General Note
NHS Fife acknowledges and agrees with the importance of regular and timely review of policy/procedure statements and aims to review policies within the timescales set out.
New policies/procedures will be subject to a review date of no more than 1 year from the date of first issue.
Reviewed policies/procedures will have a review date set that is relevant to the content (advised by the author) but will be no longer than 3 years.
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INJURY ALLOWANCE PROCEDURE
December 2018
TABLE OF CONTENTS
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1. |
Introduction |
1 |
|
2. |
Eligibility |
1 |
|
3. |
Scale of Injury Allowance |
2 |
|
4. |
Application Process |
2 |
|
5. |
Appeals Process |
3 |
|
6. |
Pay Protection |
4 |
|
7. |
NHS Injury Benefits Scheme – Transitional Arrangements |
4 |
|
8. |
Review |
4 |
|
9. |
Appendix A – Application for Injury Allowance Form |
5 |
|
10. |
Appendix B – Flow Chart |
15 |
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11. |
Appendix C – Injury Allowance Guide for Staff |
16 |
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12. |
Appendix D – Injury Allowance Guide for Managers |
25 |
1. INTRODUCTION
1.1 PCS (AFC) 2013/1 informed NHS Boards of the revised Injury Allowance provisions which are effective from 31 March 2013. This revised allowance replaced the previous Injury Benefits Scheme administered by the Scottish Public Pensions Agency (SPPA). However under transitional arrangements, injuries or illness which were wholly or mainly attributable to the duties of NHS employment, which occurred on or before 30 March 2013 will still be eligible to be claimed under the previous Injury Benefits Scheme administered by SPPA – see section 7 below.
1.2 The Injury Allowance can provide financial assistance to an employee whose pay is reduced due to a work related injury as a result of being injured, becoming ill due to their employment or on a phased return to work with reduced or no pay.
1.3 This procedure should be read in conjunction with Section 14 and Annex Z of AFC Terms and Conditions of Employment. It does not offer an additional period of sickness absence entitlement to eligible employees.
2. ELIGIBILITY
2.1 An employee who has an injury, disease or other health condition that is wholly or mainly attributable to their NHS employment which occurred on or after 31 March 2013 may be entitled to an Injury Allowance payment subject to certain conditions as detailed in this procedure. However, the injury, disease or other health condition must have been sustained or contracted in the discharge of the employee’s duties of employment or be an injury that is not sustained on duty but is connected with or arising from the employee’s employment.
2.2 The attribution of injury, illness or other health condition will be determined by NHS Fife based on the information provided by the employee, their manager and the appropriate medical advice. In taking this decision the civil burden of proof - “on the balance of probability” (i.e. more likely than not) – will be used to determine the outcome. Where the employee disagrees with the decision taken there will be a right of appeal as detailed in this procedure.
2.3 Payment of the Injury Allowance is not dependent on length of service.
2.4 The allowance is applicable to all staff remunerated on Agenda for Change, Medical and Dental and Senior Manager Terms and Conditions of Service.
2.5 However, the Injury Allowance will not be paid in the following circumstances:
- Injury whilst on a normal journey travelling to and from work, except where the journey is part of their contractual NHS duties;
- Sickness absence as a result of employment related matters such as an investigation, capability proceedings or disciplinary action, or as a result of a failed application for promotion, secondment or transfer.
- Injury, disease or other health condition due to or aggravated by the employee’s own negligence or misconduct.
- If pay has not dropped below 85%
- After the employment contract has ended
3. SCALE OF INJURY ALLOWANCE
3.1 Injury Allowance will be paid to an eligible employee as a top up to their sick pay on reduced pay, no pay or when on reduced pay as a result of a phased return to work. The calculation will include any contributory state benefits received by the employee to 85% of pay.
3.2 The Injury Allowance payment is subject to tax and national insurance contributions but is not subject to pension contribution deductions.
3.3 Contributory state benefits received for loss of earnings will be offset at the rate at which they are actually received by the employee. All other benefits or payments received should be ignored.
3.4 Employees are required to claim any contributory state benefits they may be entitled to and to declare receipt of such benefit(s) to NHS Fife. Timely notification will ensure that overpayments of Injury Allowance are not made. NHS Fife will require repayment when an overpayment is made in line with the Over/Under Payments of Salary procedure.
3.5 The Injury Allowance will be limited to the period of the employment contract and a maximum payment period of 12 months per relevant injury or disease, subject to the Management of Absence and Rehabilitation to Work policies.
4. APPLICATION PROCESS
4.1 Where an employee considers that they may be eligible for an Injury Allowance payment, the Application for Injury Allowance form (Appendix A) should be completed providing details of the injury or illness, a copy of the DATIX incident report if relevant and any support received from Occupational Health as a result of the injury or illness. The form, together with any supporting documentation should be forwarded to the employee’s line manager. Following completion it should be forwarded to the appropriate HR Officer. Copies of any current correspondence from the Occupational Health Service associated with the injury or illness outlined in the Application for an Injury Allowance Form should be attached to the form and once signed by the HR Officer the form should be submitted to the Director of Workforce.
4.2 Each application will then be considered, within four weeks of submission, by a panel consisting of the Senior HR Manager, a member of the Executive Directors Group and a partnership representative appointed from the Staff Side of the Area Partnership Forum. In cases where the Occupational Health Service have been involved with the relevant illness or injury, where appropriate, an up to date report will be requested from Occupational Health seeking their advice on the causation of the injury, illness or health condition prior to any decisions being taken on the Injury Allowance application. This may require the employee to attend a further appointment with Occupational Health if this is considered necessary. In cases where the employee has not already been attending Occupational Health an appointment will be made for them to attend and a report requested prior to any decision being take on the Injury Allowance application. In both circumstances the Occupational Health reports will be shared with the employee. Where the employee refuses to attend an appointment at Occupational Health a decision will be taken on their Injury Allowance application in the absence of medical evidence.
4.3 The panel will then assess the application, the Occupational Health report and any other supporting documentation and take a decision as to whether, in line with the guidance, an Injury Allowance should be paid. The decision of the panel will be confirmed in writing to the employee with a copy to their line manager.
5. APPEALS PROCESS
5.1 Where an employee is unhappy with the decision taken not to pay an Injury Allowance, they will have a right of appeal against this decision. This appeal should be made within 28 days of receiving the decision of the panel and should be addressed to the Director of Workforce clearly detailing the reasons for the appeal. The Appeal Panel will comprise of the Board’s Director of Nursing or Medical Director, the Director of Workforce and the Employee Director. The panel will consider the original application and supporting evidence and the decision taken by the panel along with the letter of appeal and advise whether the decision not to pay an Injury Allowance was appropriate or not. A response will be provided to the employee within 10 working days of the Director of Workforce receiving the appeal.
5.2 Should further Occupational Health advice be required this will be requested from the Head of Service, Staff Wellbeing & Safety. Any report provided as part of the appeal process will also be shared with the employee.
5.3 The employee will be notified of the outcome of their appeal and if appropriate the Director of Workforce will notify payroll to arrange payment of the Injury Allowance. This will be the second and final stage of the process and there will be no further right of appeal.
6. PAY PROTECTION
6.1 Employees eligible for the Injury Allowance payment and who then subsequently have to change jobs permanently to a position on lower pay, or have to reduce hours due to a work related injury, disease or other health condition, will receive a period of protected pay that is the same as the provision for pay protection during organisational change.
7. NHS INJURY BENEFITS SCHEME – TRANSITIONAL ARRANGEMENTS
7.1 The previous NHS Injury Benefit provisions will continue to protect eligible employees who suffered a work related injury or disease on or before 30 March 2013as follows:
- For an additional period of 20 years (31 March 2018 to 30 March 2038). Claims associated with delayed onset of symptoms resulting from injuries sustained and diseases contracted before 31 March 2013 may still be claimed under the Injury Benefit Scheme.
These measures provide transitional protection for those who sustain a work related injury or contract a work related disease before 31 March 2013.
7.2 The NHS Injury Benefits Scheme can provide three forms of financial support for employees affected by injury or disease that is wholly or mainly attributable to their work on or before 30 March 2013 and this includes Temporary Injury Benefit, Permanent Injury Benefit or Death Benefits. The application process for this scheme remains unchanged and will be administered by the Scottish Public Pensions Agency. Further details on making such an application can be found on the SPPA website – www.sppa.gov.uk
7.3 Employees already in receipt of a Temporary or Permanent Injury Benefit on or before 30 March 2013 will not be affected by the introduction of the new arrangements for Injury Allowance.
7.4 A Flow Chart showing whether a claim should be made under the Injury Allowance or Injury Benefit Scheme is attached at Appendix B.
8. REVIEW
8.1 This process will be subject to on-going monitoring and review.
