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 F17£3,322 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£6,872, 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£6,872, 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£3,322 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.

F15Age 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 or under

38,449

68,665

80,562

82,853

85,140

86,971

88,802

90,633

92,463

94,296

38

37,350

65,913

78,136

80,932

83,306

85,140

86,971

88,802

90,633

92,463

39

36,251

63,167

75,710

79,007

81,480

83,067

85,140

86,971

88,802

90,633

40

35,156

60,418

73,284

77,081

79,642

81,477

83,306

85,140

86,971

88,804

41

34,056

57,676

70,862

75,154

77,819

79,642

81,477

83,306

85,140

86,971

42

32,951

54,933

68,431

73,243

75,986

77,819

79,642

81,477

83,306

85,140

43

31,311

51,722

66,007

71,775

74,707

76,904

78,732

80,562

82,394

84,227

44

29,659

48,520

63,576

70,312

73,423

75,986

77,819

79,642

81,477

83,306

45

28,015

45,316

61,152

68,845

72,144

75,066

76,904

78,732

80,562

82,394

46

26,367

42,115

58,729

67,382

70,862

74,158

75,986

77,819

79,642

81,477

47

24,721

38,908

56,300

65,913

69,580

73,243

75,066

76,904

78,732

80,562

48

23,300

37,627

54,383

62,987

67,382

70,673

72,509

74,339

76,165

78,003

49

21,881

36,345

52,459

60,056

65,186

68,111

69,943

71,775

73,607

75,440

50

20,461

35,064

50,572

57,128

62,987

65,547

67,382

69,210

71,039

72,873

51

19,043

33,782

48,611

54,196

60,786

62,987

64,834

66,644

68,480

70,312

52

17,623

32,499

46,690

51,267

58,587

60,418

62,258

64,085

65,913

67,742

53

16,294

30,215

43,758

48,704

56,393

58,587

60,418

62,258

64,085

65,913

54

14,967

27,924

40,828

46,147

54,196

56,763

58,587

60,418

62,258

64,085

55

13,644

25,636

37,905

43,576

51,997

54,933

56,763

58,587

60,418

62,258

56

12,312

23,344

34,972

41,015

49,803

53,097

54,933

56,763

58,587

60,418

57

10,987

21,054

32,044

38,449

47,614

51,268

53,097

54,933

56,763

58,587

58

10,114

19,135

28,613

34,509

42,844

46,234

48,201

50,126

51,998

53,829

59

9,245

17,210

25,175

30,579

38,082

41,195

43,301

45,316

47,239

49,066

60

8,380

15,286

21,743

26,640

33,327

36,162

38,400

40,512

42,481

44,312

61

7,505

13,364

18,313

22,704

28,563

31,127

33,504

35,706

37,719

39,550

62

6,636

11,443

14,877

18,765

23,803

26,091

28,613

30,901

32,951

34,790

63

6,180

10,344

13,364

16,779

21,174

23,433

25,816

28,015

30,026

31,859

64

5,732

9,245

11,855

14,784

18,536

20,783

23,027

25,131

27,095

28,926

65

5,266

8,149

10,344

12,797

15,910

18,126

20,233

22,248

24,171

26,001

66

4,809

7,051

8,834

10,802

13,276

15,470

17,440

19,360

21,240

23,071

67

4,351

5,951

7,321

8,812

10,644

12,821

14,651

16,477

18,313

20,142

68

4,231

5,762

7,072

8,449

10,279

12,312

14,076

15,976

17,735

19,545

69

4,121

5,585

6,823

8,080

9,914

11,811

13,507

15,470

17,169

18,946

70

4,005

5,405

6,568

7,714

9,546

11,302

12,934

14,967

16,592

18,357

71

3,892

5,216

6,317

7,344

9,177

10,802

12,363

14,466

16,024

17,761

72

3,778

5,035

6,065

6,982

8,812

10,302

11,785

13,960

15,446

17,169

73

3,681

4,946

5,975

6,844

8,672

10,072

11,559

13,597

14,993

16,662

74

3,594

4,852

5,882

6,708

8,540

9,840

11,331

13,232

14,533

16,146

75

3,504

4,765

5,792

6,568

8,398

9,613

11,100

12,863

14,076

15,652

76

3,410

4,666

5,698

6,431

8,260

9,387

10,874

12,498

13,613

15,155

77 or over

3,322

4,576

5,610

6,292

8,124

9,154

10,644

12,136

13,161

14,651

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.

F16Part 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 or under

24,353

41,523

46,556

47,931

49,073

38

23,804

39,964

45,180

46,556

48,018

39

23,257

38,408

43,808

45,179

46,965

40

22,703

36,848

42,434

43,808

45,913

41

22,154

35,294

41,061

42,434

44,860

42

21,610

33,743

39,686

41,061

43,808

43

20,619

31,727

38,450

39,823

42,800

44

19,637

29,706

37,211

38,590

41,784

45

18,654

27,694

35,977

37,352

40,783

46

17,668

25,678

34,635

36,116

39,777

47

16,685

23,665

33,511

34,885

38,772

48

15,932

23,114

32,596

33,922

37,536

49

15,171

22,564

31,677

32,960

36,297

50

14,419

22,015

30,764

31,993

35,063

51

13,665

21,467

29,849

31,038

33,831

52

12,910

20,920

28,932

30,076

32,596

53

12,564

19,637

27,195

28,747

31,583

54

12,221

18,354

25,451

27,420

30,580

55

11,880

17,072

23,712

26,094

29,573

56

11,537

15,791

21,971

24,768

28,559

57

10,987

14,513

20,233

23,438

27,555

58

10,114

13,593

18,245

21,107

24,768

59

9,245

12,676

16,254

18,767

21,971

60

8,380

11,768

14,258

16,434

19,182

61

7,505

10,848

12,270

14,100

16,389

62

6,636

9,937

10,275

11,768

13,593

63

6,180

9,866

10,143

11,326

12,795

64

5,732

9,245

9,999

10,894

12,003

65

5,266

8,149

9,866

10,458

11,191

66

4,809

7,051

8,834

10,025

10,392

67 or over

3,322

4,576

5,610

6,292

8,124

Part B

F16Age of disabled person on their last birthday before their death

Payment £

37 or under

49,073

38

48,018

39

46,965

40

45,913

41

44,860

42

43,808

43

42,800

44

41,784

45

40,783

46

39,777

47

38,772

48

37,536

49

36,297

50

35,063

51

33,831

52

32,596

53

31,583

54

30,580

55

29,573

56

28,559

57

27,555

58

24,768

59

21,971

60

19,182

61

16,389

62

13,593

63

12,795

64

12,003

65

11,191

66

10,392

67 or over

8,124

(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.