Company : Sol Infotech Pvt. Ltd. Website : www.courtkutchehry.com Gujarat Workmens Compensation Rules, 1967 CONTENTS CHAPTER 1 :- Preliminary 1. Short Title 2. Definitions CHAPTER 2 :- Review Of Half-Monthly Payments And Commutation Thereof 3. When Application May Be Made Without Medical Certificate 4. Procedure On Application For Review CHAPTER 3 :- Deposit Of Compensation 5. Deposit Under Section 8 (1) 6. Publication Of List Of Deposits 7. Application By Dependants For Deposits Of Compensation 8. Deposit Under Section 8 (2) 9. Investment Of Money CHAPTER 4 :- Notice, Statement And Report Of Accidents 10. Notice And Statement Under Section 10-A (1) 11. Report Of Fatal Accidents 12. Right Of Employer To Present Memorandum When Information Received CHAPTER 5 :- Medical Examination 13. Workman Not Be Required To Submit To Medical Examination Save In Accordance With Rule 14. Examination When Workman And Medical Practitioner Both Present On Premises 15. Examination In Other Cases 16. Restriction On Number Of Examination 17. Examination After Suspension Of Right To Compensation 18. Examination Of Women CHAPTER 6 :- Procedure 19. Introductory 20. Application 21. Production Of Documents 22. Application Presented To Wrong Commissioner 23. Examination Of Applicant 24. Summary Dismissal Of Application 25. Preliminary Inquiry Into Application 26. Notice To Opposite Party 27. Appearance And Examination Of Opposite Party 28. Framing Of Issues 29. Power To Postpone Trial Of Issues Of Fact Where Issues Of Law Arise 30. Diary 31. Reasons For Postponement To Be Recorded 32. Judgment 33. Summoning Of Witness 34. Exemption For A Payment Of Costs 35. Right Of Entry For Local Inspection 36. Procedure For Local Inspection 37. Power Of Summary Examination 38. Agreement To Abide By Commissioners Decision 39. Procedure Where Indemnity Claimed Under Section 12(2) 40. Procedure In Connected Cases 41. Certain Provisions Of Code Of Civil Procedure, 1098 Apply 42. Provision Regarding Signature On Form 43. Apportionment Of Compensation Among Dependants CHAPTER 7 :- TRANSFER 44. Transfer For Report 45. Transmission Of Money CHAPTER 8 :- Deposit Of Compensation 46. Deposit Under Section 8 (1) 47. Application By Dependants For Deposits Of Compensation CHAPTER 9 :- Record Of Memoranda Of Agreement 48. Form Of Memorandum 49. Procedure Where Commissioner Not Inclined To Refuse To Record 50. Procedure Where Commissioner Inclined To Refuse To Record Memorandum 51. Procedure On Refusal To Record Memorandum 52. Registration Of Memorandum Accepted For Record CHAPTER 10 :- Scales Of Costs And Fees 53. Costs 54. Fees 55. When Applicant May Be Required To Deposit Deficiency Of Fees 56. Manner Of Collecting Fees CHAPTER 11 :- Maintenance Of Registers, Language Of The Court Records, Certified Copies And Allowance To Witness. 57. Register Of Applications 58. Register Of Fatal Accidents 59. Register Of Non Accidents 60. Language Of The Record 61. Supply Of Certified Copies To Parties 62. Allowances To Witness CHAPTER 12 :- Assessors 63. Fees To Assessors CHAPTER 13 :- Miscellaneous Provisions 64. Displaying Of Abstracts Of Act And Rules By Employers 65. Repeal SCHEDULE 1 :- SCHEDULE I SCHEDULE 2 :- Form A SCHEDULE 3 :- Form B SCHEDULE 4 :- Form C SCHEDULE 5 :- Form D SCHEDULE 6 :- Form E SCHEDULE 7 :- Form F SCHEDULE 8 :- Form G SCHEDULE 9 :- Form H SCHEDULE 10 :- Form I SCHEDULE 11 :- Form J SCHEDULE 12 :- Form K SCHEDULE 13 :- Form L SCHEDULE 14 :- Form M SCHEDULE 15 :- Form N SCHEDULE 16 :- Form O SCHEDULE 17 :- Form P SCHEDULE 18 :- Form Q SCHEDULE 19 :- Form R SCHEDULE 20 :- Form S SCHEDULE 21 :- Form T SCHEDULE 22 :- Form U SCHEDULE 23 :- Form V SCHEDULE 24 :- Form W SCHEDULE 25 :- Form Y Gujarat Workmens Compensation Rules, 1967 In exercise of the powers conferred by section 32 of the Workmen's Compensation Act, 1923 (VIII of 1923), in its application to the State of Gujarat, the Government of Gujarat hereby makes the following rules, namely:- CHAPTER 1 Preliminary 1. Short Title :- These rules may be called the Gujarat Workmens Compensation Rules, 1967. 2. Definitions :- In these rules, unless the context otherwise requires,- (a) "The Act" means the Workmens compensation Act, 1923, in its application to the State of Gujarat; (b) "Form" means a form appended to these rules; (c) "Schedule" means the Schedule appended to these rules; (d) " Section" means a section of the Act. CHAPTER 2 Review Of Half-Monthly Payments And Commutation Thereof 3. When Application May Be Made Without Medical Certificate :- Application for review of a half-monthly payment under section 6 may be made without being accompanied by a medical certificate- (a) by the employer on the ground that since the right to compensation was determined the Workmens wages have increased; (b) by the workman, on the ground-- (i) that since the right to compensation was determined his wages have diminished, or (ii) that the employer, having commenced to pay compensation, has ceased to pay the same, notwithstanding the fact that there has been no such change in the workmens conditions a s to warrant such cessation; (c) either by the employer or by the workman, on the ground (i) that the determination of the rate of compensation for the time being in force was obtained by fraud or undue influence or other improper means, or (ii) that in the determination of compensation there has been a mistake or an error apparent on the face of the record. 4. Procedure On Application For Review :- If, on an application for review by an employer in which the reduction or discontinuance of half-monthly payments is sought it appears to the Commissioner that there is a reasonable ground for believing that the employer has a right to such reduction or discontinuance, he may at any time issue an order with holding the half-monthly payments in whole or in part pending his decision on the application. CHAPTER 3 Deposit Of Compensation 5. Deposit Under Section 8 (1) :- (1) An employer depositing compensation with the Commissioner under sub-section (1) of section 8, in respect of workman whose injury has resulted in death shall furnish herewith a statements in Part I of Form A, and shall be given receipt therefore in Form B. In other cases of deposits with the Commissioner under sub-section (1) of section 8, the employer shall furnish a statement in Part II of Form A and shall be given a receipt in Form B. (2) If, when depositing compensation in respect of the fatal accident the employer indicates in the statement referred to in sub- rule (1) that he desires to be made a party to the distribution proceedings, the Commissioner shall before alloting the sum deposited as compensation, afford to the employer an opportunity of establishing that the person to whome he proposes to allot such sum is not a dependant of the deceased workman or, as the case may be, that no one of such persons is such a dependent. (3) The statement of the disbursement to be furnished on application by the employer under sub-section (4) of the section 8 shall be in Form C. 6. Publication Of List Of Deposits :- The Commissioner shall cause to be displayed in prominent position outside his office an accurate list of the deposits received by him under sub-section (1) of section 8, together with the names and address of the depositors and of the workman in respect of whose death or injury the deposits have been made. 7. Application By Dependants For Deposits Of Compensation :- (1) A dependent of a deceased workman may apply to the Commissioner for the issue of an order to deposit compensation in respect of the death of the workman. Such application shall be made in Form D. (2) If compensation has not been deposited, the Commissioner shall dispose of such application in accordance with the provisions of Part VI of these rules. Provided that- (a) the Commissioner may, at any time before issue are framed, cause noticed to be given in such manner as he thinks fit to all or any of the dependants of the deceased workman who have not joined in the application, requiring them, if they desire to join therein, to appear before him on a date specified in this behalf; (b) any dependant to whom such notice has been given and who fails to appear and to join in the application on the date specified in the notice shall not be permitted thereafter to claim that the employer is liable to deposit compensation unless he satisfies the Commissioner that he was prevented by any sufficient cause from appearing when the case was called on for hearing. (3) If, after completing the enquiry into the application, the Commissioner issues an order requiring the employer to deposit compensation in accordance with sub-section (1) of section 8, nothing in sub-rule (2) shall be deemed to prohibit the allotment of any part of the sum deposited as compensation to a dependent of the deceased workman who failed to join in the application. 8. Deposit Under Section 8 (2) :- A n employer depositing compensation in accordance with sub-section (2) of section 8, shall furnish there with a statement in Form E, and he shall be given a receipt therefore in Form F. 9. Investment Of Money :- Money in the hands of the Commissioner may be invested for the benefit of the dependants of a deceased workman in accordance with the law, or rules, as the case may be under clause (2) of article 283 of the Constitution of India. CHAPTER 4 Notice, Statement And Report Of Accidents 10. Notice And Statement Under Section 10-A (1) :- The Notice sent by a Commissioner to an employer under section 10A shall be in Form G and shall be accompanied by a blank copy of Form H. (2) The statement submitted by an employer under the said section 10A shall be in Form H. 11. Report Of Fatal Accidents :- The report required by section 10-B shall be in Form I. 12. Right Of Employer To Present Memorandum When Information Received :- (1) Any employer who has received information of an accident may at any time, notwithstanding the facts that no claim for compensation has been instituted in respect of such accident, present to the Commissioner a memorandum, supported by an affidavit made by himself or by any person subordinate to him having knowledge of the facts stated in the memorandum, embodying the result of any investigation or inquiry which has been made into the circumstances or cause of the accident. (2) A memorandum presented under sub-rule (1) shall, on payment of the requisite fee recorded by the Commissioner. CHAPTER 5 Medical Examination 13. Workman Not Be Required To Submit To Medical Examination Save In Accordance With Rule :- A workman who is required by sub-section (1) of section 11 to submit himself for medical examination shall be bounded to do so only in accordance with the rules contained in this part and not otherwise. 14. Examination When Workman And Medical Practitioner Both Present On Premises :- When such workman is present at the employer s premises, and the employer offers to have him, examined free of charge by a qualified medical practitioner who is so present, the workman shall submit himself for such examination forthwith. 15. Examination In Other Cases :- In cases to which rule 14 does not apply the employer may - (a) send the medical practitioner to the place where the workman is residing for the time being in which case the workman submit himself for medical examination on being requested to do so by the medical practitioner, or (b) send to the workman and offer in writing to have him examined free of charge by a qualified medical practitioner, in which case the workman shall submit himself for medical examination at the employers premises or at such other place in the vicinity as is specified in such offer and at such time as is so specified: Provided that- (i) the time so specified shall not, save with the express consent of the workman, be between the hours of 7 p.m and 6 a.m and (ii) where the workmans conditions renders is impossible or inadvisable that he should leave the place where he is residing for the time being, he shall not be required to submit himself for medical examination, save at such place. 16. Restriction On Number Of Examination :- A workman who is in receipt of a half-monthly payment shall not be required to submit himself for medical examination elsewhere than at the place where he is residing for the time being more than twice in the first month following the accident or more than once in any subsequent month. 17. Examination After Suspension Of Right To Compensation :- If a workman whose right to compensation has been suspended under subsection (2) or subsection (3) of section 11 subsequently offers himself for medical examination his examination shall take place on the employers premises or at such other place in the vicinity thereof as may be fixed by the employer ans at a time to be fixed by the employer not being, save with the express consent of the workman, more than 72 hours after the workman has so offered himself. 18. Examination Of Women :- (1) No woman shall without her consent be medically examined by a male practitioner, save in the presence of another woman. (2) No woman shall be required to be medically examined by a male practitioner if she deposits a sum sufficient to cover expenses of examination by a female practitioner. CHAPTER 6 Procedure 19. Introductory :- Save as otherwise provided in these rules, the procedure to be followed by a Commissioner in the disposal of cases under the Act or these rules and by the parties in such cases shall be regulated in accordance with the rules contained in this part. 20. Application :- (1) Any application of the nature referred to in section 22 may be sent to the Commissioner by registered post or may be presented to him or to any of his subordinates authorized by him in this behalf and, if so sent or presented, shall unless the commissioner otherwise directs, be made in duplicate in Form J or K as the case may be or in other appropriate form, if any and, shall be signed by the applicant. (2) There shall be appended to every such application a certificate signed by the applicant, to the effect that the statement of facts contained in the application is, to the best of his knowledge and belief, accurate. 21. Production Of Documents :- (1) When the application for relief is based upon a document, the document shall be appended to the application. (2) Any other document which any party desires to tender in evidence shall be produced at or before the first hearing. (3) Any document which is not produced at or within the time specified in sub-rule (1) or (2) as the case may be, shall not, without the permission of the Commissioner, be admissible in evidence on behalf of the party who should have produce it. (4) Nothing in this rule applies to any documents which is produced for the purpose of cross-examining a witness or is shown to a witness for refreshing his memory. 22. Application Presented To Wrong Commissioner :- (1) If it appears to the Commissioner on receiving an application that should have been presented to another Commissioner, he shall return it to the applicant after endorsing thereon the dates of presentation and return thereof, the reason for returning it and the designation of the Commissioner to whom it should be presented. (2) If it appears to the Commissioner at any subsequent stage an application should have been presented to another commissioner, he shall send the application to the Commissioner empowered to deal with it sahll in form the applicant (and the opposite party, if any to whom a copy of the application has been sent under rule 26), accordingly. (3) The Commissioner to whom an application is transferred under sub-rule (2) may continue the proceedings as if the previous proceedings or any part of them had been taken before him, if he is satisfied that the interest of the parties will not thereby be prejudiced. 23. Examination Of Applicant :- (1) On receiving an application of the nature referred to in section 22, the Commissioner may examine the applicant on oath, or may send the application to any officer authorized by the State Government in this behalf and direct such officer to examine the applicant and his witness and forward the record thereof to the Commissioner. (2) The substance of any examination made under sub-rule (1) shall be recorded in the manner provided for the recording of evidence in section 25. 24. Summary Dismissal Of Application :- (1) The Commissioner may, after considering the application and the record of the examination, if any, of the applicant under rule 23, summarily dismiss the application, if, for reasons to be recorded, he is of the opinion that there are no sufficient grounds for proceeding thereon. (2) The mere dismissal of the application under sub-rule (1) shall not preclude the applicant from presenting a fresh application for the settlement of the same matter. 25. Preliminary Inquiry Into Application :- If the application is not dismiss under rule 24, the commissioner may, for reasons to be recorded, call upon the applicant to produce evidence in support of the applicant before calling upon any other party, to defend it and if upon considering such evidence, the Commissioner is of the opinion that there is no case for the relief claimed, he may dismiss the application with a brief statement of his reasons for so doing. 26. Notice To Opposite Party :- If the Commissioner does not dismiss the application under rule 24 or rule 25, he shall send to the party form whom the applicant claims relief (hereinafter referred to as the opposite party) a copy of the application, together with a notice of the date on which he will dispose of the application, and may call upon the parties to produce on that date any evidence which they may wish to tender. 27. Appearance And Examination Of Opposite Party :- (1) The opposite party may, and if so required the Commissioner, shall at or before the first hearing or with in such time as the Commissioner may permit, file a written statement dealing with the claim raised in the application, and any such written statement shall from part of the record. (2) If the opposite party contests the claim, the Commissioner may, and if no written statement has been filed, shall proceed to examine him upon the claim, and shall reduce the examination to writing. 28. Framing Of Issues :- (1) After considering any written statement and the record of any examination of the parties, the Commissioner shall ascertain upon what material propositions of fact or of law the parties ar at variance, and shall thereupon proceed to frame and record the issues upon which the right decision of the case appears to him to depend. (2) In recording the issues, the Commissioner shall distinguish between those issues which in his opinion relate to questions of fact and those which relate to question of law. 29. Power To Postpone Trial Of Issues Of Fact Where Issues Of Law Arise :- When issues both of law and of fact arise in the same case, and the Commissioners is of the opinion that the case may be disposed of on the issues of law only, he may try those issues first and for that purpose may, if he thinks fit, postpone the determination of the issues of fact until after the issues of law have been determined. 30. Diary :- The Commissioner shall maintain under his hand a brief diary of the proceedings on an application. 31. Reasons For Postponement To Be Recorded :- If the Commissioner is unable to dispose of an application at one hearing, he shall record the reasons which necessitate a postponement. 32. Judgment :- (1) The Commissioner shall, while passing orders, record concisely a judgment, his finding on each of the issues framed and his reasons for such findings. (2) The Commissioner shall, at the time of signing and dating his judgments, pronounce his decision, and thereafter no addition or alternation shall be made to the judgment other than the correction of a clerical or arithmetical mistake arising from any accidental slip or omission. 33. Summoning Of Witness :- If an application is presented by any party to the proceedings for the citation of witnesses, the Commissioner shall, on payment of the requisite expenses and fees, issue summons for the appearance of such witnesses, unless he considers that their appearance is not necessary for the just decision of the case. 34. Exemption For A Payment Of Costs :- If the Commissioner is satisfied that the applicant is unable by reason of poverty, to pay the prescribed fees, he may remit any or all of such fees. If the case is decided in favour of the applicant, the prescribed fees which, had they not been remitted, would have been due to be paid, may be added to the costs of the case and recovered in such manner as the Commissioner in his order regarding costs directs. 35. Right Of Entry For Local Inspection :- A Commissioner before whom any proceeding relating to an injury by accident is pending may at any time enter the place where the workman was injured, or where the workman ordinarily performed his work, for the purpose of making a local inspection or of examining any person likely to be able to give information relevant to the proceedings. Provided that the Commissioner shall not enter any Premises of any industrial establishment except during the ordinary working hours of that establishment, save with the permission of the employer or of some person directly responsible to him for the management of the establishment. 36. Procedure For Local Inspection :- (1 ) If the Commissioner proposes to conduct a local inspection with a view to examining on the spot the circumstances in which an accident took place, he shall give the parties or their representatives notice of his intention to do so, unless in his opinion the urgency of the case renders, the giving of such notice impracticable. (2) Such notice may be given orally or in writing, and in the case of an employer, may be given to any person upon whom notice of a claim can be served under sub-section (2) of section 10, or the representative of any such person. (3) Any party, or his representative may accompany the Commissioner at a local inspection. (4) After making a local inspection, the Commissioner shall note briefly in a memorandum any facts observed, and shall show the memorandum to any party who desires to see the same and on payment of the requisite fee shall supply any party with a copy thereof. (5) The memorandum shall form part of the record. 37. Power Of Summary Examination :- (1) The Commissioner may, during a local inspection or at any other time, save at a formal hearing of a case pending before him, examine summarily any person likely to be above to give information relative to such case, whether such person has been, or is to be called as a witness in the case or not, and whether any or all of the parties are present or not. (2) No oath shall be administered to a person examined under sub-rule (1) (3) A statement made by a person examined under sub-rule (1), if reduced to writing shall, not be signed by the person making the statement, nor shall it, except as hereinafter provided, be incorporated in the record or utilized by the Commissioner for the purpose of arriving at a decision in the case. (4) If a witness who has been examined under sub-rule (1) makes in his evidence any statement contradicting in material particulars any statement made by him in such examination and reduced to writing, the Commissioner may call his attention to such statement and shall in that case direct that the parties be furnished with the relevant part of such statement of the purpose of using it in examining or cross-examining the witness. (5) Any statement or part of a statement which is furnished to the parties under sub-rule (4) shall be in incorporated in the record. (6) Where a case is steeled by agreement between the parties, the Commissioner may incorporate in the record any statement made by a person examined under sub- rule (1) and may utilize such statement for the purpose of justifying his acceptance of, or refusal to accept, the agreement reached. 38. Agreement To Abide By Commissioners Decision :- (1) If a party expresses in writing his willingness to abide by the decision of the Commissioner, the Commissioner shall ascertain whether the other party also is willing so to abide. (2) If the other party is so willing, the fact of his willingness shall be recorded in writing and the record thereof shall be signed by him. (3) If the other party is not willing to abide by the Commissioners decision, the party which had initially expressed his willingness to abide by the decision of the Commissioner shall not be bound so to abide. 39. Procedure Where Indemnity Claimed Under Section 12(2) :- (1) Where the opposite party claims that if compensation is recovered from him he would be entitled under sub- section (2) section 12, to be indemnified by a person not being a party to the case, he shall, when first called upon to defend the application, present a notice of such claim to the Commissioner accompanied by the requisite fees, and the commissioner shall thereupon issue a notice to such person in Form I. (2) If any person served with a notice under sub-rule (1) desires to contest the applicant s claim for compensation or the opposite partys claim to be indemnified, he shall appear before the Commissioner on the date fixed for the hearing of the case or on any date to which the case may be adjourned and , if he so appears, he shall have all the rights of a party to the proceedings. If he does not so appear he shall be deemed to have admitted the validity of any award which may be made against the opposite party and to have admitted his own liability to indemnity the opposite party for any compensation which may be recovered from him: Provided that, if any person so served subsequently and satisfies the Commissioner that he was prevented by any sufficient cause from appearing, the Commissioner shall, after giving notice to the applicant and the aforesaid opposite party, hear such person, and may set aside or vary any award made against such person upon such terms as the commissioner thinks just. (3) If any person served with a notice under sub-rule (1) whether or not he desire to contest the applicants claim for compensation or the opposite partys claim to be indemnified claims that being a contractor he is himself a principal and is entitled to be indemnified by a person standing to him in the relation of a contractor from whom the workmen could have recovered compensation he shall on or before the date fixed in the notice under sub-rule (1) present a notice of such claim to the Commissioner accompanied by the requisite fee and the commissioner shall thereupon issue notice to such person in Form M. (4) If any person served with a notice under sub-rule (3) desires to contest the applicants claim for compensation or the claim under sub rule (3) to be indemnified, he shall appear before the Commissioner on the date fixed in the notice in Form K or on any date to which the case may be adjourned and, if he so appears shall have all the rights of a party to the proceedings. If he does not so appear he shall be deemed to have admitted the validity of any award which may be made against the original opposite party or the person served with a notice under sub-rule (1) and have admitted his own liability to indemnity the party against whom such award is made for any compensation which may be recovered from him: Provided that, if any person so served appears subsequently and satisfies the Commissioner that he was prevented by any sufficient cause form appearing, the Commissioner, shall, after giving notice to all parties on the record, hear such person, and may set aside or very any award made against such person upon such terms as the Commissioner thinks just. (5) In any proceedings in which a notice has been served on any person under sub-rule (1) or sub-rule (3), the Commissioner shall, if he awards compensation, record in his judgment a finding in respect of each of such persons, whether he is or is not liable to indemnify any of the opposite parties, and shall specify the party, if any, whom he is liable to indemnify. 40. Procedure In Connected Cases :- (1) Where two or more cases pending before a Commissioner arise out of the same accident, and any issue involve is common to two or more such cases, such cases may, so far as the evidence hearing on such issue is concerned, be heard simultaneously. (2) Where the procedure specified in sub-rule (1) is followed, the evidence bearing on a common issue shall be recorded in the proceedings of one case, and the Commissioner shall certify under his hand in the proceedings of any other such case, the extent to which the evidence so recorded applies to such other case, and the fact that the parties to such other case had the opportunity of being present, and, if they were present, of cross examining the witnesses. 41. Certain Provisions Of Code Of Civil Procedure, 1098 Apply :- Save as otherwise expressly provided in the Act of these rules, the following provisions of the First Schedule to code of Civil Procedure, 1098 in its application to the State of Gujarat namely those contained in order V, rules 9 to 13 and 15 to 30; Order IX ; Order XII, rules 3 to 10; Order XVI rules 2 to 21 Order XVII; Order XXIII, rules 1 and 2 and Order XXVI rules 1 to 8 shall apply to proceedings before a Commissioner in so far as they may be applicable thereto: Provided that- (a) for the purpose of facilitating the application of the said provisions the Commissioner may construe them in such manner without affecting the substance thereof, as may be necessary or proper in regard to the matter before him, and (b) the Commissioner may, for sufficient reasons which shall be recorded, proceed otherwise than in accordance with the said provisions, if he is satisfied that the interest of the parties will not thereby be prejudiced. 42. Provision Regarding Signature On Form :- Any Form, other than a receipt for compensation, which is by these rules, required to be signed by a Commissioner may be signed under his direction and on his behalf by any officer subordinate to him appointed by him in writing for this purpose. 43. Apportionment Of Compensation Among Dependants :- The provisions of this Part, except those contained in rules 26, 27 and 39 shall, as far as may be apply in the case of any proceeding relating to the apportionment of compensation among dependants of a deceased workman. CHAPTER 7 TRANSFER 44. Transfer For Report :- (1) A Commissioner transferring any matter to another Commissioner for report in accordance with sub-section (2) of section 21 shall, along with the documents referred to in that subsection transmit to such other Commissioner a concise statement, in the form of question for answer, of the matter on which report is required. (2) A Commissioner to whom a case is so transferred for report shall not be required to report on any question of law. 45. Transmission Of Money :- Money transmitted by one Commissioner to another in accordance with sub-section (2) of section 21 shall be transmitted either by remittance transfer receipt, or by money order, or by messenger, as the Commissioner transmitting the money may direct. CHAPTER 8 Deposit Of Compensation 46. Deposit Under Section 8 (1) :- (1) An employer depositing compensation with the Commissioner under sub-section (1) of section 8, in respect of workman whose injury has resulted in death shall furnish herewith a statements in Part I of Form A, and shall be given receipt therefore in Form B. In other cases of deposits with the Commissioner under sub-section (1) of section 8, the employer shall furnish a statement in Part II of Form A and shall be given a receipt in Form B. (2) If, when depositing compensation in respect of the fatal accident the employer indicates in the statement referred to in sub- rule (1) that he desires to be made a party to the distribution proceedings, the Commissioner shall before allotting the sum deposited as compensation, afford to the employer an opportunity of establishing that the person to whom he proposes to allot such sum is not a dependant of the deceased workman or, as the case may be, that no one of such persons is such a dependent. (3) The statement of the disbursement to be furnished on application by the employer under subsection (4) of the section 8 shall be in Form C. 6. Publication of list of deposits:- The Commissioner shall cause to be displayed in prominent position outside his office an accurate list of the deposits received by him under sub-section (1) of section 8, together with the names and address of the depositors and of the workman in respect of whose death or injury the deposits have been made. 47. Application By Dependants For Deposits Of Compensation :- (1) A dependent of a deceased workman may apply to the Commissioner for the issue of an order to deposit compensation in respect of the death of the workman. Such application shall be made in Form D. (2) If compensation has not been deposited, the Commissioner shall dispose of such application in accordance with the provisions of Part VI of these rules. Provided that- (a) the Commissioner may, at any time before issue are framed, cause noticed to be given in such manner as he thinks fit to all or any of the dependants of the deceased workman who have not joined in the application, requiring them, if they desire to join therein, to appear before him on a date specified in this behalf; (b) any dependant to whom such notice has been given and who fails to appear and to join in the application on the date specified in the notice shall not be permitted thereafter to claim that the employer is liable to deposit compensation unless he satisfies the Commissioner that he was prevented by any sufficient cause from appearing when the case was called on for hearing. (3) If, after completing the enquiry into the application, the Commissioner issues an order requiring the employer to deposit compensation in accordance with sub-section (1) of section 8, nothing in sub-rule (2) shall be deemed to prohibit the allotment of any part of the sum deposited as compensation to a dependent of the deceased workman who failed to join in the application. 8. Deposit under section 8 (2),- An employer depositing compensation in accordance with sub-section (2) of section 8, shall furnish there with a statement in Form E, and he shall be given a receipt therefore in Form F. 9. Investment of money:- Money in the hands of the Commissioner may be invested for the benefit of the dependants of a deceased workman in accordance with the law, or rules, as the case may be under clause (2) of article 283 of the Constitution of India. CHAPTER 9 Record Of Memoranda Of Agreement 48. Form Of Memorandum :- Memoranda of agreement sent to the Commissioner under sub-section (1) of section 28 shall, unless the Commissioner otherwise directs, be in duplicate, and shall be in as close conformity as the circumstances of the case admit with Form N or Form O or Form P as the case may be. 49. Procedure Where Commissioner Not Inclined To Refuse To Record :- (1) On receiving a memorandum of agreement, the Commissioner shall unless he considers that there are grounds for refusing to reword the memorandum, fix date for recording the same, and shall issue a notice in writing in Form Q to the parties concerned. Provided that, the notice may be communicated orally to any parties who are present at the time when notice in writing would otherwise issue. (2) On the date so fixed, the Commissioner shall record the memorandum unless, after hearing any of the parties who appear and desire to be heard, he considers that it ought not to be recorded. Provided that, the issue of a notice under sub-rule (1) shall not be deemed to prevent the Commissioner from refusing to record the memorandum on the date so fixed, even if no objection be made by any party concerned. (3) If no such date the Commissioner decides that the memorandum ought not to be recorded he shall inform the parties present of his decision and of the reason thereof and if any party desiring the memorandum to be recorded is not recorded is not present, he shall send, the information to that party in Form R. 50. Procedure Where Commissioner Inclined To Refuse To Record Memorandum :- (1) If, no receiving a memorandum of agreement, the Commissioner considers that there are grounds for refusing to record the same, he shall fix a date for hearing the party desiring the memorandum to be recorded, and shall inform such party and, if he thinks fit, any other party concerned of the date so fixed and of the grounds on which he considers that the memorandum should not be recorded. (2) If, the parties to be informed are not present, a written notice shall be sent to them in Form S or Form T, as the case may be, and the date fixed in such notice shall not be earlier than the expiry of seven days after the date of the issue thereof. (3) If, on the date fixed under sub-section (1) the party desiring the memorandum, to be recorded shows adequate cause for recording if the Commissioner may, if information has already been given to all the parties concerned, record the agreement. If information has been given to all such parties he shall proceed in accordance with rule 49. (4) If, on the date so fixed the Commissioner refuses to record the memorandum, he shall send a notice in Form R to any party who did not receive information under sub-rule (1) 51. Procedure On Refusal To Record Memorandum :- (1) if, in any case the Commissioner refuses to record to a memorandum of agreement, he shall briefly record his reasons for such refusal. (2) If, the Commissioner refuses to record a memorandum of agreement, he shall not pass any order directing the payment of any sum or amount over and above the sum specified in the agreement, unless opportunity has been given to the party liable to pay such sum to show cause why it should not pay. (3) Where the agreement is for the redemption of half-monthly payments by the payment of a lump sum, and the Commissioner considers that the memorandum of agreement should not be recorded by reason of the inadequacy of the amount of such as fixed in the agreement he shall record his estimate of the probable duration of the disablement of the workman. 52. Registration Of Memorandum Accepted For Record :- In recording a memorandum of agreement, the Commissioner shall cause the same to be entered in a registered in Form U and shall cause an endorsement to be entered under his signature on a copy of the memorandum to be retained by him in the following terms, namely: "This memorandum of agreement bearing serial No.............................. of 19................................ in the register has been recorded this........................... day of...................................... (Signature) Commissioner. CHAPTER 10 Scales Of Costs And Fees 53. Costs :- (1) Where the Commissioner directs that any costs shall not follow the event, he shall state his reasons therefore in writing. (2) The Costs which may be awarded shall include - (a) the charge necessarily incurred on account of court fees; (b) the charges necessarily incurred on subsistence money to witness; and (c) pleaders fees on the scale hereinafter provided for. (3) (a) in any proceeding involving an application for compensation in the form of a lump sum an application for review or an application for indemnification, the fees allowed shall be 25 rupees, subject to a Special order of the Commissioner to diminution to a sum not less than 15 rupees an to increase to a sum not more than 150 rupees for each such proceedings. In all other applications the fees allowed shall be 15 rupees subject to increase by special order to a sum not exceeding 50 rupees. (b) No fee shall be charged in excess of the amount determined under clause (a). (4) Where a party engages more pleaders than one to conduct or defend a case, he shall be allowed one set of costs only. (5) Where several defendants having substantially one defence to make employ several pleaders they shall be all owed one set of costs only. In such cases, it will be for the applicant, at the time of hearing, to ask for a direction of the Commissioner that separate costs be not allowed. (6) When two or more defendants having different substantial defense have engaged the services of one pleaders they shall be allowed separate sets of costs. In such a case, it will be for the defendants interested to apply at the hearing for separate costs. (7) When several defendants having different defense are represented by separate pleaders, they shall be entitled to separate costs. (8) The Commissioner shall, out of the amount deposits as compensation and costs, arrange to disburse the amount of compensation and costs in accordance with the order made in that behalf. 54. Fees :- The fees specified in the third column of the schedule shall be payable in respect of the proceeding specified against it in the second column thereof. 55. When Applicant May Be Required To Deposit Deficiency Of Fees :- If in any case the Commissioner considers that he ought to pass orders granting relief of a kind or to an extent different from that claimed by the applicant, and if the fees would have been payable by the applicant on an application for the relief which the Commissioner considers to be due is greater than the fees which has actually been paid, the Commissioner may require the applicant to deposit fees to the extent of the difference. 56. Manner Of Collecting Fees :- All fees payable under these rules shall be collected in the same manner as that laid down for collecting of court fees under the Bombay Court Fees Act, 1959. CHAPTER 11 Maintenance Of Registers, Language Of The Court Records, Certified Copies And Allowance To Witness. 57. Register Of Applications :- All application presented to the Commissioner shall be registered in a register to be maintained in Form V. 58. Register Of Fatal Accidents :- Every Commissioner shall maintain a seperate register in Form W of fatal accidents which come to his knowledge either on account of deposit made by or on behalf of employees, or because of applications made by dependants of a deceased workman for an order deposit and payment of compensation. 59. Register Of Non Accidents :- Every Commissioner shall maintain a separate register in Form X of non fatal accidents which come to his knowledge in any of the following ways:- (a) on account of an application for registration of memoranda of agreement; (b) on account of an application for commutation of half monthly payments; (c) on accounts of an amount of compensation deposited with the Commissioner under sub-section (2) of section 8; (d) on account of an application for settlement of claim made by an injured workman. 60. Language Of The Record :- The record of the Commissioner shall be kept in the English or the Gujarati Language. 61. Supply Of Certified Copies To Parties :- Certified copies of any document in any proceeding before a commissioner shall be supplied to a party in the same manner as that laid down in the rules contained in Chapter XXV (in so far as consistent with the Act) of the Civil Manual issued by the former High Court of Bombay for the guidance of civil Courts, or corresponding rules for the time being in force for the guidance of such Courts in the State of Gujarat. 62. Allowances To Witness :- Where a Commissioner has to issue a summons to a witness either at the instance of a party to a proceedings before him or on his own initiative, the allowances to be paid to the witness shall be on the same scales as those obtaining in that behalf of the Civil Court having jurisdiction in that area. CHAPTER 12 Assessors 63. Fees To Assessors :- Where in pursuance of the provision of subsection (3) of section 20, any person possessing special knowledge of any matter relevant to the mater under inquiry is chosen by the Commissioner to assist him in holding the inquiry he shall be entitled to such fee per day as the Commissioner may fix, subject to a maximum of rupees fifty and a minimum of rupees twenty: Provided that, he shall be entitled to an additional fees of rupees ten- (a) for each additional case, if he is required to assist in more than one case on the same day; and (b) for each of the days other than the first day. CHAPTER 13 Miscellaneous Provisions 64. Displaying Of Abstracts Of Act And Rules By Employers :- (1) A notice containing the abstracts of the Act and the rules made there under shall be displayed on the board or in any other conspicuous manner by the employer in English and in a language understood by the majority of the workers employed by him. (2). The notice shall be in Form Y. 65. Repeal :- The workmens Compensation Rules 1924, the Bombay workmens Compensation Rules, 1934 the Saurashtra workmans Compensation (scale of costs) Rules, 1948, the Saurasthra Workmans Compensation Ordinance (Rules), 1949 and the Kutach Workmans Compensation Rules, 1951 shall stand repealed: Provided that the, repeal shall not affect anything done or omitted to be done under the rules so repealed prior to the repeal thereof. SCHEDULE 1 SCHEDULE I (See rule 54) No. Description of Proceeding Amount of fee. 1 2 3 1. Application for compensation (a) Where compensation is claimed in the form of recurring payments. Fifty paise (b) (b) Where compensation is claimed in the One rupee where the sum form of a lump sum, does not exceed 500 rupees puls one rupee for each additional sum of 500 rupees or fraction thereof. II. Application for commutation. (a) by agreement between the parties Fifty paise. (b) in all other cases Two rupees. III. Application for the deposit of compensation - (a) under section 8 (1) of the Act Nil. (b) under section 8(2) of the Act (in respect of each person to whom compensation is payable). Fifty paise IV. Application for distribution by dependants, for each dependant. One rupee. V. Application for review or commutation.- (a) Where the review claimed is the continuance, increase, decrease or ending of half monthly payments. Fifty paise. (b) where the half monthly payments are sought to be commuted into a lump sum. two rupees. (c) in all other cases. one rupee. VI. Application for the registration of an agreement- (a) where the application or the memorandum of agreement is signed by both parties. Nil. (b) in all other cases Fifty paise. VII. Application to summon witness- (a) for the first witness mentioned in the application. Fifty paise. (b) for every subsequent witness Twenty five paise. VIII. Application for indemnification Three rupees. IX. Application for the recovery of compensation. (a) under an order already passed by the Commissioner. Fifty paise. (b) in all other cases. The same fee as that payable on a similar application for compensation. X. Application or memorandum not otherwise provided for. Fifty paise. SCHEDULE 2 Form A (See rule 5) Part I Deposit of Compensation for Fatal Accident [Section 8 (1) of the Workmans Compensation Act, 1923] Compensation amounting to Rs..................... is thereby presented for deposit in respect of injuries resulting in the death of workman, whose particulars are given below, which occurred on................................................ Name .................................................................................................... Fathers name.......................................................................................... (Husbands name in the case of married woman or widow.) Caste ..................................................................................................... Local Address........................................................................................ Permanent address................................................................................. His/Her monthly wages are estimated at Rs........................He/She was over/under the age of 15 years at the time of his/her death. (2) The said workman had prior to the date of his/her death, received the following payments, namely: Rs..................on...........................Rs.........................on..................... Rs..................on...........................Rs.........................on..................... Rs..................on...........................Rs.........................on..................... amounting in all to Rs................................. (3) An advance of Rs.............................. has been made on account of compensation to .being his/her dependant...................................................... (4)* I do not desire to be made a party to the proceedings for distribution of the aforesaid compensation. Dated .......................19 Employer. *An Employer desiring to be made a party to the proceedings shall strike out the words "do not". Part II Deposit of Compensation for Non-Fatal Accidents to a Woman or Person under Legal Disability. [Section 8 (1) of the Workmens Compensation Act 1923]. Compensation amounting to Rs........................ is hereby presented for deposit in respect of injuries sustained by ................................residing at...................... on.............19, resulting in the loss of ...........................temporary disablement. His/Her monthly wages are estimated at Rs................................ He/She was over/under the age of 15 years at the time of the accident. (2) The said injured workman has prior to the date of the deposit of the deposit received the following half-monthly payments, namely: Rs.................. on........................... Rs...................on........................ Rs..................on........................... Rs..................on........................... Rs..................on........................... Rs..................on........................... Dated .......................19 Employer. SCHEDULE 3 Form B Receipt for Compensation [Deposited under section 8(1) of the Workmens Compensation Act, 1923] Book No.....................Receipt No.........................Register No. Depositor......................................................................................................... Deceased or injured workmen..................................................................... Date of deposit...................................................................19....................... Sum deposited Rs........................................................................................ Commissioner. SCHEDULE 4 Form C (See Rule 5) State Of Disbursements [Section 8(4) of the Workmens Compensation Act, 1923] Serial No............................................................................................. Depositor. ............................................................................................ Date ....................................... Rs.............................. Amount deposited .............................................................................. Amount deducted and repaid to the employer under the proviso to Section 8(1).................................................................................................. ______________________________________________________________________________ ______________________________________________________________________________ Funeral expenses paid...................................................................... ______________________________________________________________________________ Compensation paid to the following dependants: Name Relationship ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Total ______________________________________________________________________________ Dated .......................19 Commissioner SCHEDULE 5 Form D (See rule 7) Application for Order to Deposit Compensation To the commissioner Workmens Compensation................................. residing...........................................................................................................at........................................................................ Vs. residing at Opposite Party, it is hereby submitted that...... (1)....................................... workmen employed by (a contractor with) the opposite party on the day of.....................19....................... received personal injury by accident arising out ................... of and in the course of his employment resulting in his death on the ........................... day of 19......... The cause of the injury was (hereby in ordinary language the cause of the .................. injury).................................................................... ( 2 ) The applicant(s) is /are dependent(s) of the deceased workmen being his ...................................................................................................... (3) The monthly wages of the deceased amount to Rs.................... The deceased was over/under the age of 15 years at the time of his death. (4) (a) Notice of the accident was served on the ............ day of......... (b) Notice was served as soon as practicable. (c) Notice of the accident was not served (in due time) by reason of............................................................................. (5) The deceased before his death received as compensation in the total sum of Rs........................................ The applicant(s) is/are accordingly entitled to receive a lump sum payment of Rs................................... You are therefore requested to award to the applicant(s) the said compensation or any other compensation to which he/they may be entitled. (Applicant(s....................................... Dated...................................... 19...................................... Strike out the clauses which are not applicable. SCHEDULE 6 Form E (See Rule 8) Deposit of Compensation for Non-Fatal Accidents, Other Than To A Woman or Person under Legal Disability (Section 8 (2) of the Workmens Compensation Act, 1923) Compensation amounting to Rs....................... is hereby presented for deposit in respect of permanent/temporary injuries sustained by................................ residing at.....................................which occurred on..................19.................... Dated...........................................19........................................Employer. SCHEDULE 7 Form F (See rule8) Receipt for Compensation [Deposited under section 8(2) of the Workmans Compensation Act, 1923] Book No......................... Receipt No.....................Register No................ Depositer.............................................................................................. In favour of ...................................................................................... Date of deposit.................................................................................. Sum deposited Rs.............................................................................. Commissioner. SCHEDULE 8 Form G (See rule 10) Whereas I have received information that (I).................................... a workman employed by you in (2)................................................................ had died as the result of an accident arising out of and in the course of his employment, I here by require you in accordance with section 10A of the Workmens Compensation Act, 1923 to submit to me withing thirty days of the receipt of this notice the enclosed Form H with the particulars required in paragraphs 1, 2, 3, and the particulars required in either paragraph 4 or 5 duly filed in. In the event of your admitting liability to pay compensation, the necessary deposit must, under sub-section (2) of the said section 10A be made within thirty days of the receipt of this notice. Dated..........................19 Commissioner (1) Here insert the name of the Workman........................................... (2) Here insert the name of the establishment...................................... SCHEDULE 9 Form H (See rule 10) 1. In reply to your notice dated the ...............19..............which was received by me on the............19.............it is submitted that (I).......................................................................................................residing at........................................................................................................a work met with an accident on..............................................19................................ The Monthly wages of the deceased amounted to Rs........................... 2. The circumstances in which the death of the workman occurred were as follows: 3. The deceased left the following dependants (s) namely:- 4. I admit liability to pay sa compensation, on account of the deceaseds death, the amount of Rs...........................................which will be deposited with you on the............. 19......... was............... before.............. 5. I disclaim liability to pay compensation on account of the deceaseds death on the following grounds:- Employer. (1) Here insert the name of the workman. (2) Here insert the name of the establishment. (3) Here insert the name(s) and address (es) where, known. Strike out the paragraph which is not applicable. SCHEDULE 10 Form I (See Rule 11) Report of Fatal Accidents on Serious Bodily Inquiry To, Sir, I hereby submit the following report on an accident which occured on............ (date), at............(here enter details of premises)...................... and which resulted in the death of/serious bodily injury to/the workman/workmen whose particulars are given in the statement annexed. 2. The circumstances in which the death/serious bodily injury/occured/ to the workman/workmen were as under: (a) Time of the accident: (b) Place where the accident occured: (c) Manner in which deceased was/were employed at the time: (d) Cause of the accident: (e) Any other relevant particulars: Yours Faithfully, (Signature and designation of person making the report.) Statement Name Sex Age Nature of employment Full Postal address SCHEDULE 11 Form J (See Rule 20) Application for Compensation by Workman To, The Commissioner for Workmens Compensation. residing at.........................................................................................applicant. Vs. residing at................................................................................,Opposite party. It is hereby submitted that- (1) The applicant, A workman employed by (a contractor with) the opposite party on the......................... day....................... of...................... 19......................, received personal injury by accident arising out of and in the course of his employment. The Cause of the injury was (here insert briefly in ordinary language the cause of the injury (2) The applicant sustained the following injuries, namely:- (3) The monthly wages of the applicant amount to Rs...................................... the applicant is over/under the age of 15 years. (4) (a) Notice of the accident was served on the ........................... day of................................................... (b) Notice was served as soon as practicable, (c) Notice of the accident was not served (in due time) by reason of................................................... (5) The applicant is accordingly entitled to receive- (a) Half monthly of Rs...........from the.........day of................... 19................to.........................day of ............................19 (b) A lump sum payment of Rs............................................ (6) The applicant has taken the following steps to secure a settlement by agreement, namely.....................................but it has proved impossible to settle the questions in dispute because......................................................... You are therefore, requested to determine the following questions in dispute namely:- (a) Whether the applicant is a workman within the meaning of the Act; (b) Whether the accident arose out of or in the course of the applicants employment; (c) Whether the whole or any part of the amount of compensation claimed is due; (d) Whether the opposite party is liable to pay such compensation as is due; (e) etc., (as required) Dated.............................19......................... .........................Applicant. SCHEDULE 12 Form K (See Rule 20) Application for Commutations (Under Section 7 of the Workmens Compensation Act, 1923) To the Commissioner for Workmens Compensation, r e s i d i n g at................................................................................................... ,applicant........................................................................................ Vs. r e s i d i n g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at ..............................................................................................Opposite Party It is hereby submitted that:- (1) The applicant/opposite party has been in receipt of half-monthly payments from............................. to..........................in respect of temporary disablement by accident arising out of and in the course of his employment. (2) The Applicant is derious that the right to receive half-monthly payments should be redeemed. (3) (a) The opposite party is unwilling to agree to the redemption of the right to receive half monthly payments. (b) The [arties have been unable to agree regarding the sum for which the right to receive half monthly payments should be redeemed. You are therefore to pass orders:- (a) Directing that the right to receive half-monthly payments should be redeemed. (b) Fixing a sum for the redemption of the right to receive half- monthly payments. Date.................................19 .........................Applicant. SCHEDULE 13 Form L (See rule 39) Notice Whereas a claim for compensation has been made by................. applicant, against .............and the said..................... has claimed that .................is liable under section 12 (2) of the Workmens compensation Act, 1923 to indemnify him against any compensation which he may be liable to pay in respect of the aforesaid claim, you are hereby informed that you may appear before me on........................... and contest the claim for compensation made by the said applicant or the claim for indemnify made by the opposite party. In default of your appearance you will be deemed to have admitted the validity of any award which may be made against the opposite party and your liability to indemnify the opposite party for any compensation which may be recovered from him. Dated...............19....................... . .......................... Commissioner. SCHEDULE 14 Form M (See rule 39) Notice Whereas a claim for compensation has been made by .......................... applicant, against................. and the said................ has claimed that ............ is liable under section 12(2) of the Workmens Compensation Act, 1923 to indemnify him against any compensation which may be liable to pay in respect of the aforesaid claim and whereas the said......................on notice served has claimed that you .................... stand to him in the relation of a contractor from whom the applicant.....................could have recovered compensation, you are hereby informed that you may appear before me on........................ and contest the claim for compensation made by the said applicant or the claim for indemnity made by the opposite party.................... In default of your appearance you will be deemed to have admitted the validity of any award which may be made against the opposite party................................ and your liability to indemnify the opposite party........for any compensation which may be recovered from him. Dated.......................... Commissioner. SCHEDULE 15 Form N (See rule 48) Memorandum of Agreement It is hereby submitted that on the .................day of............. 19....... personal injury was caused to...............residing at......................by accident arising out of and in the course of employment in........................The said injury has resulted in temporary disablement to the said workman whereby it is estimated that he will be prevented from earning more than his previous any wage for a period of..............months. The said workman has been in respect of half-monthly payments which continued from the ..................day of........19............until the day of..................19 amounting to Rs....................in all. The said workmans monthly wages are estimated at........... Rs..........in all. The said workmans monthly wages are estimated at Rs....................................The workman is over the age of 15 years/will reach the age of 15 years on.............. If is further submitted that .............the employer of the said workman, has agreed to pay and the said workman has agreed to accept, the sum of Rs.............in full settlement of all and every claim under the Workmans Compensation Act, 1923 in respect of all disablement of a temporary nature arising out of the said accident, whether now or hereafter to become manifest. It is therefore requested that this memorandum be duly recorded. Dated ...................196 Signature of Employer....................... Witness........................................................................................................ Signature of Workman............................. Witness...................................... (Note:- An application to register and agreement can be presented under the signature of one party, provided that other party has agreed to the (Receipt to be filled in when the money has actually been paid) In accordance with the above agreement, I have this day received that sum of Rs......................................... Workman. Seal Dated.....................19........................... This money has been paid and this receipt signed in my presence. Witness...................................... Note:- This form may be varied to suit special cases e.g. injury occupational disease agreement when is under legal disability etc. SCHEDULE 16 Form O (See rule 48) Memorandum of Agreement It is hereby submitted that on the ..................day of..............19.......personal injury was accused to residing at .............by accident arising out of and in the course of his employment................. in..................The said injury has resulted in permanent disablement to the said workman of the following nature, namely:- The said workmans monthly wages are estimated at Rs....................... The workman is over the age of 15 years/will reach the age of 15 years on........The said workman has, prior to the date of this agreements received the following payments namely: Rs..................on..................Rs.........................on.......................... Rs..................on..................Rs.........................on.......................... Rs..................on..................Rs.........................on.......................... It is further submitted that...............................................the employer of the said workman, has agreed to pay, and the said workman has agreed to accept the sum of, Rs....................in full settlement of al and every claim under the Workmans Compensation Act, 1923, in respect of the disablement stated above and all disablement now manifest. It is therefore requested that this, memorandum be duly recorded. Dated ...................196 Signature of Employer....................... Witness....................................................................................................... Signature of Workman............................. Witness............................................... Note:- An application to register and agreement can be presented under the signature of one party, provided that other party has agreed to the terms. But both signature should be appended whenever possible. (Receipt to be filled in when the money has actually been paid). In accordance with the above agreement, have this day received the sum of Rs............ Dated .........................196 ............................... Workman Seal This money has been paid and this receipt signed in my presence. Witness Note:- This Form may be varied to suit special cases e.g. injury by occupational disease, agreement when workmen is under legal disability, etc. SCHEDULE 17 Form P (See rule 48) Memorandum of Agreement It is hereby submitted that on the ...................say of .............196..... personal injury was caused to residing at...........by accident arising out of and in the course of employment in........The........... said injury has resulted in temporary disablement to the said workman, who is at present in receipt of wages amounting to Rs........per month/no wages. The said workmans monthly wages prior to the accident are, estimated at Rs...................The workman is subject to a legal disability by reason of...................... It is further submitted that.........the employer of the workman has agreed to pay and .......on behalf of the said workman has agreed to accept half-monthly payments at the rate of Rs.........for the period of the said temporary ..........disablement. This agreement is subject to the condition that the amount of the half- monthly payments may be varied in accordance with the provisions of the Workmans compensation Act, 1923 on account of an alternation in the earnings of the said workman during disablement. It is further stipulated that all rights of commutation under section 7 of the said Act are unaffected by this agreement. If is therefore requested that this memorandum be duly recorded. Dated .........................196 Signature of Employer..................... Seal Witness..................... Signature of workman.................... Witness..................... Note:- An application for registration of an agreement can be presented under the signature of one party, provided that the other party has agreed to the terms. But both signature should be appended, whenever possible. (Receipt to be filled in when the money has actually been paid). In accordance with the above agreement, I have this day received the sum of Rs.......... .Workman.............. Dated...........196 Seal This money has been paid and this receipt signed in my presence. Witness.................................................... Note:- This Form may be varied to suit special case, e.g. injury by occupational disease, etc. SCHEDULE 18 Form Q (See rule 48) Memorandum of Agreement It is hereby submitted that on the ..................day of..............19.......personal injury was accused to residing at .............by accident arising out of and in the course of his employment................. in..................The said injury has resulted in permanent disablement to the said workman of the following nature, namely:- The said workmans monthly wages are estimated at Rs....................... The workman is over the age of 15 years/will reach the age of 15 years on........The said workman has, prior to the date of this agreements received the following payments namely: Rs..................on..................Rs.........................on.......................... Rs..................on..................Rs.........................on.......................... Rs..................on..................Rs.........................on.......................... It is further submitted that...............................................the employer of the said workman, has agreed to pay, and the said workman has agreed to accept the sum of Rs....................in full settlement of al and every claim under the Workmans Compensation Act, 1923, in respect of the disablement stated above and all disablement now manifest. It is therefore requested that this, memorandum be duly recorded. Dated ...................196 Signature of Employer....................... Witness....................................................................................................... Signature of Workman............................. Witness............................................... Note:- An application to register and agreement can be presented under the signature of one party, provided that other party has agreed to the terms. But both signature should be appended whenever possible. (Receipt to be filled in when the money has actually been paid). In accordance with the above agreement, have this day received the sum of Rs............ Dated .........................196 ............................... Workman Seal This money has been paid and this receipt signed in my presence. Witness Note:- This Form may be varied to suit special cases e.g. injury by occupational disease, agreement when workmen is under legal disability, etc. SCHEDULE 19 Form R (See rules 49 and 50) Take notice that registration of the agreement to pay compensation said to have been reached between you................................and ..............on the .............19......has been refused for the following reasons, namely:- Dated.........19 Commissioner. SCHEDULE 20 Form S (See rule 50) Whereas an agreement to pay compensation is said to have been reached between............................................ and........................................ and whereas.............................................has/had applied for registration of the agreement under section 28 of the Workmans Compensation Act 1923 and whereas it appears to me that the said agreement out not to be registered for the following reasons namely:- an opportunity will not be afforded to you of showing cause............................................... on............................19.................why the said agreement should be registered. If no adequate cause is shown on that date, registration of the agreement will be refused. Dated...........19 Commissioner. SCHEDULE 21 Form T (See rule 50) Whereas an agreement to pay compensation is said to have been reached between..............and and whereas ...........has/have applied for registration of the agreement under section 28 of........ the Workmans Compensation Act, 1923 and whereas it appeals to me that said agreement ought not to be registered for the following reasons namely:- an opportunity will be afforded to the said......................................of showing cause on........................19........., why the said agreement should be registered. Any representation which you may have to make with regard to the said agreement should be made on that date. If adequate cause is then shown, the agreement may be registered. Dated........19 Commissioner. SCHEDULE 22 Form U (See rule 52) Refister of Agreements for the Year 19........................... S. No . Date of agreement Date of registration Employer Workman Initials of Commi ssioner Reference to orders rectifying the register SCHEDULE 23 Form V (See Rule 57) Register of Applications for the Year 19...... Nature of the Application Nam e and addr ess of the appl icant Name and addre ss of the oppos ite party Order Date of presentation of n applicatio Serial No. For distributio. For deposi For compensatio For half monthly paymen For commutatio For revie For recovery Application for registration Miscellaneous Claim Date H For wha am A B C D E F G I SCHEDULE 24 Form W (See Rule 58) Register of Fatal Accidents for the Year 19............ S. No Date of infor matio n Name of the decea sed work man Name of the Emplo yer Dependants of the deceased workman. Nature of accident and injury. Amount of compensation and rate of monthly wages. Date of distribution among the dependants Remar ks. SCHEDULE 25 Form Y (See Rule 64) Abstract of the Workmens Compensation Act, 1923, and Rules Made There Under (1) Whom the Act affects. The Act provides for payment by employers to their workmen of compensation for injury by accidents arising out of and in the course of employment. (2) Definitions. "Dependent" means any of the following relatives of a deceased workman, namely:- (1) A widow, a minor legitimate son, and unmarried legitimate daughter, or a widow mother, and (2) If wholly dependent on the earnings of the workman at the time of his death, a son or a daughter who has attained the age of 18 years, and who is infirm; (3) If wholly or in part dependent on the earnings of the workman at the time of his death; (a) A widower; (b) A parent other than the widowed mo ther; (c) A minor illegitimate son, an unmarried illegitimate daughter of a daughter legitimate if married and a minor or if widowed and a minor; (d) A minor brother or unmarried sister or a widowed sister if a minor; (e) A widowed daughter in law; (f) A minor child of a pre-deceased son; (g) A minor child of a predeceased daughter where no parent of the child is a live or, (h) A paternal grandparent if no parent of the workman is alive. (3) "Partial disablement" means where the disablement is of temporary nature, such disablement as reduces the earning capacity of the workman in the employment in which he was engaged at the time of the accident and where the disablement is of a permanent nature, such disablement as reduces his earning capacity in every employment which he was capable of understanding a the time. (4) "Total disablement" means such disablement as incapacitates a workman for all work which he was capable of performing at the time of the accident. (5) Workmen covered. "Workman" means any person who is employed all monthly wages not exceeding five hundred rupees in any capacity as is specified in Schedule II to the Act. It does not include a person whose employment is of a casual nature and who is employed otherwise than for purpose of the employers trade or business. (6) Employers liability for compensation. If personal injury is caused to a workman by accident arising out of and in the course of his employment the employer is liable to pay compensation. (7) Occupational diseases for which compensation is payable Anthrax, compressed air illness, poisoning by nitrous fumes, poisoning by Organic Phosphorous intercedes, poisoning by lead, poisoning by Phosphorous, poisoning by mercury, poisoning by benzene, Chrome ulceration, poisoning by arsenic, pathological manifestations due to radium and other radio active substances or X-Rays, primary epitheliomatous cancer of the skin, poisoning by halogenated hydrocarbons, poisining by carbon disulphide, occupational cateract due to infrared radiations telegraphists cramp, poisoning by maganese, silicosis coal miners" pneumoconiosis, asbestosis and bagassois. (8) Amount of Compensation. The minimum amount of compensation payable for permanent total disablement is Rs 1,400 and the maximum Rs. 14,000. A workman whose monthly wages and a workman whose wages exceeds Rs.400 gets Rs. 14,000. For permanent partial disablement the amount of compensation payable is proportionate to the percentage of loss of earning capacity. For death of a workman the amount payable to his dependants varies from Rs.1000 to Rs. 10,000. (9) Compensation not be assigned attached or charged. No lump sum or half monthly payment can be assigned or charged or be liable to attachment or pass to any person other than the workman nor can any claim be set off against the same. (10) Notice of claim. No claim for compensation will be entertained by a Commissioner unless notice of the accident is given in the prescribed manner as soon as practicable after the happening thereof. The claim must be preferred within two years of the occurrence of the accidents or in case of death within two years from the date of death. Commissioner has power to entertain an application made after the expiry of the period of limitation, if sufficient cause is shown for delay in making it. (11) Contracting: If any person (principal) contracts with any other (contractor) for the execution of any work which is ordinarily part of the trade or business of the principal. The principal is liable to pay compen sation under the Act to a workman employed directly by the Contractor. The principal who is liable to pay compensation is entitled to be identified by his contractor. (12) Contracting out Any contract or agreement where by a workman relinquishes any right of compensation from the employer for personal injury is null and void. (13) Appearance of parties. Any appearance or application on behalf of a party before or to a Commissioner can be made by the following persons if authorised in writing by such party:- (1) A legal practitioner; or (2) An official of an Insurance Company; or (3) An official of a registered Trade union; or (4) An inspector appointed under the Factories Act or the mines Act; or (5) By any other officer specified by the State Government in this behalf; or (6) By any other person with the permission of the Commissioner.