Assessing your claim for IIDB
Applications for Industrial Injuries Disablement Benefit (IIDB) – for asbestosis and diffuse pleural thickening – require an applicant to attend a medical which will be arranged by the Jobcentre Plus and will involve accessing your medical records in order to make a decision on your claim.
Applications for mesothelioma and lung cancer do not normally require a medical examination but you do need confirmation from a medical professional that you have been diagnosed with the disease.
Industrial Injuries Disablement Benefit is a weekly benefit paid to people who become disabled because of an accident at work or due to certain prescribed diseases caused by their job, or whilst working on an approved employment training scheme or course.
The amount you get depends on how badly you are disabled as a result of the industrial injury or disease.
Employed earner’s employment
Only employed earners, or people who can be treated as employed earners, are covered by the Industrial Injuries Scheme, or people who were on an approved employment training scheme or course when the accident or event happened. (Legislation (8) – SS C&B Act 1992 sec 94 –accidents) (Legislation (9) – SS C&B Act 1992 sec 108 –prescribed diseases)
An employed earner is a person who is gainfully employed in Great Britain either under a contract of service or is an office holder (for example, a company director). (Legislation (10) – SS C&B Act 1992 sec 2(1)(a))
Some people who are not employed earners are treated as though they were for the purposes of the scheme, for example:
- special constables, who are not paid and so cannot be said to be working for reward
- agency staff who are self-employed under a contract for services but are still liable to pay Class 1 National Insurance (NI) contributions in respect of their earnings. Legislation (11) – SS (Employed Earners Employment for Industrial Injuries Purposes) Regs 1975 Sched 1 Part 1 & Sched 3)
- people who were on an approved employment training scheme or course when the accident or event happened
Questions arising on a prescribed diseases claim
The primary questions arising on a prescribed disease claim are:
- Is the disease a prescribed disease?
- Is the disease prescribed in relation to your occupation and work history? This involves considering whether your employment could have caused the disease and whether the employment was employed earner’s employment
- Are you suffering from the disease, or have you suffered from the disease? This is called the diagnosis question
- Is the disease due to the nature of your employment?
- When was the date of onset of the disease?
- Have you suffered a relevant loss of faculty due to the disease?
Loss of physical or mental faculty means some loss of power or function of an organ of the body. Whether a loss of faculty results in disability is decided by comparing your condition as a result of the disease with the condition of a normal healthy person of the same age and sex. Although this comparison is theoretical, it is important that you take the opportunity to explain the things that you can no longer do as a result of your asbestos condition. For example how your walking ability is affected due to breathing problems, or if you have had to give up things that you previously were able to do.
Disability is decided by comparing your condition as a result of the disease with the condition of a normal healthy person of the same age and sex
The doctor at your medical examination will ask you a number of questions regarding any limitations (disablement) due to your condition. This forms part of your assessment and your answers to the questions the doctor asks are recorded and form your ‘statement’.
The doctor will advise the Jobcentre Plus on:
- whether you are suffering from a prescribed disease, and if so;
- whether you have suffered a loss of faculty from the disease, and if so;
- the level of your disablement and how long it is expected to last.
- If the doctor has advised that you are suffering from a prescribed disease he will also advise on the date of onset of the disease.
- The doctor will also provide an explanation for the decision maker ( Jobcentre Plus) as to how they arrived at their opinion.
- The doctor will also advise if, in their opinion, the disease is due to the nature of your employed earner’s employment. This is called causation.
If the doctor decides that you are suffering from a prescribed disease he will advise the Jobcentre Plus on the level of disablement, expressed as a percentage between 1-100%. If you are found to be suffering from asbestosis, you will automatically receive an assessment of at least 1% and will qualify for IIDB. For all other conditions, you must be assessed at least 14% disabled before you can be paid IIDB. If you disagree with the decision on your claim, you can appeal against it.
The doctor acting on behalf of the Jobcentre Plus is not bound to agree with the consultant at the hospital who originally advised you that you were suffering from an asbestos related condition.
Applications for mesothelioma and lung cancer do not normally require a medical but you do need confirmation from a medical professional that you have been diagnosed with the disease. Those who are found to be suffering from asbestos-related lung cancer and mesothelioma are automatically assessed as 100% disabled. If you are assessed as 100% disabled, as well as being awarded IIDB, you will be invited by the Jobcentre Plus to apply for Constant Attendance Allowance.
To see what the current level of payment is for Industrial Injuries Disablement Benefit, please click here.
Last reviewed: October 2019