If you have an accident at work, on the roads or elsewhere, are the victim of an assault or develop an industrial disease which causes you to have time off your usual work, you may be entitled to state benefits.
It is important to report the accident or illness to your employer immediately and complete the appropriate forms. You should also report it to the regional Jobcentre Plus disablement office as soon as possible, a list of which can be found here. It will then issue a declaration that you had an accident or illness, which should help to reduce delays if you decide to claim benefits at a later date.
If you are in any doubt about what you may be eligible to claim, ask the person dealing with your case. You may have to repay any benefits you receive from your compensation package, but again we will explain all this to you.
Your union, the Citizens Advice Bureau or the Department for Work and Pensions (DWP) can help with processing any claims.
Please note, there is a limit on the total amount of benefit that most people aged 16-24 can receive.
Statutory Sick Pay
Statutory Sick Pay (SSP) is paid to employees by their employer for up to 28 weeks if they are off sick from work.
To qualify for SSP, you must be incapable of work for four or more days. A GP’s fit note is normally required after seven days of absence. It is important to tell your employer you are sick before its deadline or within seven days if they do not have one.
SSP is payable at a fixed rate and is treated like other earnings. It is therefore subject to tax and National Insurance, but it is not means-tested nor is it dependent on National Insurance contributions. However, your earnings must at least equal the Lower Earnings Limit, which changes every year. Up-to-date rates can be found at www.gov.uk.
Your contract of employment may provide for payment of occupational sick pay over and above SSP, so it’s worth checking. Agency workers are entitled to SSP providing the above criteria are met.
Universal Credit
Universal Credit is replacing Jobseeker’s Allowance, Housing Benefit, Working Tax Credit, Child Tax Credit, Employment Support Allowance and Income Support.
Applicants have to accept a ‘claimant commitment’ if they wish to get Universal Credit, and this is an agreement that the applicant will complete certain tasks.
Further information is available by calling the Universal Credit helpline on 0800 328 5644 or via textphone on 0800 328 1344. Alternatively, you can visit the government website.
Industrial Injuries Disablement Benefit
Industrial Injuries Disablement Benefit (IIDB) is payable if you are disabled as a result of an accident at work or a disease caused by a job.
To qualify you must (generally) establish:
- You were employed
- You suffered a personal injury in an industrial accident or are suffering from a prescribed industrial disease
- As a consequence, you are disabled and are defined as having at least 14% disablement.
Jobcentre Plus has a list of diseases known to have a link to particular occupations and these are known as ‘prescribed industrial diseases’.
IIDB is not means-tested, nor is it subject to National Insurance contributions, and it doesn’t affect any other National Insurance benefit, such as Incapacity Benefit or your pension. However, IIDB will affect any income-related benefits that you or your partner receive, such as Income Support, Housing Benefit and Council Tax Benefit.
Do not delay in claiming because IIDB cannot be paid for a period more than three months before the date of your claim. However, you are not able to obtain the benefit for the first 90 days (not including Sundays) after your accident and you should therefore consider claiming two months after the accident.
The Jobcentre Plus medical will assess the percentage disablement. No payment will be made if your disability is assessed as less than 14%. If you are assessed to have more than 14% disablement, the amount of benefit payable will depend upon the percentage of disability. If the assessment is less than 14%, providing it is registered at the time of assessment, it can be added to subsequent assessments in respect of further industrial accidents or disease. Even if each assessment is less than 14%, a payment of benefit will be triggered if, when added together, the assessments exceed 14%.
Awards of benefit are made for the period you are expected to continue to suffer from the relevant loss of faculty and can be made for an indefinite period.
Personal Independence Payment
This benefit is currently payable to those aged 16 to 64 who have a long-term health condition or disability and difficulties with activities related to daily living or mobility.
To be eligible, you must have had the difficulties for three months and you must expect them to last at least nine months (unless you are terminally ill and you don’t expect to live more than six months).
Daily living and mobility are each made up of two components: standard and enhanced. It depends on how your condition affects you as to whether you get one or both of these components.
Claims can be made by calling 0800 917 2222 or via textphone on 0800 917 7777. There are special rules which apply if you were born after 8 April 1948, are aged over 65 and were previously receiving Disability Living Allowance. In this situation, you will be invited to apply for Personal Independence Payment and you do not need to do anything until you are contacted by the Department of Work and Pensions.
NHS Injury Benefits
The NHS Injury Benefit Scheme forms part of the terms and conditions of NHS employment. Benefits are available to NHS employees who have suffered an injury attributable to their duties.
Where the accident, disease or other health condition was sustained before 31 March 2013, an application can be made for Temporary Injury Allowance (TIA) or Permanent Injury Benefit (PIB). Where the accident, disease or other health condition occurred after 31 March 2013 the application will be for Injury Allowance. The Injury Allowance scheme is administered by employers.
If compensation is received for an injury, this will be taken into consideration when the level of Injury Benefit award is assessed. This may mean that some or all of any NHS Injury Benefit may need to be paid back from any compensation received. This is why it is important for you to tell us if you are receiving any of these benefits.
If you have queries about your entitlement to these benefits you should seek advice or raise them with your human resources department.
Civil Service Pensions Injury Benefits Scheme (CSPIBS)
The CSPIBS scheme provides benefits to members who suffer reduced earning capacity as a result of injury at work suffered in the course of official duty. It is a ‘no fault’ scheme and entitlement to benefits does not mean that a member necessarily has a personal injury compensation claim that is likely to succeed.
It should also be noted that if a member does successfully pursue a claim for compensation against the employer and is in receipt of these injury benefits, they will be taken into consideration and will probably have to be repaid upon settlement of the personal injury claim.
Claims may be made by a surviving spouse or civil partner, children or parents in the event of death. Members wishing to apply for these injury benefits are advised to contact their union and/or their department/agency’s superannuation section in the first instance.
Benefits following the death of a spouse
There are three main benefits payable on the death of a husband, wife, or civil partner:
- A bereavement payment – a one off lump sum payment payable upon the death of your husband, wife, or civil partner, which is not means tested. You must apply for the payment within 12 months of the death.
- Widowed Parent's Allowance – a weekly benefit paid to widows and widowers who are parents of a child or children living with them. You must be under state pension age and be entitled to child benefit for at least one child. This is not means tested and if your spouse died as a result of industrial injury or disease it is not subject to their National Insurance contributions. You may also be able to claim if you are pregnant and your husband dies, or you are pregnant after fertility treatment and you civil partner has died.
- Bereavement Allowance – this is a weekly benefit paid for up to 52 weeks to widows or widowers who were 45 or over when their husband, wife, or civil partner died, but under state pension age. You cannot receive both Widowed Parent's Allowance and Bereavement Allowance. This benefit is not means tested nor is it subject to National Insurance contributions if your spouse died as a result of an industrial injury or disease.
Applications must be made within 52 weeks of your spouse’s death. You can contact the bereavement service helpline on 0345 606 0265.
Dust-related diseases
In certain cases where a disease is caused by dust, such as asbestos dust, a victim or dependant may be able to claim compensation from the government under the Pneumoconiosis etc. (Workers Compensation) Act 1979.
Victims (or dependants) of diffuse mesothelioma who are unable to make a claim under the 1979 act and have not received payment in respect of the disease from an employer, may be eligible for a lump sum payment under the Diffuse Mesothelioma Scheme.
For further information or to request a claim form, call 0345 603 1358.
Effect of state benefits on compensation payments
If you receive a compensation payment, subject to the amount received, your entitlement to continue to receive state benefits will depend on whether or not a particular benefit is means tested.
Non-means tested benefits
The following benefits are payable whatever levels of income or capital you have and any compensation payment will not affect your entitlement to continue to receive the benefit:
- Incapacity Benefit
- Industrial Injuries Benefits
- Personal Independence Payment.
Means-tested benefits
Subject to the amount of the award, your compensation payment may make you ineligible to receive benefits. The following benefits are means tested:
- Income Support
- Income Based Jobseeker’s Allowance
- Income Based Employment and Support Allowance
- Housing Benefit
- Council Tax Benefit
- Health Benefits.
However, the compensation payment will not be taken into account if you put it into a special needs trust which can be set up by your solicitor. Money held in this way is invested but payments can be met from the trust to cover specific expenses such as holidays or buying a car. The trust can be ended at any time and the compensation money returned to your control.
You should also consider whether any compensation is placed in a personal injury trust.
The Compensation Recovery Unit
The Compensation Recovery Unit (CRU) is part of the Department for Work and Pensions. It is responsible for recovering state benefits which have been paid as a result of an accident or industrial injury from compensation money.
Benefits will only be recovered, however, in the event that a compensation payment is made. The repayment will be deducted from your compensation payment, before it is sent to you. Not all of your compensation payment can be reduced and certain benefits may only be deducted from specific elements of your award. There will be no deduction at all from the injuries, pain and suffering element of your compensation payment.
You will receive a Certificate of Recoverable Benefits which sets out the amount the CRU says should be repaid in the event of a successful claim. It details the total of each relevant benefit which they say should be taken into account.
You can ask the CRU to review the certificate at any time if you feel there is an error and it can issue a new one.
You can appeal against the certificate, but only after final settlement. A typical appeal would be on the basis that the CRU has taken into account benefit that was not related to the injury or disease for which compensation has been paid. The appeal is heard by an appeal tribunal consisting of a legally qualified chair and one or two medical members.
If the amount of recoverable benefit is reduced, whether or not you receive a refund depends on the terms of settlement of your compensation claim. If you accept a total sum, less recoverable benefits, then you should be entitled to a refund. If you accept a specific sum with recoverable benefits payable in addition, then you will not be entitled to a refund.
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