The National Insurance Employment Injury Benefit is paid to an insured person who is rendered incapable of work through personal injury caused by an accident, which arises out of and in the course of his employment, or through a prescribed industrial disease caused by the nature of his employment.
What is Employment Injury Benefit?
Employment Injury Benefit is a unique benefit in that it consists of four (4) categories of benefit:
Injury Benefit - payable for 52 calendar weeks.
Disablement Benefit - consists of either a monthly benefit or a lump sum payment.
Medical Expenses - a cash benefit to defray related medical expenses.
Death Benefit - monthly benefit payable to the spouse, dependent parents and dependent children.
Payment of the benefit is made to:
- An insured person who suffered personal injury caused by an accident which
arises out of and in the course of his/her employment.
- An insured person who is required to abstain from work because they are
suspected of carrying a contagious disease or who has had contact with a case of
infectious disease or an insured person who is rendered incapable of work through a
prescribed industrial disease caused by the nature of his job; or
- To the dependents of an insured person who dies as a result of such an injury on the job.
Who Can Claim?
Anyone who is in insurable employment in relation to Employment Injury Benefits (that is where a person is employed and a contribution was paid or due to have been paid for that week of employment) and:-
- Is away from the job because of an accident/disease that arose out of or
in the course of employment;
- Is required to abstain from work because they are suspected of carrying a
contagious disease or who has had contact with a case of infectious disease
- Is incapable of work for a period of more than 3 days as a result of the
injury or prescribed industrial disease.
Time Frames: 0 - 14 days - Claim on
time and can be accepted
14 days - 12 months - Claim late and may be accepted with good cause
12 months and over - Claim late and shall be disallowed
Forms To Be Completed
NI19 - Application for Injury Benefit
NI19A - Medical Certificate for continuing injury/disease
- Marriage Certificate for a woman whose name has changed since her
- Foreign medical certificates must be accompanied by a letter of
- Late Claim Letter showing good cause which caused the claim to be made late.
When To Apply
The insured person must apply for the benefit within 14 days of the date of the accident or development of the disease. Late submission of a claim can result in loss of the benefit. The date of development of the industrial disease is the date on which the insured person was rendered incapable of work as result of the disease.
How Much Will Be Paid?
The class of contribution in the week of the accident and the week prior will be considered. Benefit will be paid in the higher class. However, unpaid apprentices and persons in receipt of a receipt of a Retirement Pension who have returned to work will be paid in the lowest Earnings Class - Class 1.
You must apply on time to ensure that you receive your benefit. Failure to submit your claim to the Board within 13 weeks (3 months) of the start of your injury can result in you losing all or part of your benefit. You may lose any period that is more than 13 weeks (3 months) earlier than the date on which the Board receives your claim unless you can show there was good cause for the delay in submission. Your explanation must be submitted in writing. Even with good cause you may still lose your benefit.
Even with good cause, if your claim is made more than 12 months after the start of your injury the benefit shall be forfeited.
For How Long Will Injury Benefit be Paid?
Where the period of incapacity lasts for more than three (3) days, payment will be made from the 1st day of incapacity and may continue for a maximum of 52 calendar weeks.
What Happens after Injury Benefit?
At the end of the injury benefit period the extent of disability is immediately assessed to determine the insured person’s entitlement to Disablement Benefit.