“What happens if you are injured and cannot work?”
When you have been injured, whether at work, due to an accident or you have developed an industrial disease, or you have been involved in an accident outside of work eg in a road traffic accident (RTA), you may become eligible for benefits.
“I have just had an accident at work when my hand was caught in my machine. My doctor says that I will be off work for at least two weeks, but it could be longer.”
In these circumstances, while your employers should of course already know about your accident, it is important that somebody at senior level is made aware of your injury and that some written record is made (eg accident record book).
You should complete form BI100A from the Department of Work and Pensions (DWP), which is a request for a declaration that you were involved in an accident or suffered an illness at work.
Your first monetary claim should be for Statutory Sick Pay from your employer. Your employer will probably require something from your doctor (eg a doctor’s certificate) but many employers will accept a self-certificate if the absence is going to be 7 days or less.
“My hand has not recovered as anticipated. I am under the supervision of a Consultant who has diagnosed tendon damage. I have been off work for 3.5 months now, following the accident.”
If 90 days (excluding Sundays) has elapsed since the date of a work related accident (or the onset of industrial disease) you may be able to apply for Industrial Injuries Disablement Benefit. Even if you have returned to work but still suffer from the injury, and are receiving the same or reduced wages, it might be possible to make a claim.
Make a claim at your local JobCentrePlus Office, where you will be asked to complete form BI100A, which is now the same form as the declaration.
You will be assessed by the DWP Medical Board. Subject to limited exceptions for example, Pneumononiosis (Asbestosis) (Disease D1), if the assessment finds you are less than 14% disabled, you will not receive benefits.
If you are assessed at 14% disabled or over, you should receive a payment. The amount of benefit depends on the extent of your disablement. For example, if you were assessed at 40%, you would receive a slightly higher benefit than those at 14%.
“It is now 7 months and I haven’t returned to work. My Consultant says that the continuing symptoms will be permanent.”
After 28 weeks Statutory Sick Pay stops and is replaced by Incapacity Benefit. Your employer will complete an SSP1. You will have to pass a medical test.
For the first 28 weeks of a benefit the “own occupation test” is applied. You have to show that, due to your injury, you are incapable of doing work in the occupation in which you were employed prior to your injury. This is normally confirmed by your GP, but after 28 weeks, the “personal capability assessment” applies.
This test is based on your GP’s comments, a questionnaire completed by you and a DWP medical examination in appropriate cases. If you fail in your application for incapacity benefit, you should consider applying for Income Support and / or Job Seekers Allowance.
“Are there any other injury related benefits?”
Those with more severe problems eg requiring case or those who have a mobility problem with difficulty in walking, may be entitled to receive Disability Living Allowance (DLA) which is a tax free benefit, non-means tested and does not depend on National Insurance contributions.
A “Working Tax Credit” benefit may also be available to lower paid workers with a disability.
Attendance Allowance (AA) is available if you are over 65 with supervision needs.
For those who get Industrial Disablement Benefit at a 100% rate and need daily care and attention, you may be entitled to Constant Attendance Allowance (CAA) or Exceptionally Severe Disablement Allowance (ESDA).
Recovery of Benefits
If we are acting for you in relation to a personal injury claim against the third party who injured you, it is important to be aware that if you claim is successful it will be necessary for any DWP benefits you have received as a result of the injury to be deducted from your compensation payment and repaid to DWP.
However, compensation is split into two major categories. Firstly, compensation for pain and suffering, called “General Damages” and secondly, other losses called “Special Damages” which relate to your loss of wages and any other losses as a direct result of your accident.
DWP benefits can only be deducted from your special damages eg loss of wages, and therefore any compensation in respect of pain and suffering will not be affected. You must always keep you solicitor informed of any changes in your benefit situation, as this can materially affect your claim.
Finally, the above only touches the surface of DWP benefits. The fact that you are on reduced income may entitle you to many other benefits eg free prescriptions and reduced council tax. Specialist advice is often requried.
At Morrish Solicitors, we are able to point you in the right direction. We have close contact with DWP related agencies, who deal specifically with welfare benefits.