5.10 Injury benefits

5.10.1 The Civil Service Injury Benefit Scheme (CSIBS) applies to most individuals employed in the Civil Service not just members of the CSP arrangements. The CSIBS pays benefits to members who have sustained a qualifying injury as defined in the CSIBS rules and, as a result of the injury, their earnings capacity has been impaired. It is paid to bring their income up to a guaranteed level.

A qualifying injury includes the following:

• injury or death in the course of official duty. This means an injury that is solely attributable to the nature of the employee’s duty or arising from an activity reasonably incidental to it (for injuries sustained on or before 31 March 2003); or wholly or mainly attributable to the nature of the employee’s duty if they sustain an injury on or after 1 April 2003;
• incapacity or death from an attack while off duty but directly attributable to being employed by the government;
• incapacity or death from a disease to which the employee was exposed solely, wholly or mainly by the nature of their duty;
• incapacity or death from a medical condition which is aggravated by service abroad;
• injury or death as a result of a disturbance abroad in an area where the employee was serving (provided they were recruited in the United Kingdom);
• injury or death as the result of a terrorist attack or assault which is not in the course of official duty but is directly attributable to the employee being employed in the Civil Service.

An employee will not qualify for injury benefit if their death or injury is unrelated to their employment or happens while they are:

• travelling to and from work;
• during a main meal break;
• working at home, (unless the work is authorised by the employer and is solely, wholly or mainly attributable to the nature of the employee’s official duty);
• on special leave (whether paid or unpaid);
• deviating from the most direct route on a duty journey or during any breaks in a duty journey;
• at work but not carrying out their duties; for example, sport, any form of entertainment, leisure activities, or giving blood.

An employee will also be excluded from injury benefits if their injury or death is a result of their own negligence or misconduct.

5.10.2 Employees who have suffered a qualifying injury may also benefit from extended sick leave. You can find out more about this in the Civil Service Management Code.

5.10.3 Normally the Scheme Administrator decides if a member has suffered an injury that may qualify them for an injury benefit. The Scheme Administrator may take the advice of the Scheme Medical Advisor but the Scheme Administrator always makes the decision as to whether the member has a qualifying injury.

5.10.4 Employers meet the cost of injury benefits. Injury benefit may be paid when:

• the member is on sick leave due to their injury and they are paid at less than the full rate;
• they are downgraded or work in a different capacity with impaired earnings because of their injury;
• the individual leaves your employment.

You must tell the Scheme Administrator of any of these events within 30 days.

5.10.5 If the individual dies their injury benefits can be paid to their dependents. This includes dependent parents and siblings.

5.10.6 The level of injury benefit paid to the member can be affected if you pay them damages or they are paid compensation. It is important that you tell the Scheme Administrator if the individual asks you for damages and keep them informed of progress.

Please note: To apply for Injury Benefit you and the employee must complete form CSIBS1 and send it to the Scheme Administrator together with all supporting documentation. The supporting documentation required is stated at the bottom of the form and includes:

• relevant accident reports and/or accident book entries;
• a personal statement from the employee describing the reasons for the injury;
• a statement from you accepting or disputing the employee’s statement. This should explain the reasons for disputing any element of the personal statement and also details of any disciplinary/grievance procedure (and outcome);
• any witness statements (obtained by either you or the employee);
• the employee’s job description;
• any sickness absence details. Clearly identify the date the absence relevant to the injury started;
• copies of any Scheme Medical Adviser correspondence relating to the case (or any earlier referral if relevant to the current case);
• a medical in confidence envelope and any additional original medical evidence relating to injury.

If you unsure about any of the information to be provided or have any questions relating to the injury benefits process, please contact the Scheme Administrator to discuss.

5.10.7 The CSCS Personal Injury Compensation arrangement gives benefits comparable to those of a typical travel insurance scheme. The benefits are paid to a person whose duties have taken them far away enough from their normal workplace to justify an overnight stay and then sustain an injury by accident which results in:

• total and permanent loss of sight in one or both eyes; or
• total and permanent loss of use of one or both hands or feet; or
• total and permanent disablement from engaging in paid employment/occupations of any kind; or
• death.

This is regardless of whether the individual was actually planning to stay away from home. Benefits are paid at one of three flat rates. The individual’s employer meets the cost of the benefit.

5.10.7 The CSCS Personal Injury Compensation arrangement gives benefits comparable to those of a typical travel insurance scheme. The benefits are paid to a person whose duties have taken them far away enough from their normal workplace to justify an overnight stay and then sustain an injury by accident which results in:

• total and permanent loss of sight in one or both eyes; or
• total and permanent loss of use of one or both hands or feet; or
• total and permanent disablement from engaging in paid employment/occupations of any kind; or
• death.

This is regardless of whether the individual was actually planning to stay away from home. Benefits are paid at one of three flat rates. The individual’s employer meets the cost of the benefit.