Employment Injury

Employment injury is a benefit paid to an insured person or persons who are incapable of work because of an injury sustained as a result of an accident or  disease arising out of and in the course of employment. It is comprised of six benefits;

• Injury Benefit
• Disablement Benefit
• Constant Attendance Allowance
• Medical Expense
• Funeral Grant
• Death Benefit

Injury Benefit

Injury Benefit at the rate of seventy percent (70%) is paid to any person who is unable to work due to injuries or a disease sustained on the job or during the course of employment. This benefit is paid for a maximum of twenty-six (26) weeks.

Duration of Injury Benefit

Injury Benefit is paid up to a maximum period of twenty-six (26) weeks, as long as the incapacity exists. After that period your doctor must re-assess you disability to determine you eligibility for the Disablement 

Benefit.

How to claim Injury Benefit

• Report the accident to your employer or someone in authority as soon as possible.

• Visit your doctor immediately or go to the hospital. Ask the doctor to certify your injury on the Medical Report Form.

• Complete and sign the Claim Form and submit it to the National Insurance Office as soon as is possible. (Be sure to answer all questions)

The daily rate of Injury Benefit is seventy percent (70%) of the average weekly insurable earnings of the insured person divided by six (6).

Employers are required to investigate the circumstances of an all edged accident and submit a written report to the National Insurance Board. 

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Disablement

This a follow-on benefit to the Injury Benefit. If after the six (6) months of Injury Benefit the injured person is still unable to work, they could become entitled to a Disablement Benefit. If according to the disablement schedule which is made available to doctors, the insured person is assessed to have sustained an injury of thirty percent (30%) or more, a Disablement Pension will be paid. If the injury is less than thirty (30%) a Disablement Grant is Paid.

When to claim Disablement Benefit

Immediately on the conclusion of Injury Benefit the medical assessment should be done and a claim submitted.

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Constant Attendance Allowance

In cases where an injury is so severe that is assessed at one hundred percent (100%) or more by the doctor, then the person becomes entitled to a Constant Attendance Allowance. The pension rate will be increased by fifty (50%). This is to facilitate payments to a caretaker.

Death Benefit

This is similar to a survivors benefit and is payable to the spouse and child/children or dependants of a deceased insured person. It is paid only if death resulted from an injury or disease sustained on the job, or during the course of employment. Death Benefit is paid to the dependent of the deceased insured person with the following order to priority:

• widow
• widower
• children including adopted children, step children and children under sixteen years or up to eighteen years if in full time education.
• any other person including children, not qualifying under (C) and whom the Executive Director adjudges to be a dependant.
• any named beneficiary who does not qualify under any of the above.

The dependant person should submit a claim as soon as possible after the death of the insured person.

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Medical Expenses

This benefit is paid to cover the cost of drugs and supplies in the treatment of an injury which occurred on the job or during the course of employment. Coverage is provided for medicines, surgery, overseas treatment, fittings, artificial limbs, dentures, spectacles and other apparatus and appliances. the cost of traveling overseas for medical treatment is also covered but the National Insurance Office should first be notified of plans to travel for overseas treatment except it is an emergency. Please note this benefit is only paid in respect of employment related injuries.

What payments are made

• Medical, surgical, dental and hospital treatment, skilled nursing services and the supply of medicines.

• The supply of fittings, maintenance, repair and renewal of artificial limbs, dentures spectacles and other apparatus and appliances.

• The cost of traveling for the purpose of obtaining any of the above.

Payment of Medical Expenses

For Medical Expenses to be paid:

•  The expenses must be reasonable and reasonably incurred.

• The expenses must relate to obtaining treatment which is provided so as to secure maximum effectiveness at maximum reasonable cost.

• The fees or charges constituting the medical expenses must not be more than would be properly and reasonably charged if the insured person were paying HIMSELF.

How to claim Medical Expense.

·         Keep all bills and receipts for drugs, medication, doctor's fees, traveling, hospitalization etc safety and submit to the National Insurance office.

·         Details of the nature of the treatment which was received, both as an in-patient and as an out-patient must be indicated on the form

Fees for air fares and costs of hospitalization and operations undertaken abroad will be paid if these expenses were incurred outside the country with prior approval of the Board. If these were incurred without prior knowledge of the Board, the claim will be restricted to E.C. $1000.00.

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Funeral Grant

If an insured dies as a result of an employment-related injury, a Funeral Grant of two thousand dollars ($2,000.00) will be paid to the person who has met or who will meet the expenses of the funeral.  See more