NHS injury allowance

Injury allowance is a top up for NHS staff on Agenda for Change terms who are off sick, or on a phased return, on reduced pay or no pay because of a work related injury, illness or other health condition. It brings your income, including some state benefits, up to 85 per cent of your pay for up to 12 months per episode. It is set out in Section 22 of the NHS Terms and Conditions of Service Handbook, and your employer decides whether you qualify.

Who qualifies

The condition has to be wholly or mainly attributable to your NHS employment. The handbook says it must have been sustained or contracted in carrying out your duties, or be an injury that did not happen on duty but is connected with or arises from your employment. NHS Employers’ guide explains “wholly” as totally and “mainly” as for the most part. It also says the work does not have to be the sole, dominant, direct or proximate cause, only a contributory causal one.

Examples the guide says may be considered include psychiatric injury, a disease that appears years later (such as asbestosis, or hepatitis C after a needlestick injury), a road accident on official duty and an assault on the way home by an ex-patient. It says a condition is unlikely to qualify where another cause is responsible, such as the natural progression of a pre-existing condition, normal wear and tear or a condition unrelated to work. If you were assaulted at work, see also the guide on violence and aggression against NHS staff.

Length of service does not matter, because the handbook says payment is not dependent on it.

What does not qualify

Paragraph 22.7 excludes three situations:

• an injury on a normal journey to or from work, unless the journey is part of your contractual NHS duties
• sickness absence arising from disputes about employment matters, conduct or job applications
• an injury, disease or condition caused or seriously aggravated by your own negligence or misconduct

The employers’ guide adds that the allowance is not payable where your pay has not fallen below 85 per cent, or where your employment contract ends. It also says an unrelated dispute, such as a challenge over a wage error, should not be a reason on its own to withhold the allowance.

What it pays and for how long

The allowance is a top up to your sick pay, or to your earnings if you are on reduced pay, including on a phased return. The calculation includes any contributory state benefits you receive and brings the total to 85 per cent of pay as defined in paragraph 14.4. Contributory state benefits for loss of earnings are counted at the rate you actually get. Other benefits and payments are ignored. You must claim any contributory state benefits you may be entitled to and tell your employer, and an overpayment can be recovered. The handbook says the employer should consider how long the overpayment lasted when agreeing repayment.

It is limited to up to 12 months per episode, subject to local absence management, return to work and rehabilitation policies. It does not give extra sickness absence entitlement. For tax, the payment is subject to National Insurance and income tax, but no pension contribution is deducted. For the wider effect on your pension, see NHS pension and sick leave.

If you have to move permanently to a lower paid post because of a work related injury, illness or health condition, the handbook gives a period of protected pay, the same as the local arrangement for pay protection during organisational change.

How it works with sick pay

Injury allowance sits alongside the Section 14 sick pay scale described in NHS sick pay. The handbook says staff off with a work related injury, disease or condition may also be entitled to injury allowance.

It can also protect your sick pay allowance. When your employer works out how much sick pay you have used in the previous 12 months, certain absences are disregarded under paragraph 14.7. These include unpaid sick absence and absence from a condition wholly or mainly attributable to NHS employment, sustained or contracted in carrying out your duties. Certain injuries from a crime of violence connected with your employment are also disregarded in specified circumstances, such as where the Criminal Injuries Compensation Authority made a payment. How this affects your own entitlement depends on your service, which is explained in reckonable service for NHS sick pay.

If you return on a phased basis with reduced pay, paragraph 22.13 allows the top up to 85 per cent during an employer approved period of rehabilitation. See phased return to work in the NHS.

Who decides and how to apply

Your employer decides whether the condition is attributable to your NHS employment, and it should seek appropriate medical advice. The test is the civil standard, the balance of probability, which means more likely than not. You are expected to give all relevant information, including medical evidence in your possession or that can reasonably be obtained. The guide lists evidence an employer may use, including accident reports, occupational health notes and records, your job description and training records.

The handbook does not set out claiming steps beyond that. The employers’ guide says it is done through your employer’s locally agreed absence management policy and includes a template claim form, so ask HR or payroll how your trust handles claims. If you are told no, you can appeal through local grievance procedures, and our guide to raising a grievance explains how that works.

Older cases

NHS Employers’ guide says injury allowance took effect from 31 March 2013, and transitional protection applies to injuries or diseases that happened on or before 30 March 2013 under the earlier NHS Injury Benefit Regulations 1995.