1988 No. 668

SOCIAL SECURITY

The Pneumoconiosis etc. (Workers' Compensation) (Payment of Claims) Regulations 1988

Made

Coming into force

The Secretary of State in exercise of the powers conferred on him by sections 1 and 7 of the Pneumoconiosis etc. (Workers' Compensation) Act 19791 and of all other powers enabling him in that behalf hereby makes the following Regulations, of which a draft has been approved by resolution of each House of Parliament:—

Citation, commencement, revocation and transitional provision1

1

These Regulations may be cited as the Pneumoconiosis etc. (Workers' Compensation) (Payment of Claims) Regulations 1988 and shall come into force on 11th April 1988 in relation to any case in which a person first satisfies the conditions of entitlement to a payment under the Act on or after that date.

2

Subject to paragraph (3), the Pneumoconiosis etc. (Workers' Compensation) (Payment of Claims) Regulations 19852 are revoked.

3

Notwithstanding the revocation in paragraph (2), those Regulations shall continue to have effect as provided in those Regulations in any case in which a person first satisfies the conditions of entitlement to a payment under the Act before 11th April 1988.

Interpretation2

1

In these Regulations unless the context otherwise requires:—

a

the Act” means the Pneumoconiosis etc. (Workers' Compensation) Act 1979;

b

“the appropriate percentage” means, in the case of any disease, the percentage specified in section 57(1) of the Social Security Act 19753 or, if Regulations have been made under section 77 of that Act specifying a different percentage in relation to that disease, the percentage specified in the Regulations;

c

“the appropriate period” means, in the case of any disease, the period specified in section 57(4) of the 1975 Act or, if Regulations have been made under section 77 of that Act specifying a different period in relation to that disease, the period specified in the Regulations;

d

“claim” means a claim made in accordance with the Pneumoconiosis etc. (Workers' Compensation) (Determination of Claims) Regulations 19854;

e

“determination” as respects a Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be), a Silicosis Medical Board or a Medical Appeal Tribunal means a determination in connection with a claim for disablement benefit;

f

“disease” means a disease to which the Act applies, namely pneumoconiosis, byssinosis, diffuse mesothelioma, primary carcinoma of the lung and bilateral diffuse pleural thickening;

F5g

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h

“percentage assessment” means percentage disability assessed in respect of a disease by a Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be), or Medical Appeal Tribunal, as the case may be, for the purpose of determining entitlement to disablement benefit under section 76 of the Social Security Act 1975 or under any corresponding provision of the former Industrial Injuries Acts7;

i

“primary carcinoma of the lung” means primary carcinoma of the lung where there is accompanying evidence of one or both of the following:—

i

asbestosis

ii

bilateral diffuse pleural thickening;

j

“Secretary of State” means the Secretary of State for Employment.

2

Any reference in these Regulations to a numbered regulation shall be construed as a reference to the regulation bearing that number in these Regulations and any reference to the Schedule shall be construed as a reference to the Schedule to these Regulations.

Payments to persons disabled by a disease3

1

The amount of any payment made to any person disabled by a disease who has made a claim for, and in respect of whom there is entitlement to a payment under the Act, shall be determined in accordance with Table 1 of the Schedule.

2

For the purpose of a determination as respects F6... Table 1 of the Schedule the age of the person concerned and the percentage assessment shall be related to the first determination that he was suffering from the disease in the following manner—

a

in any case where the said determination was a determination of a Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be), the age of the person concerned shall be the age of that person at his last birthday preceding the first day of the month in which that determination was made, and the percentage assessment shall be that which is applicable either at the time or retrospectively for the period immediately following the date of the determination by that Board;

b

in any case where the said determination was a determination of a Medical Appeal Tribunal, the age of that person shall be his age at his last birthday preceding the first day of the month in which his case was last considered by a Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be), (being at a time prior to the aforesaid determination of a Medical Appeal Tribunal) and the percentage assessment shall be that which is applicable for the period immediately following the date of that last consideration by a Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be).

F73

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4

In any case where, at the time of the first determination of a Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be), or a Medical Appeal Tribunal that the disabled person was suffering from the disease, the aforesaid Board or Tribunal, as the case may be, diagnosed that pneumoconiosis was accompanied by tuberculosis, the provisions of this regulation shall apply subject to the provisions of regulation 6.

F45

Where—

a

a payment is made to a person under section 46 of the Child Maintenance and Other Payments Act 2008 (the mesothelioma payment) in respect of diffuse mesothelioma,

b

subsequently it is determined that the same person is entitled to a payment under section 1(1) of the Act in respect of the same diffuse mesothelioma,

the amount payable under paragraph (1) shall be reduced by the amount of the mesothelioma payment.

Payments to dependants of persons disabled by a disease4

1

The amount of any payment made to a dependant of a person to whom disablement benefit in respect of a disease was payable immediately before he died, or would have been payable but for his disablement amounting to less than the appropriate percentage, being the dependant entitled to a payment under the Act, shall be determined by ascertaining the amount which would have been payable to the deceased in accordance with regulation 3 had he still been alive and had duly made a claim for payment under the Act, deducting from that amount the sum which would have been payable to the deceased if his age at his last birthday preceding his death were substituted for the age used in ascertaining the said amount in accordance with the said regulation 3.

2

Where the Secretary of State is satisfied that the deceased died as a result of the disease, there shall be added to the amount calculated in accordance with paragraph (1) of this regulation a further amount determined in accordance with Table 2 of the Schedule and the age of the deceased for this purpose shall be his age at his last birthday preceding his death. In the case of a disease other than diffuse mesothelioma, the percentage disablement F8... shall be the same as that used in determining the amount payable under the provisions of regulation 3.

3

For the purpose of determining whether a payment should be made under the provisions of paragraph (2) of this regulation, it shall be sufficient evidence that the deceased died as a result of the disease if death benefit is payable or was paid as a lump sum by reason of the deceased’s death as a result of the disease.

4

It shall not be open to the Secretary of State to be satisfied that the deceased died as a result of the disease if there is clear evidence that a claim for death benefit has been disallowed on the ground that the deceased did not die as a result of the disease.

5

Where no claim for death benefit has been made, it shall not be open to the Secretary of State to be satisfied that the deceased died as a result of the disease if there is clear evidence available that in the opinion of two doctors of the pneumoconiosis medical panel or Medical Boarding Centre (Respiratory Diseases), as the case may be, the deceased did not die as a result of the disease.

6

a

A dependant of a person to whom disablement benefit in respect of a disease was not payable immediately before he died, being the dependant entitled to a payment under the Act, shall be paid an amount determined in accordance with Table 2 of the Schedule F1in cases where:—

i

death benefit is payable to or in respect of the said dependant F2by reason of the deceased’s death as a result of the disease, or

ii

disablement benefit would have been payable to the deceased immediately before he died but for his not having claimed benefit, or but for his having died before he had suffered from the disease for the appropriate period.

b

The relevant percentage assessment F9for the purposes of Part A of Table 2 shall be that determined by a Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be), or a Silicosis Medical Board in respect of the period immediately prior to the deceased’s death or if no such determination was made the said relevant percentage assessment F10... shall be taken as 10 per cent. F11... and the age of the deceased, for this purpose, shall be taken as his age at his last birthday preceding his death.

7

As respects any claim made by the dependant of a deceased person where that person has died as a result of diffuse mesothelioma, the provisions of this regulation shall apply subject to the provisions of regulation 5.

Payment where death results from diffuse mesothelioma5

1

In any case where the Secretary of State is satisfied, as respects a claim by a dependant of a deceased person who died on or after 22nd August 1966 (the said dependant being the dependant who is entitled to a payment under the Act), that the said deceased person died as a result of diffuse mesothelioma the amount of the payment to that dependant shall be:—

a

the amount payable in accordance with regulation 4 in respect of diffuse mesothelioma if—

i

disablement benefit was payable to the deceased immediately before he died solely in respect of diffuse mesothelioma, or

F3ii

where disablement benefit in respect of a disease was not payable to the deceased immediately before he died death benefit is payable to or in respect of the said dependant by reason of the deceased’s death as a result of the disease, or

iii

disablement benefit would have been payable to the deceased immediately before he died but for his not having claimed the benefit or but for his having died before he had suffered from the disease for the appropriate period;

b

if disablement benefit was payable to the deceased immediately before he died solely in respect of pneumoconiosis, either—

i

the total amount payable in accordance with regulation 4 in a case where the deceased’s death resulted from pneumoconiosis or, if greater—

ii

the amount payable in accordance with regulation 4(6) in respect of the deceased’s death as a result of diffuse mesothelioma;

c

if disablement benefit was payable to the deceased immediately before he died in respect of both pneumoconiosis and diffuse mesothelioma or would have been payable to him but for the circumstances specified in (a)(iii) above, either the amount payable in accordance with paragraph (a) of this regulation or that payable in accordance with paragraph (b)(i), whichever amount is the greater.

Provided that in any case the amount payable to a dependant under this regulation shall be at least F15£3,051 more than the amount which would have been payable to him if he had been entitled to a payment calculated in accordance with regulation 4(6).

2

In the case of any amount payable in accordance with this regulation to the dependant of a deceased person the Secretary of State shall deduct from any such amount a sum equal to any payment made under the provisions of the Act to the said deceased person prior to death, save that any amount so payable after any such deduction shall not, in any event, be less than the minimum payment prescribed in regulation 8.

Payment where pneumoconiosis is accompanied by tuberculosis6

1

In any case where, at the time of the first determination of a Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be), or Medical Appeal Tribunal that the disabled person was suffering from the disease, the aforesaid Board or Tribunal, as the case may be, diagnosed that pneumoconiosis was accompanied by tuberculosis, the amount payable to any such disabled person under the provisions of the Act shall be determined by adding together—

a

the sum of F18£6,375, if the percentage assessment applicable for the period immediately following the date relevant for the purposes of regulation 3(2) was one hundred per cent. or if less than one hundred per cent. that percentage of F18£6,375, in respect of the year beginning on that date (that is to say the date relevant for the purpose of regulation 3(2)), and in respect of each successive year beginning on the anniversary of that date on the first day of which the said disabled person was, or appears to the Secretary of State to have been, suffering from pneumoconiosis accompanied by active tuberculosis, and

b

a lump sum determined in accordance with F12... Table 1 of the Schedule, taking, for this purpose, the age of the disabled person as his age at his last birthday prior to the end of the last year to which paragraph (1)(a) of this regulation applies, and taking also for this purpose the percentage assessment as that applicable for the period immediately following the end of the period during which the said disabled person was suffering from pneumoconiosis accompanied by active tuberculosis.

2

The amount payable to a dependant of any disabled person who, had he been alive, would have been entitled to a payment determined in accordance with paragraph (1) of this regulation, being the dependant entitled to a payment under the Act, shall be determined in accordance with regulation 4, save that the amount which would have been payable to the deceased in accordance with paragraph (1) of this regulation shall be substituted for the amount which would have been payable to him in accordance with regulation 3 with the percentage disablement taken for the purpose of determining the sum to be deducted under regulation 4(1) from the aforesaid amount being the percentage disablement used for the purpose of determining the lump sum under paragraph (1)(b) of this regulation.

3

In any case to which the provisions of this regulation apply and where it appears to the Secretary of State that tuberculosis either remains active at the time a claim is made under the provisions of the Act, or remained active until the time when the disabled person died, the amount of the payment shall be determined as if at the time of its first determination that the disabled person was suffering from the disease the Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be), or Medical Appeal Tribunal, as the case may be, had not diagnosed that pneumoconiosis was accompanied by tuberculosis.

4

No payment made in accordance with this regulation shall exceed the amount which would have been payable if at the time of its first determination that the disabled person was suffering from the disease the Pneumoconiosis Medical Board, (or Special Medical Board, as the case may be), or Medical Appeal Tribunal, as the case may be, had not diagnosed that pneumoconiosis was accompanied by tuberculosis.

Power of Secretary of State to determine amount of payment7

In the case of a claim by any person who appears to the Secretary of State to be entitled to a payment under the Act but in respect of whose claim the Secretary of State is unable to determine affirmatively or accurately, to his satisfaction, the amount which should properly be paid to that person in accordance with these Regulations (whether because the date relevant for the purposes of regulation 3 is unknown or uncertain or for some other reason), payment shall nevertheless be made to that person of whatever amount, in any particular case, appears to the Secretary of State to be just and equitable:

Provided that in the case of any such payment—

a

where the date relevant for the purposes of regulation 3 is unknown or uncertain, the date to be taken as the relevant date shall be the latest date which, on the evidence available, could have been the relevant date;

b

where the relevant percentage disablement is unknown or uncertain this shall be taken as the lowest percentage on the evidence available which could have been the relevant percentage disablement;

F13c

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Minimum amount payable to dependant8

In any case where entitlement to payment under the Act has been established by the dependant of any person who immediately before he died was disabled by a disease and the amount of any payment to the said dependant under the foregoing provisions of these Regulations is less than the sum of F19£3,082 the amount actually payable to that dependant shall, in no such case, be less than that sum.

Signed by order of the Secretary of State.

Patrick NichollsParliamentary Under Secretary of State,Department of Employment

F14SCHEDULE

Regulations 3, 4 and 6

Annotations:
Amendments (Textual)
F14

Sch. substituted (1.4.2015) (with application in accordance with reg. 1(2) of the amending S.I.) by The Pneumoconiosis etc. (Workers Compensation) (Payment of Claims) (Amendment) Regulations 2015 (S.I. 2015/503), regs. 1(1), 2(5)

TABLE 1

1

This table is for the determination of payments to disabled persons under regulation 3 or regulation 6 and for the determination of payments to dependants of deceased sufferers under regulation 4(1).

2

The relevant period is the period specified in regulation 3(2) or, in the case of a disabled person to whom regulation 6 applies, the first period specified in regulation 6(1)(b).

3

1

The age of the disabled person is their age determined in accordance with regulation 3(2) or, in the case of a disabled person to whom regulation 6 applies, regulation 6(1)(b).

2

In determining the amount payable to a dependant of a disabled person under regulation 4(1), the age to be taken for the purpose of calculating the sum to be deducted from the amount which would have been payable to the disabled person had they still been alive, is the age of the deceased on their last birthday before their death.

4

The table prescribes payments to disabled persons to whom disablement benefits are payable under section 108 of the Social Security Contributions and Benefits Act 1992 or under any corresponding provision of the former Industrial Injuries Acts, or would be payable but for the disablement amounting to less than the appropriate percentage.

F16Age of

disabled

person

Percentage assessment for the relevant period

10%

or under

£

11%

-20%

£

21%

-30%

£

31%

-40%

£

41%

-50%

£

51%

-60%

£

61%

-70%

£

71%

-80%

£

81%

-90%

£

91%

-100%

£

37 and under

35,666

63,695

74,732

76,857

78,979

80,677

82,376

84,075

85,772

87,473

38

34,648

61,144

72,481

75,075

77,278

78,979

80,677

82,376

84,075

85,772

39

33,628

58,596

70,231

73,289

75,584

77,055

78,979

80,677

82,376

84,075

40

32,612

56,046

67,981

71,503

73,879

75,582

77,278

78,979

80,677

82,378

41

31,592

53,502

65,733

69,716

72,188

73,879

75,582

77,278

78,979

80,677

42

30,566

50,957

63,480

67,943

70,487

72,188

73,879

75,582

77,278

78,979

43

29,045

47,980

61,230

66,581

69,300

71,339

73,034

74,732

76,432

78,132

44

27,513

45,009

58,976

65,224

68,110

70,487

72,188

73,879

75,582

77,278

45

25,988

42,037

56,727

63,862

66,923

69,634

71,339

73,034

74,732

76,432

46

24,458

39,067

54,479

62,506

65,733

68,791

70,487

72,188

73,879

75,582

47

22,932

36,092

52,226

61,144

64,545

67,943

69,634

71,339

73,034

74,732

48

21,614

34,904

50,447

58,429

62,506

65,558

67,261

68,959

70,652

72,358

49

20,297

33,715

48,662

55,710

60,469

63,182

64,882

66,581

68,281

69,981

50

18,981

32,527

46,912

52,994

58,429

60,804

62,506

64,202

65,898

67,599

51

17,664

31,337

45,092

50,274

56,387

58,429

60,142

61,821

63,524

65,224

52

16,348

30,147

43,311

47,556

54,349

56,046

57,751

59,447

61,144

62,840

53

15,115

28,028

40,591

45,180

52,312

54,349

56,046

57,751

59,447

61,144

54

13,884

25,904

37,874

42,807

50,274

52,655

54,349

56,046

57,751

59,447

55

12,656

23,781

35,162

40,422

48,234

50,957

52,655

54,349

56,046

57,751

56

11,421

21,655

32,441

38,047

46,199

49,254

50,957

52,655

54,349

56,046

57

10,191

19,530

29,725

35,666

44,168

47,557

49,254

50,957

52,655

54,349

58

9,383

17,750

26,543

32,012

39,744

42,888

44,713

46,499

48,235

49,934

59

8,576

15,964

23,353

28,366

35,327

38,214

40,168

42,037

43,820

45,516

60

7,774

14,180

20,169

24,712

30,916

33,546

35,620

37,580

39,407

41,106

61

6,962

12,398

16,987

21,060

26,496

28,874

31,080

33,121

34,989

36,687

62

6,156

10,616

13,801

17,408

22,081

24,203

26,543

28,664

30,566

32,272

63

5,732

9,596

12,398

15,565

19,642

21,737

23,949

25,988

27,853

29,552

64

5,317

8,576

10,997

13,714

17,195

19,279

21,360

23,313

25,134

26,833

65

4,884

7,558

9,596

11,871

14,758

16,815

18,768

20,638

22,422

24,120

66

4,461

6,541

8,194

10,019

12,316

14,350

16,178

17,959

19,703

21,401

67

4,036

5,520

6,791

8,174

9,874

11,893

13,590

15,284

16,987

18,684

68

3,925

5,345

6,560

7,837

9,535

11,421

13,057

14,820

16,451

18,131

69

3,822

5,181

6,330

7,496

9,197

10,956

12,529

14,350

15,926

17,576

70

3,715

5,014

6,092

7,156

8,855

10,485

11,998

13,884

15,391

17,029

71

3,611

4,838

5,860

6,813

8,513

10,019

11,468

13,418

14,864

16,477

72

3,504

4,671

5,626

6,477

8,174

9,557

10,932

12,950

14,328

15,926

73

3,416

4,588

5,543

6,349

8,045

9,343

10,722

12,613

13,908

15,456

74

3,334

4,501

5,456

6,222

7,922

9,127

10,512

12,275

13,482

14,978

75

3,251

4,420

5,373

6,092

7,789

8,917

10,296

11,932

13,057

14,519

76

3,163

4,328

5,285

5,966

7,663

8,708

10,087

11,593

12,628

14,058

77 and over

3,082

4,245

5,204

5,837

7,537

8,491

9,874

11,258

12,209

13,590

TABLE 2

1

This table is for the determination of payments to dependants of deceased sufferers under regulation 4(2) or (6).

2

The relevant period is the period specified in regulation 3(2) or, in the case of a disabled person to whom regulation 6 applies, the first period specified in regulation 6(1)(b).

3

1

Part A of the table prescribes payments to dependants of disabled persons who died as a result of a disease other than diffuse mesothelioma.

2

Part B of the table prescribes payments to dependants of disabled persons who died as a result of diffuse mesothelioma.

4

Part A of the table prescribes payments to—

a

dependants to whom industrial death benefit under section 108 of the Social Security Contributions and Benefits Act 1992 is payable;

b

dependants of a person to whom disablement benefit under that section or under any corresponding provision of the former Industrial Injuries Acts was payable immediately before that person died; and

c

dependants of a person to whom disablement benefit would have been payable immediately before that person died but for the occurrence of one of the circumstances listed in regulation 5(1)(a)(iii), or but for the person’s disablement amounting to less than the appropriate percentage.

F17Part A

Age of disabled person on their last birthday before their death

Percentage assessment for the relevant period

10%

or under £

11%-20%

£

21%-30%

£

31%-49%

£

50% or over £

37 and under

22,591

38,517

43,186

44,463

45,522

38

22,082

37,072

41,911

43,186

44,543

39

21,574

35,628

40,637

41,910

43,566

40

21,059

34,182

39,363

40,637

42,590

41

20,551

32,740

38,089

39,363

41,614

42

20,046

31,301

36,815

38,089

40,637

43

19,126

29,430

35,667

36,942

39,703

44

18,216

27,556

34,518

35,797

38,760

45

17,304

25,689

33,374

34,649

37,832

46

16,389

23,819

32,129

33,502

36,898

47

15,477

21,951

31,086

32,360

35,966

48

14,780

21,442

30,238

31,467

34,819

49

14,074

20,932

29,384

30,575

33,670

50

13,375

20,421

28,538

29,678

32,526

51

12,677

19,914

27,689

28,792

31,383

52

11,976

19,406

26,839

27,899

30,238

53

11,654

18,216

25,227

26,667

29,298

54

11,337

17,026

23,609

25,436

28,367

55

11,020

15,837

21,996

24,206

27,433

56

10,702

14,648

20,382

22,976

26,492

57

10,191

13,463

18,768

21,742

25,561

58

9,383

12,609

16,925

19,580

22,976

59

8,576

11,758

15,078

17,410

20,382

60

7,774

10,916

13,226

15,245

17,794

61

6,962

10,063

11,383

13,080

15,202

62

6,156

9,218

9,531

10,916

12,609

63

5,732

9,152

9,409

10,507

11,869

64

5,317

8,576

9,276

10,106

11,134

65

4,884

7,558

9,152

9,701

10,381

66

4,461

6,541

8,194

9,299

9,640

67 and over

3,082

4,245

5,204

5,837

7,537

F17Part B

Age of disabled person on their last birthday before their death

Payment £

37 and under

45,522

38

44,543

39

43,566

40

42,590

41

41,614

42

40,637

43

39,703

44

38,760

45

37,832

46

36,898

47

35,966

48

34,819

49

33,670

50

32,526

51

31,383

52

30,238

53

29,298

54

28,367

55

27,433

56

26,492

57

25,561

58

22,976

59

20,382

60

17,794

61

15,202

62

12,609

63

11,869

64

11,134

65

10,381

66

9,640

67 and over

7,537

(This note is not part of the Regulations)

These Regulations, which come into force on 11th April 1988, prescribe the amount of payments to be made under the Pneumoconiosis etc. (Workers' Compensation) Act 1979 (“the Act”), as amended by the Social Security Act 1985 and the Social Security Act 1986, to persons disabled by a disease to which the Act applies (namely pneumoconiosis, bysinnosis, diffuse mesothelioma, primary carcinoma of the lung (where accompanied by asbestosis or bilateral diffuse pleural thickening) and bilateral diffuse pleural thickening) or to dependants of persons who immediately before they died were disabled by such a disease. All such persons should satisfy the conditions of entitlement prescribed in section 2 of the Act.

The Regulations re-enact the Pneumoconiosis etc. (Workers' Compensation) (Payment of Claims) Regulations 1985 (“the 1985 Regulations”) which are revoked. In addition to minor and drafting amendments they make the following changes of substance:—

a

The amount of payments laid down by the 1985 Regulations is increased by 8.5% rounded up or down to the nearest £1 as appropriate.

b

Regulations 4 and 5 are amended to take account of the changes made to the conditions of entitlement in section 2 of the 1979 Act by the Social Security Act 1986.

c

Amendments are made consequential on the changes of title of the Pneumoconiosis Medical Board, the Pneumoconiosis Medical Panel and Insurance Officer.