Industrial Injuries Disablement Benefit
Industrial Injuries Disablement Benefit is a benefit for people who are disabled either as a result of an accident at work (industrial accident) or a prescribed disease. The scheme does not cover certain groups of people, for example, the self-employed, members of the Armed Services or some trainees.
Industrial accidents and prescribed diseases
An industrial accident is an incident or series of discrete identifiable incidents that result in personal injury. A prescribed disease is an industrial disease “prescribed” by regulations to be included in the Industrial Injuries Benefit Scheme. There are currently about 70 prescribed diseases. The Industrial Injuries Advisory Council is an independent body that advises the Secretary of State for Work and Pensions on whether a disease should be included in the list of prescribed diseases.
Decisions about entitlement
Non-medical decision makers collect evidence to decide on claims and make decisions about entitlement.
In a claim for an industrial accident, the decision maker collects evidence to establish if there has been an incident which is an accident for entitlement purposes. In a claim for a prescribed disease, the decision maker will establish whether the person has worked in a prescribed occupation.
If the decision maker is satisfied that the person has suffered an industrial accident or has worked in a prescribed occupation, they usually seek advice from a healthcare professional working for Atos Healthcare before they make a decision on the claim.
To receive benefit, a person’s disablement has to be 1% or more for certain respiratory diseases, 20% or more for occupational deafness and 14% or more in all other cases.
Claims and payments
With some exceptions, IIDB is not payable until 90 days after the accident or date of onset of a prescribed disease. However, if the person might have had an industrial accident or prescribed disease, they should make a claim as soon as possible because there are time limits to the backdating of benefit.
The role of healthcare professionals
DWP may ask the healthcare professional responsible for the clinical care of the person to provide clinical information if it is not possible to make a decision about whether to award benefit without this. DWP usually request this information by sending form BI205 (to GPs) or BI127A (to hospitals).
In a small number of cases for prescribed diseases D3 (diffuse mesothelioma) and D8/D8a (lung cancer related to asbestos exposure), the healthcare professional responsible for the clinical care of the person may be contacted by phone to request evidence in order to confirm the diagnosis. In view of the urgency of the requirement to make a decision on benefit in these cases, it would be helpful if any documentary evidence required is supplied as quickly as possible.