Permanent Injury Benefit (PIB)

We, with advice from the Scheme’s medical advisers, decide upon an applicant’s entitlement to PIB. The information on this page will help applicants assess their likelihood of receiving payments through the Injury Benefits Scheme, should they submit a claim.

In order for entitlement to PIB to be granted, the Scheme administrators must satisfy themselves that 2 criteria have been met by the applicant:

• they must be suffering from an injury or disease which is wholly or mainly attributable to their NHS employment
• they must have suffered a permanent loss of earning ability of more than 10%

Determining the permanent loss of earning ability involves looking at the applicant’s pensionable pay when the employment ended or when they moved to lower paid employment and then assessing their permanent reduction in earnings ability as a result of the injury or disease.

The Scheme’s medical advisers will consider the applicant’s capability for work in the general field of employment.

 If successful, the PIB awarded will be based on a percentage of the applicant’s pensionable pay when the employment ended or they moved to permanent lower paid employment, the number of years worked for the NHS at that time, and the level of permanent reduction in their earnings ability that has resulted. The PIB benefits table shows how PIB is calculated for a specific case.

A lump sum may also be payable if the applicant’s NHS employment ends because of the injury or disease. This is also a percentage of the applicant’s pensionable pay and can be calculated from the table.

In calculating the annual PIB allowance due to a successful applicant, the Scheme administrators are required to deduct annual income applicants may be getting from pensions (NHS, SERPS or any other public or private sector pension scheme connected with their NHS employment), from a range of specific Department for Work and Pension (DWP) benefits and from damages or compensation claims.

As a result, there are some people who may have a successful claim for PIB but, because of income received from other sources; they will receive no actual payment from the Scheme.

This does not mean PIB will never be payable in these cases: if the applicant suffers a further reduction in their earning ability as a result of the injury or disease, or their income from a pension or  DWP payment stops, they can contact the Scheme administrators for a review of the PIB.

The PIB allowance for successful applicants is based on a percentage of their pensionable pay at the time employment ends or they move to a permanent lower paid employment, the number of years worked for the NHS at that time, and the level of permanent reduction in earnings ability that has resulted. The table below shows how PIB can be calculated for a specific case.

A lump sum may also be payable if the applicant’s NHS employment ends because of the injury or disease. This is also a percentage of the applicant’s pensionable pay but unlike the PIB allowance is not connected to the length of service.

In calculating the annual PIB allowance due to a successful applicant, the Scheme administrators are required to deduct annual income applicants may be getting from pensions (NHS, SERPS or any other public or private sector pension scheme connected to their NHS employment), from a range of specific DWP benefits and from damages or compensation claims.

Because of these deductions, there are some people who may have a valid application for PIB but, because of income received from other sources, they will receive no actual payment from the Scheme. This does not mean PIB will never be payable in these cases. If the applicant suffers a further reduction in their earning ability as a result of their injury or disease, or their income from a pension or DWP payment stops, they can contact the Scheme administrators for a review of the PIB.

Once set, the PIB is only reviewed if the applicant’s circumstances change. That means if:

• their DWP benefits start or stop (but not if the payments increase or decrease)
• they have received damages or compensation in respect of the same injury for which PIB has been awarded.
• they reach normal pension age
• their earning ability declines further and they ask for a review
• the applicant returns to NHS paid employment anywhere in the UK

A person leaves the NHS after seven years employment because of an injury or disease wholly or mainly attributable to their NHS duties. The Scheme’s medical adviser assesses their permanent reduction in earning ability to be more than 25% and up to 50%. The best of their last three years pensionable pay (member of the 1995 Section of the NHS Pension Scheme) was £10,000.00 a year.

Using the table (from Permanent Injury Benefits payable (PIB) section) you can see that their potential income from the NHS Injury Benefits Scheme would be calculated at 50% of the best of their last three years pay. So, 50% of £10,000.00 is £5,000.00 a year. This means that if their income, including their NHS pension and certain social security benefits (paid by the DWP), is less than £5,000.00 a year, the Scheme would pay the difference.

The pension/benefits that form part of the allowance are as follows:

• NHS (or other public sector) pension / private pension / SERPS.
• Incapacity / Invalidity Benefit (paid by the DWP)
• Contribution Based Employment and Support Allowance (paid by the DWP)
• Severe Disablement Allowance (paid by the DWP)
• Industrial Disablement Benefit (paid by the DWP)
• Reduced Earnings Allowance / Retirement Allowance (paid by the DWP)
• Damages / compensation

If in the example above an NHS pension of £1,000.00 a year and various social security benefits adding up to £3,200.00 a year were in payment totalling £4,200.00 a year, PIB of £800 a year would be payable.

With a permanent reduction of earning ability of more than 25% and up to 50% the lump sum shown on the table would be 25%. Based on a salary of £10,000.00 this would equate to £2,500.00 (25% of £10,000.00).

The rates used to calculate benefits are the rates that applied on the date earnings were permanently reduced. This will be either the day someone stopped working or the day when they started lower paid employment. A lump sum is not payable if an individual moves to a lower paid job in the same employment.

The PIB annual allowance may only be reviewed if relevant DWP benefits stop or start and will not be reviewed if the benefits are adjusted.

People eligible for PIB may also be eligible for a range of DWP benefits. Income from these benefits is taken into account in the calculation of the annual allowance to be provided by the NHS Injury Benefits Scheme. The PIB allowance will then be recalculated if and when the DWP benefits stop or start (but not if their level is adjusted). Relevant DWP benefits are:

Industrial Injuries Disablement Benefit - awarded if the accident is accepted by the DWP as an industrial injury and there is a loss of faculty of 14% or more.

Incapacity Benefit

Reduced Earnings Allowance - this benefit is paid if income is reduced resulting from an injury or disease, which occurred before 1 October 1990.

Retirement Allowance - this benefit came into force in April 1989 and replaced the Reduced Earnings Allowance at State Retirement Age.

Severe Disablement Allowance - this is awarded where the disability is rated to be extreme; i.e. 85% disabled.

Contribution Based Employment and Support Allowance - this can be paid when Statutory Sick Pay has ended.

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 NHS Pensions as soon as their damages (or compensation) claim is settled.