a) What is an Industrial Accident?
(i) The word “accident” is given a wide interpretation and covers any unexpected happening resulting in a Personal Injury, whether the effects of the accident are immediate, as when someone breaks a leg in a fall or delayed, as when blood poisoning follows a cut.
(ii) An industrial accident is one “arising out of and in the course of” the injured person’s employment. If, as a result of the accident, incapacity, disablement or death occurs, the benefits under the Scheme can be paid.
(iii) The condition that the accident must “arise out of and in the course of” the employment means that it must occur whilst the injured person was doing something he/she was employed to do or because their employment exposed them to some particular risk.
Accidents that occur “in the course of” employment are treated as having arisen out of the employment unless there is evidence to the contrary. Benefit cannot be paid if the accident happened before the employment began or after it ended. All accidents on duty must be recorded in the Employers Accident Book (Accidents for BT employees, must be reported to the Accident Reporting Group (ARG).
In addition to informing your employer, Union Headquarters should be supplied with the fullest possible information on form LS3. It is particularly important that the cause of the accident should be given in detail. This is necessary because under the Law of Personal Injuries, it is possible to claim against the employer where they or one of their servants can be proved negligent.
(b) Entitlement Under the Industrial Injuries Act
When an accident has arisen “in and out of” the course of employment, it must be reported to the Benefits Agency for registration as soon as possible.
This is important to safeguard the injured person in any subsequent claim for benefit. All enquiries on this aspect should be directed to Legal Services for clarification and advice (see leaflet LS18).
(c) Disablement Benefit
Disablement Benefit is a payment depending on the degree of disablement the injured person is still suffering as a result of the accident or disease when the injury benefit period ends.
To qualify the accident must arise out of and in the course of the victim’s duty and must be registered with the Benefits Agency as an Industrial Injury within a period of 3 months. If the victim does not make a complete recovery within a period of 3 months, an application should be made for disablement benefit. The claimant will be medically examined and the injuries assessed in a percentage term. If the assessment is 14% or more, a weekly payment depending on that percentage will be made for the duration of the assessment period.
The assessment can be for a set time such as 12 months or on a provisional basis. If the assessment is provisional, the claimant will be automatically re-examined at the end of the assessment period and a further assessment may be granted. If the Medical Board decides that the injured person’s condition is not likely to change considerably, they can make a final assessment for life. If they consider that the condition will only last for a limited period after which no further appreciable disability is to be expected, they can make a final assessment for a limited period. (Members can apply for “Reconsideration on a Change of Circumstances”).
(d) Medical Appeal Tribunals
If the member is unhappy with the level/type of assessment, there is a right of appeal.
If the member decides to appeal he/she should:
1) Lodge appeal with the Benefits Agency within 1 month of decision, also inform them of CWU involvement.*
2) Send copy of the assessment form to Legal Services Department via Branch Official.
If there is no existing specialist report then arrangements will be made by Union Headquarters for the member to be examined. If the medical report is in the member’s favour, representation at the Tribunal is provided at Headquarters level.
*However, Branches should be aware that Appeals are only dealt with where the initial award is 10 per cent or more (except in Bandit Attack cases).
If it is decided to make an appeal after receiving the medical board’s decision, it is important that the matters be referred to Union Headquarters for advice. In the event of the medical evidence being in favour of an appeal, then Union Headquarters will provide representation at the Tribunal. The Tribunal have the right to vary the original award either by increasing or decreasing it or rescinding the original award completely. Decisions given by a Medical Board or a Medical Appeals’ Tribunal can be reviewed at any time by a Medical Board, if the Board is satisfied by fresh evidence that the decision was given because of non-disclosure or misrepresentation of a material fact.
A Medical Board can also review its decision if there turns out to be an unforeseen aggravation of the results of the relevant injury.
(e) Incapacity Benefit
Advice only is given from Union Headquarters on Incapacity Benefit (Procedures and Appeals).
Head of Legal Services
To contact the department: firstname.lastname@example.org