Injury Benefit

What Do We Mean By “Accident”?
What Do We Mean By “Occupational Disease”?
What Benefits Are Available For Accidents And Occupational Diseases?
Who Can Receive Employment Injury Benefit?
What Are the Contribution Conditions For Payment of Injury Benefit?
When to Apply?
How To Claim Injury Benefit?
How Much is Injury Benefit?
What is the Payment Period for Injury Benefit?
How is Payment Made?
What Do We Mean By Disability?
How Do You Qualify For Disablement Benefit?
How Much is Disablement Benefit?
How Much is Disablement Grant?
How Does Your Disablement Pension Start?
How Much Will You Receive?
Constant Attendance Allowance
Medical Treatment
Disqualification For Injury & Disablement Benefit
Appeals

If you have had an on-the-job injury or are suffering from a disease that arose out of or occurred during the course of your employment, which prevents you from working, then you may be entitled to Injury Benefit. This booklet gives information on benefits provided under the National Insurance Scheme for accidents and occupational diseases. If more specific information about your case is needed, please contact any office of the National Insurance Board.

What Do We Mean By “Accident”?

Accident means an “industrial accident” arising out of and during the course of the employment of an insured person and includes an accident involving an employed person while traveling to or from the insured person’s work place.

Also, an accident involving an employed person on or about any premises at which he or she is employed is considered to have arisen out of and in the course of his employment if it happens while he is taking steps onto an actual or supposed emergency at those premises, to rescue, aid or protect persons who are thought to be injured or in danger, or to prevent or minimize serious damage to property.

What Do We Mean By “Occupational Disease”?

Occupational Disease means a disease prescribed by the National Insurance Legislation in the Schedule of Diseases. The schedule describes the diseases and the occupations for which the disease is prescribed. The fact that an insured person suffers from a disease prescribed in the Schedule of Diseases does not give the insured person the right to benefits for an occupational disease. The insured person must prove that he or she worked in an occupation which is prescribed by the legislation as causing the disease.

What Benefits Are Available For Accidents And Occupational Diseases?
One or more of the following benefits may be paid as a result of an industrial accident:

  • Injury Benefit
  • Disablement Benefit
  • Constant Attendance Allowance
  • Death Benefit
  • Death Grant
  • In addition, medical treatment is provided at the expense of the Scheme.

1. Injury Benefit

WHO CAN RECEIVE EMPLOYMENT INJURY BENEFIT
Injury Benefit may be payable if an injured insured person has been certified by a Government Medical Doctor as being unable to work as a result of:

  • A personal injury suffered by an accident arising out of, and in the course of his or her job; or
  • A “prescribed disease” caused by the type of work he or she was employed to do.

WHAT ARE THE CONTRIBUTION CONDITIONS FOR PAYMENT OF INJURY BENEFIT
Unlike other benefits, there are no contribution conditions for Employment Injury Benefit; this is because you may be injured on the very first day of work.

WHEN TO APPLY
You should apply within 6 days of the date of the accident or no later than 6 days from the date the Government Medical Doctor certified that you had developed a disease arising from your job. In exceptional cases, late claims may be considered based on the reason given, in which case the period of 6 days may be extended to 13 weeks. Please note, however, that if your injury does not extend beyond three days, you are not entitled to an Injury Benefit, and therefore should not apply.

HOW TO CLAIM INJURY BENEFIT
You must apply by completing Part 1 of the form “Claim For Injury Benefit” and your employer completing Part II of the claim form before it is submitted. If you are unable to complete Part I, another person may help you. Injury Benefit forms can be collected at all National Insurance offices.

We will need certain information in order to process your application. The information includes:

  • the injured person’s National Insurance Number.
  • a signed medical certificate from a Government Medical Officer stating the nature of the incapacity and the number of days you are unable to work.

HOW MUCH IS INJURY BENEFIT
How much you can receive from the National Insurance Board depends on your average weekly insurable earnings. This means the higher the earnings, the higher the benefit will be. The weekly rate of Injury Benefit is 60% of your average weekly earnings. The daily rate of Injury Benefit is 1/6th of the weekly amount. (Sundays are not included).

WHAT IS THE PAYMENT PERIOD FOR INJURY BENEFIT
Injury Benefit is payable after the 3rd consecutive day of your injury e.g. if your injury resulted in your being away from work for 5 days, Injury Benefit is payable for two (2) days only. As from the 4th day, Injury Benefit will be paid for each day (excluding Sundays) that you are ill and unable to work. Injury Benefit may continue for up to a maximum of 12 months (365 payable days).

HOW IS PAYMENT MADE
Injury Benefit schedules are prepared for beneficiaries on a biweekly basis (every two weeks). Schedules can be collected at a convenient National Insurance Board office and must be cashed within 6 months from the date of issue. If you prefer, you can include the name of your bank along with your current or savings account number, and your benefit will be directly deposited.

AWARD OF CREDITED CONTRIBUTIONS
For each full week (Monday thru Saturday) that your receive Injury Benefit, you are not required to pay a contribution. Instead, National Insurance will add (or credit) contribution/s to your records. These credited contributions should help you to receive future benefit payments. Note: If an accident happens while you are working, report as soon as possible, all details of the accident to your employer, or to someone in authority. If you are unable to do so, have someone report it for you. Even if the accident does not seem serious at the time, make sure it is reported. Some accidents prove to be serious later on. Your employer is required by law to keep a book in which a record of all accidents are kept. 

2. Disablement Benefit

This section of the booklet describes the National Insurance Board Disability Benefits. It focuses on benefits for people who have worked or earned sufficient National Insurance credits to qualify for disability. Disability Benefit is one of the most complicated of all the National Insurance benefits; therefore, this booklet may not cover, in depth, all the particulars of the benefit. We recommend that you call or visit one of our offices if you have any additional questions or queries.

WHAT DO WE MEAN BY “DISABILITY”?
The National Insurance Board’s definition of disability refers to all disabilities that the claimant would be expected to have that will permanently keep him or her from leading a normal life and occurred as a result of a physical or mental condition arising from an industrial accident or some work related illness. All injuries may not lead to 100% disability. For example, there may be a person who, due to an industrial accident, loses two limbs, in which case he or she will be considered 100% disabled; whilst someone might lose hearing in one ear and be considered 20% disabled. Because there are different degrees of disabilities, Disablement Benefit is paid based on the severity of the disability and will only be paid if the degree of disability is more than 10%.

HOW DO YOU QUALIFY FOR DISABLEMENT BENEFIT
There are two types of Disablement Benefits:

  • Disablement Pension and
  • Disablement Grant.

The Medical Board certifies disability and allocates a certain percentage from 1-100% based on its assessment of the disablement. If the claimant’s disability is greater than 10% but less than 20%, the Disablement Benefit will be a single lump-sum payment known as Disablement Grant. If the disability is 20% or more, you will be paid a monthly Disablement Pension.

HOW MUCH IS THE DISABLEMENT GRANT
The amount of disablement grant will be equal to: 220 x Average Weekly Insurable Earnings x Degree of Disablement.

WHEN DOES YOUR DISABILITY PENSION START
Disability Pension can begin at any time after the 3rd day following the day in which the employment accident occurred. In most cases, however, the claimant receives Injury Benefit during the period his or her injuries are being assessed by the Medical Board. Injury Benefit ceases when a decision is made on the degree of disability. From such time the claimant will receive Disablement Benefit.

HOW MUCH WILL YOU RECEIVE
You can obtain a personalized estimate of benefits due you from the Benefit/Records Department of the National Insurance Board. There are also tables available which give the degree of disability prescribed for certain accidents. The general rate is calculated as follows:

Degree of Disability                  Disablement Pension
(1) 100%                                            60% of average weekly insurable earnings
(2) 20% or more, but less than      100% The weekly rate of disablement pension will be calculated in proportion to the degree of disablement.

(1) 100% 60% of average weekly insurable earnings
(2) 20% or more, but less than 100% The weekly rate of disablement pension will be calculated in proportion to the degree of disablement.

A beneficiary of Disablement Pension who ordinarily receives less than 60% of his or her weekly insurable earnings will be entitled to 60% of average weekly earnings if:

  • he or she is receiving approved hospital or treatment related to the accident;
  • he or she is attending a course of full-time occupational training or rehabilitation;
  • he or she is deemed permanently incapable of work as a result of his or her disablement.

AWARD OF CREDITED CONTRIBUTIONS
For each full week (Monday thru Saturday) that you receive Disablement Pension assessed at 100%, you are not required to pay a contribution. Instead, National Insurance will add (or credit) contributions to your records. These credited contributions should help you to receive future benefit payments.

SUCCESSIVE ACCIDENTS
If you suffer personal injury as a result of an accident on your job and then suffer personal injury as a result of another accident on the job, you will again be entitled to receive Injury Benefit or Disablement Benefit. However, the total amount payable will not be more than 60% of your average weekly insurable earnings.

DUPLICATE RIGHTS
You will not for the same period be entitled to receive Injury Benefit and Disablement Pension but will receive the benefit which is payable at the higher rate.

3. Constant Attendance Allowance

If you are 100% disabled and require the constant personal attendance of another person, you may qualify for a Constant Attendance Allowance which is fifty dollars ($50) per week once it is determined by the Director that you are entitled to the allowance.

4. Medical Treatment

If you are injured on the job, you will be provided with medical treatment at a Government hospital or clinic. National Insurance will pay all the expenses. Medical Treatment includes the following:

  • Medical, surgical and dental treatment (including specialist care as an inpatient or outpatient) at Government hospitals, clinics and other similar institutions;
  • Supply, maintenance, repair and renewal of dental appliances; spectacles, artificial limbs and other appliances; and
  • Essential medicines prescribed by a doctor. At the time of the accident your employer should arrange your transportation from the place of injury to the nearest Government hospital or clinic.

The National Insurance Board will reimburse you for reasonable travelling expenses with regard to the particular employment injury. Receipts must be sent to the National Insurance Board.

DISQUALIFICATION FOR INJURY BENEFIT AND DISABLEMENT BENEFIT
A person will be disqualified from receiving Injury Benefit or Disablement Pension for such period not exceeding six weeks as the Director may direct, if:

  • after the Director has required him to submit himself to medical or other examination or to medical treatment, he refuses or fails without good cause to follow the instructions of the Director;
  • he or she refuses or fails without good cause to follow the instructions of the medical authority;
  • he or she works on a day for which the Injury Benefit was claimed;
  • he or she behaves in a manner likely to retard recovery; or he or she fails without good cause to attend vocational training or a rehabilitation course after the Director has required him to attend.
  • A person may be disqualified for receiving any benefit for any period during which he is undergoing imprisonment. However, if he wholly supported a wife and children, an amount not exceeding one half of the amount of benefit may be allowed.

If your death is a result of an injury or disease arising out of your job, your dependents will receive Death Benefit, which is similar to Survivors’ Benefit except it includes a Parent’s Pension referred to as Parent’s Death Benefit. A Parent’s Death Benefit is paid if the parent shows to the satisfaction of the Director that he or she was wholly and mainly maintained by the relevant person at the time of his death. (See separate booklet, “Survivors’ Benefits”)

Death Grant Death Grant is payable in respect of the death of:

  • An employed person who dies as a result of an accident or occupational disease; or
  • A person who at the date of death was entitled to death benefit; or
  • A dependent of a person entitled to death benefit.

APPEALS

If your claim is disallowed, you may appeal the decision within 21 days to an Appeals Tribunal. If we are wrong, the decision will be changed. However, if you are dissatisfied with the decision of the Appeals Tribunal, you may take your case to the Supreme Court on a point of law only.

Please Note: This information provides a general overview only of the National Insurance Board’s Employment Injury Benefits. It is not intended to cover all provisions of the law. For more specific information, write, visit or contact the National Insurance Board.