case of an employer carrying on business in Zambia whose Zambian worker is temporarily employed by such employer in Zimbabwe the law in respect of compensation applicable to such worker during the whole of any continuous period not exceeding 12 months during which he is so employed in Zimbabwe shall be the law of Zambia. If the employment in Zimbabwe continues after such period of 12 months, the law applicable after such period shall be the law of Zimbabwe.

[Am by 156 of 1965.]

5. Zimbabwe law to apply to Zimbabwean workers temporarily in Zambia

In the case of an employer carrying on business in Zimbabwe whose Zimbabwean worker is temporarily employed by such employer in Zambia, the law in respect of compensation applicable to such worker during the whole of any continuous period not exceeding 12 months during which he is so employed in Zambia shall be the law of Zimbabwe. If the employment in Zambia continues after such period of 12 months, the law applicable after such period shall be the law of Zambia.

[Am by 156 of 1965.]

6. Rules where employer carries on business in both countries

In the case of an employer who ordinarily carries on business both in Zambia and in Zimbabwe and who transfers a worker temporarily from the one country to the other, the following provisions shall apply—

(a) in the case of a worker temporarily transferred from Zambia to Zimbabwe, the law in respect of compensation applicable to such worker during the whole of any continuous period not exceeding 12 months during which he is so employed in Zimbabwe shall be the law of Zambia. If the employment in Zimbabwe continues after such period of 12 months, the law applicable after such period shall be the law of Zimbabwe.

(b) in the case of a worker temporarily transferred from Zimbabwe to Zambia, the law in respect of compensation applicable to such worker during the whole of any continuous period not exceeding 12 months during which he is so employed in Zambia shall be the law of Zimbabwe. If the employment in Zambia continues after such period of 12 months, the law applicable after such period shall be the law of Zambia.

For the purposes of this rule, a worker shall not be considered to have been temporarily transferred but shall be considered to have been permanently transferred if, in the opinion of the Workers’ Compensation Commissioner in Zambia or in Zimbabwe as the case may be, the transfer is made in accordance with the ordinary terms of the employment from a branch of the employer’s business in the one country to a branch of the employer’s business in the other country.

[Am by 156 of 1965.]

7. Admission of evidence in High Court

In any proceedings for the recovery of compensation the High Court or the magistrate or the Commissioner, as the case may be, may admit evidence taken in Zimbabwe before a magistrate in regard to any matter relating to compensation if such evidence is taken on oath and is certified by such magistrate as having been duly taken by him. Nothing in this rule contained shall be deemed to prevent the High Court or a magistrate from ordering the taking of evidence in any manner provided under any other law.

8. Obtaining evidence from witnesses for use in Zimbabwe

(1) A magistrate or the Commissioner, as the case may be, shall have the power to procure and take evidence for use in Zimbabwe or otherwise for the purpose of facilitating proceedings for the recovery of compensation under the laws of Zimbabwe.

(2) Whenever such evidence is required from a witness who resides or then is in Zambia and it is certified by the High Court or a Magistrate’s Court of Zimbabwe to the Commissioner or, as the case may be, to the magistrate of the district in which such witness resides or then is, that the evidence of such witness is required for use in Zimbabwe for the purpose of facilitating proceedings for the recovery of compensation under the laws of Zimbabwe, and that interrogatories to be put to such witness have been duly framed, it shall be the duty of the Commissioner or, as the case may be, the magistrate of the district in which such witness resides or then is, upon the receipt of such interrogatories together with the reasonable expenses of such witness in accordance with the rates prescribed under the Subordinate Courts Act, to summon such witness to appear before him and upon the appearance of such witness to take his evidence as though such witness were a witness in an application under the Act, and to put to such witness the interrogatories aforesaid and all other questions calculated to obtain full and true answers to such interrogatories, and to take down or cause to be taken down in writing the evidence of such witness and to transmit the same certified as having been duly taken to the High Court or Magistrate’s Court, as the case may be, in Zimbabwe.

[Am by 156 of 1965.]

9. Compensation may be transferred

(1) Compensation awarded in Zimbabwe to any person resident or becoming resident in Zambia may be transferred to and administered by the Commissioner.

(2) Compensation awarded under the Act to any person resident or becoming resident in Zimbabwe may be transferred to and administered by the Workers’ Compensation Commissioner of Zimbabwe.

(3) Where the Commissioner to whom compensation has been transferred in terms of sub-rule (1) is unable for any reason to pay such compensation to the person to whom it has been awarded within a period of 12 months from the date on which it was so transferred, then in such event the Commissioner shall refund such compensation to the Workers’ Compensation Commissioner in Zimbabwe.

[Am by 156 of 1965.]

10. Obligation to insure under the respective laws

The obligation in regard to insurance imposed upon employers in regard to the workers to whom the provisions of rules 3, 4 and 5 apply, shall be determined by the law which is applicable to such workers by virtue of the provisions of the said rules.

[Section 96]

Arrangement of Regulations

Regulation

1. Title

2. Prescribed forms

SCHEDULE

GN 208 of 1957,

GN 331 of 1962,

GN 284 of 1963,

GN 497 of 1964,

SI 124 of 1965,

SI 229 of 1965.

[Regulations by the Minister]

1. Title

These Regulations may be cited as the Pneumoconiosis (Forms) Regulations.

2. Prescribed forms

The forms set out in the Schedule are hereby prescribed for use in the cases to which they respectively refer.

R.Z. BUREAU NO.

M.B……………………

PRESCRIBED FORMS

MINE REGISTRATION NO

……………………..……….

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

APPLICATION FOR MEDICAL EXAMINATION OF THE NATURE INDICATED BELOW

1. INITIAL (Section 39).

2. INITIAL failing which SPECIAL (Section 39(3) (c) and 39(4) and proviso to 39(5)).

3. INITIAL failing which INITIAL (RESTRICTED) to employment as…………………………………………….. (Section 39(3) (b) and proviso 39(5)).

4. BENEFITS (Section 48). Not applicable to men in employment as miners previously examined by the Bureau, Form 2 must be used instead of this Form.

Name in full (BLOCK CAPITALS) …………………………Date of examination …………………………………………………

Age …….Mine …………………………. *Mine No …………………………*National Registration No ………………………………….

*Place of birth …………………………………………….. Address for letters ……………………………………………………

…………………………………………………………………………………………………………………………………..

*Chief …………………………………………….. *Village …………………………………………………………………………………………….

*District ………………………………………….. *Country …………………………………………………………………………………………..

* Complete as required

Have you been examined and given a number by any of the Bureaux named?If so, state the number.

R.Z. Bureau Number ……………………………………………..S.A. Bureau Number ……………………………………………..S.R. Bureau Number ……………………………………………..

MINING SERVICE

Fill up the table below as accurately as possible, stating the years (e.g. 1926-32 or 1943-44 and 1946) during which you have worked in each place named and stating the number of months worked in each of the occupations named.

NOTE.-When this form is used for the re-examination of any man who has been previously examined by the Bureau, it is sufficient to write in the space for mining service “Service since last examined” followed by the particulars of that service only.

*Country, Name and Nature of Mine	Dates of Service	Surface Scheduled Service in Months	Underground Service in Months	Total
		Concentrator Including Crushers, Screening and Belt Conveyors	Other Including Sample Crushing, Change House, Tailing Dump, Rock Drill Sharpening, Coal Plant	Production Including Drilling, Blasting, Lashing Rock Removal, Ore Transport	Other Including Pumps, Sanitation, Pipe Fitting, Survey, Tracks, Sampling, Timbering, etc.

			Grand Total. . . . . .

*Country to be shown as R.Z., Zim., S.A. or “Elsewhere”. Nature of mine to be shown as “Gold”, “Asbestos”, “Coal” or “Other”. Country and nature may be omitted for R.Z. Copper Mines. Put a line after the record of service for any mine.I declare that the above statements are true to the best of my knowledge and belief.

Signature or thumb-print of person examined: Signature of Witness: ………………………………………….

……………………………………………………………….. …………………………………………………………………….

Place of examination if not the R.Z. Bureau:

…………………………………………………

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

R.Z. BUREAU NO.

M.B. ……….…………….

MINE REGISTRATION NO.

…………………………………

APPLICATION FOR MEDICAL EXAMINATION OF THE NATURE INDICATED BELOW

1. PERIODICAL (SECTIONS 40, 41, 42).	2. PERIODICAL Restricted (SECTION 43(1) (b)).	3. Discharge (SECTION 44).	4. Suspect (SECTION 47).	5. Additional (SECTION 49). Applicable only to men in employment as miners.	6. Benefits (SECTION 48). Not applicable to men in employment as miners and if the man has not been previously examined by the Bureau, Form 1 must be used instead of this Form.
Engagement Employee	Engagement Employee

Name in full (BLOCK CAPITALS) …………………………………..Date of examination …………………………………

Age ……………. Mine …………………………. *Mine No. ……………*National Registration No …………………………………

*Place of birth …………………………………………..*Address for letters or tribal particulars …………..…………………..

…………………………………………………………………………………………………………………………..

*Complete as required.

Have you been given a number by either of the Bureaux named since last examined by or for the R.Z. Bureau?

If so, state number.

{S.A. Bureau No. ……………………………………………………….

S.A. Bureau No. ……………………………………………………….

What occupation other than mining have you been engaged in since your last examination by the R.Z. Bureau? ……………………………………………………………………..

MINING SERVICE SINCE LAST BUREAU EXAMINATION

Country, Name and Nature of Mine	Dates of Service	Surface Scheduled Service in Months	Underground Service in Months
Concentrator Including Crushers, Screening and Belt Conveyors	Other Including Sample Crushing, Change House, Tailing Dump, Rock Drill Sharpening, Coal Plant	Production Including Drilling, Blasting, Lashing Rock Removal, Ore Transport	Other Including Pumps, Sanitation, Pipe Fitting, Survey, Tracks, Sampling, Timbering, etc.

Cumulative Absence from work of more than 14 days (Leave, Hospital, etc.) No. of Days …………………………..

Right thumb-print

I declare the above statement to be true to the best of my knowledge and belief.
Signature or thumb-print of person examined:
………………………………..……………..
Signature of Witness…………..…………….
Place of examination if not Republic of Zambia
……….…………………………………..….

(This entry to be put in by a member of the Bureau staff.) Apparent total mining service to date:
……..……………………………….months
R.Z. ………………………………………..
Elsewhere ………………………………….

(FACE)

BUREAU NO.

M.B……………….

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

INITIAL CERTIFICATE

Full name ……………………………………………………………………

Address ………………………………………………………………………

This is to certify that the person named above underwent on …………………………….. an initial examination as prescribed by section 39 of the Pneumoconiosis Act and was found to satisfy the requirements for the issue to him of this certificate.

The validity of this certificate expires on …………………………………………………………………………………………

after which date the certificate will be of no effect.

…………………………………

Secretary of the Bureau

Kitwe, ………………………………………

…………………………………..

Signature or right thumb-print of

person named above

INITIAL (RESTRICTED) CERTIFICATE

(BACK)

If the word “Restricted” is stamped upon the face of this certificate, then this certificate is valid only for the occupations and only at the mine named below.

OCCUPATIONS:

…………………………………………………………………………………………………………………………..

MINE:

…………………………………………………………………………………………………………………………..

(FACE)

BUREAU NO.

M.B………………..

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

PERIODICAL CERTIFICATE

Full name ……………………………….………………………………………………………………………………

Address …………………………………………………………………………………………………………………..

This is to certify that the person named above underwent on …………………………….. a periodical examination as prescribed by section 40 of the Pneumoconiosis Act and was found to satisfy the requirements for the issue to him of this certificate.

The validity of this certificate expires on………………………………………………………………………………………….

after which date the certificate will be of no effect.

Tuberculosis is absent. Pneumoconiosis is absent/pneumoconiosis is present in the first/second stage.

…………………………………

Secretary of the Bureau

Kitwe, ……………………………

…………………………………………….

Signature or right thumb-print of

person named above

PERIODICAL (RESTRICTED) CERTIFICATE

(BACK)

If the word “Restricted” is stamped upon the face of this certificate, then this certificate is valid only for the occupations and only at the mine named below.

OCCUPATIONS:

…………………………………………………………………………………………………………………………..

MINE:

…………………………………………………………………………………………………………………………..

(FACE)

BUREAU NO.

M.B…………………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

SPECIAL CERTIFICATE

(See important note on back)

Full name ………………………………………………………………………………………………………………..

Address ………………………………………………………………………………………………………………….

The validity of this certificate expires on ………………………………………………………………………………………after which date the certificate will be of no effect.

…………………………………

Secretary of the Bureau

Kitwe, ……………………………………………….

………………………………………..

Signature or right thumb-print of person named above

IMPORTANT NOTE

(BACK)

This certificate is issued under the authority of section 39(3)(c) and (5) of the Pneumoconiosis Act. It is not lawful for the person in respect of whom it is issued to work as a “miner” or for an employer to employ him as a “miner” for an aggregate of more than 100 hours in any period of thirty days.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………………

Date ………………….

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. Box 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Section 39(3)(a))

Name of person reported on …………………………………………………………………………………………….

Date of examination …………………………………………………………………………………………………….

With reference to the examination on the above date, I am directed to report as follows:

(1) A Republic of Zambia INITIAL CERTIFICATE valid to ……………………………………………………….. has been sent to the Mine Secretary of ……………………………………………………………………………Mine, is enclosed herewith.

*(2) The original of this report has been sent to the Mine Secretary of …………………………………………………Mine.

…………………………………………..

Secretary of the Bureau

*To examine if not presented for examination by employer or prospective employer with copy to Mine Secretary if previously employed as a miner in scheduled mines.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. Box 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Initial: Section 39(3)(b))

Name of person reported on ……………………………………………………………………………………………

Date of examination …………………………………………………………………………………………………….

With reference to the examination on the above date, I am directed to report as follows:

(1) A Republic of Zambia INITIAL (RESTRICTED) CERTIFICATE valid to

……………………………………………………………………………………………has been sent to the Mine Secretary of ………………………………………………………………….………………………………Mine.

(2) The validity of the above-mentioned certificate is restricted to the occupations of …………………………………………………………..…………………………………………………… at ……………………………………………………………………………….………………………………… Mine.

(3) Tuberculosis is absent.

Pneumoconiosis is absent/present in the first/second stage.

(4) The date of this certification is ………………………………………………………………………………………

(5) Previous certifications if any:

Pneumoconiosis in the first stage ………………………………………………………………………………………

Pneumoconiosis in the second stage ……………………………………………………………………………………

(6) A copy of this report has been sent to:

*Examinee.

*The Secretary, Zambia Pneumoconiosis Compensation Board.

(7) The original of this report has been sent to the Mine Secretary of ………………………………………………..

Mine.

………………………………………..

Secretary of the Bureau

*These lines are for use only when the presence of pneumoconiosis is certified: delete in other cases.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. Box 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Initial: Section 39(3)(c))

Name of person reported on ……………………………………………………………………………………………

Date of examination ………………………….…………………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) A Republic of Zambia SPECIAL CERTIFICATE valid to ……………………………………………………… has been sent to the Mine Secretary of …………………………………………………………………………Mine.

(2) Pneumoconiosis is absent.

Pneumoconiosis is present in the first/second stage. Tuberculosis is absent.

(3) The certificate named constitutes an authority for the person in respect of whom it is issued to work or to be employed as a “miner” provided that his work in that capacity does not exceed in aggregate 100 hours in any month. (Section 39(3) (c) and (4) of the Pneumoconiosis Act.)

(4) Previous certifications if any:

Pneumoconiosis in the first stage ………………………………………………………………………………………

Pneumoconiosis in the second stage ……………………………………………………………………………………

(5) A copy of this report has been sent to:

*The Examinee.

*The Secretary, Zambia Pneumoconiosis Compensation Board.

(6) The original of this report has been sent to the Mine Secretary of …………………………………………………

Mine.

…………………………………

Secretary of the Bureau

*These lines are for use only when the presence of pneumoconiosis is certified: delete in other cases.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. Box 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Initial: Section 39(3)(d))

Name of person reported on ……………………………………………………………………………………………

Date of examination …………………………………………………………………………………………………….

With reference to the examination on the above date, I am directed to report as follows:

(1) NO CERTIFICATE can be issued since the person named above is not up to the physical standard required by law. He is at liberty, however, to apply for re-examination after months from the date of this report.

(2) Pneumoconiosis is absent; tuberculosis is absent.

*(3) The original of this report has been sent to the Mine Secretary of ………………………………………………

Mine.

……………………………………………

Secretary of the Bureau

*To examine if not presented for examination by employer or prospective employer with copy to Mine Secretary if previously employed as a miner in scheduled mines.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. Box 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Initial: Section 39(3)(e))

Name of person reported on …………………………………………………………………………………………….

Date of examination …………………………………………………………………………………………………….

With reference to the examination on the above date, I am directed to report as follows:

(1) NO CERTIFICATE can be issued since the person named above is found by the Bureau to be not fit for work as a miner in any circumstances. He is therefore not eligible to be examined again by this Bureau for a certificate of fitness.

(2) Pneumoconiosis is absent/present in the ………………………………………………………………stage.

Tuberculosis is absent/present.

(3) A copy of this report has been sent to:

*The Secretary, Zambia Pneumoconiosis Compensation Board.

*The Examinee

**(4) The original of this report has been sent to the Mine Secretary of ………………………………………………

Mine.

………………………………………….

Secretary of the Bureau

*These lines are for use only when the presence of pneumoconiosis and/or tuberculosis is certified; delete in other cases.

**To examine if not presented for examination by employer or prospective employer with copy to Mine Secretary if previously employed as a miner in scheduled mines.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. Box 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Periodical: Section 43)

Name of person reported on …………………………………………………………………………………………….

Date of examination …………………………………………………………………………………………………….

With reference to the examination on the above date, I am directed to report as follows:

(1) A Republic of Zambia PERIODICAL CERTIFICATE, valid to …………………………………………….

has been sent to the Mine Secretary of ………………………………………………………………………Mine. is enclosed herewith.

(2) Pneumoconiosis and tuberculosis are both absent.

*(3) The original of this report has been sent to the Mine Secretary of ……………………………………………

Mine.

………………………………………….

Secretary of the Bureau

NOTE-If the word “Restricted” is stamped on the face of this report, it implies that the certificate referred to above was issued under special provisions of the pneumoconiosis law and that such certificate is valid only for the occupations of:

……………………………………………………………..……………………………………………………

…………………………………………………………..………………………………………………………

…….………………………………………………………..……………………………………………………

at the following mine:

……………………………………………………………..……………………………………………………

…………………………………………………………..………………………………………………………

…….………………………………………………………..……………………………………………………

……………………………………………………………..……………………………………………………

*To examine if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. Box 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Periodical: Section 43)

Name of person reported on ………………..……………..……………………………………………………………

Date of examination ………………..……………..……………………………………………………………………….

With reference to the examination on the above date, I am directed to report as follows:

(1) A Republic of Zambia PERIODICAL CERTIFICATE valid to …………………………………………………

has been sent to the Mine Secretary of ..……………..……………………………………………………………Mine

is enclosed herewith.

(2) Pneumoconiosis is present in the first stage. Tuberculosis is absent.

(3) The date of this certification is …..……………..……………………………………………………………

(4) Previous certifications if any:

Pneumoconiosis in the first stage …………..……………..……………………………………………………………

(5) A copy of this report has been sent to:

The Secretary, Zambia Pneumoconiosis Compensation Board.

*(6) The original of this report has been sent to the Mine Secretary of …………………………………………Mine.

……………………………..

Secretary of the Bureau

NOTE. – If the word “Restricted” is stamped on the face of this report, it implies that the certificate referred to above was issued under section 43(1)(b) of the Pneumoconiosis Act and that such certificate is valid only for the occupation of:

……………………………………………………………..……………………………………………………

at the following mine:

……………………………………………………………..……………………………………………………

*To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date ……….……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. Box 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Periodical: Section 43)

Name of person reported on ……………………………..……………………………………………………………

Date of examination ……………………………………..………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) A Republic of Zambia PERIODICAL CERTIFICATE valid to ………………………………………………….

has been sent to the Mine Secretary of …………………………………………………………………………… Mine is enclosed herewith.

(2) Pneumoconiosis is present in the second stage. Tuberculosis is absent.

(3) The date of this certification is …………………..…………………………………………………………….

(4) Previous certifications if any:

Pneumoconiosis in the first stage …………..……………..…………………………………………………………….

Pneumoconiosis in the second stage .……………………..……………………………………………………………

(5) A copy of this report has been sent to: The Examinee.

The Secretary, Zambia Pneumoconiosis Compensation Board.

*(6) The original of this report has been sent to the Mine Secretary of ………………………………………………

Mine.

………………………………………….

Secretary of the Bureau

NOTE.-If the word “Restricted” is stamped on the face of this report, it implies that the certificate referred to above was issued under section 43(1) (b) of the Pneumoconiosis Act and that such certificate is valid only for the occupations of:

……………………………………………………………..……………………………………………………at the following mine: ……………………………………..……………………………………………………………

*To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. Box 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Periodical: Section 43)

Name of person reported on ………..……………………..……………………………………………………………

Date of examination ..……………………………………..……………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) For the reason stated in paragraph (2) NO CERTIFICATE can be issued.

(2) Pneumoconiosis is present in the third stage without tuberculosis.

Tuberculosis is present without pneumoconiosis. Tuberculosis and pneumoconiosis are both present.

(3) The date of this certification is …………………..……………………………………………………………

(4) This certification immediately and finally cancels any existing certificate in respect of the person named above authorising him to work or to be employed as a “miner” in Zambia and the law requires that he forthwith cease to be so employed.

(5) Previous certifications if any:

Pneumoconiosis in the first stage …………………..……………………………………………………………………

Pneumoconiosis in the second stage …………………..………………………………………………………………..

(6) A copy of this report has been sent to:

The Secretary, Zambia Pneumoconiosis Compensation Board. The Examinee.

*(7) The original of this report has been sent to the Mine Secretary of ………………………………………………Mine.

……………………………………..

Secretary of the Bureau

*To examine if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Periodical: Section 43(1)(c))

Name of person reported on ………………..……………………………………………………………………………

Date of examination ………………..…………………………………………………………………………………..

With reference to the examination on the above date, I am directed to report as follows:

(1) Pneumoconiosis is absent.

Pneumoconiosis is present in the first/second stage.

Tuberculosis is absent.

(2) Despite the absence of tuberculosis and of pneumoconiosis in the third stage NO CERTIFICATE can be issued for the reason stated in paragraph (3).

(3) The Bureau is of the opinion that the fitness for work as a miner of the person reported on has been seriously impaired by old age/disease. (Section 43(1) (c) of the Pneumoconiosis Act.)

(4) Previous certifications if any: Pneumoconiosis in the first stage Pneumoconiosis in the second stage

(5) A copy of this report has been sent to:

*The Secretary, Zambia Pneumoconiosis Compensation Board.

*The Examinee.

**(6) The original of this report has been sent to the Mine Secretary of ………………..………………………… Mine.

…………………………………

Secretary of the Bureau

*These lines are for use only when pneumoconiosis is certified to be present.

**To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Benefits: Section 48)

Name of person reported on ………………..……………………………………………………………………………

Date of examination ………………..……………………………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) Pneumoconiosis is absent.

Tuberculosis is absent.

(2) Unless specially directed by the Director of the Bureau to present himself at the Bureau for re-examination at some earlier date, the person named above is not eligible to be re-examined by the Bureau sooner than one year from the date of the examination now reported on. (Section 48 (d) of the Pneumoconiosis Act.)

*(3) The original of this report has been sent to the Mine Secretary of ………………..……………………………… Mine.

…………………………………

Secretary of the Bureau

*To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Benefits: Section 48)

Name of person reported on ………………..……………………………………………………………………………

Date of examination ………………..……………………………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) Pneumoconiosis is present in the ………………..……………………………………………………………stage.

Tuberculosis is absent.

(2) The date of this certification is ………………..…………………………………………………………………….

(3) Previous certifications if any:

Pneumoconiosis in the first stage ………………..………………………………………………………………………

Pneumoconiosis in the second stage ………………..…………………………………………………………………..

Pneumoconiosis in the third stage ………………..……………………………………………………………………..

(4) Unless directed by the Director of the Medical Bureau to present himself for re-examination at some earlier date, the person named above is not eligible to be re-examined at the Bureau sooner than one year from the date of the examination now reported on. (Section 48 (d) of the Pneumoconiosis Act.)

(5) A copy of this report has been sent to:

The Secretary, Zambia Pneumoconiosis Compensation Board. The Examinee.

*(6) The original of this report has been sent to the Mine Secretary of ………………..……………………………… Mine.

…………………………………

Secretary of the Bureau

*To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Benefits: Section 48)

Name of person reported on ………………..……………………………………………………………………………

Date of examination ………………..………………………………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) Tuberculosis is present.

Pneumoconiosis is absent.

(2) The date of this certification is ………………..……………………………………………………………………

(3) Previous certification if any:

Tuberculosis without pneumoconiosis ………………..………………………………………………………………

(5) A copy of this report has been sent to:

The Secretary, Zambia Pneumoconiosis Compensation Board. The Examinee.

*(6) The original of this report has been sent to the Mine Secretary of ………………..………………………………. Mine.

…………………………………

Secretary of the Bureau

*To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Benefits: Section 48)

Name of person reported on ………………..……………………………………………………………………………

Date of examination ………………..………………………………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) Pneumoconiosis is present.

Tuberculosis is present.

(2) The date of this certification is ………………..………………………………………………………………

(3) Previous certifications if any:

Pneumoconiosis in the first stage …………..……………………………………………………………………………

Pneumoconiosis in the second stage ……….……………………………………………………………………………

Pneumoconiosis in the third stage …………..……………………………………………………………………………

Pneumoconiosis with tuberculosis ……..…..……………………………………………………………………………

Tuberculosis without pneumoconiosis ……..……………………………………………………………………………

(5) A copy of this report has been sent to:

The Secretary, Zambia Pneumoconiosis Compensation Board. The Examinee.

*(6) The original of this report has been sent to the Mine Secretary of …………..……………………………… Mine.

…………………………………

Secretary of the Bureau

*To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Discharge: Section 44; Suspect: Section 47; or Additional: Section 49)

Name of person reported on ………………..……………………………………………………………………………

Date of examination ………………..………………………………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) Pneumoconiosis is absent.

Tuberculosis is absent.

*(2) The original of this report has been sent to the Mine Secretary of ………………..……………………………… Mine.

…………………………………

Secretary of the Bureau

*To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Discharge: Section 44; Suspect: Section 47; or Additional: Section 49)

Name of person reported on ………………..……………………………………………………………………………

Date of examination ………………..………………………………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) Pneumoconiosis is present in the first/second stage.

Tuberculosis is absent.

(2) The date of this certification is …..………………………………..………………………………………….

(3) Previous certifications if any:

Pneumoconiosis in the first stage …………..……………………………………………………………………………

Pneumoconiosis in the second stage ……..………………………………………………………………………………

(4) A copy of this report has been sent to:

The Secretary, Zambia Pneumoconiosis Compensation Board.

The Examinee.

*(5) The original of this report has been sent to the Mine Secretary of …………..……………………………… Mine.

…………………………………

Secretary of the Bureau

*To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

(Discharge: Section 44; Suspect: Section 47; or Additional: Section 49)

Name of person reported on ………………..……………………………………………………………………………

Date of examination ………………..………………………………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) Pneumoconiosis is present in the third stage without tuberculosis.

Tuberculosis is present without pneumoconiosis.

Tuberculosis and pneumoconiosis are both present.

(2) The date of this certification is ……………..………………………………………………………………………

(3) This certification immediately and finally cancels the validity of any certificate of fitness in respect of the person named above authorising him to work or to be employed as a “miner” in Zambia and the law requires that he forthwith cease to be so employed.

(4) Previous certifications if any:

Pneumoconiosis in the first stage …………..……………………………………………………………………………

Pneumoconiosis in the second stage ………………..…………………………………………………………………..

(5) A copy of this report has been sent to:

The Secretary, Zambia Pneumoconiosis Compensation Board. The Examinee.

*(6) The original of this report has been sent to the Mine Secretary of ………………..……………………………… Mine.

…………………………………

Secretary of the Bureau

*To examinee if not presented for examination by employer or prospective employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

[Sections 56 and 57]

Name of deceased person ………………..………………………………………………………………………………

Date of examination ………………..………………………………………………………………………………………

With reference to the post-mortem examination performed on the above date, I am directed to report as follows:

(1) Pneumoconiosis was found to be absent/present in the………………………………………………… stage.

Tuberculosis was found to be absent/present. Death was due to pneumoconiosis.

Death was not due to pneumoconiosis but pneumoconiosis was a contributory or predisposing factor.

Death was not due to pneumoconiosis and pneumoconiosis was neither a contributory nor a predisposing factor.

The date of this certification is …………………………………………………………………. i.e., the date of the post-mortem examination.

(2) In the case of the deceased person now reported on, certification of the presence of compensable disease during life was made as follows:

Pneumoconiosis in the first stage on …..…………………………………………………………………………………

Pneumoconiosis in the second stage on ..……………………………………….……………….………………………

Pneumoconiosis in the third stage on …..……………………………………….………………….……………………

Pneumoconiosis with tuberculosis on …..………………………………………….……………………………………

Tuberculosis without pneumoconiosis on .………………………………………………………………………………

(3) A copy of this report has been sent to:

*The Secretary, Zambia Pneumoconiosis Compensation Board.

The next of kin.

**(4) ………………..……………………The original of this report has been sent to the Mine Secretary of ………………..…………………………………………..……………………………………………………

Mine.

…………………………………

Secretary of the Bureau

*Delete this line if no compensable disease was found.

**To next of kin if examination not arranged by employer with copy to Mine Secretary.

CONFIDENTIAL

BUREAU NO.

M.B. …………………..

MINE REGISTRATION NO.

……………………………….

Date……………..

REPUBLIC OF ZAMBIA

PNEUMOCONIOSIS MEDICAL AND RESEARCH BUREAU

P.O. BOX 205, KITWE

REPORT ON MEDICAL EXAMINATION

Name of person reported on ………………..……………………………………………………………………………

Date of examination ………………..………………………………………………………………………………………

With reference to the examination on the above date, I am directed to report as follows:

(1) The examination referred to above was inconclusive.

(2) Further examination is required as follows:

Clinical examination by the Bureau on date to be arranged.

X-ray examination by the Bureau on date to be arranged.

Examination of ………………..…………………….…specimens of sputum expectorated on successive days. Observation in hospital for ……………. days.

(3) (For use when the person examined is employed at a mine*.) The Mine

Secretary, ………………..…………………………………………………………………………………………………….

Mine has been asked, by copy of this notice, to make the necessary arrangements which he will communicate to the person concerned.

(3a) (For use when the person examined is not employed at a mine*.) Arrangements for the required further examination will be as follows:

…………………………….……………..………………………………………………………………………………

**(4) A Periodical Certificate valid for fourteen days has been sent to the Mine

Secretary, …………………………….……………..………………………………………………………………………Mine.

This will cover the continuation of work as a miner until a final decision is intimated.

**(4a) Under the authority given by section 43(2) of the Pneumoconiosis Act, any certificate of fitness extant in the name of the person named above is hereby suspended and no fresh certificate will be issued until a final decision is reached and intimated.

*(5) A copy of this report has been sent to the Mine Secretary, ………………………………………………………

Mine.

…………………………………

Secretary of the Bureau

NOTE FOR BUREAU GENERAL OFFICE

*If the person concerned is not employed at a mine, paragraphs (3) and (4) and the reference to the Mine Secretary in paragraph (5) must be deleted and paragraph (3a) should be completed, as the Secretary may direct, so as to show what are the arrangements for examination by the Bureau, by a Government Medical Officer, etc.

**Paragraphs (4) and (4a) should be deleted unless the official decision of the Bureau signified on the A.P. form makes the use of one or other of those paragraphs necessary.

[Section 15 of the Interpretation and General Provisions Act]

GN 194 of 1961.

Exemption

The Railways in Zambia have been exempted from the operation of *section 90 in Part VII of the Workers’ Compensation Act.

*See sections 104 and 105 of the Act.

[Section 125]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Regulations

Regulation

1. Title

2. Interpretation

3. Objections

4. Formal inquiry by Commissioner

5. Expenses of assessors

6. Expenses of members of Tribunal

7. Expenses of witnesses

8. Agreements

9. Prescribed amount of pension

10. Report of accident by employer

11. Register of accidents

12. Prescribed amount of payments to Board

13. Exemption

14. Statement by employer

15. Particulars of business

16. Particulars of employers

17. Early payment to be made

FIRST SCHEDULE

SECOND SCHEDULE

THIRD SCHEDULE

Act 13 of 1994,

GN 182 of 1964,

GN 381 of 1964,

GN 497 of 1964,

SI 143 of 1965,

SI 156 of 1965,

SI 230 of 1965,

SI 24 of 1970,

SI 31 of 1995.

[Regulations by the Minister]

1. Title

These Regulations may be cited as the Workers’ Compensation Regulations.

2. Interpretation

(1) In these Regulations, unless the context otherwise requires—

“notice” means notice in writing;

“party” means any person who is a party to any proceedings under the Act, and includes a person appearing for a party;

“send” means to post by prepaid registered post;

“sign” includes the making by a person of a mark, attested by two competent witnesses testifying that such mark was made by such person in their presence; and

“signature” includes a mark so made.

(2) Where in these Regulations reference is made to a particular form or forms, such reference shall be to be the form or forms contained in the First Schedule.

3. Objections

An objection, in terms of section 19 of the Act, shall be in the form and contain the information required in Form 1, and shall be deemed to have been lodged on the date of receipt by the Commissioner of the said form, duly completed in respect of every relevant item.

4. Formal inquiry by Commissioner

(1) Where it is proposed to hold a formal inquiry to consider and determine an objection, in accordance with the provisions of section 21 of the Act, the Commissioner shall ascertain the material questions in dispute, and shall reduce such questions into writing and shall fix a time and place for the holding of a formal inquiry into such questions.

(2) The Commissioner shall thereupon cause a notice in the form and containing the information set out in Form 2 to be sent by prepaid registered post to the parties. Such notice shall state the material questions in dispute and the time and place fixed by the Commissioner for the holding of a formal inquiry.

(3) Every party to a formal inquiry may appear in person or may be represented—

(a) by a legal practitioner; or

(b) by a member of his family; or

(d) in the case of a worker by an officer of a trade union or of an organisation approved by the Minister or, in the case of an employer, by an officer of an employers’ organisation; or

(e) by an officer of the Labour Department; or

(f) in the case of a company, by any director, secretary or other officer thereof, and, in the case of a body corporate which is not a company, by an officer thereof; or

(g) by leave of the Commissioner, by any other person.

(4) No person other than a legal practitioner shall be entitled for so appearing to recover any fee or reward except necessary out-of-pocket expenses.

(5) Upon the holding of the inquiry the Commissioner shall receive any evidence presented by the parties which he deems relevant to any question which he has to determine and may call for and receive any evidence which he deems necessary. The Commissioner may receive and have regard to a report of a medical or surgical practitioner registered in the Commonwealth or in the Republic of South Africa as to the mental or physical condition of any person in respect of whom the dispute exists or the application for revision of any award or agreement has been made.

(6) The Commissioner may from time to time adjourn or postpone any inquiry for such periods and for such reasons as he may think fit.

(7) The Commissioner shall keep or cause to be kept a true record of any proceedings before him upon any formal inquiry and upon payment of a fee to be fixed by the Commissioner any person may at any time obtain copies of the record or any part thereof.

(8) The Commissioner may appoint any person to take down in shorthand a note of oral evidence and proceedings; and such appointment may be made either generally for the purposes of all formal inquiries held by the Commissioner or specially for the purposes of any particular formal inquiry. Such person shall take an oath to the satisfaction of the Commissioner for the accurate and faithful recording of such evidence.

(9) The Commissioner shall have the power to award costs at his discretion.

(10) All costs awarded by the Commissioner shall be taxed and recoverable in manner prescribed by the law or rules governing costs in civil actions in the subordinate courts of Zambia. For the purpose of the taxation of costs, the clerk of a subordinate court (Class I) shall be the Taxing Master. Any costs awarded against a worker on any issue on which he has been unsuccessful may be set off by the Commissioner or by the exempted employer, as the case may be, by order of the Commissioner, in paying any compensation awarded to that worker:

Provided that if compensation is payable monthly or weekly the maximum amount that may be set off in respect of any one month or week shall not exceed one-quarter of the monthly or weekly payments due to the worker.

(11) The fees and expenses payable to witnesses in connection with a formal inquiry shall be as set out in the Third Schedule to the Subordinate Courts (Civil Jurisdiction) Rules.

(12) (a) The findings of the Commissioner shall be pronounced by him either immediately after the conclusion of the inquiry or as soon as is reasonably practicable thereafter at some subsequent date.

(b) As soon as practicable after the conclusion of the formal inquiry the Commissioner shall send by prepaid registered post to the parties a copy of his decision and order, which shall be in the form and contain the information required in Form 3.

(13) If any party does not appear at the time and place fixed for the formal inquiry, the Commissioner may in his discretion proceed with the inquiry and may determine the matters in dispute and make an order, or he may postpone or adjourn the inquiry and cause a notice to be sent by prepaid registered post to the parties notifying them of the postponement or adjournment and of the time and place he had fixed for the holding or continuing of the inquiry:

Provided that, if the Commissioner has in terms of this regulation determined the matters in dispute and has made an order, he may set aside the order and reopen the inquiry on good cause shown within 14 days of the date on which the order was made and may make such further orders as he deems fit.

[Am by 381 of 1964 and 156 of 1965.]

5. Expenses of assessors

The remuneration, travelling and subsistence expenses payable to an assessor appointed in terms of section 26 of the Act shall be in accordance with the scale prescribed in the Second Schedule.

6. Expenses of members of Tribunal

The remuneration, travelling and subsistence expenses payable to any person chosen as a member of the Workers’ Compensation Appeal Tribunal, in terms of section 27 of the Act, shall be in accordance with the scale prescribed in the Third Schedule.

7. Expenses of witnesses

The scale of fees and expenses payable to witnesses, in terms of section 37 of the Act, shall be as set out in the Witnesses and Assessors Allowances Rules.

8. Agreements

(1) Any agreement made, in terms of sub-section (2) of section 45 of the Act, shall be in writing and signed by the parties thereto, and shall contain the particulars set out in Form 4.

(2) The employer shall submit such agreement not later than fourteen days after the making thereof, together with a registered medical practitioner’s certificate containing the particulars set out in Form 5.

9. Prescribed amount of pension

For the purposes of section 69 of the Act, the prescribed amount shall be one thousand kwacha per month.

[Am by SI 31 of 1995.]

10. Report of accident by employer

A report of an accident to a worker made by an employer to the Commissioner, in terms of sub-section (1) of section 75 of the Act, shall be in the form and contain the information set out in Form 6.

11. Register of accidents

The register of accidents which an employer is required to keep, in terms of sub-section (4) of section 75 of the Act, shall contain the particulars set out in Form 7.

12. Prescribed amount of payments to Board

The prescribed amount for the purposes of paragraph (b) of sub-section (4) of section 99 of the Act to be paid by an insurer or exempted employer shall be one per centum of the compensation, including medical aid, paid by such insurer or exempted employer who has not transferred the obligations referred to in sub-section (2) or (3) of section 99 to the Board within the period specified in the said paragraph (b) of sub-section (4) of section 99.

[Am by 230 of 1965.]

13. Exemption

(1) Every employer desiring to be exempted, in terms of section 105 of the Act, from the necessity of paying assessments, shall apply to the Commissioner for a certificate of exemption. The application shall be in the form and contain the information required in Form 8.

(2) Every such employer shall, before a certificate of exemption is granted to him, furnish the Commissioner with full information in regard to the fund to be established and maintained by him, in terms of sub-section (1) of section 105 of the Act.

(3) For a certificate of exemption, or for the renewal thereof, such employer shall pay to the Commissioner before the said certificate is issued, the sum of seventy-five fee units.

(4) Every certificate of exemption shall expire on the 31st March in each and every year.

(5) Should an employer not wish to renew his certificate of exemption after its expiration, he shall give notice to that effect to the Commissioner not later than three months before the date of expiration.

(6) If at any time the Minister is satisfied that an exempted employer has failed to comply with any of the provisions of this regulation, he may cancel the certificate of exemption granted to such employer.

(7) After an employer has ceased to be exempted from the necessity of the payment of assessments, he shall still remain liable in respect of all obligations to his workers which have arisen, or which may arise, in respect of the period during which he was so exempt, and the amount of cash or securities deposited by him, in terms of sub-section (1) of section 105 of the Act, will not be released unless in respect of reduction of liability of the employer proved to the satisfaction of the Commissioner. Any balance retained by the Commissioner will be released upon proof that all liabilities of the employer have been discharged.

(8) Whenever compensation is payable by an exempted employer, in terms of sections 61 and 62 of the Act, he shall forthwith notify the Commissioner of the fact, and shall furnish him with all available information in respect of each such case and shall await his directions in regard to the payment of such compensation.

(9) Every exempted employer shall transmit to the Commissioner on or before the 1st June in each year, a certified copy of his latest duly audited trading account, profit and loss account and balance sheet together with—

(a) a statement of pensions payable by him under the Act as required in Form 9;

(b) a statement of children’s allowances payable by him under the Act as required in Form 10;

(d) a statement in the form and containing the information required in Form 12 of wages paid during the previous 12 months ending the 31st March.

(10) Every exempted employer shall transmit to the Commissioner, within 30 days after the end of each month, returns in the manner and containing the information required in Form 13, showing all claim payments made by him during such month.

(11) Should an exempted employer fail to meet any claim for compensation or medical aid for which he may have become liable under the Act, the Commissioner shall have the right to withdraw from the deposit made by such employer, in terms of sub-section (1) of section 105 of the Act, sufficient money, and shall have the right to sell such securities forming part of the said deposit as will realise sufficient money, for the purpose described in this sub-regulation.

(12) An exempted employer shall not be entitled to a refund of any portion of the fee paid by him under sub-regulation (3) if, in terms of the provisions of sub-regulation (6), the Minister has cancelled the certificate of exemption granted to the employer.

(13) Every exempted employer shall keep all accounts and records of all payments by him in respect of workers’ compensation under the Act separate from the records of his other business transactions.

[Am by Act 13 of 1994.]

14. Statement by employer

A statement transmitted to the Commissioner by an employer in terms of sub-section (1) of section 106 of the Act shall be in the form and contain the information set out in Form 14.

[Am by 143 of 1965.]

15. Particulars of business

The particulars of business which an employer is required to furnish to the Commissioner, in terms of sub-section (1) of section 111 of the Act, shall be in the form and contain the information set out in Form 15.

16. Particulars of employers

The particulars of employers required to be furnished by an insurance company, in terms of sub-section (1) of section 121 of the Act, shall be in the form and contain the information set out in Form 16.

17. Early payment to be made

(1) All moneys payable under the Act to any person shall be paid as soon as possible after the date on which they become payable.

(2) If the Commissioner, or the employer individually liable, as the case may be, is unable to trace the payee, and any such moneys accordingly remain unpaid after the expiration of 12 months of the date on which they became payable, the following procedure shall be adopted—

(a) Details of all such amounts payable to persons other than persons from outside Zambia shall be notified in the Gazette and in a local newspaper by the Commissioner, both in respect of moneys payable from the Fund and moneys payable by employers individually liable, who shall advise and pay to the Commissioner such moneys every quarter. Such notice shall call upon any person claiming payment of any such amount to lodge his claim with the Commissioner within a period of one month of the date thereof. If, at the expiration of the said period, no claim has been lodged, or if any claim has been lodged and rejected by the Commissioner, the amount shall be paid into the reserves of the Fund:

Provided that if at any subsequent date a claim is lodged with the Commissioner and proved to his satisfaction he shall pay the amount of the said claim.

(b) Any such unpaid moneys payable to persons from outside Zambia shall be paid to the government of the country in which such person is domiciled, or to the local representative in Zambia of such government; and any subsequent claim for payment of any such amount shall be referred to the government concerned for consideration.

[Am by 156 of 1965.]

PRESCRIBED FORMS

[Section 19]

[Regulation 3]

THE WORKERS’ COMPENSATION ACT

This objection must be lodged with the Workers’ Compensation Commissioner, P.O. Box 71534, Ndola, within thirty days of the date of the Commissioner’s decision.

(NOTE. – “Lodged within thirty days” means that the objection must reach the Commissioner within thirty days of the date of his decision.)

NOTICE OF OBJECTION

Name of workman ………………………………………………………………………

Name of employer ………………………………………………………………………

1. Full name and address of objector …………………………………………….

Full name and address of legal practitioner or other representative, if any …………………………………………………………………………………………………….

2. State whether objector is—

(a) the worker …………… or

(b) the employer ……………… or

(c) an employer’s organisation or trade union of which the person in respect of whom the decision was given, was at the relevant times a member

(NOTE. – The word “Yes” should be written against (a), or (b), or (c), whichever is applicable.)

3. Quote the reference number and date of the document containing the Commissioner’s decision against which the objection is lodged …………………………………………………………………………………………………….

4. State fully what portion of the Commissioner’s decision you object to ………………………………………………………………………………………………………..

5. Give your reasons in full for lodging the objection …………………………………

6. State the relief or order which you claim, or the question which you desire to have determined ………………………………………………………………………………..

7. Any documentary evidence (or copies thereof) which you wish to submit in support of your contentions as stated in paragraph 5 should be attached and enumerated hereunder:

Number Title or description of document

(i) …………………………………………….. (ii) ……………………………………………. (iii)…………………………………………… (iv) ……………………………………………

8. Give names and addresses of persons whom you wish to be called as witnesses to give evidence in support of your objection:

Name Address

…………………………………………………

9. On what points briefly will they give evidence?

(i)……………………………………………..

(ii)…………………………………………….

(iii)……………………………………………

(iv)……………………………………………

Place ………………………………………………….

Date ………………………………………………….

…………………………….

Signature of Objector

NOTE. – Where the objector is an employer individually liable, this form must be accompanied by a statement as to whether he admits his liability to pay compensation or denies such liability, and whether the admission or denial is total or partial, and if he admits or denies liability partially, a statement of the extent to which he admits or denies liability and, in the case of a denial of liability, the grounds thereof shall be stated.

[Regulation 4(2)]

THE WORKERS’ COMPENSATION ACT

NOTICE OF THE COMMISSIONER’S INTENTION TO HOLD A FORMAL INQUIRY

Inquiry No. ……………………………….

In the matter of the dispute or application between:

Applicant

and

Respondent

Date ……………………………………………………………

To ………………………………………………………………

of Take notice that the material questions in dispute between the parties are

The Commissioner will hold a formal inquiry at ………. (time) on the ……………………………. (date) in the ………… (place) to determine the questions in dispute and you should attend at that time and place together with your witnesses, if any, as to such questions.

………………………………………………………..

Workers’ Compensation Commissioner

[Regulation 4(12)(b)]

THE WORKERS’ COMPENSATION ACT

NOTICE OF ORDER MADE BY THE COMMISSIONER ON A FORMAL INQUIRY

Inquiry No. ……………………………….

In the matter of the dispute or application between: Applicant

and

Respondent

Date ……………………………………………………………

To ………………………………………………………………

of …………………………………………………………………………………………………………….The material questions in dispute between the parties were

The decision of the Commissioner on these questions is

And the Commissioner orders that

……………………………………………………….

Workers’ Compensation Commissioner

[Section 45]

[Regulation 8(1)]

THE WORKERS’ COMPENSATION ACT

AGREEMENT

MEMORANDUM OF AGREEMENT made and entered into between (1) (hereinafter referred to as the employer) of the one part, and (2) (hereinafter referred to as the worker) of the other part.

WHEREAS both the employer and the worker declare that they are acquainted with the liabilities, rights, privileges and benefits contained and set out in the Workers’ Compensation Act:

AND WHEREAS the worker is specially liable to meet with an accident or if he meets with an accident, to sustain serious injury in his employment as a (3) by reason of (4) mentioned in the certificate by the registered medical practitioner annexed hereto, it is hereby agreed between the worker and the employer that in the event of the worker meeting with an accident whilst in the employ of the employer the rights of the worker or his dependants to compensation under the Workers’ Compensation Act shall be limited to (5) per centum of the compensation which would otherwise be payable under the said Act.

Signed at …………….. this ………………… day of ……………………… 20…..

Witness:

………………………………………………………………

……………………………………………………………… Employer

Witness:

………………………………………………………………

……………………………………………………………… Worker

Approved under section 45 of the Workers’ Compensation Act, this day of ………………………………… 20 ……..

……………………………………………………….

Workers’ Compensation Commissioner

NOTES

(1) Full name of employer.

(2) Full name of worker.

(3) State nature of work on which worker is engaged.

(4) State “old age”, “serious physical infirmity”, or “previous injury”, as the case may be.

(5) State percentage.

[Regulation 8(2)]

THE WORKERS’ COMPENSATION ACT

CERTIFICATE OF REGISTERED MEDICAL PRACTITIONER

IT IS HEREBY CERTIFIED by me, pursuant to section 45 of the Workers’ Compensation Act, that I have this day examined (1) and that by reason of (2)—

(a) old age (state age) …………………………………………………………………

(b) serious physical infirmity (state nature of) …………………………………..

he is specially (3) liable to meet with an accident or to sustain a serious injury if employed as a I assess the degree of disability at per centum.

Dated this ……………………….. day of ……………. 20…..

………………………………………………

Registered Medical Practitioner

Address ……………………………………………………………………………………………………………….

NOTES

(1) Full name of worker.

(2) Strike out words not applicable.

(3) Registered medical practitioners should note that section 45(2) of the Act has used the words “specially liable” and not merely “more liable” and regard should be had before issuing the certificate, not only to the age, serious physical infirmity or previous injury of the worker, but also to the nature of the work in which he is employed at the time.

[Section 75]

[Regulation 10]

THE WORKER’S COMPENSATION ACT

For official use

Claim Number:

EMPLOYER’S REPORT OF AN ACCIDENT TO A WORKER

To be addressed to: …………………………………………………………………….

The Workers’ Compensation Commissioner

P.O. Box 71534, Ndola

Employer:

Worker:

Name under which trade or business is carried on (block capitals):

………………………………………………………………………………………………………………..

Address ………………………………………………………………………………………………….

Full name ………………………………………………………………………….. (block capitals)

Residential address ……………………………………………………………………………………

Occupation …………………………………………

Age …………………………………………………… Sex ………………………………………………….

1.(a) How long has he been in your employ? ……………………………………………………….

(b) If not in your direct employ, give the name and address of the sub-contractor ………………………………………………………………………………………………………….

(c) Prior to this accident had he, to your knowledge, any physical defect or did he suffer from any serious disease? If so, give details. ………………………………………………………………………………………………………..

2. Earnings—

(a) Wages (excluding bonus, commission or allowances). ………………… Per Hour

(b) Normal working hours:

per week or per shift

(d) Monthly other allowances (specify)

(e) Monthly value of free food supplied

(f) Monthly value of free quarters supplied

3. (a) Has he previously received compensation for permanent disablement? …………….

(b) If so, when and by whom employed?

4. Accident—

(a) Where did it occur? (State site, e.g., workshop, underground, etc.) …………………………………………………………………………………………….

(b) When did it occur? …………………………………………………………………

(d) If he failed to report it on the same day, what is his explanation? ………………………………………………………………………………………………..

(e) What was the worker doing when it occurred? ……………………………..

(f) Describe cause, mentioning contributory factors and any part of premises, plant or machinery connected with the accident. ……………………………………………………………………………………………

(g) Did it result from action properly within the scope of the worker’s duties? If not, please attach explanatory statement.

5. Was the accident caused by—

(a) deliberate violation of rules? …………………..

(b) drunkenness? ………………………………………

(c) deliberate contravention of any law made for the purpose of ensuring the safety of workers? (If reply is in the affirmative, please attach explanatory statement.)

6. Give the names and addresses of witnesses to the accident. ……………………………………………………………………………………………………..

7. Was the accident caused by the action of a person other than the worker? If so, give his name and address …………………………………………………………..

8. Has notice been received of any magisterial or other official inquiry? …………………………………………………………………………………………………..

If accident was investigated by the Police, state name of Police Station …………………………………………………………………………………………………….

9. Particulars of disablement—

(a) Describe the nature and extent of the injuries sustained, mentioning parts of the body, and in the case of limb, or eye, stating right or left side. ………………………………………………………………………………………………..

(b) When did the employee cease work as a result of the accident? ……………………………………………………………………………………………..

(d) Name and address of doctor attending the worker ……………………………………………………………………………………………..

(e) If in hospital, give name and address. …………………………………………………………………………………………….

I hereby certify that, to the best of my knowledge and belief, the particulars furnished in this report are true and correct.

Date ………………………………….

………………………………..

Employer’s Signature

For Official Use Only

Date received	Employer’s number	Premium checked by	Claim accepted by	Claim rejected by

[Section 75]

[Regulation 11]

THE WORKERS’ COMPENSATION ACT

EMPLOYER’S REGISTER OF ACCIDENTS TO WORKERS

Name and address of employer ……………………………………………………………………………..

…………………………………………………………………………………………………………………………….

Accident No.	Date of accident	Name of worker	Residential address of worker	Village/ Chief/ District/ of worker if applicable	Cause of accident	Nature of injuries received	Date of reporting accident to Com- missioner

[Regulation 13(1)]

THE WORKERS’ COMPENSATION ACT

APPLICATION FOR EXEMPTION IN TERMS OF SECTION 105 OF THE ACT

1. Employer’s name ………………………………………………………………………………

2. Postal address ………………………………………………………………………………..

3. Address at which workers are to be engaged ………………………………………

4. Nature and particulars of work, trade or business of employer. ………………..

5. SCHEDULE

NOTES

(1) Salaries and wages must include the value of house rent, food, commission, etc., paid or supplied by the employer. (See section 67 of the Act.)

(2) Workers shown in one class must not be shown in another class.

(3) Workers whose basic rate of pay exceeds K4,800 a year must not be included.

(4) This application must be accompanied by a certified copy of the last balance sheet, and of the trading, profit and loss accounts.

Classification of Worker	Workers whose basic rate of pay does not exceed K4,800 a year	Estimated annual wages	For official use only
(a) Engaged with woodworking machinery
(b) Engaged with machinery other than wood-working
(c) Not engaged with machinery
(d) Engaged with or handling explosives
(e) Workers whose duties involve underground work
(f) Clerical staff
(g) Salesmen (in retail shops only)
(h) Commercial travellers
(i) Drivers and wagon attendants
(j) Workers making use of aircraft
(k) ……………………………………………………………
(l) ……………………………………………………………..

6. Do you carry on more than one business in any one building? If so, specify …………………………………………………………………………………………………………………….

7. (a) Have you any machinery driven by electricity, steam, water, or any other mechanical power? If so state particulars ……………………………………………….

(b) Are your machinery, plant, and ways properly fenced and guarded and otherwise in good order and condition? ……………………………………………………………………………….

8. State what acids, chemicals or explosives will be used ……………………………………………

9. State number of workers using motor-cycles in connection with your business ……………..

10. Has any company refused to accept any proposal for insurance, increased your premium on renewal, refused renewal, cancelled your policy? Give full particulars ……………………………………………………………………………………………………………………………..

11. Were you insured during the last ten years? State name(s) of companies ……………………………………………………………………………………………………………….

12. Give full particulars of all accidents to your workers during the last ten years; the extent and nature of the injuries and the compensation paid in each case ……………………………………………………………………………………………………………….

13. State any special circumstances in connection with your business which tend to make the risk more than usually hazardous…………………………………………………………..

14. (a) What is the amount of the fund at present? ……………………………………….

(b) What will be the initial amount of the fund if exemption is granted? ………………

(d) In what securities will the fund be invested? ………………………………………………

15. (a) What amount do you consider a fair estimate of the average annual expenditure on workers compensation under the Act? ……………………………………………

(b) Please give full particulars of how the estimate has been arrived at ……………

I certify that the foregoing information is true and correct.

Date ………………………………….

…………………………………..

Signature of Employer

[Regulation 13(9)(a)]

THE WORKERS’ COMPENSATION ACT

To be completed by Exempted Employers

Statement of Capitalised Value of Pensions (1) as at 31st March, 20……, by

Claim No.

Name of pensioner

State whether Name of pensioner whether married, widow, widower, single, divorced

If pensioner is a male and has a wife dependent on him, give date of birth of wife

Sex

State whether pensioner is a workman or widow of a worker

Date from which pension is, or will be, payable

Age of pensioner at nearest birthday

Disablement of worker (2)

Monthly earnings of worker on which pension is, or will be, based

Gross annual pension

Amount of annual pension commuted (3)

Net annual pension payable

Auditor ……………………………………..

Date …………………………………………

…………………………

Signature

Address …………………………………………………………………………….

Date …………………………………….

Notes

This statement must be submitted to the Workers’ Compensation Commissioner on or before the 1st June in each year.

Where the pension payable has been commuted in full and paid prior to the 31st March, the pension should not be included in this return.

(1) A children’s allowance is not a pension and a separate statement in respect of children’s allowances must be rendered on Form 10.

(2) State fatal or permanent. If permanent give degree of disablement. If a permanently injured worker in receipt of a pension dies and his widow becomes the pensioner state degree of disablement of the deceased worker and the date of his death.

(3) Where part of a pension has been commuted, the commuted value should not be deducted unless payment thereof was made on or before the 31st March.

[Regulation 13(9)(b)]

THE WORKERS’ COMPENSATION ACT

To be completed by Exempted Employers

Statement of Capitalised Value of Children’s Allowances as at 31st March, 20… by ……………………………………………………………………………………………..

Claim No.

Name of Worker in respect of whom children’s allowance is payable

State whether married, widow, widower or divorced

Disablement of Worker (1)

Amount of monthly pension on which allow-ance is based

State whether allowance is payable in accordance with Third or Fourth Schedule to Act

Date from which allowance is, or will be, payable

Names of child or children

Dates of birth of children

Age of child, nearest birthday

Nearest number of years allowance has to run. Annuity value (each child)

Annual amount of allowance

Applicable to each child

Total pay for child of worker

Auditor ……………………………………………………………………………..

Date ……………………………………………………………………………………

…………………………………….

Signature

Address ……………………………………………………………………………………………………….

Date ……………………………………

Notes

This statement must be submitted to the Workers’ Compensation Commissioner on or before the 1st June in each year.

(1) State if fatal or permanent. If permanent give degree of disablement. If a permanently injured worker in receipt of a pension dies and his children are in receipt of an allowance state, in addition to the degree of permanent disablement, the date on which the workman died.

[Regulation 13(9)(c)]

THE WORKERS’ COMPENSATION ACT

To be completed by Exempted Employers

Statement of Outstanding Claims as at 31st March, 20…..

To be completed in duplicate and forwarded to reach the Workers’ Compensation Commissioner on or before the 1st June in each year.

Name and Address of Exempted Employer ………………………………………………………………………..

Injured or deceased worker	Accident	Dependants (3)
Name	Age (1)	Occupation	Earnings (2)	Date	Details (medical certificates must be enclosed showing nature and extent of injuries, probable result of accident, estimated cost of medical aid and estimated duration of disablement)	Name	Relationship to workman	Date of birth	Periodical payments	Lump sum	Capitalised pension

Total ………..

I certify that the foregoing particulars are true and correct:

From the foregoing information it is considered that an amount of K ……………………..

Date ………………………. Signature of Employer …………………. is required in respect of outstanding claims.

(1) If exact age not known, state estimated age.

(2) Specify weekly or monthly earnings and, if food and/or quarters are supplied, the value must be included.

(3) To be completed only in respect of workers fatally injured or permanently disabled.

[Regulation 13(9)(d)]

THE WORKERS’ COMPENSATION ACT

ANNUAL RETURN OF WAGES PAID BY EXEMPTED EMPLOYERS

To be completed by Exempted Employers Form 12

Exemption Certificate No. ……………………………….

Name, Address and Business of Employer …………………………………………………………………………………………………………………………………………….

Notes – (1) Wages and salaries must include the full value of rent, food, etc., paid or supplied by the employer.

(2) This statement, duly completed in duplicate, must reach the Workers’ Compensation Commissioner on or before the 1st June in each year.

(1) Classification of workers	Number of workers
(a) Engaged with woodworking machinery
(b) Engaged with machinery other than woodworking
(c) Not engaged with machinery
(d) Engaged with handling explosives
(e) Workers whose duties involve underground work
(f) Clerical staff
(g) Salesmen (in retail shops only)
(h) Commercial travellers
(i) Drivers and wagon attendants
(j) Amount paid to contractors (2) as wages of workers (see section 10 of the Act)
(k) Workers making use of aircraft Workers not included in the above (specify): (l), (m), (n)
Totals
(1) The number of workers and wages paid in respect of the same class of work must not appear under more than one heading.
(2) If liability for work of contractors has been assumed, then item (j) must be completed, if not, please complete the following particulars:
Name of contractor ………………………………………… Address…………………………………………………………………….	Amount of licence fee payable Licence . . . ……………………… on
Nature of work performed and period ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………. Amount paid to contractor……………………………………………………………….	K …………………. Total . . Work Date

Date ……………………………………………………

Certified correct ……………………………………

……………………………….

Signature of Employer

Remarks

Date ………………………………………………..

…………………………..

Signature of Auditor

[Regulation 13(10)]

THE WORKERS’ COMPENSATION ACT

To be completed by Exempted Employers

Name and Address of Employer ………………………………………………………………………

Return of Claim Payments in Respect of Worker During the Month of …………………., 20…

Date …………………………………

…………………….

Signature

(1) Claims under which payments have been shown in previous returns should be prefixed by the letter “A” before the claim number, and the month stated in which the first payment under the claim was made.

(2) State whether settlement has been arrived at by Agreement (A), Commissioner (C), or determined by Workers’ Compensation Appeal Tribunal (T).

(3) State briefly cause of accident or cause of death naming the object which was the immediate cause of the accident. For example: “Struck by fall of rock”, “Run over by cocopan”, “Buried by fall of earth”, “Slipped and fell from scaffolding”, “Spanner slipped”, “Splashed by copper”, etc.

(4) Nature and location of injury should be described briefly in such terms as will convey full information, using such phrases as amputation, burns, scalds, cuts, lacerations, strain, sprain, fractures, etc. The exact location must be indicated and in cases of all injuries to a member whether it is right or left member. For example: “Fracture of tibia right leg”, “Right arm amputated between wrist and elbow”, “Amputation two phalanges right index finger and one phalanx middle finger left hand”, “Foreign body left eye”, “Loss of use of right arm”, etc.

(5) State whether fatal, giving date of death; whether permanent, giving percentage of disablement; or total or partial, giving period of disablement.

(6) State site, e.g., workshop, yard, track, etc.

(7) Earnings means salaries, wages, commissions, cost-of-living allowances and other payments, including overtime if of a constant character or for work habitually performed, and must also include the value of food and quarters provided.

(8) This column is to be used to record payments in respect of transportation of injured workers, constant attendance (section 70), etc., and an appropriate suffix should be added to indicate the nature of the payment, i.e., Transport (T); Burial Expenses (B); Constant Attendance (C); etc.

The above statement, duly completed, must reach the Workers’ Compensation Commissioner not later than thirty days after the last day of the month in respect of which the return is rendered.

[Section 106(1)]

[Regulation 14]

THE WORKERS’ COMPENSATION ACT

ESTATE AND STATEMENT OF EARNINGS OF WORKERS

This form must be completed and returned to the Workers’ Compensation Commissioner, P.O. Box 71534, Ndola, not later than 20……., or within fourteen days of the commencement of business, whichever date is the later.

Separate Forms Must be used for Each Class of Business Carried on by Employer

1. Is your name and address correctly shown above? If so, simply state “Yes”; if not, insert correct name and postal address in block capitals.

2. State names and addresses of all branches, etc., covered by this return. If insufficient space, please answer fully on separate sheet.

3. Has there been any change in the nature of your trade or in the type of work in which your workers are employed since you completed and returned Form 15 (“Particulars of Business”)? If so, please detail; if not, simply state “No”.

4. Estimate of Earnings

Give an estimate to the nearest K of the total earnings which you expect to pay during the financial year 1st April, 20……. to 31st March, 20…….. in respect of workers (male and female) whose basic rate of pay does not exceed K ……… per annum.

(For definition of “earnings”, see section 2 of the Act.)

Average number of workers likely to be employed per month ………………………………………………………….

Average number of workers likely to be supplied with food and quarters per month ……………………………

Total earnings of all workers during the year, excluding food and quarters ……………………………………

Total cash value of food to be supplied by the employer to all workers during the year ………………………..

Total cash value of quarters to be supplied by employer to all workers during the year ……………………….

Total Earnings for Assessment …………………………………………………………………………………………………….

Average number of workers employed ………………………………………………………..
Average number of workers supplied with food and/or quarters ………………………..
Total earnings of all workers, excluding food and quarters ………………………………..
Total cash value of food supplied by employer to all workers ……………………………….
Total cash value of quarters supplied by employer to all workers ……………………………..

3. Is your name and address correctly shown overleaf? If so, simply state “YES”; if not, insert correct name and postal address in ……………………………………………………………………… BLOCK CAPITALS.

4. State names and addresses of all branches, etc., covered by this return. If insufficient space, please answer fully on separate sheet. …………………………………………………………………………………………………..

5. State the precise nature of your trade, work, business or profession.

Notes:

(1) Earnings means salaries, wages, commissions, cost-of-living allowances and other payments (including overtime) if of a constant paid during the financial year. (See section 67 of the Act.)

(2) All earnings paid or to be paid by sub-contractors not otherwise registered as employers with the Workers’ Compensation Act.

(3) Intermittent overtime and sums paid or to be paid under any Provident Fund, or by way of pension, are not to be included.

I hereby certify that to the best of my knowledge all particulars in this return are true, correct and complete, and that the estimates are fair and reasonable.

Date ………………..

……………………………

Sign

[Am by 24 of 1970.]

[Section 111]

[Regulation 15]

THE WORKERS’ COMPENSATION ACT

Financial Year ……………………………..

PARTICULARS OF BUSINESS

This form must be completed and returned, not later than ……………………………………………., or within fourteen days of the commencement of business, whichever date is the later, to the Workers’ Compensation Commissioner, P.O. Box 71534, Ndola.

SEPARATE FORMS MUST BE USED FOR EACH CLASS OF BUSINESS CARRIED ON BY EMPLOYER

Note. – Replies to Questions 9 and 10 must give full details of all activities carried on, as this information determines the premium rating.

1. Employer’s name …………………………………………………………………………………..(in full) (block capitals)

2. Employer’s postal address and telephone number …………………………………………………………………….

3. Employer’s business (street) address ………………………………………………………………………………………

4. Name under which business is carried on …………………………………………………………….(block capitals)

5. Names of partners (if any) (block capitals) …………………………………………………………………………………

6. Registered name of company (limited liability companies only) ………………………………………………………

7. State whether business commenced before 1st April, 1964 ………. Yes/No

8. If business commenced on or after 1st April, 1964, state date on which business commenced …………….

9. State the precise nature of your trade, work, business or profession …………………………………………………

10. Give a general description of the various types of work in which your workers will be engaged (e.g., commercial travellers and warehousing; workshop and sales; soft goods only; machinery sales, installation and repairs) …………………………………………………………………………………………………………………………………………….

11. What type of business licence do you hold? …………………………………………………………………………………….

12. State the names of all branches covered by this return, the nature of business of each branch and the town or suburb in which branch is situated. (Note.-Subsidiary limited liability companies must be registered on a separate form.) ……………………………………………………………………………………………………………………………………………….

13. Have you previously been insured against Workers’ Compensation risks? If so, state—

(a) under what name …………………………………………………………………………………………………………

(b) name of insurance company ………………………………………………………………………………………….

14. I hereby certify that, to the best of my knowledge, all particulars in this return are true.

Date ……………………………

………………………………………………………………………

Signature of employer or his duly authorised agent

[No. 381 of 964]

[Section 121]

[Regulation 16]

THE WORKERS’ COMPENSATION ACT

be completed by Insurance Companies

PARTICULARS OF EMPLOYERS

Policy No. ……………………………………….

Employer’s name ………………………………………………………………………………………….

Employer’s postal address ………………………………………………………………………………

Classification and Code No. of trade or business carried on by Employer …………….

……………………………………………………………………………………………………………………..

Workers employed in such trade or business whose basic rate of pay does not exceed K4,800 (male or female)	Number employed	Remuneration
A. If Wages Declaration Available	B.
Earnings exclusive of food and quarters for period 1st April, 1962, to 31st March, 1963. (See Note 1)	Value of food and quarters supplied by employer for period 1st April, 1962, to 31st March, 1963 (See Note 2)	Estimated earn inclusive of food quarters for per from ……………. to ……………….. (See Note 3)
Workers . . . ….

Earned premium if wages declaration available ………..K If no wages declaration available, premium paid on estimated earnings ………….K In each case, please state exact period covered by premium paid.

Note – 1. If earnings declared do not cover period 1st April, 1962, to 31st March, 1963, please state period to which earnings declared relate.

2. If value of food and quarters supplied have been included in earnings, please so state.

3. Please state period covered by estimated earnings and amount of earnings.

4. If value of food and quarters supplied have been included in estimated earnings, please so state.

[Regulation 5]

EXPENSES OF ASSESSORS

Any person appointed as an assessor, in terms of sub-section (1) of section 26 of the Act, shall, whilst engaged in any sitting or work of a formal inquiry, under the provisions of section 21 of the Act, be paid out of the Fund remuneration and reasonable expenses for travelling and subsistence in accordance with the following tariff—

(a) For every day or part thereof: K8.40 per day.

(b) The cost of his air or train fare.

(c) For each mile of any journey by motor transport, provided that the journey could not conveniently be undertaken by train or air: 15n per mile.

(d) For each day he is absent from his town of residence and incurs expense: K8.00 per day.

[Regulation 6]

EXPENSES OF MEMBERS OF TRIBUNAL

Any person chosen as a member of the Workers’ Compensation Appeal Tribunal shall, whilst engaged in any sitting or any work of the Tribunal, receive from moneys appropriated by Parliament, remuneration and reasonable expenses for travelling and subsistence in accordance with the following tariff—

(a) For every day or part thereof: K20.00 per day.

(b) The cost of his air or train fare.

(c) For each mile of any journey by motor transport, provided that the journey could not conveniently be undertaken by train or air: 15n per mile.

(d) For each day he is absent from his town of residence and incurs expense: K8.00 per day.

[Am by No. 156 of 1965.]

[Sections 59 and 125]

[RETAINED AS PER SECTION 15 OF THE INTERPRETATION AND GENERAL PROVISIONS ACT]

Arrangement of Paragraphs

Paragraph

1. Title

2. Basis of calculation of lump sum in certain cases

SI 146 of 1977.

1. Title

This Order may be cited as the Workers’ Compensation (Lump Sum Compensation Calculation Basis) Order.

2. Basis of calculation of lump sum in certain cases

Where a worker suffers permanent disablement but the degree of disablement does not exceed 10 per centum, the basis upon which the lump sum compensation payable to such worker shall be calculated shall be such proportion of the capitalised value as determined by the Commissioner of the pension and children’s allowances which would have been payable had the worker suffered permanent disablement to a degree of 100 per centum as the percentage of his permanent disablement bears to 100 per centum.

WORKERS’ COMPENSATION (APPOINTMENT OF EXAMINER) ORDER

[Section 2]

Arrangement of Paragraphs

Paragraph

1. Title

2. Appointment of Examiner

SCHEDULE

SI 116 of 2000.

1. Title

This Order may be cited as the Workers’ Compensation (Appointment of Examiner) Order.

2. Appointment of Examiner

The person named in the Schedule to this Order is hereby appointed Examiner for the purpose of conducting medical examinations under the Act.

SCHEDULE

[Paragraph 2]

Examiner

The Occupational Health Management Board.

[Section 152]

Arrangement of Regulations

Regulation

1. Title

2. Interpretation

3. Employer to provide transport

4. Employer to pay fees

5. Employer to pay normal wages to miner during period of examination

SCHEDULE

SI 112 of 2003,

SI 4 of 2010,

SI 87 of 2013,

SI 86 of 2016,

SI 44 of 2021.

1. Title

These Regulations may be cited as the Workers’ Compensation (Pneumoconiosis) (Charges and Fees) Regulations.

2. Interpretation

In these Regulations unless the context otherwise requires—

“miner” means a person employed as a miner;

“former miner” means—

(a) a person who was formally employed as a miner;

(b) a person who is not a holder of a valid certificate of fitness issued under section 30 of the Act; or

(c) a person who has not, within the 12 months immediately preceding the application for a medical examination, been examined by an examiner under section 42 of the Act.

3. Employer to provide transport

Where—

(a) an employer is required under the Act to provide transport to a miner or former miner; or

(b) a former miner applies for an examination to ascertain whether or not the former miner is suffering from a disease which may make the former miner eligible for a benefit under the Act;

the employer of the miner shall, for purposes of such examination, provide transport from the place of employment or residence to the Bureau and back.

4. Employer to pay fees

An employer of a miner or former miner shall, in respect of the examination, pay to the examiner the fees set out in the Schedule to these Regulations.

5. Employer to pay normal wages to miner during period of examination

Where an employer who is required under the Act to present a miner to an examiner for examination presents such miner before an examiner, the employer shall, during the period of examination, pay that miner the basic wages which the miner would normally have earned had the miner not been absent from work for purposes of attending the examination.

[Regulation 4]

[Sch subs by reg 2 of SI 44 of 2021.]

EXAMINATION FEES

Type of Examination	Fee Units
1. Initial (pre-employment) examination	1267
2. Periodic (in-employment) examination	917
3. Discharge examination	1500
4. Village benefit (post-employment) examination	1500
5. Post-mortem examination
(a) Lung histology specimen	1634
(b) Heart histology specimen	1634
(c) Brain histology specimen	1634

WORKERS’ COMPENSATION (ASSESSMENT OF EARNINGS) REGULATIONS

[Section 152 read with section 113(9)]

Arrangement of Regulations

Regulation

1. Title

2. Earnings in excess of K9,600,000.00

3. Earnings for assessment

4. Revocation of S.I. No. 79 of 2000

SI 25 of 2005.

1. Title

These Regulations may be cited as the Workers’ Compensation (Assessment of Earnings) Regulations.

2. Earnings in excess of K9.600,000.00

The Commissioner shall not assess an employer for any earnings in excess of K9,600,000.00 per annum of any worker in respect of the period to which the statement submitted under section 112 relates.

3. Earnings for assessment

The earnings for assessment purposes shall include—

(a) a worker’s annual basic salary up to K9,600,000.00;

(b) overtime payments;

(d) leave pay if not included in (a) above;

(e) payment made to casual workers employed in connection with the employer’s nature of business; and

(f) an addition of 12.5 per centum to the total of items (a) to (e) to cover food and quarters.

4. Revocation of S.I. No. 79 of 2000

The Workers’ Compensation (Assessment of Earnings) Regulations, 2000 are hereby revoked.

[Section 152]

Arrangement of Regulations

Regulation

1. Title

2. Interpretation

3. Prescribed amount under section 81 of Act

4. Calculation of lump sum payable for permanent disablement

SCHEDULE

SI 4 of 2011.

1. Title

These Regulations may be cited as the Workers’ Compensation (Permanent Disablement) (Commutation of Pension) Regulations.

2. Interpretation

In these Regulations, unless the context otherwise requires—

“Commutation factors” means actuarial factors used to determine the lump sum payable under section 81 of the Act;

“earnings” has the meaning assigned to it in the Act.

3. Prescribed amount under section 81 of Act

For the purpose of section 81 of the Act, the prescribed amount shall be 50,000 kwacha.

4. Calculation of lump sum payable for permanent disablement

A lump sum payable to a worker pursuant to section 81 of the Act for permanent disablement, shall be calculated in accordance with the formula set out in the Schedule.

[Regulation 4]

CALCULATION OF LUMP SUM PAYMENT

1. Fifty per cent of the assessed earnings of a worker who has suffered permanent disablement multiplied by the degree of disablement per centum equals the monthly pension for disablement.

2. The annual pension of a worker who has suffered permanent disablement multiplied by actuarial age factors equals the total commutation of the pension for permanent disablement.

[Section 152]

Arrangement of Regulations

Regulation

1. Title

2. Interpretation

3. Calculation of capitalised values

SI 31 of 2014.

1. Title

These Regulations may be cited as the Workers’ Compensation (Capitalised Values) Regulations.

2. Interpretation

In these Regulations, unless the context otherwise requires—

“assessment” has the meaning assigned to it in the Act;

“Board” has the meaning assigned to it in the Act;

“capitalised value” means the amount that is maintained for the payment of compensation in the case of permanent disablement to any person entitled to pension benefits under the Act;

“child” has the meaning assigned to it in the Act;

“dependant” has the meaning assigned to it in the Act;

“factors” means the actuarially determined figures used to compute capitalised values;

“Fund” has the meaning assigned to it in the Act; and

“spouse” means a party to a marriage including a polygamous marriage.

3. Calculation of capitalised values

Capitalised values for injured workers and dependants, and commutation and lumpsum paid to a worker for disability less than or equal to 10 per cent shall be calculated using the factors set out in the First, Second, Third, Fourth and Fifth Schedules as follows—

(a) capitalised value for injured worker—

in case of a permanent disability, capitalised value to be transferred to the Pension Fund to pay pension to the injured worker and subsequently to a worker’s dependants (spouse and children) is given by—

lumpsum to be transferred = P x (A+B+ perc x C) x D where—

P = [Degree of disability x compensable earnings, subject to ceiling]* 12,

A = single life annuity/factor as set out in the First Schedule based on the worker’s gender and age,

B = continuation adjustment for the spouse of the worker,

if married at disability, based on the worker’s age and spouse’s gender. The factors/annuities include allowance for the spouse to receive 4/5ths of the original pension,

Perc = the percentage of the disabled worker’s pension payable to the children, which would depend on the number of children (youngest child 15 per cent and the rest up to 7 or more children 5 per cent each),

C = children’s continuation factors/annuities as set out in the Second Schedule and Third Schedule based on the age of the child and the age and gender of the injured worker. This assumes that the pension to the child would cease at age 18,

D = expense loading – this should reflect the expected costs of continued payment of pensions. The loading must be a number greater than one to reflect the relevant expense loading. It is currently at 1.2 reflecting 20 per cent administration cost;

(b) capitalised value for dependants in a fatal case: in case of death of the worker capitalised values or lumpsums to be transferred to pay pension to dependants (surviving spouse, children) is given by—

(i) for the surviving spouse, at the death of the worker, pension commences immediately at death and capitalised value to be transferred to pay the surviving spouse’s pension as a lumpsum is given by—

lumpsum to be transferred = P x A x D

where—

P = annual pension to the surviving spouse (4/5th of original pension which would have otherwise been paid to the worker had the worker not died),

A = single life annuity/factor as set out in the First Schedule based on the surviving spouse’s age and gender,

D = expense loading, this should reflect the expected costs of continued payment of pensions. The loading must be a number greater than one to reflect the relevant expense loading; and

(ii) for the children, at the death of the worker, allowances in respect of a child become payable immediately at death and capitalised value to be transferred to pay children allowances as a lumpsum is given by—

lumpsum to be transferred = P x perc x C x D

where—

P = annual pension which would have otherwise been paid to the worker had the worker not died given by [degree of disability x compensable earnings, subject to ceiling]* 12,

C = children’s single life annuity based on a child’s age as set out in the Fourth Schedule. This assumes that an allowance to a child would cease at the age of 18. Note that for children with disabilities, the disability factors/annuities are applied as set out in the Fifth Schedule;

(c) commutation: a pensioner can elect to commute part or all of that pensioner’s pension. The lumpsum to be commuted is given by—

(i) a single pensioner—

proportion commuted x P x A

(ii) married with no children—

proportion commuted x P x (A + B)

(iii) married with children—

proportion commuted x P x (A + B = Perc x C)

where—

P = [degree of disability x compensable earnings, subject to ceiling]* 12,

A = single life annuity/factor as set out in the First Schedule based on the worker’s gender and age, proportion commuted = proportion of pension to be commuted. This should be a value between 0 and 1,

B = continuation adjustment for the spouse of the worker, if married at disability, as set out in the First Schedule, based on a worker’s age and spouse’s gender. The factors include allowance for the spouse to receive 4/5ths of the original pension,

(d) lumpsum paid to a worker for disability less than or equal to 10 per cent: for disabilities equal or less than 10 per cent in injured workers receive a once off lumpsum payment. This is given by—

(i) single pensioner—

lumpsum = P x A;

(ii) married with no children—

lump sum = P x (A + B);

(iii) married with children—

lumpsum = P x (A + B + Perc x C)

where—

P = [degree of disability x compensable earnings, subject to ceiling]* 12,

A = single life annuity/factor as set out in the First Schedule based on the worker’s gender and age,

B = continuation adjustment for spouse of the worker, if married at disability, as set out in the First Schedule, based on the worker’s age and spouse’s gender. The factors include allowance for the spouse to receive 4/5ths of the original pension,

Perc = This is the percentage of the disabled worker’s pension payable to the children, which would depend on the number of children (youngest child 15 per cent and the rest up to 7 or more children 5 per cent each),

C = children’s continuation factors/annuities as set out in the Second Schedule and Third Schedule based on the age of the child and the age and gender of injured worker. This assumes that pension to a child would cease at the age of 18.

[Regulation 3]

FACTORS FOR INJURED WORKER

A: Single Life Annuity		B: Spouses Continuation
Nearest Age	Male Worker Or Widower	Female Worker Or Widow	Spouse of Male Worker	Spouse of Female Worker
21	24.48	25.23	1.88	0.91
22	24.3	25.07	1.88	0.91
23	24.11	24.91	1.92	0.93
24	23.92	24.74	1.96	0.94
25	23.72	24.57	2.01	0.95
26	23.51	24.39	2.05	0.96
27	23.3	24.2	2.1	0.97
28	23.08	24.01	2.14	0.98
29	22.85	23.81	2.19	1
30	22.61	23.61	2.24	1.01
31	22.37	23.4	2.29	1.02
32	22.12	23.19	2.35	1.03
33	21.87	22.96	2.4	1.04
34	21.61	22.74	2.46	1.06
35	21.33	22.5	2.51	1.07
36	21.06	22.26	2.57	1.08
37	20.77	22.01	2.63	1.1
38	20.48	21.75	2.69	1.11
39	20.18	21.49	2.75	1.12
40	19.87	21.22	2.81	1.13
41	19.56	20.95	2.87	1.15
42	19.24	20.66	2.93	1.16
43	18.91	20.37	2.99	1.17
44	18.57	20.08	3.04	1.18
45	18.23	19.77	3.1	1.19
46	17.89	19.46	3.16	1.2
47	17.53	19.14	3.22	1.21
48	17.17	18.82	3.27	1.22
49	16.81	18.48	3.32	1.22
50	16.43	18.14	3.38	1.23
51	16.06	17.8	3.43	1.24
52	15.67	17.44	3.47	1.24
53	15.29	17.08	3.52	1.24
54	14.9	16.72	3.56	1.25
55	14.5	16.34	3.6	1.25
56	14.1	15.96	3.63	1.25
57	13.7	15.58	3.66	1.25
58	13.29	15.18	3.69	1.25
59	12.88	14.78	3.72	1.24
60	12.47	14.38	3.73	1.24
61	12.06	13.97	3.75	1.23
62	11.65	13.56	3.76	1.23
63	11.23	13.15	3.76	1.22
64	10.82	12.73	3.75	1.21
65	10.41	12.31	3.74	1.2
66	10.01	11.89	3.73	1.18
67	9.61	11.47	3.71	1.17
68	9.21	11.04	3.68	1.15
69	8.81	10.62	3.64	1.13
70	8.43	10.2	3.6	1.11
71	8.04	9.79	3.55	1.09
72	7.67	9.37	3.49	1.07
73	7.31	8.97	3.43	1.04
74	6.95	8.56	3.36	1.02
75	6.6	8.17	3.29	1
76	6.27	7.78	3.2	0.97
77	5.94	7.4	3.12	0.94
78	5.62	7.02	3.03	0.92
79	5.32	6.66	2.93	0.89

[Regulation 3]

CHILDREN’S CONTINUATION FACTORS FOR FEMALE DISABILITY

Child’s age at member’s disability
Female Member Age at Disability	0	1	2	3	4	5	6	7	8
20	0.1464	0.1328	0.1198	0.1073	0.0954	0.084	0.0732	0.0629	0.0534
21	1489	0.135	0.1216	0.1089	0.0967	0.0851	0.0741	0.0637	0.054
22	0.1517	0.1374	0.1237	0.1106	0.0982	0.0863	0.0751	0.0645	0.0546
23	0.155	0.1402	0.1261	0.1127	0.0999	0.0877	0.0763	0.0655	0.0554
24	0.1587	0.1434	0.1289	0.115	0.1019	0.0894	0.0777	0.0666	0 0563
25	0.1629	0.147	0.1319	0.1176	0.104	0.0912	0.0792	0.0678	0.0573
26	0.1677	0.1512	0.1355	0.1207	0.1066	0.0934	0.0809	0.0693	0.0585
27	0.1732	0.1559	0.1396	0.1241	0.1095	0.0958	0.0829	0.0709	0.0598
28	0.1794	0.1613	0.1442	0.1281	0.1129	0.0986	0.0852	0.0728	0.0613
29	0.1865	0.1674	0.1495	0.1326	0.1167	0.1018	0.0879	0.075	0.063
30	0.1945	0.1745	0.1556	0.1378	0.1211	0.1055	0.091	0.0775	0.0651
31	0.2036	0.1824	0.1625	0.1437	0.1262	0.1098	0.0946	0.0805	0.0675
32	0.2139	0.1914	0.1703	0.1505	0.1319	0.1147	0.0986	0.0838	0.0702
33	0.2254	0.2015	0.179	0.158	0.1384	0.1202	0.1032	0.0876	0.0733
34	0.2381	0.2127	0.1888	0.1665	0.1457	0.1263	0.1084	0.0919	0.0768
35	0.2522	0.225	0.1996	0.1758	0.1537	0.1331	0.1141	0.0966	0.0806
36	0.268	0.2389	0.2117	0.1864	0.1627	0.1408	0.1206	0.102	0.0851
37	0.2854	0.2543	0.2252	0.198	0.1728	0.1494	0.1279	0.1081	0.09
38	0.3045	0.2712	0.24	0.2109	0.1839	0.1589	0.1359	0.1147	0.0955
39	0.3256	0.2898	0.2563	0.2251	0.1962	0.1694	0.1448	0.1221	0.1016
40	0.349	0.3104	0.2744	0.2409	0.2098	0.1811	0.1547	0.1304	0.1084
41	0.3745	0.3329	0.2942	0.2581	0.2247	0.1939	0.1655	0.1395	0.1158
42	0.4025	0.3576	0.3158	0.277	0.241	0.2078	0.1773	0.1494	0.124
43	0.4334	0.3848	0.3396	0.2977	0.2589	0.2232	0.1903	0.1603	0.133
44	0.4672	0.4146	0.3657	0.3204	0.2785	0.24	0.2046	0.1722	0.1428
45	0.5045	0.4475	0.3945	0.3454	0.3001	0.2585	0.2202	0.1853	0.1537
46	0.5455	0.4835	0.4261	0.3729	0.3238	0.2787	0.2374	0.1997	0.1655
47	0.5905	0.5231	0.4606	0.4029	0.3496	0.3007	0.256	0.2153	0.1783
48	0.64	0.5667	0.4987	0.4359	0.3781	0.3251	0.2765	0.2324	0.1924
49	0.6948	0.6148	0.5408	0.4725	0.4096	0.3519	0.2992	0.2513	0.208
50	0.755	0.6678	0.5872	0.5127	0.4442	0.3814	0.3241	0.272	0.225
51	0.8216	0.7265	0.6384	0.5572	0.4825	0.414	0.3516	0.2949	0.2438
52	0.8951	0.7913	0.6952	0.6065	0.5249	0.4502	0.3821	03203	0.2646
53	0.9764	0.863	0.758	0.6611	0.572	0.4904	0.416	0.3485	0.2878
54	1.0663	0.9424	0.8277	0.7217	0.6243	0.5351	0,1537	0.38	0.3136
55	1.1654	1.0301	0.9047	0.7889	0.6823	0.5847	0.4957	0.415	0.3423
56	1.2747	1.127	0.99	0.8633	0.7467	0.6398	0.5423	0.4539	0.3743
57	1.3948	1.2338	1.0842	0.9457	0.818	0.701	0.5942	0.4973	0.41
58	1.5266	1.3512	1.1879	1.0365	0.8969	0.7687	0.6516	0.5454	0.4497
59	1.671	0.14801	1.302	1.1367	0.984	0.8436	0.7154	0.5989	0.4938
60	1.8284	1.6209	1.427	1.2467	1.0798	0.9262	0.7857	0.6579	0.5426
61	1.9996	1.7746	1.5638	1.3673	1.1852	1.0172	0.8633	0.7233	0.5967
62	2.1853	1.9419	1.7132	1.4994	1.3008	1.1174	0.949	0.7955	0.6566
63	2.3861	2.1233	1.8756	1.6435	1.4273	1.2272	1.0431	0.875	0.7227
64	2.6022	2.3193	2.0518	1.8003	1.5654	1.3474	1.1464	0.9625	0.7956
65	2.8338	2.5302	2.2421	1.9703	1.7156	1.4786	1.2595	1.0586	0.8759
66	3.0811	2.7564	2 447	2.154	1.8786	1.6214	1.383	1.1638	0.9639
67	3.348	2.9976	2.6664	2.3516	2.0545	1.7761	1.5173	1.2785	1.0603
68	3.6213	3.2539	2.9006	2.5635	2.2439	1.9434	1.663	1.4035	1.1657
69	3.9131	3.5246	3.1493	2.7894	2.4469	2.1234	1.8204	1.5391	1.2803
70	4.218	3.809	3.4119	3.0293	2.6634	2.3164	1.9899	1.6857	1.4048
71	4.5349	4.1061	3.6878	3.2826	2.8933	2.5222	2.1716	1.8435	1.5394
72	4.8623	4.4148	3.9759	3.5487	3.136	2.7408	2.3656	2.0128	1.6845
73	5.1983	4.7334	4.275	3.8264	3.3909	2.9716	2.5715	2.1935	1.8402
74	5.5409	5.0601	4.5835	4.1146	3.6569	3.2139	2.789	2.3855	2.0064
75	5.8882	5.3931	4.8998	4.4119	3.933	3.4669	3.1074	2.5883	2.1831
76	6.2379	5.7302	5.2219	4.7164	4.2176	3.7294	3.2559	2.8014	2.3699
77	6.5879	6.0693	5.5476	5.0263	4.509	3.9999	3.5034	3.024	2.5663
78	6.9359	6.4081	5.8749	5.3394	4.8054	4.2769	3.7585	3.2551	2.7715
79	7.2801	6.7446	6.2016	5.6538	5.1048	4.5585	4.0197	3.4933	2.9847
80	7.6184	7.0768	6.5256	5.9672	5.405	4.8428	4.2852	3.7373	3.2046
81	7.9492	7.4027	6.8448	6.2777	5.7042	5.1279	4.5533	3.9854	3.43
82	8.2709	7.7207	7.1576	6.5832	6.0002	5.4117	4.822	4.2359	3.6593
83	8.5825	8.0295	7.4622	6.8821	6.2912	5.6924	5.0895	4.4871	3.8911
84	8.8828	8.3277	7.7573	7.1726	6.5754	5.9679	5.3537	4.7371	4.1235
85	9.171	8.6143	8.0416	7.4534	6.8511	6.2367	5.613	4.984	4.3548
86	9.4464	8.8887	8.3142	7.7235	7.1173	6.4972	5.8657	5.2262	4.5834
87	9.7087	9.1502	8.5746	7.9818	7.3727	6.7482	6.1104	5.4621	4.8077
88	9.9576	9.3986	8.8221	8.2279	7.6166	6.9887	6.3459	5.6905	5.0262
89	10.1929	9.6336	9.0565	8.4613	7.8483	7.2179	6.5711	5.91	5.2376
90	10.4146	9.8551	9.2776	8.6818	8.0675	7.4352	6.7854	6.1198	5.4407
91	10.6229	10.0632	9.4855	8.8892	8.2741	7.6404	6.9883	6.3191	5.6347
92	10.818	10.2583	9.6803	9.0837	8.4681	7.8333	7.1795	6.5076	5.8189
93	11.0002	10.4404	9.8624	9.2655	8.6495	8.014	7.359	6.6849	5.993
94	11.1698	10.6101	10.032	9.435	8.8187	8.1827	7.5268	6.8511	6.1566
95	11.3275	10.7678	10.1896	9.5926	8.9762	8.3398	7.6832	7.0064	6.3098

Child’s age at member’s disability
Female Member Age at Disability	9	10	11	12	13	14	15	16	17
20	0.0444	0.0362	0.0286	0.0219	0.0159	0.0108	0.0066	0.0034	0.0011
21	0.0449	0.0365	0.0289	0.0221	0.016	0.0109	0.0067	0.0034	0.0012
22	0.0454	0.037	0.0292	0.0223	0.0162	0.011	0.0067	0.0034	0.0012
23	0.0461	0.0375	0.0296	0.0226	0.0164	0.0111	0.0068	0.0035	0.0012
24	0.0468	0.038	0.03	0.0229	0.0166	0.0113	0.0069	0.0035	0.0012
25	0.0475	0.0386	0.0305	0.0232	0.0169	0.0114	0.007	0.0035	0.0012
26	0.0485	0.0393	0.031	0.0236	0.0171	0.0116	0.0071	0.0036	0.0012
27	0.0495	0.0401	0.0316	0.024	0.0174	0.0118	0.0072	0.0037	0.0012
28	0.0507	0.041	0.0323	0.0245	0.0178	0.012	0.0073	0.0037	0.0013
29	0.0521	0.0421	0.0331	0.0251	0.0181	0.0123	0.0075	0.0038	0.0013
30	0.0537	0.0433	0.034	0.0258	0.0186	0.0126	0.0076	0.0039	0.0013
31	0.0556	0.0448	0.0351	0.0266	0.0192	0.0129	0.0078	0.004	0.0013
32	0.0578	0.0465	0.0364	0.0275	0.0198	0.0134	0.0081	0.0041	0.0014
33	0.0602	0.0485	0.0379	0.0286	0.0206	0.0138	0.0084	0.0042	0.0014
34	0.063	0.0506	0.0396	0.0298	0.0215	0.0144	0.0087	0.0044	0.0015
35	0.0661	0.053	0.0414	0.0312	0.0224	0.015	0.0091	0.0046	0.0015
36	0.0697	0.0558	0.0435	0.0327	0.0235	0.0157	0.0095	0.0048	0.0016
37	0.0736	0.0589	0.0459	0.0345	0.0247	0.0165	0.0099	0.005	0.0017
38	0.078	0.0624	0.0486	0.0365	0.0261	0.0174	0.0105	0.0053	0.0018
39	0.0829	0.0663	0.0515	0.0386	0.0276	0.0184	0.011	0.0055	0.0018
40	0.0885	0.0706	0.0549	0.0411	0.0294	0.0196	0.0118	0.0059	0.002
41	0.0945	0.0754	0.0585	0.0438	0.0313	0.0208	0.0125	0.0063	0.0021
42	0.1011	0.0806	0.0625	0.0468	0.0334	0.0222	0.0133	0.0067	0.0022
43	0.1084	0.0864	0.067	0.0501	0.0357	0.0238	0.0142	0.0071	0.0024
44	0.1164	0.0927	0.0719	0.0537	0.0383	0.0254	0.0152	0.0076	0.0025
45	0.1252	0.0997	0.0773	0.0577	0.0411	0.0273	0.0164	0.0082	0.0027
46	0.1348	0.1073	0.0832	0.0621	0.0442	0.0294	0.0176	0.0088	0.0029
47	0.1452	0.1156	0.0895	0.0669	0.0476	0.0316	0.0189	0.0094	0.0031
48	0.1565	0.1246	0.0964	0.072	0.0512	0.034	0.0204	0.0101	0.0034
49	0.1691	0.1345	0.1041	0.0777	0.0553	0.0367	0.022	0.0109	0.0039
50	0.1828	0.1453	0.1124	0.0839	0.0596	0.0396	0.0237	0.0118	0.0039
51	0.1979	0.1573	0.1216	0.0907	0.0644	0.0428	0.0256	0.0127	0.0042
52	0.2147	0.1705	0.1317	0.0981	0.0697	0.0462	0.0276	0.0138	0.0046
53	0.2334	0.1852	0.1429	0.1064	0.0755	0.0501	0.0299	0.0149	0.0049
54	0.2542	0.2016	0.1555	0.1157	0.0821	0.0544	0.0324	0.0161	0.0054
55	0.2773	0.2198	0.1695	0.1261	0.0893	0.0591	0.0353	0.0175	0.0058
56	0.3032	0.2402	0.1851	0.1376	0.0975	0.0645	0.0384	0.0191	0.0063
57	0.332	0.263	0.2026	0.1506	0.1066	0.0705	0.042	0.0208	0.0069
58	0.3641	0.2884	0.2221	0.165	0.1168	0.0772	0.046	0.0228	0.0075
59	0.3999	0.3167	0.2439	0.1812	0.1283	0.0848	0.0504	0.025	0.0083
60	0.4395	0.3481	0.2681	0.991	0.1409	0.0931	0.0554	0.0275	0.0091
61	0.4834	0.3829	0.2949	0.2191	0.1551	0.1025	0.0609	0.0302	0.01
62	0.5321	0.4216	0.3249	0.2414	0.1708	0.1129	0.0671	0.0333	0.011
63	0.586	0.4646	0.3581	0.2661	0.1884	0.1245	0.0741	0.0367	0.0121
64	0.6456	0.5121	0.3949	0.2936	0.2079	0.1374	0.0818	0.0406	0.0134
65	0.7112	0.5646	0.4356	0.3241	0.2296	0.1518	0.0904	0.0448	0.0148
66	0.7835	0.6225	0.4807	0.3579	0.2537	0.1679	0.1	0.0496	0.0164
67	0.8629	0.6863	0.5305	0.3952	0.2804	0.1856	0.1106	0.0549	0.0182
68	0.9499	0.7564	0.5852	0.4365	0.3099	0.2054	0.1224	0.0608	0.0201
69	1.0449	0.8332	0.6455	0.482	0.3426	0.2272	0.1356	0.0674	0.0223
70	1.1484	0.9171	0.7116	0.532	0.3786	0.2514	0.51501	0.0747	0.0248
71	1.2608	1.0086	0.7838	0.5869	0.4183	0.278	0.1663	0.0828	0.0275
72	1.3825	1.1082	0.8627	0.6471	0.4619	0.3075	0.1841	0.918	0.0305
73	1.5137	1.2159	0.9486	0.7128	0.5097	0.3398	0.2038	0.1018	0.0339
74	1.6545	1.3322	1.0415	0.7843	0.5619	0.3753	0.2255	0.1128	0.0376
75	1.805	1.4571	1.142	0.862	0.6189	0.4142	0.2493	0.1249	0.0417
76	1.9651	1.5908	1.2501	0.9459	0.6808	0.4567	0.2755	0.1383	0.0417
77	2.1346	1.7331	1.3659	1.0364	0.7479	0.503	0.3041	0.153	0.0513
78	2.3128	1.8839	1.4893	1.1335	0.8203	0.5532	0.3353	0.1691	0.0568
79	2.4993	2.0427	1.6203	1.2371	0.8981	0.6075	0.3693	0.1868	0.0629
80	2.6932	2.2091	1.7584	1.3472	0.9813	0.6659	0.4061	0.206	0.0696
81	2.8934	2.3822	1.9033	1.4637	1.07	0.7287	0.4458	0.2269	0.0769
82	3.0988	2.5613	2.0545	1.5861	1.1639	0.7957	0.4886	0.2496	0.0848
83	3.3038	2.7453	2.2111	1.7141	1.2631	0.8669	0.5345	0.2741	0.0935
84	3.5196	2.933	2.3724	1.847	1.3669	0.9423	0.5834	0.3004	0.1029
85	3.732	3.1231	2.5371	1.9842	1.4751	1.0215	0.6354	0.3286	0.1131
86	3.9435	3.3141	2.7043	2.1247	1.5871	1.1044	0.6902	0.3587	0.124
87	4.1528	3.5048	2.8728	2.2678	1.7023	1.1905	0.7479	0.3907	0.1358
88	4.3583	3.6937	3.0413	2.4123	1.8199	1.2795	0.8081	0.4244	0.1483
89	4.5586	3.8793	3.2085	2.5573	1.9392	1.3707	0.8706	0.4599	0.1616
90	4.7523	4.0604	3.3732	2.7015	2.0593	1.4637	0.9351	0.497	0.1758
91	4.9386	4.2359	3.5342	2.8441	2.1793	1.5578	1.0012	0.5355	0.1906
92	5.1165	4.4047	3.6905	2.9839	2.2984	1.6523	1.0684	0.5752	0.2061
93	5.2854	4.5661	3.8412	3.1199	2.4156	1.7465	1.1364	0.6159	0.2223
94	5.4449	4.7193	3.9854	3.2514	2.5302	1.8397	1.2046	0.6574	0.239
95	5.5949	4.8642	4.1226	3.3776	2.6414	1.9313	1.2726	0.6994	0.2563

[Regulation 3]

CHILDREN’S CONTINUATION FACTORS FOR FEMALE DISABILITY

Child’s age at member’s disability
Female Member Age at Disability	0	1	2	3	4	5	6	7	8
20	0.1533	0.1387	0.1249	0.1117	0.0991	0.0871	0.0758	0.0652	0.0552
21	0.1568	0.1418	0.1275	0.1139	0.1009	0.0887	0.0771	0.0662	0.0561
22	0.1607	0.1451	0.1302	0.1162	0.1029	0.0903	0.0784	0.0673	0.0569
23	0.1652	0.1489	0.1335	0.1189	0.1051	0.0921	0.0799	0.0685	0.0579
24	0.1704	0.1533	0.1372	0.122	0.1077	0.0943	0.0817	0.0699	0.059
25	0.1764	0.1584	0.1415	0.1256	0.1107	0.0967	0.0836	0.0715	0.0602
26	0.1835	0.1645	0.1466	0.1299	0.1143	0.0997	0.0861	0.0734	0.0618
27	0.1917	0.1715	0.1526	0.135	0.1185	0.1031	0.0889	0.0757	0.0636
28	0.2013	0.1797	0.1596	0.1409	0.1235	0.1073	0.0923	0.0785	0.0658
29	0.2123	0.1892	0.1678	0.1478	0.1293	0.1121	0.0963	0.0817	0.0683
30	0.2249	0.2002	0.1772	0.1558	0.136	0.1178	0.1009	0.0855	0.0714
31	0.2394	0.2127	0.188	0.1651	0.1438	0.1243	0.1063	0.0899	0.0749
32	0.2558	0.227	0.2003	0.1756	0.1528	0.1318	0.1126	0.095	0.079
33	0.2745	0.2433	0.2144	0.1877	0.1631	0.1405	0.1198	0.1009	0.0838
34	0.2954	0.2617	0.2304	0.2015	0.1748	0.1504	0.128	0.1077	0.0893
35	0.319	0.2823	0.2483	0.2169	0.1881	0.1616	0.1374	0.1154	0.0956
36	0.3454	0.3054	0.2685	0.2344	0.203	0.1743	0.148	0.1242	0.1027
37	0.3749	0.3314	0.2911	0.254	0.2199	0.1886	0.1601	0.1342	0.1109
38	0.4075	0.3601	0.3162	0.2758	0.2386	0.2046	0.1735	0.1454	0.12
39	0.4437	0.392	0.3442	0.3001	0.2595	0.2224	0.1886	0.1579	0.1303
40	0.4837	0.4273	0.3751	0.327	0.2827	0.2422	0.2053	0.1719	0.1418
41	0.5277	0.4662	0.4092	0.3567	0.3084	0.2641	0.2239	0.1873	0.1545
42	0.5763	0.5091	0.4469	0.3895	0.3367	0.2884	0.2444	0.2045	0.1686
43	0.6297	0.5563	0.4883	0.4256	0.368	0.3152	0.2672	0.2236	0.1843
44	0.6882	0.608	0.5338	0.4653	0.4023	0.3446	0.2921	0.2444	0.2015
45	0.7522	0.6646	0.5835	0.5087	0.4399	0.3768	0.3194	0.2673	0.2204
46	0.8224	0.7267	0.6381	0.5564	0.4811	0.4122	0.3494	0.2924	0.2411
47	0.8991	0.7947	0.698	0.6086	0.5264	0.451	0.3823	0.32	0.2639
48	0.9833	0.8694	0.7637	0.6661	0.5762	0.4938	0.4186	0.3504	0.289
49	1.0752	0.9509	0.8356	0.7289	0.6306	0.5405	0.4583	0.3837	0.3164
50	1.1756	1.0401	0.9143	0.7978	0.6904	0.5919	0.5019	0.4203	0.3467
51	1.2851	1.1376	1.0004	0.8733	0.756	0.6482	0.5498	0.4605	0.3799
52	1.4043	1.2439	1.0944	0.9558	0.8277	0.7099	0.6023	0.5045	0.4163
53	1.5339	1.3597	1.197	1.0459	0.9061	0.7775	0.6598	0.5528	0.4562
54	1.6749	1.4859	1.3091	1.1446	0.9922	0.8518	0.7231	0.6061	0.5003
55	1.828	1.6232	1.4313	1.2524	1.0864	0.9332	0.7927	0.6646	0.5488
56	1.9936	1.7722	1.5634	1.3699	1.1893	1.0224	0.869	0.729	0.6023
57	2.1724	1.9335	1.7086	1.4979	1.3016	1.1198	0.9525	0.7997	0.661
58	2.3648	2.1076	1.8648	1.6367	1.4238	1.2261	1.0439	0.8771	0.7255
59	2.5711	2.2949	2.0334	1.787	1.5564	1.3418	1.1436	0.9617	0.7962
60	2.7914	2.4957	2.2147	1.9492	1.6999	1.4674	1.252	1.054	0.8735
61	3.0259	2.7102	2.4091	2.1237	1.8549	1.6034	1.3698	1.1545	0.9578
62	3.2744	2.9384	2.6167	2.3107	2.0215	1.7501	1.4973	1.2637	1.0497
63	3.5365	3.1802	2.8376	2.5105	2.2003	1.9081	1.635	1.382	1.1495
64	3.8116	3.4351	3.0716	2.723	2.3911	2.0774	1.7832	1.5096	1.2576
65	4.099	3.7027	3.3183	2.9481	2.5942	2.2583	1.9421	1.6471	1.3745
66	4.3977	3.9821	3.5772	3.1854	2.8092	2.4507	2.112	1.7946	1.5003
67	4.7065	4.2725	3.8476	3.4346	3.0361	2.6547	2.2928	1.9524	1.6355
68	5.0241	4.5726	4.1285	3.6947	3.2742	2.8699	2.4845	2.1204	1.7801
69	5.3487	4.881	4.4186	3.9649	3.5229	3.0958	2.6867	2.2986	1.9342
70	5.6787	5.1961	4.7167	4.2439	3.7811	3.3317	2.8991	2.4868	2.0977
71	6.0121	5.516	5.021	4.5304	4.0477	3.5767	3.121	2.6843	2.2704
72	6.347	5.839	5.3299	4.8228	4.3215	3.8297	3.3514	2.8908	2.452
73	6.6817	6.1634	5.6416	5.1196	4.6009	4.0895	3.5896	3.1056	2.642
74	7.0142	6.487	5.9543	5.4189	4.8844	4.3547	3.8342	3.3275	2.8396
75	7.3427	6.8081	6.2659	5.7188	5.17	4.6236	4.0838	3.5556	3.044
76	7.6655	7.1249	6.5747	6.0175	5.4562	4.8946	4.337	3.7884	3.2542
77	7.9812	7.4358	6.8791	6.3132	5.741	5.1659	4.5922	4.0247	3.469
78	8.2886	7.7393	7.1773	6.6043	6.0228	5.436	4.8478	4.263	3.6872
79	8.5865	8.0342	7.468	6.8893	6.3	5.703	5.1021	4.5017	3.9074
80	8.874	8.3196	7.7501	7.1667	6.571	5.9656	5.3535	4.7393	4.1281
81	9.1503	8.5943	8.0223	7.4353	6.8345	6.2219	5.6005	4.9742	4.3479
82	9.415	8.8577	8.2839	7.6941	7.0893	6.471	5.8417	5.2049	4.5654
83	9.6675	9.1094	8.5343	7.9424	7.3344	6.7115	6.0757	5.4302	4.7791
84	9.9077	9.349	8.7729	8.1795	7.569	6.9426	6.3016	5.6488	4.9877
85	10.1353	9.5763	8.9995	8.405	7.7927	7.1635	6.5184	5.8596	5.1902
86	10.3506	9.7913	9.214	8.6187	8.0052	7.3738	6.7255	6.0618	5.3856
87	10.5534	9.9939	9.4164	8.8204	8.206	7.573	6.9222	6.2548	5.5729
88	10.7441	10.1845	9.6067	9.0104	8.3952	7.7612	7.1085	6.438	5.7517
89	10.9228	10.3631	9.7852	9.1886	8.573	7.9381	7.284	6.6113	5.9213
90	11.0899	10.5302	9.9522	9.3554	8.7394	8.1039	7.4487	6.7743	6.0815
91	11.2457	10.6859	10.1079	9.511	8.8948	8.2588	7.6029	6.9271	6.2321
92	11.3907	10.8309	10.2528	9.6558	9.0394	8.4032	7.7467	7.0699	6.3733
93	11.5253	10.9655	10.3874	9.7903	9.1738	8.5374	7.8805	7.203	6.505
94	11.65	11.0902	10.5121	9.915	9.2985	8.6618	8.0047	7.3266	6.6277
95	11.7654	11.2056	10.6275	10.0304	9.4138	8.7771	8.1197	7.4413	6.7416

Child’s age at member’s disability
Female Member Age at Disability	9	10	11	12	13	14	15	16	17
20	0.0459	0.0373	0.0295	0.0225	0.0164	0.0111	0.0068	0.0034	0.0012
21	0.0466	0.0379	0.03	0.0229	0.0166	0.0113	0.0069	0.0035	0.0012
22	0.0473	0.0384	0.0304	0.0232	0.0168	0.0114	0.007	0.0035	0.0012
23	0.0481	0.039	0.0308	0.0235	0.0171	0.0116	0.0071	0.0036	0.0012
24	0.0489	0.0397	0.0313	0.0239	0.0173	0.0117	0.0072	0.0036	0.0012
25	0.0499	0.0404	0.0318	0.0242	0.0176	0.0119	0.0072	0.0037	0.0012
26	0.0511	0.0413	0.0325	0.0247	0.0179	0.0121	0.0074	0.0037	0.0013
27	0.0525	0.0424	0.0333	0.0253	0.0183	0.0123	0.0075	0.0038	0.0013
28	0.0542	0.0437	0.0343	0.026	0.0187	0.0126	0.0077	0.0039	0.0013
29	0.0562	0.0452	0.0354	0.0268	0.0193	0.013	0.0079	0.004	0.0013
30	0.0586	0.0471	0.0368	0.0278	0.02	0.0134	0.0081	0.0041	0.0014
31	0.0614	0.0492	0.0384	0.0289	0.0208	0.0139	0.0084	0.0043	0.0014
32	0.0646	0.0517	0.0403	0.0303	0.0217	0.0145	0.0088	0.0044	0.0015
33	0.0684	0.0547	0.0425	0.0319	0.0228	0.0153	0.0092	0.0046	0.0015
34	0.0728	0.0581	0.0451	0.0338	0.0241	0.0161	0.0097	0.0049	0.0016
35	0.0778	0.0619	0.048	0.0359	0.0256	0.0171	0.0102	0.0051	0.0017
36	0.0835	0.0664	0.0514	0.0384	0.0273	0.0182	0.0109	0.0054	0.0018
37	0.09	0.0715	0.0553	0.0412	0.0293	0.0195	0.0116	0.0058	0.0019
38	0.0974	0.0773	0.0596	0.0444	0.0316	0.0209	0.0125	0.0062	0.0021
39	0.1056	0.0838	0.0646	0.0481	0.0341	0.0226	0.0135	0.0067	0.0022
40	0.1149	0.091	0.0702	0.0522	0.037	0.0245	0.0146	0.0073	0.0024
41	0.1251	0.0991	0.0764	0.0568	0.0402	0.0266	0.0158	0.0079	0.0026
42	0.1365	0.1081	0.0833	0.0619	0.0438	0.029	0.0172	0.0085	0.0028
43	0.1492	0.1182	0.091	0.0676	0.0479	0.0316	0.0188	0.0093	0.0031
44	0.1631	0.1292	0.0995	0.0739	0.0523	0.0346	0.0206	0.0102	0.0034
45	0.1784	0.1413	0.1088	0.0808	0.0572	0.0378	0.0225	0.0112	0.0037
46	0.1952	0.1546	0.119	0.0884	0.0626	0.0413	0.0246	0.0122	0.004
47	0.2137	0.1692	0.1303	0.0968	0.0685	0.0452	0.0269	0.0133	0.0044
48	0.234	0.1854	0.1428	0.1061	0.0751	0.0496	0.0295	0.0146	0.0048
49	0.2563	0.203	0.1564	0.1162	0.0823	0.0543	0.0323	0.016	0.0053
50	0.2808	0.2225	0.1714	0.1274	0.0902	0.0596	0.0355	0.0176	0.0058
51	0.3077	0.2438	0.1879	0.1397	0.0989	0.0654	0.0389	0.0193	0.0064
52	0.3373	0.2673	0.206	0.1531	0.1084	0.0717	0.0427	0.0212	0.007
53	0.3697	0.293	0.2258	0.1678	0.1188	0.0786	0.0468	0.0232	0.0077
54	0.4055	0.3214	0.2477	0.1841	0.1304	0.0862	0.0513	0.0255	0.0084
55	0.445	0.3528	0.2719	0.2022	0.1432	0.0947	0.0563	0.028	0.0092
56	0.4885	0.3874	0.2987	0.2221	0.1573	0.104	0.0619	0.0307	0.0102
57	0.5364	0.4256	0.3283	0.2442	0.173	0.1144	0.0681	0.0338	0.0112
58	0.5892	0.4677	0.361	0.2686	0.1904	0.1259	0.075	0.0372	0.0123
59	0.647	0.514	0.3969	0.2955	0.2096	0.1387	0.0826	0.041	0.0136
60	0.7105	0.5648	0.4365	0.3252	0.2307	0.1528	0.091	0.0452	0.015
61	0.7799	0.6206	0.48	0.3579	0.2541	0.1683	0.1004	0.0499	0.0165
62	0.8556	0.6816	0.5277	0.3938	0.2798	0.1855	0.1107	0.055	0.0182
63	0.9382	0.7483	0.5799	0.4332	0.3081	0.2044	0.1221	0.0607	0.0201
64	1.0279	0.8209	0.637	0.4764	0.3391	0.2253	0.1346	0.067	0.0222
65	1.1251	0.8999	0.6992	0.5236	0.3732	0.2482	0.1485	0.074	0.0246
66	1.2303	0.9855	0.7669	0.5751	0.4104	0.2732	0.1636	0.0816	0.0271
67	1.3436	1.0783	0.8405	0.6313	0.4512	0.3008	0.1804	0.0901	0.03
68	1.4655	1.1783	0.9202	0.6923	0.4956	0.3309	0.1987	0.0994	0.0331
69	1.5959	1.2859	1.0063	0.7585	0.544	0.3638	0.2188	0.1096	0.0366
70	1.735	1.4013	1.099	0.8301	0.5965	0.3997	0.2408	0.1208	0.0404
71	1.8827	1.5244	1.1984	0.9073	0.6534	0.4387	0.2648	0.1331	0.0446
72	2.0389	1.6552	1.3046	0.9901	0.7147	0.481	0.291	0.1465	0.0491
73	2.2033	1.7938	1.4177	1.0789	0.7808	0.5267	0.3194	0.1612	0.0542
74	2.3754	1.9398	1.5377	1.1735	0.8517	0.5761	0.3502	0.1772	0.0597
75	2.5546	2.0929	1.6642	1.274	0.9274	0.6291	0.3835	0.1946	0.0657
76	2.7402	2.2524	1.7971	1.3803	1.008	0.6859	0.4194	0.2134	0.0723
77	2.9312	2.4179	1.9359	1.492	1.0933	0.7465	0.4579	0.2337	0.0794
78	3.1268	2.5886	2.0801	1.6091	1.1834	0.8109	0.4992	0.2556	0.0871
79	3.3256	2.7635	2.2292	1.731	1.278	0.879	0.5431	0.2792	0.0955
80	3.5265	2.9417	2.3823	1.8574	1.3768	0.9509	0.5899	0.3044	0.1045
81	3.728	3.122	2.5386	1.9875	1.4795	1.0261	0.6393	0.3313	0.1142
82	3.929	3.3033	2.697	2.1206	1.5856	1.1046	0.6914	0.3599	0.1247
83	4.128	3.4842	2.8567	2.256	1.6945	1.1861	0.7459	0.3902	0.1358
84	4.3238	3.6638	3.0165	2.3928	1.8057	1.2701	0.8027	0.422	0.1476
85	4.5151	3.8406	3.1753	2.5302	1.9185	1.3562	0.8616	0.4554	0.1602
86	4.7009	4.0138	3.3323	2.6672	2.0322	1.4439	0.9223	0.4902	0.1734
87	4.8802	4.1821	3.4862	2.8029	2.146	1.5328	0.9845	0.5264	0.1873
88	5.0523	4.3448	3.6362	2.9365	2.2593	1.6223	1.048	0.5637	0.2019
89	5.2165	4.5011	3.7815	3.0671	2.3712	1.7118	1.1122	0.602	0.217
90	5.3723	4.6504	3.9213	3.1939	2.4811	1.8007	1.1769	0.6411	0.2327
91	5.5195	4.7921	4.0551	3.3164	2.5883	1.8885	1.2416	0.6807	0.2488
92	5.6578	4.9261	4.1823	3.4338	2.6921	1.9745	1.3058	0.7207	0.2654
93	5.7874	5.0521	4.3027	3.5159	2.7922	2.0584	1.3693	0.7607	0.2822
94	5.9083	5.1701	4.4161	3.6522	2.888	2.1396	1.4316	0.8006	0.2992
95	6.0209	5.2804	4.5226	3.7525	2.9793	2.2178	1.4924	0.8401	0.3164

[Regulation 3]

FACTORS FOR CHILDREN FOR FATAL CASES

Nearest Age	Children’s single life temporal annuity
0	13.64
1	13.07
2	12.48
3	11.88
4	11.25
5	10.61
6	9.94
7	9.25
8	8.54
9	7.8
10	7.04
11	6.26
12	5.45
13	4.61
14	3.75
15	2.86
16	1.93
17	0.98

[Regulation 3]

DISABILITY CHILDREN’S FACTORS

Nearest Number of Years to Run	Children Factors
0	0
1	0.98
2	1:93
3	2.86
4	3.75
5	4.61
6	5.45
7	6.26
8	7.04
9	7.8
10	8.54
11	9.25
12	9.94
13	10.61
14	11.25
15	11.88
16	12.48
17	13:07
18	13.64
19	14.19
20	14.72
21	15.24
22	15.74
23	16.22
24	16.69
25	17.14
26	17.58
27	18.01
28	18.42
29	18.82
30	19.2
31	19.58
32	19.94
33	20.29
34	20.63
35	20.96
36	21.27
37	21.58
38	21.88
39	22.17
40	22.45

[Sections 115 and 152]

Arrangement of Regulations

Regulation

1. Title

2. Rate of assessment

3. Payment of assessment

4. Revocation of S.I. No. 197 of 1973

SCHEDULE

SI 13 of 2021.

1. Title

These Regulations may be cited as the Workers’ Compensation (Domestic Workers) Regulations.

2. Rate of assessment

The rate of assessment payable by an employer in respect of a domestic worker is ZMW 10.00 every month during which the domestic worker is employed.

3. Payment of assessment

An employer shall pay the assessment to the Fund and submit a return as set out in the Schedule.

4. Revocation of S.I. No. 197 of 1973

The Workers’ Compensation (Private Domestic Servants) Regulations, 1973 are revoked.

Particulars of workers

Claim No. (1)

Occupation

Married or single

[Regulation 3]

ANNUAL RETURNS BY EMPLOYERS OF DOMESTIC WORKERS

To be completed by employers of domestic workers

Name: ………………………………………………………………………………………………………………

Residential address: …………………………………………………………………………………………….

E-mail address: ……………………………………………………………………………………………………

Telephone/cell phone number …………………………………………………………………………………

Financial year of the Board in respect of the return filed ……………………………………………….

to ………………………………………………

Name(s) of domestic worker	Date of birth	NRC/ Passport No.	Address of domestic worker	Date employed	Date ceased employment (state in respect of a worker who has ceased employment during the preceding financial year of the Board ending …………. day of ………. or since the last return was filed (indicate))


Date: ……………………
…………………………………………………………………….. Signed by Employer or duly authorised representative