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£3,771 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£7,801 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£7,801 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£3,771 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

43,645

77,944

91,448

94,049

96,645

98,723

100,802

102,881

104,957

107,038

38

42,397

74,820

88,694

91,869

94,563

96,645

98,723

100,802

102,881

104,957

39

41,150

71,703

85,941

89,683

92,491

94,292

96,645

98,723

100,802

102,881

40

39,907

68,582

83,187

87,498

90,404

92,487

94,563

96,645

98,723

100,804

41

38,658

65,470

80,438

85,310

88,334

90,404

92,487

94,563

96,645

98,723

42

37,403

62,356

77,678

83,141

86,255

88,334

90,404

92,487

94,563

96,645

43

35,542

58,711

74,926

81,474

84,802

87,296

89,371

91,448

93,528

95,609

44

33,666

55,076

72,167

79,814

83,345

86,255

88,334

90,404

92,487

94,563

45

31,800

51,440

69,416

78,148

81,892

85,210

87,296

89,371

91,448

93,528

46

29,930

47,807

66,666

76,488

80,438

84,179

86,255

88,334

90,404

92,487

47

28,061

44,166

63,908

74,820

78,982

83,141

85,210

87,296

89,371

91,448

48

26,448

42,711

61,732

71,499

76,488

80,223

82,307

84,385

86,457

88,544

49

24,837

41,257

59,548

68,172

73,995

77,314

79,394

81,474

83,554

85,635

50

23,226

39,802

57,406

64,848

71,499

74,404

76,488

78,563

80,638

82,720

51

21,616

38,347

55,180

61,519

69,000

71,499

73,595

75,650

77,734

79,814

52

20,004

36,890

52,999

58,194

66,504

68,582

70,671

72,745

74,820

76,896

53

18,496

34,298

49,671

55,286

64,013

66,504

68,582

70,671

72,745

74,820

54

16,990

31,698

46,345

52,383

61,519

64,434

66,504

68,582

70,671

72,745

55

15,488

29,101

43,027

49,465

59,024

62,356

64,434

66,504

68,582

70,671

56

13,976

26,499

39,698

46,557

56,533

60,272

62,356

64,434

66,504

68,582

57

12,472

23,899

36,374

43,645

54,048

58,196

60,272

62,356

64,434

66,504

58

11,481

21,721

32,480

39,172

48,633

52,481

54,714

56,900

59,025

61,103

59

10,495

19,536

28,576

34,711

43,229

46,762

49,152

51,440

53,622

55,696

60

9,513

17,352

24,681

30,240

37,830

41,049

43,589

45,987

48,222

50,300

61

8,520

15,170

20,788

25,772

32,422

35,333

38,032

40,531

42,816

44,894

62

7,533

12,990

16,887

21,301

27,020

29,617

32,480

35,077

37,403

39,491

63

7,016

11,742

15,170

19,046

24,035

26,599

29,304

31,800

34,084

36,165

64

6,507

10,495

13,458

16,781

21,041

23,591

26,139

28,527

30,756

32,835

65

5,977

9,251

11,742

14,527

18,060

20,575

22,967

25,255

27,437

29,515

66

5,459

8,004

10,028

12,262

15,070

17,561

19,797

21,976

24,110

26,188

67

4,939

6,755

8,310

10,003

12,082

14,553

16,631

18,704

20,788

22,863

68

4,803

6,541

8,027

9,591

11,668

13,976

15,978

18,135

20,132

22,186

69

4,678

6,340

7,746

9,171

11,253

13,407

15,333

17,561

19,489

21,506

70

4,546

6,136

7,456

8,756

10,836

12,829

14,682

16,990

18,834

20,838

71

4,418

5,921

7,171

8,337

10,417

12,262

14,033

16,420

18,190

20,162

72

4,288

5,715

6,885

7,925

10,003

11,694

13,377

15,847

17,533

19,489

73

4,178

5,614

6,782

7,769

9,844

11,433

13,121

15,435

17,019

18,914

74

4,079

5,507

6,676

7,615

9,694

11,170

12,862

15,020

16,497

18,328

75

3,978

5,409

6,575

7,456

9,532

10,912

12,600

14,601

15,978

17,767

76

3,871

5,297

6,468

7,300

9,376

10,655

12,343

14,186

15,453

17,203

77 or over

3,771

5,195

6,368

7,142

9,222

10,391

12,082

13,776

14,939

16,631

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

27,644

47,134

52,847

54,408

55,704

38

27,021

45,365

51,286

52,847

54,507

39

26,400

43,598

49,728

51,285

53,312

40

25,771

41,827

48,168

49,728

52,117

41

25,148

40,063

46,610

48,168

50,922

42

24,530

38,303

45,049

46,610

49,728

43

23,405

36,015

43,646

45,205

48,584

44

22,291

33,720

42,240

43,804

47,430

45

21,174

31,437

40,838

42,400

46,294

46

20,056

29,148

39,316

40,997

45,152

47

18,939

26,863

38,040

39,599

44,011

48

18,085

26,238

37,000

38,506

42,609

49

17,221

25,613

35,958

37,414

41,202

50

16,367

24,989

34,922

36,316

39,801

51

15,512

24,367

33,882

35,232

38,403

52

14,654

23,747

32,842

34,140

37,000

53

14,261

22,291

30,870

32,631

35,851

54

13,873

20,834

28,890

31,125

34,712

55

13,485

19,379

26,916

29,620

33,569

56

13,096

17,925

24,940

28,115

32,418

57

12,472

16,474

22,967

26,606

31,278

58

11,481

15,429

20,711

23,959

28,115

59

10,495

14,389

18,451

21,303

24,940

60

9,513

13,358

16,185

18,654

21,774

61

8,520

12,314

13,928

16,005

18,604

62

7,533

11,280

11,664

13,358

15,429

63

7,016

11,199

11,513

12,856

14,524

64

6,507

10,495

11,350

12,366

13,625

65

5,977

9,251

11,199

11,871

12,703

66

5,459

8,004

10,028

11,380

11,796

67 or over

3,771

5,195

6,368

7,142

9,222

Part B

F16Age of disabled person on their last birthday before their death

Payment £

37 or under

55,704

38

54,507

39

53,312

40

52,117

41

50,922

42

49,728

43

48,584

44

47,430

45

46,294

46

45,152

47

44,011

48

42,609

49

41,202

50

39,801

51

38,403

52

37,000

53

35,851

54

34,712

55

33,569

56

32,418

57

31,278

58

28,115

59

24,940

60

21,774

61

18,604

62

15,429

63

14,524

64

13,625

65

12,703

66

11,796

67 or over

9,222

(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.