2. 2
Disability Benefit
For whom?
• All disabled people
– New Zealand – No fault accident compensation scheme for all
accidents
• All social insurance contributors
– Netherlands – no work injury scheme, but comparable coverage
by sickness, invalidity and survivors benefits
• Employees who have suffered a work injury or
contracted an occupational disease
• Employees and self-employed who have suffered a work
injury or contracted an occupational disease
• Students and trainees
• Are those who suffer injury due to work accident be
treated better than those injured in any other way or who
are genetically disabled or disabled during childhood
3. 3
What is a work injury?
• Injury caused by accident arising out of and in the course
of employment, but does it cover
– Accident during travel to and from work
• Employer’s transport
• Other transport
• Travel to other than normal place of employment
– Accident during meal break
– Accident caused by worker’s (or other worker’s) prank
– Accident caused while worker drunk
– Accident playing for works sports team or recreation
– Accident while engaged in rescue attempt
– Accident at work while doing something for worker’s own
purpose
– Accident while doing something illegal or when instructed not to
– Accident while attending a meeting
4. 4
Occupational disease
or process
• Occupational diseases
– Statutory list
– To what employments do they relate?
– When is a disease or employment added?
– Degree of impairment, eg occupational deafness
• Process
– Where not a recognised occupational disease
– Where no specific accident
– A succession of continual activities which cause
impairment, eg damage caused by use of keyboard
5. 5
Basis for work injury or
occupational disease benefit
• Total incapacity for work
• Partial incapacity for work
• Total loss of earning capacity
• Partial loss of earning capacity
• Loss of function, eg loss of a finger or loss of an
eye – but effect may be greater for certain
employments
• Additional costs due to disability, eg attendance
and mobility expenses
• Is there a distinction between short-term and
long-term disability?
6. 6
Who assesses disablement
or determines entitlement?
• Individual’s own doctor
• Employer
• Employer’s own doctor or medical adviser
• Social security agency in the light of medical
evidence
• Social security agency’s doctor
• Independent doctor
• Independent medical tribunal
• Are there special requirements, eg for
psychological impairment
7. 7
Length of award
• For life
• Until retirement
• For a specified period
– Pending review
– Pending rehabilitation
• Death benefit
– For widow or widower
• For life
• Until remarriage
• Pending employment
– For orphans
• For life
• Until completion of education
8. 8
Review or appeal
• Right of appeal
– Appellate body
– The courts
• Circumstances of review
– Whether automatic or on request
– At whose request
• The claimant
• The Social Insurance Agency
– How frequently
9. 9
Work injury insurance
and civil liability
• New Zealand – no civil liability claims – covered by
statutory accident insurance scheme – but costly
• United Kingdom – Recovery of Benefits Act
– Does not deprive individual of civil liability claim
– Where social insurance benefit paid after accident or
occupational disease
– Where compensation paid for injury
• If paid by employer (or employer’s insurance), or
• If paid by motor insurance
– Compensator must
• first apply to Social Insurance agency to determine recoverable
benefit
• repay recoverable benefits for 5 year period following accident or
onset of occupational disease
• Avoids duplicate provision
10. 10
Rehabilitation & Training
• Is rehabilitation a condition for entitlement to
benefit?
• Is rehabilitation compulsory or voluntary?
• Who meets the cost of rehabilitation?
• After rehabilitation, does the disabled person
receive training for a new job and, if so, in what
circumstances?
• Who pays for the training?
– The work injury insurance
– A separate Government budget
– The current or future employer
11. 11
Disability aids
• Prostheses and wheelchairs
• Occupational therapy and physiotherapy
• Adaptation of home environment
• Adaptation of workplace environment
• Adaptation of work equipment
• Adaptation of transport
• What effect on life style and work ability
12. 12
Work options for persons with
work injury or occupational disease
• Occupations restricted to disabled persons
– Piano tuner only for blind persons
– Switchboard operator if blind or mobility problems
• Workplaces restricted to disabled people
– Subsidised by Government
– Eg Making toys or playground equipment
• Requirement for employers to employ at least a
specified percentage of disabled workers – with
criminal sanctions for non-compliance; or
• Government subsidy for employers to employ
disabled workers
13. 13
Health and Safety
• Work injury insurance contribution rate
– Higher for high risk enterprises
– Flat rate for all
• Health and safety legislation
– Government inspectorate to ensure
compliance
– Health and safety committees at work place
• Representatives of management
• Representatives of workers
