Industrial accidents
- Making a benefit claim for an industrial accident
- The decision on your claim
- Payment of benefit
- Effects of Industrial Injuries Disablement Benefit on other benefits
An ‘accident’ for Industrial Injuries Disablement Benefit purposes means any unintended happening or incident at work that has arisen out of and in the course of your employment, and has resulted in a personal injury.
It must have arisen from employed earner’s employment. [Legislation (20)]
You can only get benefit if the accident results in personal injury (also described as loss of faculty). It does not matter if the effect of the injury is immediate (for example, if you break your leg in a fall) or is delayed (for example, a blow to the knee which leads to impaired mobility at a later time). Generally an accident which happens when you are at work is accepted as having happened as a result of your work, unless there is some evidence that this is not so. Whether or not you are considered to be at work at a particular time depends on the circumstances in each case. For example,you cannot normally be regarded as being at work when you are travelling to or from work, but you may be if you are in transport provided by your employer. [Legislation (21)]
An accident can be treated as having happened when you were at work and as a result of your work if it occurred:
- because you were doing something you were employed to do
- or because your work put you at special risk
- or while you were helping in an emergency, for instance in rescue work at any premises used for your employer’s business. [Legislation (22)]
If you were doing something which your employer does not allow you to do, or the rules for your job do not allow you to do, the accident may still be treated as having happened during, and as a result of your work, if what you were doing was done for the purpose of your employer’s business and was within the scope of your job.
In some other unusual cases, such as ‘skylarking’ by workmates, an accident can be covered if it happens through no fault of your own while you are at work.
Making a benefit claim for an industrial accident
When to claim
Do not delay in making a claim if you think you may be entitled to Industrial Injuries Disablement Benefit as a result of your accident.
If you have any relevant medical evidence send it with your claim form but do not delay claiming by trying to get a fresh report.
Do not delay claiming. If you do you may lose some benefits. This is because Industrial Injuries Disablement Benefit cannot be paid:
- for a period more than 3 months before the date of your claim
- or if you are already in receipt of Industrial Injuries Disablement Benefit for other accidents or diseases, more than one month before the date of claim [Legislation (27)]
How to claim
Obtain a claim form BI100A from your Regional Industrial Injuries Disablement Benefit Centre or the Disability benefits section of GOV.UK
The date of your claim is the date your fully completed claim form is received in an office of the Department for Work and Pensions (DWP).It is very important that you carefully fill in all the details on the form and return it to your Regional Industrial Injuries Benefit Centre as soon as possible. [Legislation (28)]
If you want help filling in your claim form, or any part of it, ring the Benefit Enquiry Line for people with disabilities. The telephone number is 0800 88 22 00.Once your Regional Industrial Injuries Disablement Benefit Centre has received your application, you will be sent a written acknowledgement. They will normally write to your employer to verify the accident.
Confirmation is needed of the following:
- the time, date and place of the accident
- that the accident arose out of and in the course of your employment
- that your employment was employed earner’s employment
- that the employment was in Great Britain or was covered by special provisions.
The accident must have happened in the course of your employment while you were doing something which: [Legislation (25)]
- you were authorised, expressly or by implication, to do by your employer
- or was so closely related to your employment that it was reasonable for you to be doing it
- or is covered by the special provisions regarding actions in an emergency, transport provided by the employer, breach of the rules or accident caused by another person’s behaviour.
If your employer is no longer trading, and the location of their records is not known, you will be asked to provide details of any witnesses to the accident
Once the decision maker has accepted that you have suffered an industrial accident, you will then be asked to attend a medical examination. [Legislation (29)]
If you are asked to attend a medical examination and you fail to turn up without good cause, your claim will be disallowed. [Legislation (30)]
About the medical examination
Your medical examination will be carried out by one or possibly two experienced medical practitioners.
These doctors are specially trained in industrial injuries disablement matters.
If you can travel, you will be told when and where to go for the examination. You will be told what out-of-pocket expenses you can claim. If you are not fit to travel alone, someone can travel with you. [Legislation (31)]
If you are not fit to travel, you can also request an examination at home. You should give full details of why you are unable to attend at a Medical Boarding Centre.
The medical examination will be held in private but you may be able to take a companion if the doctor allows it. Occasionally you may be asked if an observer can be present.
You can give the doctor any evidence which was not included with your claim form, if you think it will help them to give an opinion on your disablement.
If you have attended a hospital following an industrial accident, the doctor may seek further information from the hospital. Hospital case notes may be requested by the doctor to assist in giving an opinion.
The doctor could also ask for a report from your GP.
The doctor will take a statement from you and send a written report to the decision maker based upon the examination and any other medical evidence. The doctor will give an opinion on whether you have suffered a loss of faculty as a result of the accident and, if so, advise on the level of your disablement and how long it is expected to last. The doctor will also provide an explanation for the decision maker about how they arrived at that opinion.
What is a loss of faculty?
Loss of physical or mental faculty means some loss of power or function of an organ of the body. Loss of faculty can include disfigurement even when this causes no bodily handicap. Whether a loss of faculty results in disability is decided by comparing your condition as a result of the accident with the condition of a normal healthy person of the same age and sex. [Legislation (32)]
Degree of disablement
Your disablement is assessed as a percentage up to 100%.
The degree of disablement for certain defined injuries is laid down in the Regulations. For example, for serious disablement such as loss of both hands or loss of sight the degree of disablement is 100%, for the loss of one hand it is normally 60%, and for the loss of an index finger it is usually 14%. The percentages listed in Regulations for different disablements is in Appendix 2. [Legislation (33)]
The degree of disablement for injuries not listed in the Regulations is arrived at by comparing them with these standards.
The medical advice or assessment takes account of all disabilities resulting from the industrial accident. Where your disability also results from some other cause which arose before the accident, the degree of disablement which would in any event be present due to that other cause is not counted, but the interaction between the two causes is included in the assessment.
For example, a miner who has had considerable trouble with his back for many years and who is known to have lumbar spondylosis, injures his back lifting a heavy weight at work.
The doctor considers a gross assessment of disablement for injury to the spine and deducts an amount for the disablement already present due to the earlier back problems. [Legislation (34)]
If your disablement is 11% or more, and some other condition arises after the accident but is not directly caused by it, any increase in your disablement due to the accident as a result of that other cause is also used to work out your disablement.
For example, a man fractured his left forearm in a fall at work. After the industrial accident he was involved in a traffic accident and fractured his left collar bone.
The doctor considers an assessment of disablement for injury to the forearm and if that assessment is over 11% the doctor adds a further assessment for the extent that the later fracture increases the man’s disability.
You may be given a ‘final’ assessment of disablement for life if your disability is assessed as permanent and is unlikely to change. Or where you are likely to make a full recovery the assessment may be final but for a limited period. Or you may be given a provisional assessment for a limited period at the end of which you will be re-examined and your disablement assessed again. [Legislation (35)]
The decision on your claim
After the medical examination, your claim will be decided by a decision maker. The decision maker will look at the doctor’s advice and any other available evidence.
Regional Industrial Injuries Disablement Benefit Centre will write to tell you the decision on your claim, the amount of any benefit you will get and the period for which you will receive benefit.
The decision only takes account of your physical or mental condition. Basic Industrial Injuries Disablement Benefit is not affected by what type of job you do or any loss of earnings. It can be paid whether or not you have returned to work and it does not depend on your earnings.
Loss of earnings and other circumstances may, however, mean you can get one or more of the other benefits described later in this guide.
If you disagree with the decision on your claim
Payment of benefit
How much benefit you will get
The amount of benefit you get depends on how badly you are disabled by the accident.
Industrial Injuries Disablement Benefit cannot be paid for the first 15 weeks (90 days not including Sundays) after the date of your accident. [Legislation (36)]
You will not get benefit if your disablement is assessed at less than 14%. [Legislation (37)]
But you may be able to get benefit if you have had more than one accident or disease and the total disablement, when the effects of all the accidents and diseases are added together, is 14% or more. This is known as aggregation. [Legislation (38)]
If your disablement is at least 14% your benefit will be paid as a weekly pension.
If your disablement is:
between 14% and 19% you will get a pension at the 20% rate, 20% or over it will be rounded up or down to the nearest 10%. [Legislation (39)]
The following table provides a breakdown of the percentage assessment and percentage payable:
| Percentage assessment | Percentage payable |
|---|---|
| 14 – 24 % | 20% |
| 25 – 34 % | 30% |
| 35 – 44 % | 40% |
| 45 – 54 % | 50% |
| 55 – 64 % | 60% |
| 65 – 74 % | 70% |
| 75 – 84 % | 80% |
| 85 – 94 % | 90% |
| 95 – 100% | 100% |
The maximum rate payable for Industrial Injuries Disablement Benefit is 100% even if you have several assessments which add up to over 100%.
For current rates see Benefit and pension rates (BRA5DWP)
How you are paid
Our policy is to pay all benefits directly into an account.
This is the safest way to pay you and lets you choose how and when you get your money. You can use a bank or building society.
You may be able to use a cash machine, which will usually mean you can get your money at any time of the day or night.
There are arrangements with banks and building societies so that you can collect cash from some of their accounts at your Post Office® branch.
The Post Office® also provides a bank account that we can pay benefits into. With this account you can only collect your money in cash from Post Office® branches.
The other advantages of having your money paid into an account are:
- you can get your money from many different places
- from some accounts you could have regular bills paid. This could save you money but you will need to make sure that there is enough money in your account to pay the bills. If not, you may be charged a fee
- using an account may help you save.
The account can be:
- in your name, or
- in the name of your partner. We use partner to mean a person you are married to or a person you live with as if you were married to them, or a civil partner or a person you live with as if you are civil partners, or
- in the names of both yourself and your partner, or
- in the name of the person acting on your behalf, or
- in the names of both yourself and the person acting on your behalf.
Benefit is paid either every 4 weeks, every 13 weeks or every week.
If you have a bank or building society account but you do not wish to use it, for example a joint account, any bank or building society will help you open an account that suits you better. Remember to ask whether their accounts allow you to get your money from the Post Office®, if this is important to you.
Basic bank account
If you have had problems opening a current account, or if you are worried about being overdrawn, you could ask any bank or building society about opening a basic bank account.
These are sometimes called introductory or starter accounts and are available from all major banks.
These accounts offer free banking but overdrafts are not available.
You can use these accounts to pay money in, pay bills automatically and get cash out.
Many basic bank accounts also allow you to get cash from Post Offices®.
If your circumstances change
A decision can be looked at again at any time if your condition has changed.
If the condition for which you are getting benefit improves you must tell us straight away.
If you feel your condition has got worse and you want us to have another look at the decision, complete and return form BI168, which you can get from your Regional Industrial Injuries Disablement Benefit Centre.
If you are receiving Industrial Injuries Disablement Benefit you must also tell us if:
- you marry, remarry or form a civil partnership and change your name
- you change your address
- you leave the country
- you go into prison.
If you leave the country
If you leave the country, Industrial Injuries Disablement Benefit is payable while you are away.
- For further details please read the ‘How you are paid’ paragraphs of this guide. [Legislation (41)]
If you intend to be away for more than 3 months, payment of your benefit will be made by the International Pensions Centre (IPC).
You will be asked how you want your payments to be made while you are away. You can choose between:
- Direct Payment to a United Kingdom (UK) bank or building society account every 4 or 13 weeks
- payable orders sent directly to you every 4 or 13 weeks while you are away
- Transcontinental Automated Payments (TAPS), if the country has this arrangement with Jobcentre Plus
- payment to a nominee
- payment when you return to the UK.
You must let us know when you return to the UK.
If you go to prison
If you go into prison, you must let us know the date you were admitted.
Payment of Industrial Injuries Disablement Benefit is suspended during any period of imprisonment.
When you are released let us know the date. Arrears of Industrial Injuries Disablement Benefit may be paid for the period of imprisonment subject to a maximum of one year’s benefit. [Legislation (42)]
If you die
If you die, someone should let us know straight away.
Effects of Industrial Injuries Disablement Benefit on other benefits
Your basic Industrial Injuries Disablement Benefit does not affect any other National Insurance benefits such as:
- Incapacity Benefit
- Employment and Support Allowance (contribution-based)
- Contribution-based Jobseeker’s Allowance
- Retirement Pension.
But Industrial Injuries Disablement Benefit may affect income-related benefits that you or your partner receive such as:
- Income Support
- Employment and Support Allowance (income-related)
- Income-based Jobseeker’s Allowance
- Pension Credit
- Housing Benefit
- Working Tax Credit
- Child Tax Credit.
Note: You will have to contact your local authority to confirm if any reduction you or your partner receive in your council tax bill is affected.
Industrial Injuries Disablement Benefit may also affect how much War Pension you get, if you are entitled to both.
