S.I. No. 102/2007 - Social Welfare (Consolidated Occupational Injuries) Regulations 2007

S.I. No. 102 of 2007

ARRANGEMENT OF ARTICLES

PART 1 Preliminary

1.

2.

3.

4.

5.

PART 2 Insurable (Occupational Injuries) Employment

6.

PART 3 Occupational Injuries

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

PART 4 Prescribed Diseases

CHAPTER 1 General

18.

19.

CHAPTER 2 Prescription of Diseases and Presumptions as to their origin

20.

21.

22.

23.

24.

CHAPTER 3 Date of Development and Recrudescence

25.

26.

27.

28.

CHAPTER 4 Application of Regulations

29.

30.

31.

32.

33.

34.

35.

CHAPTER 5 Special Provisions as to Pneumoconiosis, Byssinosis, Occupational Asthma, Vibration-Induced White Finger and Occupational Deafness

36.

37.

38.

39.

PART 5 Claims and Payments

CHAPTER 1 General

40.

CHAPTER 2 General provisions relating to Claims

41.

42.

43.

44.

CHAPTER 3 Occupational Asthma and Occupational Deafness

45.

46.

47.

48.

CHAPTER 4 Notice of Accidents

49.

50.

CHAPTER 5 Payments

51.

52.

53.

54.

55.

CHAPTER 6 Payment to person other than the claimant or beneficiary

56.

57.

58.

59.

60.

61.

62.

CHAPTER 7 Payments on Death

63.

64.

CHAPTER 8 Loss of Purchasing Power

65.

66.

67.

68.

69.

70.

CHAPTER 9 Absence from State or imprisonment

71.

72.

73.

CHAPTER 10 Funeral Grant

74.

CHAPTER 11 Disqualifications

75.

SCHEDULE 1 Weekly rates of Injury Benefit payable to persons under the age of 16 years

SCHEDULE 2 Prescribed degree of disablement

SCHEDULE 3 Scale of Disablement Gratuities and of weekly rates of Pension in lieu of Disablement Gratuities

SCHEDULE 4

PART 1 Description of each Prescribed Disease or injury and nature of employment in respect of which it is prescribed

PART 2 Nature of employment in respect of which Pneumoconiosis is prescribed

SCHEDULE 5

PART 1 Assessment of the extent of Occupational Deafness

PART 2 Formula for calculating Binaural Displacement

SCHEDULE 6 Revocations

S.I. No. 102 of 2007

SOCIAL WELFARE (CONSOLIDATED OCCUPATIONAL INJURIES) REGULATIONS 2007.

Notice of the making of this Statutory Instrument was published in “Iris Oifigiúil” of 13th March, 2007.

The Minister for Social and Family Affairs, in exercise of the powers conferred on him by sections 2 (as amended by section 29 and Schedule 6 of the Social Welfare Law Reform and Pensions Act 2006 (No. 5 of 2006)), 3 (as amended by section 37 and Schedule 7 of the Social Welfare Law Reform and Pensions Act 2006 ), 4 (as amended by section 17 and Schedule 3 of the Social Welfare Law Reform and Pensions Act 2006 ), 71, 72, 74, 75, 77, 79, 84, 85, 86, 87, 88, 89, 91, 92, 93, 241 (as amended by section 17 and Schedule 3 of the Social Welfare Law Reform and Pensions Act 2006 ), 242, 243, 244 (as amended by section 29 and Schedule 6 of the Social Welfare Law Reform and Pensions Act 2006 ), 245, 247 (as amended by section 4 and Schedule 1 of the Social Welfare Law Reform and Pensions Act 2006 ), 249 (as amended by section 4 and Schedule 1 of the Social Welfare Law Reform and Pensions Act 2006 ) and 251 (as amended by section 29 and Schedule 6 of the Social Welfare Law Reform and Pensions Act 2006 ) of the Social Welfare Consolidation Act 2005 (No. 26 of 2005), hereby makes the following Regulations:

PART 1 Preliminary

Citation

Commencement

Definitions

“claim for benefit” includes an application or a declaration that an accident was an occupational accident;

“deceased” means, in relation to death benefit, the person in respect of whose death the benefit is claimed or payable;

“funeral grant” means death benefit payable by way of a grant under section 84 of the Principal Act in respect of funeral expenses;

“gratuity” means a disablement benefit or death benefit payable by way of a gratuity;

“medical care payment” means a payment under section 86 of the Principal Act in respect of the cost of medical care;

“the Principal Act” means the Social Welfare Consolidation Act 2005 (No. 26 of 2005).

Interpretation

• (a) a reference to a Part, Chapter or section is to a Part, Chapter or section of the Principal Act,

• (b) a reference to a Schedule is to a Schedule to these Regulations,

• (c) a reference to an article is to an article of these Regulations,

• (d) a reference to a sub-article is to a sub-article of the article in which the reference occurs,

• (e) a reference to a paragraph is to a paragraph of the sub-article or article in which the reference occurs.

Revocations

PART 2 Insurable (Occupational Injuries) Employment

Insurable (Occupational Injuries) Employment

Employment in the State as a member or a person training to become a member of any fire-brigade, rescue brigade, first-aid party or salvage party at any factory or premises to which any of the provisions of the Factories Act 1955 (No. 10 of 1955), applies, or at any mine or quarry to which any of the provisions of the Mines and Quarries Act 1965 (No. 7 of 1965), applies, in any case in which such organisation is established in pursuance of an obligation imposed under statute or by or with the consent of the owner or occupier of any such factory, premises, mine or quarry.

• (2) For the purposes of section 71 any employment specified in Regulations made under paragraph 4 of Part 2 of Schedule 1 to the Principal Act as being of such a nature that it is ordinarily adopted as subsidiary employment only and not as the principal means of livelihood, other than employment as a member of the Defence Forces involving service in either An Forsa Cosanta Áitiúil or An Slua Muirí for any period not in excess of 21 consecutive days, shall be taken as not being so specified.

(3)The courses prescribed for the purposes of section 71(10) shall be—

• (a) a course provided or approved by An Foras Áiseanna Saothair, Teagasc or the National Tourism Development Authority, and

• (b) courses established under projects approved by the Department of Enterprise, Trade and Employment and co-funded through the European Social Fund.

PART 3 Occupational Injuries

Injury benefit payable to persons under the age of 16 years

• (2) The weekly rate of injury benefit in the case of any such person shall be the amount set out, as appropriate, in column (2) of Schedule 1 and such injury benefit shall not be payable otherwise than to a parent or guardian of such person or to a person appointed by the Minister to receive the benefit on behalf of such person.

• (3) In column (1) of Schedule 1, “relevant employment” means any employment in which the person under the age of 16 years was or would, but for the relevant injury, have been employed during the week in which, as the result of the relevant injury, he or she first became incapable of work.

Assessment of disablement and prescribed degrees of disablement

• (2)
• (a) Subject to paragraph (b), where as a result of the relevant accident the claimant has suffered an injury specified in column (1) of Schedule 2, other then a case to which sub-article (3) applies, the loss of faculty suffered by the claimant as a result of that injury shall be treated for the purposes of section 75 as resulting in the degree of disablement set against such injury in column (2) of Schedule 2.

• (b) Where a person has suffered an injury referred to in paragraph (a) and specified in Schedule 2 which includes any other injury so specified, sub-article (a) shall apply only to the first-mentioned injury.

• (3) Where as a result of the relevant accident the claimant has suffered an injury specified in Schedule 2, but—

• (a) as a result of that injury the claimant may be expected, having regard to his or her physical and mental condition at the date of the assessment in respect of that injury, to be subject to greater disabilities than would normally be incurred as a result of such an injury, or

• (b) the part of the body by which the injury was sustained would not, apart from that injury, have been normal at the date of assessment,

the loss of faculty suffered by the claimant as a result of such injury shall be assessed by reference to the degree of disablement set against such injury in column (2) of Schedule 2 subject to such adjustment as may be reasonable in the circumstances of the case.

• (4) For the purposes of assessing the extent of the disablement resulting from any injury which is not specified in Schedule 2, regard as may be appropriate may be had to the provisions of sub-article (2) or sub-article (3).

Amount of disablement gratuities

• (a) if the period taken into account by that assessment is limited by reference to the claimant’s life or is not less than 7 years, be the amount specified in column (2) of Schedule 3 as appropriate to that degree of disablement,

• (b) in any other case, be an amount which bears the same proportion to the amount so specified as the period taken into account by the assessment bears to a period of 7 years, a fraction of 5 cent being, for this purpose, treated as 5 cent.

Pension in lieu of disablement gratuities

Increase of disablement pension on account of incapacity

Adjustment of benefit for successive accidents where a disablement gratuity is payable

• (a) a person who is entitled, as a result of an accident, to disablement pension (hereafter in this article referred to as an “existing pension”) which is payable in respect of an assessment for a period which is limited by reference to that person’s life, becomes as a result of any other accident subject to a loss of faculty in respect of which disablement gratuity would, but for this article, be payable, and

• (b) the aggregate amount of the assessment in respect of the existing pension and of the assessment in respect of which such disablement gratuity would be payable would, if it were the amount of the assessment of the extent of the disablement resulting from the accident which gave rise to the existing pension, have entitled him or her to receive disablement pension at a higher rate than the rate of such existing pension,

if, at any time before his or her claim for disablement benefit is determined, he or she so elects, that person shall be entitled to disablement pension in lieu of the said disablement gratuity at a rate equal to the difference between the said higher rate and the rate of the existing pension.

• (2) In a case in which a person who is entitled as a result of any accident to disablement pension who would but for the provisions of this sub-article become entitled in respect of any other accident to disablement gratuity—

• (a) if the assessment in respect of which such pension is payable to him or her amounts to not less than 100 per cent, such person shall not be entitled to receive any disablement gratuity in respect of such other accident,

• (b) in any other case, such person shall not be entitled to receive, by way of disablement gratuity in respect of such other accident, an amount exceeding that which would be payable in respect of an assessment equal to the difference between 100 per cent and the percentage of the assessment in respect of which such pension is payable to him or her.

• (3) For the purposes of sub-articles (1) and (2), references to an existing pension within the meaning of sub-article (1) and to any disablement pension in sub-article (2) respectively shall include references to all such pensions which may be payable to the person concerned, and references to the amount of the assessment in respect of which, and the rate at which, any such pension is payable shall include references to the aggregate amount of the assessments in respect of which, or the aggregate of the rates at which, all such pensions are payable.

Adjustment of increase of disablement benefit in respect of successive accidents

• (2) At any time at which the sum total of the several assessments in respect of two or more accidents suffered by any person amounts to less than 100 per cent during the continuance of the periods respectively taken into account thereby, the weekly rate of disablement pension which is payable to him or her may be increased in accordance with section 78 if he or she requires constant attendance as a result of the loss of faculty resulting from any one or more such accidents, whether or not that pension is payable in respect of an assessment of 100 per cent or in respect of that loss of faculty.

• (3) A beneficiary who has suffered two or more accidents shall not be entitled at any time to more than one of each of the following increases of benefit, that is to say—

• (a) by way of incapacity supplement, under section 77,

• (b) in respect of the need of constant attendance, under section 78,

• (c) in respect of a qualified child under section 76(2) or (3),

• (d) in respect of a qualified adult under section 76(1).

Provisions as to incapacity for work

• (2) A person who is not incapable of work shall, if it is so decided under the Principal Act, be deemed to be incapable of work by reason of some specific disease or bodily or mental disablement for any day when—

• (a) he or she is under medical care in respect of such disease or disablement and it is certified by a registered medical practitioner that by reason of such disease or disablement the person should abstain from work and he or she does not work, or

• (b) he or she is a probable source of infection with a disease specified in regulations under the Health Act 1947 (No. 28 of 1947), to be an infectious disease and the person abstains from work in pursuance of a written order or written advice of a registered medical practitioner.

• (3) A person who at the commencement of any day is, or thereafter on that day becomes, incapable of work by reason of some specific disease or bodily or mental disablement and does not work on that day shall be deemed to be so incapable throughout that day.

• (4) Subject to section 74(4), a day shall not be treated for the purposes of occupational injuries benefit as a day of incapacity for work if an insured person—

• (a) fails to prove to the satisfaction of the Minister in respect of that day that he or she is incapable of work, or

• (b) does any work on that day other than work of a nature specified in article 75(6),

• (c) is in respect of that day being paid by his or her employer in respect of holiday leave.

• (5)
• (a) Subject to paragraph (b), a day shall not be treated for the purposes of occupational injuries benefit as a day of incapacity for work if it is a day in respect of which a person has not claimed, or is disqualified for receiving injury benefit.

• (b) A day not treated as a day of incapacity for work, referred to in paragraph (a), shall be disregarded for the purpose of section 75(3).

Night Workers

• (2) Subject to sub-article (3), where a period of employment begun on any day extends over midnight into the following day, the person employed shall, in respect of such period—

• (a) be treated as having been employed on the first day only, if the employment before midnight is of longer duration than that after midnight, and, in that case, the first day shall not be treated as a day of incapacity for work, or

• (b) be treated as having been employed on the second day only, if the employment after midnight is of longer duration than that before midnight, or if the employments before and after midnight are of equal duration, and, in either of these cases, the second day shall not be treated as a day of incapacity for work.

• (3) Where a person—

• (a) suffers an occupational accident during any such period of employment as is referred to in sub-article (2), and

• (b) is thereby immediately rendered incapable of work,

sub-article (2) shall apply, subject to the following qualifications—

• (i) if the period of employment before midnight would, apart from the onset of the incapacity, have been of longer duration than that after midnight, the first of the two days shall be treated as the day of the accident and the person employed shall in respect of such period be treated as employed on that day only, and

• (ii) nothing in sub-article (2) shall be taken as preventing the day of the accident or the day which is to be treated as the day of the accident from being treated as a day of incapacity for work.

• (4) Where a person—

• (a) is by virtue of any of this article to be treated as having been employed on one day only of the two days, and

• (b) throughout that part of the other of those two days during which that person is not employed, is, or is to be treated in accordance with regulations as, incapable of work as a result of an occupational accident,

that person shall be treated as being so incapable of work throughout that other of those two days.

• (5) Where a person—

• (a) is, by virtue of paragraph (b) of sub-article (2), to be treated as having been employed on the second day only of two days, and

• (b) throughout the day immediately preceding the first of those two days, is, or is to be treated in accordance with regulations as, incapable of work as a result of an occupational accident,

that person shall be treated as being so incapable of work throughout the first of those two days.

Accident while travelling to or from work

• (a) in the case of an accident while travelling to work, shall be engaged in travelling to his or her place of employment at the time with a view to carrying out the duties of his or her employment, such journey being an unbroken journey from his or her normal place of residence, or

• (b) in the case of an accident while travelling from work, shall be engaged in travelling directly, after he or she had completed the duties of employment, from his or her place of employment in an unbroken journey to his or her normal place of residence.

Application of the provisions of the Act and Regulations

PART 4 Prescribed Diseases

CHAPTER 1 *General*

Interpretation

• (2) In this Part—

“asbestos textiles” means yarn or cloth composed of asbestos or of asbestos mixed with any other material;

“coal mine” means any mine where one of the objects of the mining operation is the getting of coal (including bituminous coal, cannel coal, anthracite, lignite and brown coal);

“foundry” means those parts of industrial premises where the production of metal articles (other than pig iron or steel ingots) is carried on by casting (not being diecasting or other casting in metal moulds), together with any part of the same premises where any of the following processes are carried on incidentally to such production, namely, the drying and subsequent preparation of sand for moulding (including the reclamation of used moulding sand), the preparation of moulds and cores, knock-out operations and dressing or fettling operations;

“grindstone” means a grindstone composed of natural or manufactured sandstone and includes a metal wheel or cylinder into which blocks of natural or manufactured sandstone are fitted;

“insured person” means a person insured under Chapter 13 of Part 2 of the Principal Act;

“mine” includes every shaft in the course of being sunk, and every level and every inclined plane in the course of being driven, and all shafts, levels, planes, works, tramways and sidings, both below ground and above ground, in and adjacent to and belonging to the mine, but does not include any part of such premises on which any manufacturing process is carried on other than a process ancillary to the getting or dressing of minerals or the preparation of minerals for sale;

“occupational asthma” means the disease numbered D.1 in Part 1 of Schedule 4;

“occupational deafness” means the disease numbered A.11 in Part 1 of Schedule 4;

“pneumoconiosis” means fibrosis of the lungs due to mineral dust including silica dust, asbestos dust and coal dust, and includes the condition of the lungs known as dust reticulation but does not include byssinosis;

“prescribed disease” means a disease or injury prescribed under Chapter 2 of this Part of these Regulations and reference to a prescribed disease being contracted shall be deemed to include reference to a prescribed injury being received;

“silica rock” means quartz, quartzite, ganister, sandstone, gritstone and chert, but not natural sand or rotten rock;

“tuberculosis” in the description of the disease numbered B.8 in Part 1 of Schedule 4 means a disease due to tuberculous infection, but when used elsewhere in these Regulations in connection with pneumoconiosis means tuberculous of the respiratory system only;

“vibration-induced white finger” in the description of the disease A.13 in Part 1 of Schedule 4 means traumatic vasospasm of at least two distal phalanges of three or more digits of one hand, occurring without seasonal intermission;

“non-endemic infectious or parasitic diseases” in the description numbered B.10 in Part 1 of Schedule 4 means infectious or parasitic diseases which are not endemic in the State and include malaria, leprosy, yellow fever, leishmaniasis and toxoplasmosis.

Application of articles 14 and 15 to prescribed diseases

• (2) In considering the application to a prescribed disease case of article 32, sub-article 14(3) shall be disregarded.

• (3) Sub-article 15(3) shall not apply in a prescribed disease case.

CHAPTER 2 *Prescription of Diseases and Presumptions as to their origin*

Description of diseases and injuries

• (a) Subject to paragraphs (b) and (c), each disease or injury set out in column (1) of Part 1 of Schedule 4 is prescribed in relation to all insured persons who have been employed on or after 1 May 1967 in insurable (occupational injuries) employment in any occupation set against such disease or injury in column (2) of Schedule 4,

• (b) Pneumoconiosis is prescribed—

• (i) in relation to all insured persons who have been employed on or after 1 May 1967 in insurable (occupational injuries) employment in any occupation set out in Part 2(A) of Schedule 4; and

• (ii) in relation to all other insured persons who have been employed on or after 1 May 1967 in insurable (occupational injuries) employment in an occupation set out in Part 2(B) of Schedule 4 and who have not worked at any time (whether in insurable (occupational injuries) employment or not) in any occupation in relation to which pneumoconiosis is prescribed by virtue of paragraph (i) of this sub-article, and

• (c) Occupational deafness is prescribed in relation to all insured persons who have been employed—

• (i) in insurable (occupational injuries) employment at any time on or after 1 May 1967, and

• (ii) for a period or periods (whether before, on or after 1 May 1967) amounting in the aggregate to not less than 10 years in any occupation set against the disease in column (2) of paragraph A.11 of Part 1 of Schedule 4.

Occupational deafness

“the better ear” means that ear in which the claimant’s hearing loss due to all causes is the lesser;

“the worse ear” means that ear in which the claimant’s hearing loss due to all causes is the greater.

• (2) Subject to sub-article (3), section 75(4) shall have effect in relation to occupational deafness.

• (3) The extent of disablement in respect of occupational deafness shall, subject to such adjustment as may be reasonable in the circumstances of the case, be assessed at the percentage calculated by applying the formula set out in Part 2 of Schedule 5 to the percentages specified in column (2) of Part 1 of Schedule 5 opposite the appropriate amount of hearing loss in the better ear and the worse ear respectively specified in column (1) of Part 1 of Schedule 5, being the total hearing loss due to all causes, measured in each case by pure tone audiometry over the 1, 2 and 3 kilohertz frequencies.

Individual proof

• (2) A claimant shall, for the purposes of establishing whether a disease prescribed in Part 1 or Part 2 of Schedule 4 has been due to the nature of that person’s (occupational injuries) employment, provide and furnish evidence, including medical reports, documentation and such information as may be required by the Minister.

Sequela or resulting conditions

• (a) is insured under Chapter 13 of Part 2 of the Principal Act against a prescribed disease, and

• (b) is suffering from a condition which in his or her case has resulted from that disease,

section 87 and this Part shall apply to him or her as if he or she were suffering from that disease, whether or not the condition from which he or she is suffering is itself a prescribed disease.

Presumption of origin

• (2)
• (a) Where an insured person in relation to whom either occupational deafness or byssinosis is prescribed has developed the disease, that disease shall, unless the contrary is proved, be presumed to be due to the nature of his or her insurable (occupational injuries) employment.

• (b) Where an insured person in relation to whom either of the following diseases is prescribed has developed the disease, that disease shall, unless the contrary is proved, be presumed to be due to the nature of his or her insurable (occupational injuries) employment where—

• (i) in respect of tuberculosis, the date on which under the provisions of this Part he or she is treated as having developed the disease is not less than 6 weeks after the date on which he or she was first employed in any occupation—

• (I) set against the disease in column (2) of paragraph B.8 of Part 1 of Schedule 4, or

• (II) established under article 22, the nature of which has resulted in the development of tuberculosis,

and not more than 2 years after the date on which he or she was last so employed in insurable (occupational injuries) employment;

• (ii) in respect of pneumoconiosis, he or she has been employed in any occupation—

• (I) set out in Part 2(A) of Schedule 4, or

• (II) established under article 22, the nature of which has resulted in the development of pneumoconiosis,

for a period or periods amounting in the aggregate to not less than 2 years in employment which was either insurable (occupational injuries) employment, or would have been insurable (occupational injuries) employment if it had taken place on or after 1 May 1967.

CHAPTER 3 *Date of Development and Recrudescence*

Development of disease

Date of development

• (b) Where, on the consideration of a claim referred to in paragraph (a), an award of benefit is not made, any date of development determined for the purposes of that claim shall be disregarded for the purposes of any subsequent claim.

• (2) Where a claim for the purposes of which the date of development is to be determined is—

• (a) a claim for injury benefit, the date of development shall be either the first day on or after 1 May 1967 on which the claimant was incapable of work as a result of the disease or, where applicable, the date from which benefit is payable, or

• (b) a claim for disablement benefit, the date of development shall be either the day on or after 1 May 1967 on which the claimant first suffered from the relevant loss of faculty or, where applicable, the date from which benefit is payable, or

• (c) a claim for death benefit, the date of development shall be the date of death.

• (3) In sub-article (2), “the date from which benefit is payable” means, in relation to any claim, the first day of the period in respect of which benefit may be paid on that claim having regard to article 43 or may have been so paid but for section 74(2).

Recrudescence

• (a) where the further attack of the disease commences or the death occurs during an injury benefit period or during a period taken into account by an assessment of disablement relating to such a previous award (either of which period is referred to as a “relevant period”) it shall be treated as a recrudescence of the attack to which the relevant period relates except where, having regard to the particular circumstances relating to the further attack it is found that the disease was contracted or received afresh, in which case it shall be then so treated,

• (b) where the further attack of the disease commences or the death occurs on a date outside a relevant period, it shall be treated as having been contracted or received afresh, and

• (c) for the purposes of this sub-article, the date on which the further attack of the disease commenced shall be the date deemed to be the date of development under the provision of article 26 applied as though no previous claim had been made in respect of the disease.

• (2) Where, in accordance with this article, a disease is treated as having been contracted afresh, the provisions of article 26 shall be applied as though no previous claim had been made in respect of that disease and the date of development shall be determined accordingly.

• (3) Where, in accordance with this article, a disease is treated as a recrudescence during a period taken in to account by a previous assessment of disablement, any assessment of disablement in respect of the recrudescence shall be by way of revision of such previous assessment.

Transitional provision

CHAPTER 4 *Application of Regulations*

Definition

• (a) as having developed on a date other than the date which, under the said provisions, is treated as the date of development for the purposes of the claim under consideration, or

• (b) as a recrudescence of a disease for which compensation has been paid or awarded under the Workmen’s Compensation Acts.

Disease contracted outside the State

Injury benefit

• (2) Save as provided in article 32, the injury benefit period shall begin with the date of the development.

Disablement benefit not preceded by injury benefit

• (a) Section 75(3) (which relates to the period for which disablement benefit is not available) shall not apply and the claim shall be treated as if there had been no injury benefit period,

• (b) Section 75(6) (which relates to the period to be taken into account by an assessment of the extent of the claimant's disablement) shall have effect as if for references therein to the end of the injury benefit period were substituted by references to the date of development.

Assessment of extent of disablement

Exception from requirement as to notice

Provisions as to medical examination

• (2) Article 75(4)(b) (which relates to the giving of notice to the registered medical practitioner in attendance on the person required to submit himself or herself for examination in respect of his or her claim or entitlement to injury benefit or disablement benefit) shall not apply in relation to prescribed diseases.

CHAPTER 5 *Special Provisions as to Pneumoconiosis, Byssinosis, Occupational Asthma, Vibration-Induced White Finger and Occupational Deafness*

Injury benefit not payable

Byssinosis — period of assessment

Pneumoconiosis — effect of tuberculosis

Vibration-induced white finger — special provision

PART 5 Claims and Payments

CHAPTER 1 *General*

Interpretation

“benefit” means occupational injuries benefit under Chapter 13 of Part 2 of the Principal Act;

“claim for benefit” includes an application for a declaration that an accident was an occupational accident;

“deceased” means in relation to death benefit, the person in respect of whose death the benefit is claimed or payable;

“funeral grant” means death benefit payable by way of grant under section 84;

“gratuity” means disablement benefit or death benefit payable by way of a gratuity.

CHAPTER 2 *General Provisions relating to Claims*

Claims

Information to be given when claiming

Prescribed time for claiming

• (a) in the case of injury benefit, the period of 21 days commencing on the first day of incapacity in respect of which the claim is made,

• (b) in the case of disablement benefit, the period of 3 months commencing on the first day on which, apart from satisfying the conditions of making a claim, the conditions for the receipt of that benefit are satisfied,

• (c) in the case of an increase of disablement benefit under sections 77 or 78, on the grounds respectively of being incapable of work or in need of constant attendance, the period of 3 months commencing on the first day on which, apart from satisfying the condition of making a claim, the conditions for the receipt of the relevant increase of benefit are satisfied,

• (d) in the case of death benefit, the period of 3 months commencing on the date of death of the deceased,

• (e) in the case of medical care, 6 weeks from the date of commencement of such care.

Claims made after due date

• (2) Where a claim in respect of benefit is made in respect of any period which is greater than that allowed under section 241(2), the period in respect of which payment may be made before the date on which the claim is made, shall be extended to a period calculated in accordance with this article, where it is shown to the satisfaction of a deciding officer or an appeals officer that the person was entitled to the benefit.

• (3) In any case where the delay in making the claim is due to information given by an officer of the Minister to the person or a person appointed to act on his or her behalf, the period for which payment may be made shall be—

• (a) the period between the date of claim and the date information was given by an officer of the Minister plus a period equal in duration to that allowed under section 241(2), or

• (b) the period between the date of claim and the date entitlement commenced, or

• (c) such part of the period referred to in paragraph (a) for which a person was entitled to the benefit, or

• (d) such part of the period referred to in paragraph (b) for which the person was entitled to the benefit,

whichever is the shorter period.

• (4) Subject to sub-article (5), in any case where the delay in making the claim was due to a person being so incapacitated that he or she was unable to make a claim or appoint a person to act on his or her behalf, the period for which payment may be made shall be—

• (a) the period for which such incapacity continued plus a period equal in duration to that allowed under section 241(2), or

• (b) the period between the date of claim and the date entitlement commenced, or

• (c) such part of the period referred to in paragraph (a) for which the person was entitled to the benefit, or

• (d) such part of the period referred to in paragraph (b) for which the person was entitled to the benefit,

whichever is the shorter period.

• (5) A claim referred to in sub-article (4), shall be made—

• (a) where the person ceases to be incapacitated, before or within a period equal in duration to that for which payment is allowed under section 241(2), or

• (b) where, at the date of claim, a person continues to be so incapacitated that he or she is unable to make a claim or appoint a person to act on his or her behalf, within the period for which such incapacity continued plus a period equal in duration to that allowed under section 241(2).

• (6) Subject to sub-article (7), in any case where the delay in making the claim was due to a person suffering an event which is a force majeure, the period for which payment may be made shall be—

• (a) the period for which such force majeure continued plus a period equal in duration to that allowed under section 241(2), or

• (b) the period between the date of claim and the date entitlement commenced, or

• (c) such part of the period referred to in paragraph (a) for which the person was entitled to the benefit, or

• (d) such part of the period referred to in paragraph (b) for which the person was entitled to the benefit,

whichever is the shorter period.

• (7) A claim referred to in sub-article (6), shall be made—

• (a) when the event which is a force majeure ceases, before or within a period equal in duration to that for which payment is allowed under section 241(2), or

• (b) where, at the date of claim, a person continues to suffer an event which is a force majeure, within the period for which such force majeure continued plus a period equal in duration to that allowed under section 241(2).

• (8) In any case where a person has a current level of financial indebtedness which cannot reasonably be financed from—

• (a) current income, including payments made or due under this article, or

• (b) the disposal of current assets, or

• (c) any combination of said income or disposal of said assets,

payment shall be made from—

• (i) the date of entitlement, or

• (ii) whatever date after the date of entitlement appears appropriate to the deciding officer or appeals officer.

CHAPTER 3 *Occupational Asthma and Occupational Deafness*

Occupational asthma — time limit for claiming benefit

• (a) prescribed in relation to occupational asthma, or

• (b) established under article 22, the nature of which has resulted in the development of occupational asthma.

• (2) Sub-article (1) shall not apply to any claim made by or in respect of an insured person who has at any time been found to be suffering from asthma as a result of an occupational accident and who by virtue of that finding has been awarded disablement benefit either for life or for a period which includes the date from which the claim for disablement pension was made.

• (3) Subject to sub-article (4), occupational injuries death benefit shall not be paid in respect of occupational asthma where the insured person, in respect of whose death the benefit has been claimed, died more than 10 years after the date on which he or she ceased to be employed in any occupation prescribed in relation to occupational asthma.

• (4) Sub-article (3) shall not apply to any claim made in respect of the death of an insured person who had at any time been found to be suffering either from asthma as a result of an occupational accident or from occupational asthma and who by virtue of that finding had been awarded disablement benefit either for life or for a period which included the date of his or her death.

Occupational deafness — time limit for claiming benefit

• (2) Disablement benefit shall not be payable in respect of occupational deafness which is made later than 5 years after the latest date, before the date of the claim, on which the claimant worked in an occupation prescribed in relation to occupational deafness.

Occupational deafness — further claim

• (a) where such further claim is made after the expiration of 3 years from the date of a claim which was disallowed because the claimant was not suffering from occupational deafness, or

• (b) where such further claim is made after the expiration of 3 years from the date the extent of his disablement has been reassessed at less than 20 per cent, or

• (c) where the claimant would otherwise be precluded by article 46(2) from making a further claim after the expiration of 3 years from the date of the disallowed claim or from the date the extent of his or her disablement has been reassessed at less than 20 per cent, as the case may be, and it is the first claim made since that date and is made within 5 years from the latest date before the date of the further claim on which he or she worked in an occupation prescribed in relation to occupational deafness.

Occupational deafness — period to be covered by assessment of disablement

• (2) The period to be taken into account by any subsequent reassessment of the extent of the claimant’s disablement in respect of occupational deafness, if not limited by reference to the claimant’s life, shall be not less than 5 years.

CHAPTER 4 *Notice of Accidents*

Notice of accidents

• (2) Every notice given in accordance with sub-article (1) shall contain the appropriate particulars and shall be given to the person who is the insured person’s employer at the time of the accident or (if there is more than one employer) to one of such employers, or to any foreman or other official under whose supervision the insured person is employed at the time of the accident or to any person designated for the purpose by the employer.

• (3) Any entry of the appropriate particulars of an accident made in a book kept for that purpose in accordance with article 50 shall, if made as soon as practicable after the occurrence of an accident by the insured person or by some person acting on his or her behalf, be sufficient notice of the accident for the purpose of this article.

• (4) In this article and in article 50, “the appropriate particulars” means the following particulars:

• (a) the name, address and occupation of the injured person,

• (b) the date and time of the accident,

• (c) the place where the accident occurred,

• (d) the cause and nature of the injury,

• (e) the name, address and occupation of the person giving the notice, where the notice is given by a person other than the injured person.

• (5) In a case of failure without good cause to give notice in accordance with sub-articles (1) to (4), the decision on any claim for occupational injuries benefit or any amount under section 86 arising out of an accident may be suspended until such time as the notice is given.

• (6) Where an insured person who suffers personal injury by accident in respect of which occupational injuries benefit or any amount under section 86 may be payable, dies as a result of the accident before giving notice thereof in accordance with sub-article (1), the said notice may be given by any other person.

Reporting of accidents by employers

• (2) Every employer who is required to do so by the Minister shall furnish to an officer of the Minister, within such reasonable time as may be required, such information and particulars as may be required of—

• (a) any accident or alleged accident in respect of which occupational injuries benefit or any amount under section 86, may be payable to a person or in respect of the death of a person, employed by him or her at the time of the accident or alleged accident,

• (b) the nature of and other relevant circumstances relating to any occupation prescribed for the purposes of section 87, in which any person to whom or in respect of whose death, benefit under that section or any amount under section 86, may be payable, was or is alleged to have been employed by him or her,

• (c) the remuneration provided by him or her in respect of an employment in relation to which occupational injuries benefit or weekly payments under section 85, may be payable to a person who is or has been employed by him or her, and any other information which may be required for the determination of a claim for occupational injuries benefit or for weekly payments under section 85.

• (3) Every owner or occupier (being an employer) of any mine or quarry to which any of the provisions of the Mines and Quarries Act 1965 (No.7 of 1965) applies or of any premises to which any of the provisions of the Factories Act 1955 (No. 10 of 1955) apply to keep readily accessible a book in a form approved by the Minister in which the appropriate particulars (as defined in article 49) of any accident involving any person employed at such mine, quarry or premises may be entered by such person or some other person acting on his or her behalf.

• (4) Any person who fails to comply with this article shall be guilty of an offence.

CHAPTER 5 *Payments*

Manner of payment

• (2) Subject to sub-article (3), the manner of payment under sub-article (1) shall comprise—

• (a) an order payable at a post office designated by the claimant or where the Minister considers it appropriate, at a post office designated by the Minister,

• (b) a cheque issued by post or otherwise to a claimant or beneficiary at his or her place of residence,

• (c) by electronic fund transfer to an account nominated by the claimant or beneficiary and where the benefit is so paid, the claimant or beneficiary shall be deemed to have received such payment,

• (d) in cash payable at a post office.

• (3) The Minister may arrange for the payment of benefit otherwise than in accordance with sub-article (2) where the circumstances so warrant.

Time of payment

• (a) in the case of injury benefit and a medical care payment on such days and at such intervals as the Minister may determine in any particular class or classes of case,

• (b) in the case of disablement pension, disablement gratuity payable by instalments and death benefit by way of pension, weekly in advance on the Friday of each week.

• (2)
• (a) Where the day from which a payment or a change in the rate of a payment under paragraph (b) of sub-article (1) takes effect is a day of the week other than a Friday such payment or the change in the rate of such payment shall take effect as from and including the next following Friday,

• (b) Where a payment under paragraph (b) of sub-article (1) ceases to be payable as from and including a day of the week other than a Friday, such payment shall continue to be payable in respect of the days of the week up to but not including the next following Friday.

• (3) The Minister may in any particular case or classes of case, arrange for the payment of any benefit other than in advance or otherwise.

Time and manner of payment of gratuities

• (2) A disablement gratuity may be paid by instalments of such amounts and at such times as appear to the Minister to be reasonable in the circumstances of any particular case or classes of case, if—

• (a) the beneficiary is, at the date of the award of the gratuity, under the age of 18 years, or

• (b) the amount of the gratuity awarded exceeds €67 and the beneficiary requests that payments thereof shall be made by instalments.

• (3) A gratuity or any part of a gratuity, shall not, unless the Minister in any case or classes of case otherwise decides, be payable until after the expiration of the time limited for any appeal against the decision on which the award of such benefit is based or, where such an appeal is brought, until after the decision on appeal has been given.

Extinguishment of right to sums payable by way of pension which are not obtained in the prescribed time

• (2) Sub-article (1) shall not apply in respect of any benefit where a deciding officer or an appeals officer is satisfied that entitlement to the payment exists and where—

• (a) the sum payable is not received within the time allowed in sub-article (1) due to the mental or other incapacity of the beneficiary or his or her approved agent, or

• (b) in any other case where the deciding officer or appeals officer is satisfied that there was good cause for the delay in claiming the payment within the time allowed in sub-article (1).

Provision of information

• (a) furnish in such manner and at such times as an officer of the Minister may determine, such certificates, documents and information affecting the right to benefit or medical care payment or to the receipt thereof as the said officer may require, and

• (b) notify the Minister of any change in circumstances which affects the right to benefit or medical care payment, or to the receipt thereof, as soon as is reasonably practicable thereafter.

• (2) Where any sum is receivable on account of an increase of benefit or medical care payment in respect of a qualified adult the beneficiary shall, in such cases or classes of cases as the Minister may direct, furnish a declaration signed by such qualified adult confirming the particulars in respect of him or her furnished by the claimant.

CHAPTER 6 *Payment to persons other than the claimant or beneficiary*

Nominated persons

• (2) Every nomination under sub-article (1)—

• (a) shall be made to the Minister in the form for the time being approved by the Minister, and

• (b) may be revoked by the claimant or beneficiary on giving notice in writing of that fact to the Minister.

• (3) The Minister may, where he or she considers it appropriate, withdraw his or her consent to a nomination under sub-article (1) and in such case the person so nominated shall, on receipt of a notice of such withdrawal, deliver to the Minister the order book issued to him or her, if any.

Payable orders

• (2) A book of orders issued to any person shall remain the property of the Minister.

• (3) Any person having a book of orders or any unpaid orders in respect of benefit or medical care payment shall at the request of an officer of the Minister, deliver such orders to such person as the officer may direct.

• (4) A person who fails to comply with articles 55(1) or 56(3) or sub-article (3) of this article shall be guilty of an offence.

Extinguishment of right to payment

• (2) Sub-article (1) shall not apply in respect of any benefit where a deciding officer or an appeals officer is satisfied that entitlement to the payment exists and where—

• (a) the sum payable is not received within the time allowed in sub-article (1) due to the mental or other incapacity of the beneficiary or his or her approved agent, or

• (b) in any other case where a deciding officer or appeals officer is satisfied that there was good cause for the delay in claiming the payment within the time allowed in sub-article (1).

Persons unable to act

• (a) unable for the time being to act, or

• (b) under the age of 16 years,

the Minister may, subject to such conditions as he or she thinks fit, appoint some other person to exercise, on behalf of the claimant or beneficiary, any right or power which the claimant or beneficiary may be entitled to exercise under the Principal Act and any such person may receive and deal with any sum payable by way of benefit or medical care payment on behalf of the claimant or beneficiary.

• (2) An appointment made under sub-article (1) shall terminate on the day on which the Minister receives notice that a Committee of the estate of the claimant or beneficiary has been appointed.

• (3) Anything required to be done under the Principal Act by a claimant or beneficiary in relation to benefit or medical care payment may be done as respects a claimant or beneficiary who is unable to act by the person appointed under sub-article (1) to act on his or her behalf.

Payment to appointed persons generally

Payment to appointed persons living together with the applicant

• (a) injury benefit, so much of the benefit as is payable by virtue of section 76(2), together with one half of the benefit as is payable by virtue of sections 74(5) and 76(1),

• (b) disablement pension, so much of the pension as is payable in respect of a qualified child or qualified children by virtue of section 76(2), together with one half of the aggregate sum of

• (i) the increase of pension as is payable in respect of a qualified adult by virtue of section 76(1), and

• (ii) the increase of pension as is payable on account of incapacity supplement by virtue of section 77(1).

Provisions relating to appointments