Injury benefits

Temporary and Permanent Injury Benefit payable under the NHS Injury Benefit Scheme is not available to employees who sustain an injury or contract a disease due to NHS employment on or after 31 March 2013.

From 31 March 2013 Temporary Injury Benefit will be replaced by a new allowance known as Injury Allowance and will form part of NHS Staff Terms and Conditions of Service set out in section 22.  Permanent Injury Benefit under the NHS Injury Benefit Scheme will not be available to employees who sustain an injury or contract a disease due to NHS employment on or after 31 March 2013.

Injury Allowance

The new Injury Allowance (IA) covers employees who sustain an injury or contract a disease or other health condition due to NHS employment on or after 31 March 2013.

Employers are responsible for the administration and payment of the IA. The criteria for awarding IA and the level of that allowance are similar to the Temporary Injury Benefit payable under existing NHS Injury Benefit provisions. However, the new IA is limited to the period of the employment contract and a maximum payment period of 12 months for each relevant injury or disease.

Any dispute regarding entitlement to IA falls to be considered under employer's local grievance procedures.

SPPA will only process Injury Benefit applications received by 30 March 2038, for applicants who can provide substantial medical evidence there has been a delayed onset of their symptoms, such that an application was not previously necessary before 30 March 2018.

Access to the NHS Injury Benefit Scheme closes on 31 March 2038.

No new applications will be accepted by SPPA on or after this date.

SPPAs NHS Injury Benefit Team can be contacted direct if there are any questions regarding the scheme or issues with a specific application.

Email: sppainjury@gov.scot  This e-mail address is being protected from spambots. You need JavaScript enabled to view it or call 01896 893000 (ask for Injury Benefits when prompted)

The NHS Injury Benefits Scheme covers most NHS employees, including General Practitioners and Dental Practitioners. The main exceptions being GP Practice staff and the majority of employees with Direction Body status. The governing regulations are not part of the National Health Service Superannuation Scheme (Scotland) (NHSSS(S)) and eligibility to claim Injury Benefit does not rely on superannuation scheme membership. However, any pension paid from the NHSSS(S) is taken into account when calculating an Injury Benefit.

The NHS Injury Benefit Scheme is a 'no blame' income protection scheme, which provides income protection for employees who suffer a loss of earnings, as a result of an injury, disease or condition that is wholly or mainly attributable to the duties of their NHS employment. No benefits would be payable if the injury or disease was seriously aggravated by the employee's own culpable negligence or misconduct.

If a claim is accepted, the employee may receive payment if:

• they are temporarily absent from work (usually certified sick leave) on reduced or no pay. A Temporary Injury Benefit (TIB) makes up their total reckonable income (which includes certain Department of Work & Pensions (DWP) benefits) to 85% of their average pay prior to reduced pay. Payment of TIB does not automatically lead to payment of Permanent Injury Benefit (PIB) and if/when the employee returns to work on full pay, TIB will stop. Until SPPA are advised of the employees return to work, TIB will continue to be considered, however, it is a temporary benefit.
• their permanent degree of earning ability is reduced in the general field of employment by more than 10% following termination of employment or re-employment at a lower income, due to the injury. All PIB applications are sent to our independent medical adviser for advice on acceptance and banding. If accepted the amount payable is variable and divided into five bands dependant on the degree of permanent loss of earning ability and length of NHS employment, PIB is payable for life.
• they die as a result of the injury or disease, leaving a spouse and/or dependants.

When calculating any Injury Benefit, other sources of income are taken into account. These include NHSSS(S) pension, further NHS earnings, certain personal pensions and any relevant DWP benefits.

Once TIB is awarded it is paid until the employee returns to work, is re-employed or employment is terminated. TIB can also be paid if an employee is on reduced pay whilst on a phased return to work. All benefits paid under the NHS Injury Scheme are index linked and payments made by our payroll are recharged to the relevant employer.

Up to 6 April 2011, SPPA calculated and paid all approved TIB in house after deducting tax. Instructions from HMRC, which took effect from 6 April 2011, mean that the payment of TIB or PIB to employees continuing in employment can be regarded as earnings from employment and National Insurance Contributions (NIC) must be deducted from payments. SPPA is, however, unable to deduct NIC, therefore, payment of effected benefits is passed to the relevant NHS employer payroll to pay and make the required deductions for tax and NIC.

The administration and calculation of NHS Injury Benefit remains with us. Any payments payable pre 6 April 2011 will continue to be paid by our Payroll and recharged accordingly.

Re-employment is similar to that for retired NHS scheme members in receipt of a pension.

If the combined re-employment earnings plus PIB exceed the pre-retirement earnings then the PIB is reduced accordingly.

Re-employed earnings for Injury Benefit abatement purposes also include any NHSSS(S) pension in payment.

The Injury Benefit will be abated before the NHSSS(S) pension.

A damages or compensation award made in respect of the same injury may affect the applicant's Injury Benefit and some or all of the money paid under the Injury Benefit Scheme may have to be recovered or offset against future benefits.

If an employee claims damages the employer's legal advisers should be made aware of the injury benefit application. When a claim for damages is settled, it is essential the employer notifies us immediately.

Regulation 17 gives SPPA authority to withhold or reduce Injury Benefits, or in some cases, request repayment of all or some of the benefits already paid if the applicant received damages/compensation at a later date.

The National Health Service (Scotland) (Injury Benefits) Regulations 1998

Anyone wishing to apply for NHS Injury Benefit should complete pages 1 and 2 of the Injury Benefits Application (INJ 1) form.  The completed form should be forwarded to the employer with the following information:

• witness statements and/or witness contact details, if no incident form completed
• copies of any relevant DWP benefit awarding letters
• any other relevant information.

On receipt of the application SPPA may require further medical information* from the employee's GP or consultant.

*Please note the applicant is responsible for the payment of any fees requested for the provision of such information.

SPPA require the employer to supply the following information in support of an application:

• an accident/incident report form
• all relevant reports held by Occupational Health, including details on any pre-existing and or related conditions
• applicant's job description
• any other relevant information.

In order to prevent any unnecessary delays and to avoid causing the applicant possible hardship, in addition to the completed INJ 1 form it is important the above information is provided. It is advisable that all injury applications and supporting information should be sent by Recorded Delivery for the attention of the NHS Injury Benefits Team.

All sections in the employer part of the INJ 1 form must be completed in full. Contact names and telephone numbers are essential. The requested information must be provided where possible and all relevant sections of form complete. If for any reason the employer is unable to do so, a written statement to verify this must be supplied.

The employer payroll department must complete parts 2 and 3. Pay figures should be provided in the requested format and our Injury Benefit Team must be informed of any changes in the pay or dates as soon as possible. We will advise NHS payroll of an applicant's acceptance and for TIB, monthly pay figures should be provided on a regular basis to avoid late or non-payment to the applicant. These pay figures should cover the period that the applicant goes on to reduced pay until the day the applicant returns to their post and contracted hours or their contract is terminated.

Any loss of earnings incurred during a phased return to work must also be submitted to our Injury Benefit Team, with a letter from the Human Resources or Occupational Health department supporting the employee's phased return.

Any medical or private documents sent in with the completed application form should be in a sealed envelope clearly marked with the applicant's name, superannuation scheme reference number (if applicable) and National Insurance number.

Incomplete application forms will not be processed and will be returned to the employer for completion and the applicant advised accordingly.

The NHS Injury Benefit Team can be contacted direct if there are any questions regarding the scheme or issues with a specific application. Email: sppainjury@gov.scot
 

The NHS Injury Benefit Scheme is a compensation scheme for employees in the National Health Service (Scotland) who sustain an injury or disease attributable to their NHS duties. However, you are only eligible to apply for NHS Injury benefits if you are injured or contract a disease on or before 30 March 2013.

Key facts 

• The NHS Injury Benefits Scheme is administered by the Scottish Public Pensions Agency (SPPA) but under a different set of rules from the NHS Superannuation scheme in Scotland.
• The NHS Injury Benefits Scheme is a compensation scheme for almost all NHS employees in the National Health Service (Scotland).
• You do not have to be a member of the NHS Superannuation Scheme (Scotland) to be covered by the Injury Benefits Scheme. There is no qualifying period.
• If approved, the scheme provides benefits where an employee suffers temporary loss of income when absent on certificated sick leave with reduced pay or no pay; or a permanent reduction of more than 10% in their earning ability due to an injury or disease.
• It may also provide benefits to a widow/widower/surviving partner/surviving civil partner and dependants of an NHS employee whose death has been caused or substantially hastened by an injury or disease.
• Under a UK wide agreement reached between NHS employers and staff representatives the NHS Injury Benefit Scheme is now closed for applications resulting from injuries or illness occurring after 31 March 2013. SPPA will continue to process injury benefit applications for an injury or disease occurring on or before 30 March 2013 and received by 30 March 2018. Provision is also made that applications can be made up to 30 March 2038 for those who can provide evidence there has been a delayed onset of their symptoms, such that an application was not previously necessary before 30 March 2018.
• If you think you qualify, please complete form INJ1 (Application for NHS Injury Benefits) available from our website or your NHS employer. If further medical evidence is required to support an application, any fee requested is payable by the applicant.
• Injury benefits will not be paid if the injury was caused by an employee’s own culpable negligence or misconduct.

Temporary Injury Benefit 

Temporary Injury Benefit only applies if your injury or disease was sustained before 30 March 2013.

If approved, Temporary Injury Benefit is paid for any period your reckonable income falls below 85% of the gross average pensionable pay which you were receiving immediately before your pensionable pay was reduced because of injury. If you are non-superannuated this is calculated as if you had been paying superannuation. 

If you have more than one NHS employment, only service up to full time can be considered towards average pensionable pay. Certain benefits paid by the Department of Works and Pensions (DWP) are taken into account when calculating Temporary Injury Benefit. Temporary Injury Benefit can be adjusted when certain DWP benefits start or stop but not when they fluctuate. 

Temporary Injury Benefit is calculated by SPPA and is processed by your NHS payroll department. Payment is subject to income tax and National Insurance deductions but not pension contribution deductions. 

Temporary Injury Benefit is not payable if your reckonable income is more than 85% of your gross average pensionable pay.

Temporary Injury Benefit stops:

• when you return to your NHS employment on full pay.
• if you leave your NHS employment (If this is due to your injury or disease you may be entitled to apply for Permanent Injury Benefits).

Permanent Injury Benefit (non-taxable) 

Permanent Injury Benefit only applies if your injury or disease was sustained before 30 March 2013.

Permanent Injury Benefit may be payable if the injury or disease causes a permanent reduction in your earning ability of more than 10% in the general field of employment. It can be paid if due to the injury: 

• the number of hours you are able to work is permanently reduced
• you have to change to a lower paid job
• you have to leave your NHS employment. 

Permanent Injury Benefit is intended to top up your reckonable income (i.e further NHS pay, NHS pension, certain DWP benefits, personal pensions and any successful damages claim) to ensure you have a guaranteed level of income. 

Permanent Injury Benefit can be adjusted when certain DWP benefits start or stop but not when they fluctuate.

Permanent Injury Benefit is calculated as a percentage of your gross average pensionable pay and is based on: 

• your calendar length of all NHS employment
• the permanent degree of reduction in your earning ability in the general field of employment. (As assessed by our independent Medical Adviser).

If your employment ends because of the injury, you may also qualify for a one off lump sum payment. This is a proportion of your annual gross average pensionable pay. The table below shows how the guaranteed income and lump sum are calculated.

If, in the future, your injury worsens and reduces your earning ability further, you can apply to SPPA for a re-assessment of the degree of reduction in earning ability.

Death Benefits 

If you die as a result of the injury, payment may be made to your spouse or surviving partner/ civil partner and to certain dependants. These payments are intended to ensure a guaranteed income by topping up payments such as an NHS widow/widower/civil partner pension or certain Department for Work and Pensions benefit. This guaranteed income is a percentage of your gross average pay. The percentages are shown in the table below. 

The total amount of allowances cannot be more than 100% of your gross average pay. 

A lump sum of 50% of your average pay may also be paid, providing a lump sum has not already been paid.

Damages and Compensation

If you receive damages of compensation for the injury or illness, it may affect your injury benefit. You cannot receive the full amount of a damages or compensation claim settlement and all of your injury benefit. This may mean that you have to pay back some or all of the injury benefit payment that you have already had and future benefits may be reduced. If you claim damages, you should discuss the matter with your legal adviser. When your damages claim is settled, please let us know immediately. 

Index linking 

All allowances from the NHS Injury Benefits Scheme are index-linked. 

How to Contact us

If you need more information about the Injury Benefits Scheme, you can contact us.

If you are not in the scheme or do not have a reference number, it will be helpful if you tell us your full name, your date of birth and your National Insurance number.