NHS injury benefits scheme - a well kept secret

Mental Health Nursing,  Mar 2007  by Brown, Barrie

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Barrie Brown reveals an underused right of employees who suffer injury or illness through their employment in the National Health Service.

Abstract

There is lack of awareness among stakeholders of the NHS Injury Benefit Scheme, a no-fault cover for all injuries and diseases sustained or contracted in the course of the persons employment. This article outlines what employees are entitled to under the Temporary Injury Allowance and the Permanent Injury Benefit schemes.

Key words

NHS, employment, Permanent Injury Benefit

Introduction

In early 2006 the NHS Staff Council established a sub-group to review ill-health, retirement, injury benefit and sickness absence in the NHS. The work of that group will lead to a number of recommendations later in 2007. One of the early findings from the review was the lack of awareness among staff, employers and indeed human resource departments of the NHS Injury Benefit Scheme.

What is the scheme?

The current scheme was established in 1995 by the National Health Service (injury benefits) regulations. The purpose of the scheme is to provide no-fault cover for all injuries and diseases sustained or contracted in the course of the person's employment, and which are attributable to the person's employment. Three types of benefit can be paid under the scheme: Temporary Injury Allowance (TIA); Permanent Injury Benefit (PIB) and Death Benefit. The scheme provides for significant benefits for NHS employees who encounter problems arising from injury or illness contracted at their place of work. But it is clear that there is a lack of awareness of this scheme. There is, for example, no section in the Agenda for Change handbook relating to the Injury Benefit Scheme. However, the scheme does form part of the terms and conditions of service for staff working in the NHS and is separate, for example, from the NHS pension scheme. You do not have to be a member of the NHS Pension Scheme, therefore, to be eligible for the Injury Benefit Scheme.

The lack of awareness of this scheme is evident from the data available on claims which have been made for permanent injury benefit. There are currently between 500 and 600 PIB claims a year and approximately half of these claims are successful. As a percentage of a workforce totalling 1.3 million staff this represents a very low level of scheme usage. However, it could be argued that it is not just lack of awareness of this scheme, but that the NHS has a very low level of workplace incidents which lead to injury or occurrences of health problems directly attributable to NHS work. This seems rather unlikely.

Temporary Injury Allowance (TIA)

Temporary Injury Allowance is the responsibility of the NHS employer. An employee who is eligible for the TIA can receive up to 85% of the pre-incident income. Effectively, this means that a member of staff who has had an injury or contracted an illness directly attributable to her or his work will receive a top-up to any payments such as sick pay, to provide an income of 85% of the average remuneration earned prior to the injury or health incident. Where full sick pay is being paid, the TIA would clearly be less. Therefore, a TIA would normally be claimed when someone is on half sick pay and the cause of their absence is directly related to their NHS work.

Permanent Injury Benefit (PIB)

PIB may be paid in two circumstances. Where the work-related injury or health problem means that the employee ceases to work in the NHS, a tax-free gratuity or an annual allowance may be paid, subject to a minimum of 11% of reduced earning capability caused by the injury or health problem. The greater the reduction in earnings ability, the higher the level of guaranteed income. This is demonstrated by the PIB box, which contains part of the 1995 regulations. (see Box 1.)

The rate of the PIB payment can be changed as a result of other benefits which may be received, including the payment or cessation of payment of state benefits. The award can also be increased where the individual's health has deteriorated as a direct result of the original injury. The following serves as an example of how this would work in practice:

A 55 year old nurse with 18 years' NHS service, and an annual salary of £25,000 is awarded the maximum injury allowance. He/she would therefore receive a one-off lump sum payment of £12,500 and an index linked annual allowance of £21,250 per year for life.

It is important to emphasise that the annual payment is paid for life - not just until normal retirement age. The PIB payments in these circumstances are borne by the NHS employer. In the example quoted above, a trust could be paying £637,000 plus the cost of increases, if we assume that a person's life expectancy would be 80 years. Perhaps it is no surprise, therefore, that NHS employers do not shower staff with guidance on the NHS Injury Benefit Scheme; a successful claim can be very costly for the employer. Nevertheless, the scheme is intended for all NHS employees.