We administer the NHS Injury Benefits Scheme.
We provide an annual income to an employee who suffers a temporary loss of NHS earnings, this can be either:
- Temporary Injury Allowance (TIA)
- Permanent Injury Benefit (PIB)
These must be the result of an injury or disease which is wholly or mainly attributable to NHS employment or duties of employment.
The Scheme may also pay benefits to the surviving partner and dependants of a NHS employee whose death has been caused by, or substantially hastened by, their NHS employment.
The NHS Injury Benefits Scheme changed on 31 March 2013. Employees who sustain an injury or contract a disease due to NHS employment on or before 30 March 2013 can still access the NHS Injury Benefits Scheme until 30 March 2038 under new transitional arrangements.
Under these transitional arrangements the NHS Injury Benefits Scheme will continue to provide:
- Death Benefits.
We'll process injury benefit applications received up to and including 30 March 2018 only, and only injuries sustained or diseases contracted on or before 30 March 2013 will be considered.
The only exception to this rule is that we'll process injury benefit applications received by 30 March 2038 for applicants who can provide evidence there has been a delayed onset of their symptoms, such that an application was not possible before 30 March 2018. In order for us to consider an application from 31 March 2018 to 30 March 2038, the applicant will be required to provide compelling evidence to demonstrate that their injury was sustained or disease was contracted on or before 30 March 2013.
Access to the NHS Injury Benefits Scheme closes on 31 March 2038.
No new applications will be accepted by us on or after this date.
People who are in receipt of TIA or PIB on or before 30 March 2013 will not be affected by the changes from 31 March 2013.
People who have applied for TIA or PIB in respect of an injury sustained or a disease contracted on or before 30 March 2013 but where the outcome has not been determined at that date will not be affected by the changes from 31 March 2013.
The 2-stage internal dispute resolution procedures that we operate remain available to applicants who wish to challenge (appeal) the outcome of their application for TIA or PIB.
The existing scheme provisions for Department for Work and Pensions (DWP), age benefit reviews, deterioration reviews under regulation 13, and damages recovery under regulation 17 of the NHS.
Injury Benefit Regulations 1995 remain in force.
- paid by employers to NHS employees on authorised absence with reduced pay or no pay because of an injury or disease wholly or mainly attributable to their employment
- tops up the employee’s income to 85% of their average pay they were getting before their pay was reduced as a result of the injury or disease
- is subject to income tax and National Insurance deductions but not pension contribution deductions
It is not payable if the employee’s income is more than 85% of their average pay, and it stops when they return to work or leave employment.
TIA payable under the NHS Injury Benefits Scheme is no longer available to people who sustain an injury or contract a disease wholly or mainly due to NHS employment on or after 31 March 2013.
On 31 March 2013 Temporary Injury Allowance was replaced by a new allowance known as Injury Allowance and forms part of NHS staff terms and conditions of service – Section 22 refers.
PIB is available to NHS employees who suffer a permanent reduction in their earning ability of more than 10% by reason of an injury or disease which is wholly or mainly attributable to their NHS employment
An application for Permanent Injury Benefit can only be considered if either:
- the number of hours the employee can work is permanently reduced
- if they have to change to a permanent lower paid NHS job
- if they have to leave their NHS employment
It is not payable if the permanent reduction in the employee’s earning ability is assessed at 10% or less.
PIB under the NHS Injury Benefits Scheme is no longer available to people who sustain an injury or contract a disease wholly or mainly due to NHS employment on or after 31 March 2013.
Death Benefits are paid to surviving partners and dependants if an employee dies as a result of an injury sustained or disease contracted on or before 30 March 2013 and which is wholly or mainly attributable to their NHS employment.
These allowances are intended to top up payments such as an NHS adult dependant’s pension.
The income provided is a percentage of the employee’s average pay.
The new Injury Allowance covers employees who sustain an injury or contract a disease or other health condition wholly or mainly attributable to their NHS employment on or after 31 March 2013.
Employers are responsible for the administration of the Injury Allowance.
Any dispute about entitlement to the Injury Allowance falls to be considered under employer’s local grievance procedures.
More information about Injury Allowance and supporting guidance can be found on the NHS Employers website.
More information about Injury Benefits can be found in the Injury Benefits Scheme Guide.
Who is covered by the NHS Injury Benefits Scheme
Almost all staff employed in the NHS are covered by the Scheme from their first day of work until their last day of employment and they do not have to be members of the NHS Pension Scheme.
NHS employees covered by the Scheme include:
- an employee of a NHS Trust, PCT, Health Authority (including Special and Strategic HAs), Local Health Board
- GPs, Ophthalmic Practitioners, and Dental Practitioners working for the NHS
- holders of honorary appointments with an Employing Authority
- holders of NHS appointments approved by the Scheme
- employees of certain other NHS organisations that have been approved by the Secretary of State to be covered by the Scheme (known as Direction Employers – more information can be found on the NHS Pensions website
Who is not covered by the NHS Injury Benefits Scheme
Certain people are not covered by the Scheme:
- GP practice staff
- GP co-operative staff
- dental practice staff
- APMS staff
- freelance GP and dental locums
- most Direction employees
- staff working for a private or public limited company that provides a service to the NHS (i.e. agency staff)
NHS employees can make an application under the NHS Injury Benefits Scheme in connection with any of these circumstances:
- injury or disease sustained on duty due to a specific incident or series of incidents (e.g. falling off a ladder, injury due to a malfunction of equipment, attack by a patient)
- injury or disease sustained on duty that does not manifest itself for several years
- injury sustained off duty whilst serving as a volunteer at an accident or emergency (e.g. providing treatment at the scene of a road traffic accident)
- injury sustained whilst travelling on official duty (e.g. road traffic accident whilst travelling in a car from one hospital to another)
- injury inflicted off duty, the cause of which can be wholly or mainly attributed to NHS employment (e.g. being attacked at home by a disgruntled ex-patient)
- physical or psychiatric injury (or disease) contracted due to an incident or series of incidents wholly or mainly attributable to NHS duties (e.g. exposure to noxious substances, overwork)
- disease contracted on duty (e.g. by a dentist treating a patient who was suffering from hepatitis, or a haematologist handling contaminated blood)
- death caused by, or hastened by, a person’s NHS duties
Entitlement under the Scheme may not be considered if a person is injured whilst on a normal journey travelling to and from work (except for community nurses who may be entitled), or goes off sick as a result of investigations or disciplinary action, or sustains an injury or disease wholly or mainly due to or seriously aggravated by the applicant’s own culpable negligence or misconduct.
Reservists injured whilst on duty with the armed forces cannot be considered under the Scheme though they may be able to claim from the armed services.
Damages and compensation
If the applicant receives damages and compensation for the injury, these will be taken into account when the level of Injury Benefits awarded is assessed.
This may mean paying back some or all of the NHS Injury Benefits received where damages or compensation has also been received for the same injury. It may also reduce any future NHS Injury Benefits.
If the applicant is claiming damages or compensation they should notify their legal advisor that they are claiming NHS Injury Benefits and draw their attention to the Scheme Regulations.
Anyone applying for or receiving NHS Injury Benefits must inform us as soon as their damages or compensation claim is settled.
The Scheme forms part of the terms and conditions of NHS employment and is governed by its own Regulations.
It's separate to the NHS Pension Scheme.
NHS Injury Benefit Scheme Regulations for England and Wales are available:
1995 Injury Benefits Regulations - Informal consolidation to 1 April 2019 (PDF: 316KB)
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