The Occupational Injuries Scheme provides benefits for people injured or incapacitated by an accident at work or while travelling directly to or from work. The scheme also covers people who have contracted a disease as a result of the type of work they do. There are a number of benefits available and there are different conditions attached to each benefit.
The benefits are:
- Injury Benefit
- Disablement Benefit
- Incapacity Supplement
- Constant Attendance Allowance
- Medical Care Scheme.
There are also death benefits under this scheme:
- Widow’s, Widower’s or Surviving Civil Partner’s Pension (paid at a higher rate than the ordinary Contributory Widow’s, Widower’s or Surviving Civil Partner’s Pension)
- Orphan’s Pension
- Funeral Grant
Injury Benefit is a weekly payment if the claimant is unfit for work due to the accident or disease. Payment is normally made from the 4th day of incapacity for work.
Injury Benefit can be paid for up to 26 weeks from the date of the accident or development of the disease . If the accident or disease caused loss of physical or mental ability, the claimant ma apply for Disablement Benefit before Injury Benefit ceases. If he or she is still unfit for work after 26 weeks he or she may apply for Illness Benefit or Disability Allowance.
Disablement Benefit is paid if there has been a loss of physical or mental faculty after the accident or disease. It is not required that the person is unfit for work.
There must be a medical assessment to determine the degree of loss of faculty and the rate of benefit is based on this. Disablement Benefit can be paid as a lump sum (called Disablement Gratuity) or as a weekly payment (called Disablement Pension).
Incapacity Supplement is a weekly supplement, which may be paid if the claimant is not eligible for Illness Benefit or another social welfare payment. To get the supplement they must be getting Disablement Pension and be permanently incapable of work.
Constant Attendance Allowance is a weekly allowance, which may be paid to a claimant in receipt of Disablement Benefit who is seriously disabled as to need someone to help you daily at home to attend to personal needs.
Medical costs incurred as a result of an occupational injury or disease, and of certain expenses which are not covered by the Health Service Executive (HSE) or through the Treatment Benefit Scheme under the Medical Care Scheme. The cost of private or semi-private accommodation and treatment cannot be recouped under the Occupational Injuries Scheme.
In general people in employment insurable at PRSI Class A, D, J or M (Class M only where the employee is under 16 years of age) are covered in full for Occupational Injuries Benefits.
Civil servants recruited prior to April 1995 and insured at Class B may only qualify for limited Occupational Injuries Benefits. Education and Training Board trainees, people on employment schemes and people over 66 who are working are covered for Occupational Injuries Benefits.
Unlike other social insurance benefits, it is not necessary to have a set number of PRSI contributions to qualify. It is simply necessary to be in employment that is insurable for Occupational Injuries.
The Recovery of Certain Benefits and Assistance (RBA) Scheme enables the Department of Social Protection to recover the value of certain illness-related social welfare payments as a consequence of personal injuries claims. They are recovered from the compensator and not from the injured person.