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Industrial Injuries Scheme
WHO IS COVERED BY THE SCHEME? The industrial injuries scheme provides no-fault tax-free benefit for an employee who 'suffers personal injury caused after 4/7/48 by accident arising out of and in the course of' work, or who contracts a prescribed disease or a prescribed injury while working. You are covered by the Industrial Injuries scheme if you are working for an employer. It doesn't matter if you don't earn enough to pay National Insurance (NI) contributions, or if you are too old or too young to pay them - e.g. a 14 year old paper boy is covered. Nor does it matter if the accident happens on your first day at work. What counts is that you are gainfully employed under a contract of service, or as an office-holder with earnings that are taxable. If you are genuinely self-employed you will not be covered unless the accident happens while you are doing specified types of voluntary work, e.g. a special constable. You are covered by the Industrial Injuries scheme if your accident occurred outside the UK if your employer was paying NI contributions for you while you were working abroad or if you were working in an EC country or Norway or on the continental shelf of the UK, or as a mariner or airman, or as a volunteer development worker who continued to pay UK contributions. Apprentices who are not 'gainfully employed' are covered by the scheme. But if you are a non-employed trainee on a youth or adult training schemes you are covered by the Analogous Industrial Injuries scheme also administered by DWP. Benefits are equivalent to those paid under the industrial injuries scheme. For more information ring free on 0800 590 395. If there is any doubt over your status as an employed earner, your case is decided by an officer of the HM Revenue & Customs with a right of appeal to the General Commissioners of Income Tax. It may be possible to show that you were an employee for benefit purposes (despite the tax and NI arrangements) if the real relationship between you and the contractor is that of an employee and employer. This applies in particular to building workers who are very often categorised as self-employed. Your trade union may be able to advise you. INDUSTRIAL ACCIDENTS If you have an accident at work you should report the details as soon as possible to your employer. Enter them in the accident book (one must be kept at any workplace where 10 or more people usually work). Do this even if things don't seem serious at first. A cut can turn septic. A pain in the stomach can turn out to be a hernia. If you think the accident might have some ill-effect in future, apply to the DWP for a declaration that you have had an industrial accident. You can get the application form (BI100A) from your Jobcentre Plus office. In most cases it will be clear whether an 'accident' has happened and whether it was 'industrial', but case law has expanded these concepts to include less obvious situations. For example, a conversation or verbal harassment could constitute an accident. If you are in any doubt about whether you are covered by the Industrial Injuries scheme you should apply for an 'accident declaration' and claim benefit anyway. The case law is complex so always get advice if you are turned down. If your accident occurred before 5/7/48 see DWP booklet DB1, A guide to Industrial Injuries Benefits, which gives details of the Workmen's Compensation Scheme. PRESCRIBED INDUSTRIAL DISEASES Benefit can be paid for around 60 different diseases or conditions which are prescribed as being risks of particular occupations and not risks common to the general population. These are listed in the DWP guide DB1 along with the types of occupations you must have been working in to qualify for benefit. Provided you have worked in the relevant occupation at some time since 5/7/48, it does not matter if the disease started earlier, the date of onset can be treated as 5/7/48. If your relevant occupation finished before 5/7/48, you may be covered instead by the Pneumoconiosis, Byssinosis and Miscellaneous Diseases Benefit Scheme or the Workmen's Compensation Scheme. Booklet DB1 has details. It is up to you to claim benefit for a prescribed disease. If you have any reason to suspect that your illness is related to your work, you must ask the DWP and your doctor for advice. If you do not, you may lose benefit. For example, few secretaries realise that they may be covered by prescribed disease A4 if they experience cramp of the hand or forearm. Similarly, welders or hairdressers with hay fever symptoms may have a claim for prescribed disease D4, allergic rhinitis. If your disability arises from a non-listed condition that was contracted at work, you may still be able to claim under the 'accident' provisions. Case law has shown that the 'catching' of the condition can be accepted as an industrial accident; such cases include a nursery nurse who contracted poliomyelitis from an infected child and a tinner whose frequent burns on the hands caused cysts. INDUSTRIAL INJURIES DISABLEMENT BENEFIT Industrial Injuries Disablement Benefit (IIDB) is paid to compensate those who have suffered disablement from a 'loss of physical or mental faculty' caused by an industrial accident or prescribed disease. A loss of faculty may include disfigurement even if it does not trouble you. Your employer does not have to be at fault in any way for you to get benefit. You can claim whether or not you are incapable of work or have had any drop in earnings. Benefit is payable from 15 weeks after the date of the accident or the onset of the disease if your disablement is assessed at 14% or more. For some prescribed chest diseases you can get benefit if the assessment is from 1% to 13%. For occupational deafness you can only get benefit if your disablement is 20% or more. If you are claiming for a prescribed disease, the date of onset should be the date the disease started, not the date of claim. As benefit is only payable 15 weeks after this date, you should check this and challenge it if necessary. However, for occupational deafness, the law says that the date of onset must be the date a successful claim was made, and payment can start from that day. There is no 15-week waiting period for people with prescribed disease D3, diffuse mesothelioma, PDA10 occupational deafness, PDD8 and PDD8A (primary carcinoma of the lung). REDUCED EARNINGS ALLOWANCE Reduced earnings allowance (REA) replaced special hardship allowance from 1/10/86. REA itself was abolished on 1/10/90, but only for accidents or diseases occurring after that date. So if your accident or the onset of a prescribed disease (which must be listed before 10.10.94) occurred before 1/10/90, you can still claim REA. RETIREMENT ALLOWANCE Retirement allowance (RA) replaces REA if you are already getting at least £2 a week REA and are not in regular employment when you reach state pension age. IIDB, REA and RA are all tax free and paid on top of any earnings or other non-means-tested benefits you may receive. INDUSTRIAL DEATH BENEFIT Industrial Death Benefit is now only payable where the death occurred before 11/4/88. Those widowed on or after 11/4/88 as a result of an industrial accident or prescribed disease are entitled to widows' benefits and, since 9/4/01, bereavement benefits, without having to satisfy any contribution conditions. HOW DO YOU CLAIM IIDB? You should get form BI100A for an accident; BI00PD for any of the prescribed industrial diseases from your local Jobcentre Plus office. HOW MUCH DO YOU GET? Percentages and amounts
Note: Lower rates apply to under -18s without dependants. HOW DO YOU APPEAL? You have the right of appeal against the Secretary of State's decision on your claim to an appeal tribunal. You have one month from the date the decision was sent to you. To appeal, you should fill in the form in DWP leaflet GL24. You should give as much detail as possible as to why you disagree with the decision. As Industrial Injuries Benefits are complex, you may need expert advice - your trade union or a local advice centre may help. As an alternative to an appeal, you can ask the DWP to look at your claim again; this is called a revision. However, in cases where a medical question is involved, the decision maker is unlikely to change the original decision based on the DWP doctor's report even if you provide your own medical evidence to support your claim. As the time limit for appeal is now so restricted, it may be safer to appeal straight away. |
