Statutory Instruments 1998 No. 1594 (S. 84)
The National Health Service (Scotland) (Injury Benefits) Regulations 1998
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The Secretary of State, in exercise of the powers conferred on him by sections 10 and 12 of, and Schedule 3 to, the Superannuation Act 1972[1] and of all other powers enabling him in that behalf, after consulting such representatives of persons likely to be affected by these Regulations as appear to him appropriate in accordance with section 10(4) of that Act, and with the consent of the Treasury[2], hereby makes the following Regulations:



PART I

PRELIMINARY

Citation, commencement and effect
     1.  - (1) These Regulations may be cited as the National Health Service (Scotland) (Injury Benefits) Regulations 1998 and shall come into force on 31st July 1998.

    (2) In their application to a person mentioned in regulation 3(1)(e) or (f), these Regulations shall have effect from 1st April 1998.

Interpretation
    
2.  - (1) In these Regulations-

    "the 1961 Regulations" means the National Health Service (Superannuation) (Scotland) Regulations 1961[4];

    "the 1980 Regulations" means the National Health Service (Superannuation) (Scotland) Regulations 1980[5];

    "the Superannuation Scheme Regulations" means the National Health Service Superannuation Scheme (Scotland) Regulations 1995[6];

    "the previous Regulations" means the National Health Service (Scotland) (Injury Benefits) Regulations 1974[7];

    "assistant practitioner" means-

    (a) an employee of a medical practitioner, or dental practitioner on the list of a Health Board, being himself a medical practitioner or dental practitioner who, in such employment, is engaged in assisting his employer in the actual discharge of his duties as such practitioner and for whose employment the consent of the Health Board has been obtained; or

    (b) a medical practitioner who is being trained in general practice as a trainee general practitioner under arrangements made by the Secretary of State;

    "average remuneration" means-

    (a) in relation to a person other than a practitioner, such amount as would be or would have been his final year's pensionable pay, within the meaning of regulation A2 of the Superannuation Scheme Regulations, as an officer to whom those Regulations apply (assuming, in the case of a person to whom regulation 3(1)(c) applies, that he was in receipt of the pensionable pay which would, in the opinion of the Secretary of State, have been payable if he were employed whole-time by an employing authority on similar duties);

    or

    (b) in relation to a practitioner, the yearly average of such amount as would be or would have been his uprated earnings, within the meaning of paragraph 11(2) of Schedule 1 to the Superannuation Scheme Regulations, as a practitioner to whom those Regulations apply,

calculated as if he had retired-

      (i) in the case of a person eligible for an allowance under regulation 4(3), on the date on which he ceased to be employed as a person to whom regulation 3(1) applies;

      (ii) in the case of a person eligible for an allowance under regulation 4(4) or (5), on the date on which his emoluments were reduced;

      (iii) in the case of any other person, on the date on which by reason of the injury or disease his employment ceased:

    Provided that in respect of a person to whom regulation 3(1)(a) applies who, immediately before he ceased to be employed by reason of the injury or disease or as a person to whom regulation 3(1) applied, or immediately before the date on which his emoluments were reduced, as the case may be, was employed as a specialist registrar, senior registrar, registrar, senior house officer or house officer, average remuneration shall be increased to the amount which in the opinion of the Secretary of State represents the average remuneration of a general medical practitioner, or a general dental practitioner, as the case may be, of comparable age;

    "dental list" means a list prepared in accordance with regulations made under section 25(2)(a) of the National Health Service (Scotland) Act 1978[8];

    "emoluments" means all salary, wages, fees and other payments paid or made to a person as such for his own use, and also the money value of any accommodation or other allowances in kind appertaining to his employment, but does not include payments for overtime which are not a usual incident of his employment, or any allowances payable to him to cover the cost of providing office accommodation or clerical or other assistance, or any travelling or subsistence allowance or other money to be spent, or to cover expenses incurred, by him for the purposes of his employment; and where fees or other variable payments were made to a person as part of his emoluments during any period immediately preceding a reduction of emoluments, the amount in respect of fees or other variable payments to be included in the emoluments shall be the average of the fees or other payments paid to him during the period of three years immediately preceding the reduction of the emoluments, or such other period as the Secretary of State may think reasonable in the circumstances;

    "employing authority" means-

    (a) a Health Board or Special Health Board established under section 2 the National Health Service (Scotland) Act 1978[9];

    (b) the Common Services Agency for the Scottish Health Service established under section 10 of that Act[10];

    (c) a National Health Service trust established under section 12A of that Act[11];

    (d) in respect of employment in a state hospital provided under section 102 of that Act[12], the Secretary of State or, where the hospital is managed on his behalf by a committee constituted under section 91 of the Mental Health (Scotland) Act 1984[13], a Health Board or the Common Services Agency, the body so managing it;

    (e) any other body which is constituted under an Act relating to health services and which the Secretary of State agrees to treat as an employing authority for the purposes of these Regulations;

    "medical list" means a list prepared in accordance with regulations made under section 19(2)(a) of the National Health Service (Scotland) Act 1978;

    "personal pension scheme" has the meaning given in section 1 of the Pension Schemes Act 1993[14];

    "pilot scheme" has the meaning given in section 1(1) of the 1997 Act;

    "pilot scheme employee" has the meaning given in section 2(3) of the 1997 Act;

    "piloted services" has the meaning given in section 1(4) of the 1997 Act;

    "practitioner" means-

    (a) a medical practitioner or a dental practitioner on the medical list or, as the case may be, the dental list of a Health Board;

    (b) an assistant practitioner;

    (c) a medical practitioner who is providing piloted services; or

    (d) a medical practitioner who is a pilot scheme employee and

      (i) whose name appears on the medical list of a Health Board, or

      (ii) who was an assistant practitioner,

    prior to the commencement of the pilot scheme;

    "relevant pension scheme" means any form of arrangement, whether subsisting by virtue of an Act of Parliament, trust, contract or otherwise for the provision of pension benefits in connection with employment mentioned in regulation 3(1), including a personal pension scheme or the additional pension referred to in section 44(3)(b) of the Social Security Contributions and Benefits Act 1992[15], but excluding-

    (a) any arrangements for the provision of benefits under legislation relating to social security, other than the said additional pension;

    (b) any arrangement for the provision of benefits paid for by additional voluntary contributions under which the rate or amount of benefit payable is calculated by reference to the proceeds of the investment of those contributions;

    "service" has the meaning given in regulation 5.

    (2) Where any pension or child's allowance which is or would have been payable under a relevant pension scheme is taken into account for the purpose of any calculation under these Regulations, such pension or allowance shall exclude any amount by which it is or would have been increased under the Pensions (Increase) Act 1974[16].



PART II

INJURY BENEFITS

Persons to whom the Regulations apply
     3.  - (1) Subject to paragraph (3) of this regulation and regulation 16, these Regulations apply to any person who, while he-

(hereinafter referred to in this regulation as "his employment"), sustains an injury, or contracts a disease, to which paragraph (2) applies.

    (2) This paragraph applies to an injury which is sustained and to a disease which is contracted in the course of the person's employment and which is wholly or mainly attributable to his employment and also to any other injury sustained and any other disease contracted, if-

    (a) it is wholly or mainly attributable to the duties of his employment;

    (b) it is sustained or, as the case may be, contracted, while, as a volunteer at an accident or emergency, he is providing health services which his professional training and code of conduct would require him to volunteer; or

    (c) it is sustained or, as the case may be, contracted while he is travelling as a passenger in a vehicle to or from his place of employment with the permission of the employing authority and if in addition-

      (i) he was under no obligation to the employing authority to travel in the vehicle but, if he had been, the injury would have been sustained, or the disease contracted, in the course of, and have been wholly or mainly attributable to, his employment, and

      (ii) at the time of the injury or the contracting of the disease the vehicle was being operated, otherwise than in the ordinary course of a public transport service, by or on behalf of the employing authority or by some other person by whom it was provided in pursuance of arrangements made with the authority.

    (3) These Regulations shall not apply to any person in relation to any injury or disease wholly or mainly due to, or seriously aggravated by, his own culpable negligence or misconduct.

Scale of benefits
     4.  - (1) Benefits in accordance with this regulation shall be payable by the Secretary of State to any person to whom regulation 3(1) applies whose earning ability is permanently reduced by more than 10 per cent by reason of the injury or disease, but, in the case of a person to whom paragraph (5) applies, the Secretary of State shall pay those benefits without regard to any reduction in the person's earning ability.

    (2) Where a person to whom regulation 3(1) applies ceases to be employed as such a person by reason of the injury or disease and no allowance or lump sum, other than an allowance under paragraph (5), has been paid under these Regulations in consequence of the injury or disease, there shall be payable, from the date of cessation of employment, an annual allowance of the amount, if any, which when added to the value, expressed as an annual amount, of any of the pensions and benefits specified in paragraph (6) will provide an income of the percentage of his average remuneration shown in whichever column of the table hereunder is appropriate to his service in relation to the degree by which his earning ability is reduced at that date.


TABLE

Degree of reduction of earning ability Service
  Less than 5 years 5 years and over but less than 15 years 15 years and over but less than 25 years 25 years and over
(1) (2) (3) (4) (5)
More than 10% but not more than 25% 15% 30% 45% 60%
More than 25% but not more than 50% 40% 50% 60% 70%
More than 50% but not more than 75% 65% 70% 75% 80%
More than 75% 85% 85% 85% 85%

    (3) Where, before attaining age 60, a person to whom regulation 3(1) applies ceases to be employed as such a person other than by reason of the injury or disease and no allowance or lump sum, other than an allowance under paragraph (5), has been paid under these Regulations in consequence of the injury or disease, he may be paid, from the date on which he attains age 60, or such earlier date as the Secretary of State may in any particular case allow, an annual allowance of the amount, if any, which when added to the value, expressed as an annual amount, of any of the pensions and benefits specified in paragraph (6) will provide an income of the percentage of his average remuneration shown in whichever column of the table in paragraph (2) is appropriate to his service in relation to the degree by which his earning ability is reduced by reason of the injury or disease at that date.

    (4) Where a person to whom regulation 3(1) applies suffers a reduction in the emoluments of an employment mentioned in that regulation by reason of the injury or disease, there shall be payable, from the date of that reduction, an annual allowance-

    (a) of the amount, if any, which when added to the value, expressed as an annual amount, of any of the pensions and benefits specified in paragraph (6), will provide an income of the percentage of his average remuneration shown in whichever column of the table in paragraph (2) is appropriate to his service in relation to the degree by which his earning ability is reduced at the date that his emoluments were reduced; or

    (b) of the amount, if any, which, when added to the value, expressed as an annual amount, of any pension specified in paragraph (6)(a), will provide an income at the annual rate at which a pension would have been payable to the person under his relevant pension scheme if, on the day before such reduction, he had ceased to be employed and was incapable of discharging efficiently the duties of his employment by reason of permanent ill-health or infirmity of mind or body;

whichever is the greater:

    Provided that regulation 13(4) shall apply to that allowance as if the person had ceased to be employed on the day before his emoluments were reduced and had been re-employed on the following day with the reduced emoluments.

    (5) Where a person to whom regulation 3(1) applies is on leave of absence from an employment mentioned in that regulation with reduced emoluments by reason of the injury or disease, there shall be payable during the period of such leave an annual allowance of the amount, if any, which when added to the aggregate of-

    (a) the emoluments payable to the person during his leave of absence, and

    (b) the value, expressed as an annual amount, of any of the pensions and benefits specified in paragraph (6),

will provide an income of 85 per cent of his average remuneration.

    (6) The pensions and benefits specified in this paragraph are-

    (a) any pension payable to the person under a relevant pension scheme, disregarding any reduction in the amount of that pension under regulation T5 (offset for crime, negligence or fraud) or T6 (loss of rights to benefits) of the superannuation scheme regulations and disregarding any increase in the amount of that pension, under the Pensions (Increase) Act 1971[18], after the date at which the average remuneration used in the calculation of the allowance was calculated;

    (b) any of the following benefits, at the rates in operation at the date on which the employment ceased or the emoluments were reduced, as the case may be, which are payable to the person-

      (i) disablement pension or gratuity payable under section 103 of the Social Security Contributions and Benefits Act 1992[19] or so much of any such pension or gratuity as relates to the injury or disease (hereinafter referred to as "the relevant part"), together with-

        (a) any increase in such pension payable by way of unemployability supplement under paragraph 2 of Part I of Schedule 7 to that Act (or so much of any such increase as is proportionate to the relevant part of the said pension) but excluding any increase in that supplement under paragraph 3 of Part I of Schedule 7 to that Act; and

        (b) any increase in such pension payable under paragraph 4[20] or 6 of Part I of Schedule 7 to that Act in respect of a dependant or so much of any such increase as is proportionate to the relevant part of the said pension;

      but excluding any increase under sections 104 (increase where constant attendance is needed) or 105 (increase for exceptionally severe disablement) of that Act;

      (ii) incapacity benefit payable under section 30A of the Social Security Contributions and Benefits Act 1992[21] in respect of the injury or disease together with any increase in such benefit payable under section 80 (dependent children), 86A (increase for adult dependants) or 87 (rate of increase where associated retirement pension is attributable to reduced contributions) of that Act[22];

      (iii) severe disablement allowance payable under section 68 of the Social Security Contributions and Benefits Act 1992[23] in respect of the injury or disease together with any increase in such allowance payable under section 90 (dependants) of that Act;

      (iv) reduced earnings allowance payable under paragraph 11 of Part IV of Schedule 7 to the Social Security Contributions and Benefits Act 1992 in respect of the injury or disease;

      (v) where a person ceased to be employed on or after 1st January 1993 any retirement allowance payable under paragraph 13 of Part V of Schedule 7 to the Social Security Contributions and Benefits Act 1992 in respect of the injury or disease.

    (7) Where the relevant pension scheme is the Federated Superannuation System for Universities, the Federated Superannuation Scheme for Nurses and Hospital Officers or any other scheme under which the benefits may be paid otherwise than as an annual pension, and all or part of the contributions to the scheme on behalf of the person have been paid from public funds, the pension payable thereunder shall, for the purposes of paragraph (6)(a), be deemed to include three-quarters of such sum that, in the opinion of the Secretary of State, represents the value, expressed as an annual amount, of the benefits of the policies or accumulated investments held under the scheme on behalf of the person.

    (8) Where a practitioner has received payments under regulation 72 of the 1961 Regulations or under regulation 78 of the 1980 Regulations, there shall, for the purposes of paragraph (6)(a), be deemed to be payable to him a pension of such amount, if any, as the Secretary of State thinks fit, but not exceeding the amount of the pension to which the practitioner would, if he had not been entitled to such payments, have become entitled under those regulations, in respect of the period or periods for which such payments were made to him, if he had attained age 60 and had served the minimum period of qualifying service.

    (9) A person mentioned in paragraph (2) or (3), or a person mentioned in paragraph (4) who subsequently ceases to be employed as such a person by reason of the injury or disease, shall be entitled to receive a lump sum of the proportion of average remuneration shown in column (2) of the table hereunder in relation to the degree by which his earning ability is reduced.


TABLE

Degree of reduction of earning ability Proportion of average remuneration
(1) (2)
More than 10% but not more than 25% One-eighth
More than 25% but not more than 50% One-quarter
More than 50% but not more than 75% Three-eighths
More than 75% One-half

Meaning of service
     5. A person's service shall comprise all of the periods which at the date on which he ceased to hold an employment or appointment mentioned in regulation 3(1), or on which the emoluments of such employment or appointment were reduced, as the case may be, fell within any of the following descriptions, but no period shall be taken into account under more than one description-

    (a) any period during which he held such employment or appointment;

    (b) any period of employment that would be taken into account for any purpose of a relevant pension scheme; and

    (c) any other period that the Secretary of State may approve in any particular case.



PART III

BENEFITS ON DEATH OF INJURED PERSON

Grounds of entitlement
    
6. If a person to whom these Regulations apply dies as a result of, or his death was, in the opinion of the Secretary of State, substantially hastened by, the injury or disease, the Secretary of State shall pay in respect of that person (hereinafter referred to as "the deceased") the benefits provided in this part of these Regulations, except that such benefits shall not be payable in respect of an injury or disease wholly or mainly due to, or seriously aggravated by, the culpable negligence or misconduct of the deceased.

Widow's or widower's allowance
    
7.  - (1) Subject to the provisions of this regulation and to regulation 10, there shall be payable to the widow or widower of a person mentioned in regulation 6 an annual allowance of the amount, if any, which when added to the amount of any pension payable under a relevant pension scheme in respect of the deceased, to or for the benefit of the widow or widower, will provide an income of 45 per cent of the deceased's average remuneration.

    (2) Subject to paragraph (3), for the first 6 months immediately following the death of a person who at the date of his or her death was entitled to an allowance under these Regulations there shall be payable to the widow or widower an annual allowance of the amount, if any, which when added to the amount of any pension under a relevant pension scheme in respect of the deceased will provide an income of the percentage of average remuneration by reference to which the deceased's annual allowance was calculated:

    Provided that this paragraph shall not apply where the aggregate of annual allowances otherwise payable under paragraph (1) and regulations 8(1) and 9(1) would exceed an allowance payable under this paragraph.

    (3) A widow or widower shall not be entitled to receive an allowance-

    (a) if the marriage took place after the deceased last ceased to be employed as a person to whom these Regulations apply or after the date on which his or her earning ability was reduced as a result of the injury or disease, whichever is the later;

    (b) if at the date of the deceased's death such widow or widower and a man or, as the case may be, a woman to whom she or he is not married are living together as husband and wife; or

    (c) in respect of any period after such widow or widower remarries or during which she or he lives together with another person as if she or he was married to that other person, so, however, that where such marriage has terminated, the Secretary of State may restore an allowance to a widow or widower if he is satisfied that such widow or widower is suffering hardship.

    (4) Where the deceased died before 6th April 1988, a widower shall not be entitled to receive an allowance unless, at the date of the deceased's death, he was incapable by reason of permanent ill-health or infirmity of mind or body of earning his own living and was wholly or mainly dependent upon the deceased.

Child's allowance
    
8.  - (1) Subject to the provisions of this regulation and to regulation 10, on the death of a person mentioned in regulation 6 or, where an allowance is payable under regulation 7(2), on the termination of payment of that allowance, there shall be payable to any dependent child or children an annual allowance of the amount, if any, which when added to the annual amount of any pension payable under a relevant pension scheme in respect of the deceased to, or for the benefit of, such child or children will provide an income of 10 per cent of the deceased's average remuneration multiplied by the number of children not exceeding four, or of twice that sum where there is no surviving parent:

    (2) Subject to the provisions of this regulations, "dependent child" means any child who is-

and who satisfies the requirements of paragraph (3).

    (3) The requirements of this paragraph are satisfied by any child described in paragraph (2) who was-

    (4) A child is a dependent child for so long as he is-

    (5) A child who is aged 17 or over and who has ceased to be a dependent child will be treated as a dependent child if he returns to full-time education, or to full-time training for a trade, profession or vocation for which he is not receiving remuneration in excess of the allowable maximum, before reaching age 21 and within 12 months after ceasing to be a dependent child.

    (6) In this regulation, the "allowable maximum" means the amount to which a pension under the pension scheme regulations of £1,702 a year beginning on 11th April 1994 would have been increased under Part I of the Pensions (Increase) Act 1971[25] at the date in question (calculated as if the words "for a period of not less than two years" in section 3(3)(d) of that Act were omitted), plus the yearly amount of any expenses necessarily incurred for the purposes of the education or training.

    (7) An allowance payable under this regulation shall be paid to the child, or, in such proportion as the Secretary of State thinks fit, to the children, entitled thereto:

    Provided that the Secretary of State may, if he thinks fit, pay the allowance to such other person or persons as he may specify and such person or persons shall apply such allowance, in accordance with any directions given by the Secretary of State, for the benefit of the child or children entitled thereto.

    (8) Where a child is a dependent child by virtue of regulation 8(4)(d), the child allowance shall cease to be payable after 12 months if the child has not then returned to full-time education, or full-time training for a trade, profession or vocation, but will be reinstated if the child later returns to some such education or training and the Secretary of State is satisfied that the child intended to do so from the start of the break.


Notes:

[1] 1972 c.11; section 10(1)(a) was amended by the National Health Service (Scotland) Act 1972 (c.58), Part II of Schedule 7, and sections 10(2A), (3A) and (6) and 12(4A) were inserted, and sections 10(1), 12(2) and (4) amended, by the Pensions (Miscellaneous Provisions) Act 1990 (c.7), sections 4(2), 8(5) and 10.back

[2] See section 10(1) of the Superannuation Act 1972 and article 2 of the Transfer of Functions (Minister for the Civil Service and Treasury) Order 1981 (S.I. 1981/1670).back

[3] 1997 c.46.back

[4] S.I. 1961/1398, which was revoked by the National Health Service (Superannuation) (Scotland) Regulations 1980 (S.I. 1980/1177).back

[5] S.I. 1980/1177, which was revoked by the National Health Service Superannuation Scheme (Scotland) Regulations 1995 (S.I. 1995/365).back

[6] S.I. 1995/365, amended by S.I. 1997/1434 and 1916.back

[7] S.I. 1974/1838, amended by S.I. 1986/587 and S.I. 1992/3046.back

[8] 1978 c.29.back

[9] Section 2 was amended by the National Health Service and Community Care Act 1990 (c.19) ("the 1990 Act"), section 28 and Schedules 9 and 10.back

[10] Section 10 was amended by the Health Services Act 1980 (c.53), Schedule 6, paragraph 2 and by the 1990 Act, Schedule 10.back

[11] Section 12A was inserted by the 1990 Act, section 31.back

[12] section 102 was substituted by the State Hospitals (Scotland) Act 1994 (c.16), section 1.back

[13] 1984 c.36.back

[14] 1993 c.48.back

[15] 1992 c.4.back

[16] 1974 c.9.back

[17] 1978 c.29.back

[18] 1971 c.56.back

[19] 1992 c.4.back

[20] Paragraph 4 was amended by S.I. 1996/671 and 1997/577.back

[21] 1992 c.4; section 30A was inserted by section 1 of the Social Security (Incapacity for Work) Act 1994 (c.18) ("the 1994 Act").back

[22] Section 86A was inserted by section 2 of the 1994 Act; and section 87 was amended by the 1994 Act, Schedule 1, paragraph 24 and Schedule 2.back

[23] Section 68 was amended by the 1994 Act, section 9 and Schedules 1 and 2 and by S.I. 1994/2556.back

[24] 1992 c.4; section 124 was amended by the Jobseekers Act 1995 (c.18), Schedule 2, paragraph 30 and Schedule 3.back

[25] 1971 c.56.back



 
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