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United Kingdom Statutory Instruments |
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You are here: BAILII >> Databases >> United Kingdom Statutory Instruments >> The Armed Forces and Reserve Forces (Compensation Scheme) Order 2005 No. 439 URL: http://www.bailii.org/uk/legis/num_reg/2005/20050439.html |
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Made | 8th March 2005 | ||
Laid before Parliament | 14th March 2005 | ||
Coming into operation | 6th April 2005 |
1. | Citation and commencement |
2. | Interpretation |
3. | Definition of "late onset illness" |
4. | Definition of "salary" |
5. | Service of documents |
6. | The Compensation Scheme |
7. | Injury caused by service |
8. | Injury made worse by service |
9. | Death caused by service |
10. | Injury and death - inclusions |
11. | Injury and death - exclusions |
12. | Modifications of provisions for members or former members of the reserve forces and Gurkhas |
13. | Interpretation of Part III |
14. | Description of benefits - injury |
15. | Amount of lump sum |
16. | Amount of guaranteed income payment |
17. | More than one injury - general |
18. | Injury to a pair of like parts of the body |
19. | More than one injury to the same part of the body |
20. | Temporary Awards |
21. | Description of benefits - death |
22. | Meaning of "surviving adult dependant" |
23. | Meaning of "eligible child" |
24. | Eligible child - further provisions |
25. | Children born after the death of a member or former member of the forces |
26. | Amount of survivor's guaranteed income payment |
27. | Amount of bereavement grant |
28. | Amount of child's payment |
29. | Awards of child's payment: later adjustment |
30. | Children entitled to three or more awards of child's payment |
31. | Reduction of guaranteed income payment, survivor's guaranteed income payment and child's payment to take account of other amounts. |
32. | Reduction in benefit to take account of awards of damages |
33. | Abatement of awards in respect of Social Security benefits |
34. | Negligence or misconduct |
35. | Entitlement to benefit dependant on claim |
36. | Manner of making a claim |
37. | Cases where claims are not required |
38. | Date of claim |
39. | Time for making a claim - general |
40. | Time for making a claim - exceptional circumstances |
41. | Time for making a claim - physical or mental incapacity |
42. | Withdrawal or amendment of claim |
43. | Decisions |
44. | Interim awards |
45. | Reconsideration |
46. | Finality of decisions |
47. | Review on discharge on medical grounds |
48. | Review - exceptional circumstances |
49. | Review - ignorance or mistake |
50. | Burden of proof |
51. | Standard of proof |
52. | Evidence |
53. | Information and medical examination |
54. | Date on which awards of benefit become payable |
55. | Time of payment |
56. | Suspension - Pensions Appeal Tribunal |
57. | Suspension - Social Security Commissioner |
58. | Suspension - courts |
59. | Suspension in other cases |
60. | Payments on death |
61. | Persons under 18 |
62. | Persons who are mentally infirm |
63. | Annual up-rating of guaranteed income payment, survivor's guaranteed income payment and child's payment |
64. | Up-rating of relevant salary for the purposes of articles 16, 26 and 28 |
65. | Transitory provision: Coming into force of the Civil Partnership Act 2004 |
SCHEDULE 1 Article 2(1) | MEANING OF "SUBSTANTIAL AND EXCLUSIVE RELATIONSHIP" |
PART I | SUBSTANTIAL RELATIONSHIP |
PART II | EXCLUSIVE RELATIONSHIP |
SCHEDULE 2 Article 12(1) | MODIFICATIONS FOR RESERVE FORCES |
SCHEDULE 3 Article 12(2) | MODIFICATIONS FOR GURKHAS |
SCHEDULE 4 Article 14 | THE TARIFF |
SCHEDULE 5 Article 16(2) | TABLE OF FACTORS |
or any instrument amending or replacing any of those instruments;
or any later provisions corresponding to the provisions referred to in sub-paragraphs (a), (b) or (c);
(2) In this Order, any reference to claiming a benefit or to a claim
(3) In this Order, a person is "discharged on medical grounds" if he is required to be discharged on the grounds that he is medically unfit to continue in service, and -
Definition of "late onset illness"
3.
A "late onset illness" is -
Definition of "salary"
4.
- (1) Subject to paragraph (3), in this Order "salary", in relation to a member or former member of the forces in respect of whom benefit is payable, means -
(2) Subject to paragraph (1)(b), "salary" does not include -
(3) "Salary" does not include any description of payment that the Secretary of State has determined is not to be treated as salary.
Service of documents
5.
Where by any provision of this Order -
and in each case the injury was made worse by service on or after 6th April 2005.
(2) Benefit is only payable under paragraph (1) if, in each case, the injury has been worsened by service and remains worsened by service on -
(3) Subject to paragraph (4), in the case of paragraph (1)(a) and (b), benefit is only payable if -
(4) No benefit is payable where the injury which was sustained before the day on which the member of the forces entered service is worsened -
in both cases starting on that day.
(5) In the case of paragraph (1)(c), benefit is only payable if the member of the forces -
Death caused by service
9.
- (1) Benefit is payable in accordance with this Order in respect of a member or former member of the forces by reason of his death where -
(2) Where the death is not wholly caused by service, benefit is only payable if service is predominant cause of the death.
(3) The conditions referred to in paragraph (1) are that the death -
(c) occurred more than 5 years after the day on which service ends and -
Injury and death - inclusions
10.
- (1) Benefit is payable in accordance with this Order to or in respect of a person by reason of an injury sustained or death occurring, while participating in -
(b) activities approved by the relevant Service which are undertaken for the purpose of meeting and maintaining the physical standards required of members of the forces; or
(c) adventurous training courses or adventurous expeditions approved by the relevant Service;
in each case where service is the predominant cause of the injury or death.
(2) For the purposes of paragraph (1)(a)(i), the Secretary of State may approve a single sporting activity or a class of such activities and may approve such activities unconditionally or subject to any specified condition.
(3) The activities referred to in paragraph (1) do not include social events or free time associated with those activities.
(4) Benefit is payable in accordance with this Order to or in respect of a person by reason of an injury sustained or a death occurring while travelling from -
(5) The circumstances referred to in paragraph (4)(b) are where the member of the forces -
(6) Benefit is payable in accordance with this Order to or in respect of a person by reason of an injury sustained or a death occurring -
but only where service is the predominant cause of the injury or death.
(7) This article does not apply unless the cause of the injury, or the cause of the death, occurred on or after 6th April 2005.
(8) In this article, "the relevant Service" means the Army, the Navy, the Air Force or the Reserve Forces as the case may be.
Injury and death - exclusions
11.
No benefit is payable under this Order to or in respect of a person by reason of -
(b) an illness which is -
(c) a self-inflicted injury whether or not causing death except where the self-inflicting of injury is a result of a mental illness caused by service.
Modifications of provisions for members or former members of the reserve forces and Gurkhas
12.
- (1) Schedule 2 shall have effect for the modification of certain provisions of this Order in relation to the reserve forces.
(2) Schedule 3 shall have effect for the modification of certain provisions of this Order in relation to Gurkhas.
as the case may be.
Description of benefits - injury
14.
- (1) Benefits payable for injury are -
(2) The tariff shall have effect for the purpose of determining the amount of lump sum and the guaranteed income payment as follows -
(3) Subject to article 20, benefits for injury are only payable in respect of injuries specified in column (b) of Tables 1 to 9 (inclusive).
(4) Guaranteed income payment is not payable in respect of injuries giving rise to entitlement at levels 12 to 15 of the Tables 1 to 9 (inclusive) of the tariff.
(5) A person is only entitled to one guaranteed income payment regardless of the number of injuries which are sustained;
(6) If a member of the forces has sustained more than one injury in separate incidents the amount which is payable is the highest such payment which has been awarded.
(7) Guaranteed income payment is not payable until the day after the day on which the service of the member of the forces to whom it was awarded ends and no such payment is payable in respect of any period before that day.
Amount of lump sum
15.
- (1) Where one injury is sustained in one incident, the amount of the lump sum is the relevant amount, described in article 14 (2)(b), applicable to that injury.
(2) Subject to paragraph (3), where more than one injury is sustained in one incident, the amount of the lump sum shall be calculated as follows -
and no further amount shall be paid where four or more injuries are sustained in one incident.
(3) The total amount payable under paragraph (2) shall not exceed the amount specified at level 1 in column (a) of table 10.
(4) Subject to paragraph (6) where -
(5) In determining the further claim under paragraph (4) the Secretary of State may
(6) Where the Secretary of State increases the amount of the lump sum awarded in respect of the first claim, account shall be taken of the amount of benefit paid in respect of the first claim and only the difference between the earlier award and the later award shall be paid.
(7) Paragraphs (4), (5) and (6) shall not apply to a further claim for injury benefit referred to in paragraph (4)(a) unless that claim is made within the time specified in articles 39, 40 and 41 for making a claim.
Amount of guaranteed income payment
16.
- (1) The annual amount of guaranteed income payment is the relevant percentage of the base figure.
(2) The base figure is calculated by multiplying the relevant salary by the relevant factor.
(3) In this article -
(b) where more than one injury is sustained in one incident and the first and second injuries are specified in the same band, "the relevant percentage" is the percentage specified in the band immediately above the band in which the injuries are specified (except where the injuries are specified in band A in which case "the relevant percentage" is 100 per cent.);
(c) where more than one injury is sustained in one incident and the first and second injuries are specified in different bands, "the relevant percentage" is the percentage specified in respect of the band in which the injury attracting the highest lump sum is specified.
(4) Where the Secretary of State recalculates the amount of a lump sum under article 15(4) and, as a result, the first injury falls within a higher band of Table 10 of the tariff than it did before the recalculation, the Secretary of State shall then recalculate the amount of guaranteed income payment payable under paragraph (3)(b) or (c) of this article on the basis of the increased lump sum.
(5) In this article -
(6) Up-rating a former member of the forces' salary for inflation for the purposes of determining "the relevant salary" under this article shall be carried out in accordance with article 64.
More than one injury - general
17.
- (1) Except where article 18 or 19 applies, this article applies where a member of the forces sustains an injury on more than one occasion and in each case the injury is caused by service.
(2) Where a lump sum is payable for a second or subsequent injury, that sum is payable in full and guaranteed income payment is payable with reference to that lump sum but subject to article 14(5) and (6).
Injury to a pair of like parts of the body
18.
- (1) This article applies where a member of the forces loses, or loses the function of, first one ("the first injury") and later, in another incident, the other ("the second injury") of a pair of like parts of the body specified in paragraph (4) and -
(2) Where paragraph (1) applies -
(3) In this article -
(4) The pairs of like parts of the body to which this article applies are -
More than one injury to the same part of the body
19.
- (1) This article does not apply to an injury which is a fracture or a dislocation.
(2) Paragraphs (3) and (4) of this article apply where a member of the forces sustains an injury to a part of the body ("the first injury") and later, in another incident, sustains another injury to the same part of the body ("the second injury") and -
(3) Subject to article 14(5) and (6) where the second injury is sustained after the relevant period has ended, injury benefit is payable in accordance with this Order.
(4) Where the second injury is sustained before the relevant period ends -
(5) Paragraph (6) of this article applies where a member of the forces sustains a third or a fourth or more injuries to the same part of the body and all the injuries are caused by service.
(6) Where paragraph (5) applies, paragraph (2) to (4) apply as though references in those paragraphs to -
(7) In this article -
The number of whole years | The percentage paid |
(a) | (b) |
Less than 1 | 10 per cent. |
1 | 20 per cent. |
2 | 30 per cent. |
3 | 40 per cent. |
4 | 50 per cent. |
5 | 60 per cent. |
6 | 70 per cent. |
7 | 80 per cent. |
8 | 90 per cent. |
Temporary Awards
20.
- (1) Where the Secretary of State considers that -
he shall make a temporary award in respect of that person relating to the level of the tariff which he considers appropriate for that injury.
(2) The amount of the lump sum payable under a temporary award is the amount which would have been payable had the injury been included in the level of the tariff which the Secretary of State considers appropriate for the injury.
(3) Where guaranteed income payment is payable under a temporary award, the amount payable is that which would have been payable had the injury been included in the tariff at the level which the Secretary of State considers appropriate for the injury.
(4) If the Secretary of State -
(2) If the member or former member of the forces and the surviving spouse married less than 6 months before the death of the member or former of the forces, the Secretary of State may withhold benefit under this article.
(3) If the member or former member of the forces and the civil partner formed their partnership less than 6 months before the death of the member or former member, the Secretary of State may withhold benefit under this article.
(4) Where a member was a member of the AFPS 2005 and dies in service, a bereavement grant is not payable except in the circumstances specified in paragraph (5).
(5) The circumstances referred to in paragraph (4) are that the salary of the member of the forces on the day on which he died is less than the amount of the bereavement grant.
Meaning of "surviving adult dependant"
22.
A person is a surviving adult dependant in relation to a member or former member of the forces if, at the time of the member's death -
Meaning of "eligible child"
23.
- (1) In this Order, "eligible child" in relation to a deceased member of the forces or a deceased former member of the forces, means -
(2) The conditions referred to in paragraph (1) are that the person is -
Eligible child - further provisions
24.
- (1) A person who is aged under 19 on the day on which he ceases to be in full-time education is treated as being in such education until the first of the following days after he so ceases -
(2) A person who, on the day of the death of a member or former member of the forces, is aged under 23 and taking a break from full-time education or vocational training not exceeding one academic year is treated as continuing such education or training during the break for the purpose of determining whether the person is an eligible child on that day.
(3) A person who, on the day of the death of a member or former member of the forces -
is treated as continuing such education or training during the break for the purposes of determining whether the person is an eligible child on that day.
(4) An eligible child -
shall be treated as continuing such education or training during one academic year in the case of paragraph (a) and during 15 months in the case of paragraph (b) for the purpose of determining whether the person is an eligible child during the break.
(5) A person aged over 17 and under 23 who has ceased full-time education or vocational training because of ill health is treated, for the purpose of determining whether he is an eligible child, as continuing such education or training until either -
(6) Nothing in paragraphs (2), (3) or (4) requires child's payment to be paid in respect of such a child during the break.
(7) A person is no longer treated as an eligible child if a break referred to in paragraph (2), (3), (4) or (5) lasts for longer than the periods mentioned in those paragraphs.
Children born after the death of a member or former member of the forces
25.
- (1) A child who is born after the death of a member or a former member of the forces is only treated as an eligible child of that member if the child is born before the first anniversary of the death of the member or former member.
(2) No child's payment is payable in respect of any period before the birth of such a child.
Amount of survivor's guaranteed income payment
26.
- (1) Subject to paragraph (5) the annual amount of survivors' guaranteed income payment is 60 per cent. of the base figure.
(2) The base figure is calculated by multiplying the relevant salary by the relevant factor.
(3) In this article -
(4) Up-rating a former member of the forces salary for inflation for the purposes of determining "relevant salary" under this article shall be carried out in accordance with article 64.
(5) In the event that there is more than one surviving spouse entitled to the survivor's guaranteed income payment, the annual amount to which each such surviving spouse is entitled shall be 60 per cent. of the base figure, divided by the number of surviving spouses so entitled at the time of the death of the member or former member of the armed forces.
Amount of bereavement grant
27.
- (1) Subject to the following provisions of this article, the amount of the bereavement grant payable in respect of the death of a member or former member of the forces is £20,000.
(2) Where a member of the forces dies in service -
(3) Where a former member of the forces dies, the bereavement grant is payable in full
(4) In the event that there is more than one surviving spouse entitled to the bereavement grant, the amount to which each such surviving spouse is entitled shall be £20,000, divided by the number of surviving spouses so entitled at the time of the death of the member or former member of the armed forces.
Amount of child's payment
28.
- (1) The annual amount of child's payment is the relevant percentage of the base figure or, in the circumstances specified in paragraphs (3)(b) and (4)(b), the amount referred to in those subparagraphs.
(2) The base figure is calculated by multiplying the relevant salary by the relevant factor.
(3) Where a member of the forces or former member of the forces dies leaving a surviving spouse, a civil partner or a surviving adult dependant -
(b) where there are more than 3 eligible children, the amount referred to in paragraph (1) is an amount obtained by dividing 40 per cent. of the base figure by the number of eligible children left by the member or former member of the forces.
(4) Where a member or a former member of the forces dies without leaving a surviving spouse, a civil partner or a surviving adult dependant but leaves -
(5) Where a child ceases to be an eligible child, there shall be no adjustment in the amount of child's payment payable to the other children who receive child's payment as a result of the same calculation.
(6) In this article -
(7) Up-rating a former member of the forces' salary for the purposes of determining "the relevant salary" under this article shall be carried out in accordance with article 64.
Awards of child's payment: later adjustment
29.
- (1) This article applies where, after the death of a member or former member of the forces -
(2) The Secretary of State may make such adjustments in the amount of the child's payment payable in respect of the children in question as are required in view of the facts as they subsequently appear.
(3) Paragraph (2) does not affect the Secretary of State's right to recover a payment or overpayment in any case where he considers it appropriate to do so.
Children entitled to three or more awards of child's payment
30.
- (1) This paragraph applies if, apart from this paragraph, child's payment would be payable in respect of the same child under article 21(1) as a result of the death of more than two members of the forces or former members of the forces.
(2) Only child's payments payable as a result of the death of two of the members of the forces or former members of the forces which together result in the payment of the greatest annual amount in respect of the child are payable.
the guaranteed income payment, the survivor's income payment or the child's payment as the case may be is reduced in accordance with paragraphs (2) and (3).
(2) Where a person is entitled to guaranteed income payment for any period during which he is also entitled -
(3) Where a person is entitled to survivor's guaranteed income payment or child's payment for any period during which he is also entitled to a pension then the amount of the survivor's guaranteed income payment or child's payment is reduced by 75 per cent. of the amount of that pension.
(4) In this article any reference to a pension, invaliding pension, ill-health pension or a payment means the gross amount of that pension, invaliding pension, ill-health pension or payment.
Reduction in benefit to take account of awards of damages
32.
- (1) Where the Secretary of State is satisfied that -
he may take those damages into account against any benefit which might otherwise be payable under this Order and may withhold or reduce any such benefit accordingly.
(2) For the purposes of this article, damages include any payment received as a result of a claim made -
whether or not the payment is made in pursuance of a judgement or order of a court of any jurisdiction or by way of settlement or compromise of the claim and whether or not proceedings are instituted to enforce the claim.
(3) Where compensation is paid -
the person to whom or for whose benefit the compensation is paid shall be treated as recovering damages and the compensation paid shall be treated as the damages recovered.
Abatement of awards in respect of Social Security benefits
33.
Where benefit is awarded under this scheme to or in respect of a person for any past period for which benefit under the Social Security and Contributions and Benefits Act 1992[17] or the Jobseekers Act 1995[18], or any legislation in Northern Ireland corresponding thereto, had been paid to or in respect of that person, the total amount of benefit so awarded may be abated by the amount by which the amount of benefit so paid exceeds what would have been payable for that period had the benefit been concurrently payable.
Negligence or misconduct
34.
The Secretary of State may withhold up to 40 per cent. of benefit where the negligence or misconduct of a member or former member of the forces contributed to his injury or death.
Cases where claims are not required
37.
- (1) It is not a condition of entitlement to benefit that a claim be made for it where -
(2) Notwithstanding paragraph (1), where a member of the forces dies in the circumstances specified in that paragraph leaving an eligible child and either -
it is a condition of entitlement to child's payment that a claim is made by or on behalf of the child.
(3) Paragraph (1)(a) only applies to injury benefit for the injury which caused the member of the forces to be discharged on medical grounds and any injuries arising from that injury or from the same incident that caused that injury.
Date of claim
38.
- (1) Subject to paragraphs (2) and (3), the date on which a claim is made is the date on which it is received by the Veterans Agency.
(2) Where, not more than 3 months before the date on which a claim for benefit is made, the person making the claim, or a person acting on his behalf requests the Secretary of State, orally or in writing, to provide information relating to benefit or a form approved by him for the purpose of claiming benefit, the date of claim shall be the date of that request.
(3) Where article 37(1) applies, the date of claim shall be treated as -
whichever is applicable.
Time for making a claim - general
39.
- (1) Subject to articles 40 and 41, the time specified for making a claim for injury benefit is 5 years beginning with the day on which -
whichever is the earlier.
(2) Where an illness first presents within the period specified in paragraph (1) but diagnosis of the illness is not made until less than one year before the end of that period, the time for making a claim is extended by one year starting from the date on which diagnosis was made.
(3) The time specified for making a claim for death benefit where -
is one year from the date of the death.
Time for making a claim - exceptional circumstances
40.
- (1) Article 39 does not apply where -
(2) Where paragraph (1) applies, the time specified for making a claim is one year beginning with the day the late onset illness was first diagnosed or the day on which the death occurred as the case may be.
Time for making a claim - physical or mental incapacity
41.
- (1) Where a person is physically or mentally incapable of making a claim or instructing another person to make it on his behalf throughout the time specified for making a claim in article 39 or 40, that time shall be extended by the Secretary of State for such further period as in all circumstances of the case he considers reasonable.
(2) Where a person -
the Secretary of State may extend the time for making a claim for a period of up to one year if he considers there is insufficient time for the person to make a claim or instruct a person to make it on his behalf within the period referred to in article 39(1) or paragraph (1).
Withdrawal or amendment of claim
42.
- (1) A person who has made a claim may amend it by notice in writing given or sent to the Veterans Agency at any time before notice of the decision on the claim has been given or sent to the claimant, and any claim so amended shall be treated by the Secretary of State as if it had been so amended in the first instance.
(2) A person who has made a claim may withdraw it at any time before notice of the decision on the claim has been given or sent to the claimant, by notice in writing given or sent to the Veterans Agency, and any such notice of withdrawal shall have effect when it is received.
(3) Where a person has withdrawn a claim under paragraph (2), he may not reinstate that claim but may make a further claim in accordance with the provisions of this Order.
Interim awards
44.
- (1) Where the Secretary of State is satisfied that a person is entitled to injury benefit but it appears to him that the prognosis for the injury in that particular case is uncertain in that he is unable finally to decide which level of the tariff is applicable to it, he may make an interim award relating to the specific level of the tariff of such amount as he considers appropriate in all the circumstances of the case.
(2) The Secretary of State shall specify in the interim award the period during which the award has effect and may extend, and further extend, the period during which the interim award has effect but he shall make a final award within the period of two years starting with the date on which an interim award was first made.
(3) The final award shall have effect from the date on which an interim award first had effect.
(4) Where a final award is -
Reconsideration
45.
- (1) A decision of the Secretary of State ("the original decision"), other than a decision under article 44(1), shall be reconsidered by him if an application for a reconsideration is given or sent to the Veterans Agency within the period of 3 months starting with the date on which notice of the original decision is given or sent to the claimant.
(2) On a reconsideration of an original decision, the Secretary of State may -
(b) confirm the original decision.
(3) An application for a reconsideration shall -
(4) The decision of the Secretary of State on an application for a reconsideration under paragraph (1) and the reasons for that decision shall be in writing and shall be sent to the claimant who shall, at the same time, be informed of his right to appeal to a Pension Appeal Tribunal under section 5A(1) of the Pensions Appeal Tribunals Act 1943.
(5) Where an appeal has been made to a Pensions Appeal Tribunal against an original decision and no application for a reconsideration has been made in respect of that decision under paragraph (1), the Secretary of State shall reconsider the decision.
(6) The decision of the Secretary of State on a reconsideration under paragraph (5) and the reasons for the decision shall be in writing and shall be sent to the claimant and the Pensions Appeal Tribunal.
(7) Article 41 shall have effect in respect of an application for a reconsideration under this article as though a reference to making a claim was a reference to making an application for a reconsideration and reference to the time for making a claim was a reference to the time for making an application for a reconsideration.
Finality of decisions
46.
- (1) Where the Secretary of State has made a final decision awarding benefit, there shall be no review by him of that decision except in the circumstances specified in articles 47, 48 and 49.
(2) Where the Secretary of State has made a final decision which makes no award of benefit, there shall be no review of that decision except in the circumstances specified in article 49.
(3) In this article and article 48, a final decision is a decision -
(b) revised by the Secretary of State following a reconsideration under article 45;
(c) revised by the Secretary of State under article 47, 48 or 49;
(d) making a final award under article 44.
Review on discharge on medical grounds
47.
- (1) This article applies where a member of the forces has been awarded injury benefit and is later discharged on medical grounds for the same injury for which that benefit was awarded.
(2) Where paragraph (1) applies, the Secretary of State may revise the award of benefit where the injury in respect of which it was awarded has either -
and in both cases -
(3) The Secretary of State's decision on a review under this article and the reasons for the decision shall be in writing and shall be given or sent to the member of the forces concerned who shall at the same time, be informed of his right -
Review - exceptional circumstances
48.
- (1) The Secretary of State may revise an award of injury benefit if the conditions specified in paragraph (2) are satisfied and an application for a review is sent to the Veterans Agency.
(2) The circumstances referred to in paragraph (1) are that, within the period of 10 years starting with the date of the final decision, the injury in respect of which the final decision was made either has -
and in both cases -
(3) An application for review under this article may only be made within the period of one year starting with the day on which the worsening or the development began.
(4) The Secretary of State may only review an award under this article once.
(5) An application for a review under this article shall -
(6) The decision of the Secretary of State on an application for review under this article and the reasons for the decision shall be in writing and shall be given or sent to the applicant who shall, at the same time, be informed of his right -
Review - ignorance or mistake
49.
- (1) Subject to paragraph (2), any decision of the Secretary of State may be reviewed by him at any time (including on the application of the claimant) if he is satisfied that the decision was given in ignorance of, or was based on, a mistake as to a material fact or of a mistake as to the law.
(2) This article only applies -
(3) On a review under this article, the Secretary of State may -
in each case by increasing or reducing the amount of the award or so as to cancel an award of benefit;
(b) make an award of benefit where no award has been made before; or
(c) confirm the decision referred to in subparagraph (a).
(4) The decision of the Secretary of State on an application for review under this article and the reasons for the decision shall be in writing and shall be given or sent to the claimant who shall, at the same time, be informed of his right -
Burden of proof
50.
The burden of proving any issue under this Order shall lie on the claimant.
Standard of proof
51.
The standard of proof applicable in any decision which is required to be made under this Order shall be the balance of probabilities.
Evidence
52.
- (1) For the purposes of determining any issue under this Order, the Secretary of State shall produce such medical or other records of -
as are in his possession and are relevant to the issues to be decided.
(2) The Secretary of State shall consider any evidence which appears to him to be relevant to the issues which are to be decided and shall determine those issues on that evidence.
(3) Where any decision required to be made under this Order is, or includes, a decision involving a medical issue, that decision shall be made in accordance with generally accepted medical and scientific knowledge prevailing at the time the decision is made.
Information and medical examination
53.
- (1) Where a claim has been made and -
the claim shall be treated as never having been made.
(2) The treating of a claim as never having been made does not prevent the making of a new claim in accordance with the provisions of this Order.
(3) In this article, a reference to a claim includes a reference to a reconsideration under article 45 and a review under article 47, 48 or 49.
(3) Where a person who is entitled to a pension for disablement or death under The Naval, Military and Air Forces Etc. (Disablement and Death) Service Pensions Order 1983 ("the 1983 Order") subsequently becomes entitled to benefit under this Order for the same injury or death for which there was entitlement under the 1983 Order, the date on which benefit under this Order becomes payable is the date on which -
(4) Where a member of the forces dies in service, an award of survivor's guaranteed income payment and an award of child's payment become payable on the day after his death.
(5) Subject to article 14(7), an award -
(6) Subject to article 14(7) where a decision of the Secretary of State is revised under article 49 so as to award benefit or increase the amount of benefit awarded, the revised award becomes payable from the beginning of a period starting 6 years before the date on which the application for review is sent to the Secretary of State or, where no application for a review has been made, 6 years before the date on which the award is revised.
(7) Where an award is increased under article 15(4), the increased guaranteed income payment becomes payable from the date on which the further claim was made.
(8) Where the amount of an award is reduced following a review under article 49, the reduced amount becomes payable on the date on which the award is revised.
(9) Notwithstanding paragraph (6), no benefit is payable for any period before the date of claim.
Time of payment
55.
Guaranteed income payment, survivor's guaranteed income payment and child's payment shall be paid monthly in arrears unless, in any particular case, the Secretary of State arranges otherwise.
Suspension - Pensions Appeal Tribunal
56.
- (1) Where it appears to the Secretary of State that a question arises whether an appeal ought to be brought against the decision of a Pensions Appeal Tribunal, he may, subject to paragraph (2), direct that payment of benefit in accordance with that decision be suspended, in whole or in part, pending the determination of the appeal.
(2) Where it appears to the Secretary of State that a question arises under paragraph (1), he may only give directions that payment of benefit in accordance with that decision be suspended within the relevant period.
(3) A suspension under paragraph (1) shall cease unless, within the relevant period, the person awarded benefit by virtue of the decision ("the beneficiary") is given or sent notice in writing that an application for leave to appeal has been made against that decision.
(4) Subject to paragraph (5), where the beneficiary has been given or sent notice within the relevant period that an application for leave to appeal against a decision of a Pensions Appeal Tribunal has been made, the suspension may continue until that application for leave to appeal and, where leave has been granted, any subsequent appeal is determined.
(5) Where an application for leave to appeal against a decision of a Pensions Appeal Tribunal is made to a Pensions Appeal Tribunal and that application is refused, the suspension shall cease unless the Secretary of State, within a period of 28 days beginning with the date on which notice in writing of the decision of the Pensions Appeal Tribunal refusing leave to appeal is received by him, makes a further application for leave to appeal, and, if he has so applied, the suspension may continue until that application for leave to appeal and any subsequent appeal is determined.
(6) Where, on an appeal against a decision of a Pensions Appeal Tribunal, an appropriate Commissioner remits the matter for rehearing and determination by a Pensions Appeal Tribunal, the appeal is not determined for the purposes of paragraphs (4) and (5) until the matter remitted for rehearing has been determined.
(7) In this article,
Suspension - Social Security Commissioner
57.
- (1) Where it appears to the Secretary of State that a question arises whether an appeal ought to be brought against the decision of an appropriate Commissioner under section 6C[21] of the Pensions Appeal Tribunals Act 1943, he may, subject to paragraph (2), direct that payment of benefit in accordance with that decision be suspended, in whole or in part, pending the determination of the appeal.
(2) Where it appears to the Secretary of State that a question arises under paragraph (1), he may only give directions that payment of benefit in accordance with that decision be suspended within the relevant period.
(3) A suspension under paragraph (1) shall cease unless, within the relevant period, the person awarded the benefit by virtue of the decision ("the beneficiary") is given or sent notice in writing that an application for leave to appeal has been made against that decision.
(4) Where the beneficiary has been given or sent notice within the relevant period that an application for leave to appeal has been made, the suspension may continue until that application for leave to appeal and any subsequent appeal is determined.
(5) Where an application for leave to appeal against a decision of an appropriate Commissioner is made under section 6C of the Pensions Appeal Tribunals Act 1943 and that application is refused, the suspension shall cease unless the Secretary of State, within a period of 28 days beginning with the date on which notice in writing of the decision under that section refusing leave to appeal is received by him, applies to the appropriate court for leave to appeal, and, if he has so applied, the suspension may continue until that application for leave to appeal and any subsequent appeal has been determined.
(6) In this article -
(d) "relevant period" means the period of 6 weeks beginning with the date on which notice in writing of the decision in question and of the reasons for it is received by the Secretary of State;
(e) "an appropriate Commissioner" means a Great Britain Social Security Commissioner or a Northern Ireland Social Security Commissioner and includes a tribunal of Commissioners constituted under section 6D(5) of the Pensions Appeal Tribunals Act 1943[22].
Suspension - courts
58.
- (1) Where it appears to the Secretary of State that a question arises whether an appeal ought to be brought against the decision of a court, he may, subject to paragraph (2), direct that payment of benefit in accordance with that decision be suspended, in whole or in part, pending the determination of the appeal.
(2) Where it appears to the Secretary of State that a question arises under paragraph (1), he may only give directions that payment of benefit in accordance with that decision be suspended within the relevant period.
(3) A suspension under paragraph (1) shall cease unless, within the relevant period, the person awarded the benefit by virtue of the decision ("the beneficiary") is given or sent notice in writing that an application for leave to appeal has been made against that decision.
(4) Where the beneficiary has been given or sent notice within the relevant period that an application for leave to appeal has been made, the suspension may continue until that application for leave to appeal and any subsequent appeal is determined.
(5) In this article -
(b) "application for leave to appeal" means an application or petition for leave to appeal as the case may be in the proceedings referred to in heads (i) and (ii) of subparagraph (a) above;
(c) "relevant period" means the period of three months beginning with the date on which notice in writing of the decision in question and of the reasons for it is received by the Secretary of State.
Suspension in other cases
59.
- (1) Where it appears to the Secretary of State that -
he may direct that payment of the benefit under the award in the secondary case be suspended, in whole or in part -
(2) In this article the expressions "appeal" and "application for leave to appeal" have the same meanings as they have in article 56.
Payments on death
60.
- (1) On the death of a person who has made a claim for benefit, the Secretary of State may appoint such person as he thinks fit to proceed with the claim.
(2) Any sum which is payable under an award on a claim proceeded with under paragraph (1) shall be paid to the personal representatives of the deceased or to such other persons as the Secretary of State considers fit.
(3) An award on a claim proceeded with under paragraph (1) shall not provide for payment of benefit for any period after the date of death.
(4) Child's payment awarded in respect of an eligible child aged less than 18 shall be paid to the child's parent or the person having legal responsibility for the child or, if the Secretary of State considers that it is in the interests of the child that a person other than the parent or person having legal responsibility for the child should be paid the child's payment, to a person (who, if a natural person, is over the age of 18) appointed by the Secretary of State in writing and the person receiving the child's payment shall apply the payment for the benefit of the child.
(5) Where the Secretary of State has made an appointment under paragraph (4)
(b) the person appointed may resign his office after having given one month's notice in writing to the Secretary of State of his intention to do so.
(6) The Secretary of State may, before appointing a person under paragraph (4), require that person to give such undertaking as the Secretary of State considers necessary as to the use of the child's payment.
Persons who are mentally infirm
62.
- (1) Where -
the Secretary of State may in writing appoint a person (who, if a natural person, is over the age of 18) to act for that person in respect of this Order.
(2) A person appointed under paragraph (1) shall -
(3) Where the Secretary of State has made an appointment under paragraph (1) -
(4) The Secretary of State may, before appointing a person under paragraph (1), require that person to give such undertaking as the Secretary of State considers necessary as to the use of the sums paid to him.
2.
- (1) For paragraph (1) of article 4 there is substituted the following paragraph -
(2) In paragraph (2) of article 4 for "(1)(b)" there is substituted "(1)(d)".
3.
For article 31 there is substituted the following article -
the guaranteed income payment, survivor's guaranteed income payment or child's payment as the case may be is reduced in accordance with paragraphs (2) and (3).
(2) Where a person is entitled to a guaranteed income payment for any period during which he is also entitled to -
(3) Where a person is entitled to a survivor's guaranteed income payment or a child's payment for any period during which he is also entitled to a pension, reserve forces pension or civilian pension, then the amount of the survivor's guaranteed income payment or child's payment is reduced by 75 per cent. of the amount of that pension, reserve forces pension or civilian pension.
(4) In this article -
2.
Where a Gurkha is discharged into Nepal, the definition of "relevant factor" in articles 16(5), 26(3) and 28(6) has effect as if the reference to the table set out in Schedule 5 was a reference to the table set out at the end of this Schedule.
3.
Where -
is resident in Nepal, the definition of "relevant factor" in articles 26(3) and 28(6) has effect as if the reference to the table set out in Schedule 5 was a reference to the table set out at the end of this Schedule.
4.
For article 31 there is substituted -
the total amount of child's payment payable to his eligible children shall be reduced by the amount of the family pension.
(5) Where paragraph (4) applies -
Table of Guaranteed Income Payment Factors for Gurkhas
Age at last birthday | GIP Factor | Age at last birthday | GIP Factor |
16 | 1.127 | 37 | 0.831 |
17 | 1.118 | 38 | 0.808 |
18 | 1.109 | 39 | 0.784 |
19 | 1.100 | 40 | 0.758 |
20 | 1.090 | 41 | 0.730 |
21 | 1.080 | 42 | 0.701 |
22 | 1.069 | 43 | 0.671 |
23 | 1.057 | 44 | 0.638 |
24 | 1.046 | 45 | 0.604 |
25 | 1.034 | 46 | 0.566 |
26 | 1.021 | 47 | 0.527 |
27 | 1.008 | 48 | 0.484 |
28 | 0.993 | 49 | 0.439 |
29 | 0.978 | 50 | 0.390 |
30 | 0.963 | 51 | 0.339 |
31 | 0.947 | 52 | 0.282 |
32 | 0.931 | 53 | 0.221 |
33 | 0.913 | 54 | 0.155 |
34 | 0.894 | 55 | 0.083 |
35 | 0.874 | Over 55 | 0.083 |
36 | 0.853 |
Column (a) | Column (b) |
Level | Injury |
4 | Burns, with deep second degree, third degree, or full thickness burns affecting 70 per cent or more of whole body surface area. |
5 | Burns, with deep second degree, third degree, or full thickness burns affecting 50 to 69 per cent of whole body surface area. |
6 | Burns, with deep second degree, third degree, or full thickness burns affecting 15 to 49 per cent of whole body surface area. |
7 | Burns, with deep second degree, third degree, or full thickness burns to the face or face and neck resulting in or expected to result in residual scarring and poor cosmetic results despite treatment and camouflage. |
8 | Burns, with deep second degree, third degree, or full thickness burns affecting 9 to 15 per cent of whole body surface area. |
9 | Burns, with deep second degree, third degree, or full thickness burns to the face or face and neck resulting in or expected to result in residual scarring and satisfactory cosmetic results with camouflage. |
11 | Burns, with deep second degree, third degree, or full thickness burns affecting 4.5 to 8.9 per cent of whole body surface area. |
12 | Burns, with deep second degree, third degree, or full thickness burns affecting less than 4.5 per cent of whole body surface area. |
12 | Burns, with first degree or superficial second degree burns affecting more than 15 percent of whole body surface area. |
13 | Burns, with first degree or superficial second degree burns to the face or face and neck. |
14 | Burns, with first degree or superficial second degree burns affecting 4.5 to 15 percent of whole body surface area. |
15 | Burns, with first degree or superficial second degree burns affecting 1 to 4.4 per cent of whole body surface area. |
Column (a) | Column (b) |
Level | Injury |
5 | Complex injury covering all or most of the area from thigh to ankle or shoulder to wrist, with complications, causing permanent functional limitation and restriction. |
5 | Loss of both kidneys or chronic renal failure. |
6 | Complex injury covering all or most of the area from thigh to knee, knee to ankle, shoulder to elbow or elbow to wrist, with complications, causing permanent functional limitation and restriction. |
6 | Injury covering all or most of the area from thigh to ankle or shoulder to wrist, with complications, causing permanent functional limitation and restriction. |
6 | Complex injury to chest, with complications, causing permanent functional limitation and restriction. |
7 | Complex injury covering all or most of the area from thigh to ankle or shoulder to wrist, causing permanent functional limitation and restriction. |
7 | Injury covering all of the area from thigh to knee, knee to ankle, shoulder to elbow or elbow to wrist, with complications, causing permanent functional limitation and restriction. |
7 | Injury to chest, with complications, causing permanent functional limitation and restriction. |
7 | Complex injury to abdomen, including pelvis, with complications, causing permanent functional limitation and restriction. |
8 | Injury covering all or most of the area from thigh to ankle or shoulder to wrist, causing permanent functional limitation and restriction. |
8 | Complex injury covering all or most of the area from thigh to knee, knee to ankle, shoulder to elbow or elbow to wrist, causing permanent functional limitation and restriction. |
8 | Severe facial lacerations which produce poor cosmetic result despite camouflage and have required, or are expected to require, operative treatment. |
8 | Injury to abdomen, including pelvis, with complications, causing permanent functional limitation and restriction. |
8 | Injury to chest, causing permanent major functional limitation and restriction. |
9 | Injury to abdomen, including pelvis, causing permanent functional limitation and restriction. |
9 | Injury covering all or most of the area from thigh to knee, knee to ankle, shoulder to elbow or elbow to wrist, causing permanent functional limitation and restriction. |
10 | Serious permanent damage to, or loss of, one kidney. |
10 | Severe facial lacerations, which have required, or are expected to require, operative treatment resulting in or expected to result in a satisfactory cosmetic result. |
11 | Complex injury covering all or most of the area from thigh to ankle or shoulder to wrist, causing or expected to cause functional limitation and restriction at 26 weeks with substantial recovery beyond that date. |
11 | Traumatic damage to spleen which has required splenectomy and where there is, or where there is a high risk of, overwhelming post-splenectomy infection. |
11 | Severe facial scarring which produces a poor cosmetic result despite camouflage. |
12 | Complex injury covering all or most of the area from thigh to knee, knee to ankle, shoulder to elbow or elbow to wrist, causing or expected to cause functional limitation and restriction at 26 weeks with substantial recovery beyond that date. |
12 | Severe scarring of face, or face and neck, or neck, scalp, torso or limb, where camouflage produces a good cosmetic result. |
12 | Injury to chest with complications, causing or expected to cause functional limitation and restriction at 26 weeks, with substantial recovery beyond that date. |
12 | Injury covering all or most of the area thigh to ankle or shoulder to wrist, causing or expected to cause functional limitation and restriction at 26 weeks, with substantial recovery beyond that date. |
12 | High velocity gun shot wound affecting skin, subcutaneous tissue and muscle of the abdomen, chest or limbs. |
13 | Injury to abdomen including pelvis, with complications, causing or expected to cause functional limitation and restriction at 26 weeks with substantial recovery beyond that date. |
13 | Injury to all or most of the area from thigh to knee, knee to ankle, shoulder to elbow or elbow to wrist, causing or expected to cause functional limitation or restriction at 26 weeks, with substantial recovery beyond that date. |
13 | Injury to chest, causing or expected to cause functional limitation or restriction at 26 weeks, where the claimant has made or is expected to make a substantial recovery beyond that date. |
13 | Moderate facial scarring where camouflage produces a good cosmetic result. |
13 | Lung damage due to toxic fumes, smoke inhalation or blast, where symptoms have continued, or are expected to continue beyond 6 weeks and where the claimant has made or is expected to make a substantial recovery within 26 weeks. |
13 | Traumatic tension or open pneumothorax. |
14 | Injury to abdomen including pelvis, causing or expected to cause functional limitation and restriction at 26 weeks, with substantial recovery beyond that date. |
14 | Moderate scarring of scalp, neck, torso or limbs where camouflage produces a good cosmetic result. |
14 | Minor facial scarring. |
14 | Flesh wound which has required, or is expected to require operative treatment. |
14 | Fractured tooth which has required, or is expected to require root resection. |
14 | Loss of two or more front teeth. |
15 | Minor scarring of scalp, neck, torso or limbs. |
15 | Damage to one front tooth which has required, or is expected to require a crown or root canal surgery. |
15 | Damage to two or more teeth other than front which has required, or is expected to require crowns or root canal surgery. |
15 | Loss of one front tooth. |
15 | Loss of two or more teeth other than front. |
Column (a) | Column (b) |
Level | Injury |
8 | Permanent mental disorder, causing severe functional limitation and restriction. |
10 | Permanent mental disorder, causing moderate functional limitation and restriction. |
11 | Mental disorder, which is functionally limiting and restricting, and has continued, or is expected to continue for 5 years. |
12 | Mental disorder, which has caused or is expected to cause functional limitation and restriction at 2 years, from which the claimant has made or is expected to make a substantial recovery within 5 years. |
13 | Mental disorder, which has caused, or is expected to cause, functional limitation and restriction, at 26 weeks, from which the claimant has made, or is expected to make a substantial recovery within 2 years. |
14 | Mental disorder, which has caused or is expected to cause, functional limitation and restriction at 6 weeks, from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
Column (a) | Column (b) |
Level | Injury |
6 | Physical disorder causing severe functional limitation and restriction where life expectancy is less than five years. |
7 | Physical disorder causing severe functional limitation and restriction where life expectancy is reduced, but is more than 5 years. |
8 | Infertility. |
9 | Physical disorder causing permanent severe functional limitation and restriction. |
11 | Physical disorder which has caused, or is expected to cause severe functional limitation and restriction at 26 weeks where the claimant has made, or is expected to make, a substantial recovery beyond that date. |
11 | Physical disorder causing permanent moderate functional limitation and restriction. |
13 | Physical disorder which has caused, or is expected to cause, severe functional limitation and restriction at 6 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
13 | Physical disorder which has caused, or is expected to cause, moderate functional limitation and restriction at 26 weeks, from which the claimant has made, or is expected to make, a substantial recovery beyond that date. |
14 | Physical disorder which has caused, or is expected to cause, severe functional limitation and restriction at 6 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
14 | Physical disorder which has caused, or is expected to cause, moderate functional limitation and restriction at 13 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
15 | Physical disorder which has caused, or is expected to cause, moderate functional limitation and restriction at 6 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
Column (a) | Column (b) |
Level | Injury |
1 | Loss of both legs (above or below knee) and both arms (above or below elbow). |
1 | Loss of both eyes or sight in both eyes and loss of either both legs (above or below knee), or both arms (above or below elbow). |
1 | Total deafness and loss of either both legs or both arms. |
2 | Loss of both legs above knee (hip disarticulation or hemipelvectomy). |
2 | Loss of both arms above elbow (shoulder disarticulation or forequarter). |
2 | Loss of both legs (above or below knee) and one arm (above or below elbow). |
2 | Loss of both arms (above or below elbow) and one leg (above or below knee). |
3 | Loss of both legs at or above knee (trans-femoral or knee disarticulation). |
3 | Loss of both arms at or above elbow (trans-humeral or elbow disarticulation). |
3 | Loss of one leg above knee (hip disarticulation or hemipelvectomy). |
3 | Loss of one arm above elbow (shoulder disarticulation or forequarter). |
4 | Loss of both legs below knee (trans-tibial). |
4 | Loss of both arms below elbow (trans-radial). |
4 | Loss of both hands (wrist disarticulation). |
4 | Loss of one leg at or above knee and one leg below knee. |
4 | Loss of one arm at or above elbow, and one arm below elbow. |
5 | Loss of both feet at ankle. |
5 | Loss of one leg at or above knee (trans-femoral or knee disarticulation). |
5 | Loss of one arm at or above elbow (trans-humeral or elbow disarticulation). |
6 | Loss of one leg below knee (trans-tibial). |
6 | Loss of one arm below elbow (trans-radial). |
6 | Loss of one hand (wrist disarticulation). |
7 | Loss of both thumbs. |
8 | Loss of one foot at ankle. |
10 | Loss of both great toes. |
10 | Loss of thumb. |
10 | Loss of both index fingers. |
10 | Partial loss of thumbs and index fingers of both hands. |
11 | Loss of two or more fingers other than thumb or index finger from one hand. |
12 | Loss of great toe. |
12 | Loss of index finger from one hand. |
12 | Partial loss of thumb and index finger from one hand. |
12 | Partial loss of thumb or index finger of both hands. |
12 | Persistent phantom limb pain. |
12 | Stump neuroma with trigger point stump pain. |
13 | Loss of two or more toes, other than great toe, from one foot. |
13 | Partial loss of both great toes. |
13 | Loss of one finger other than thumb or index finger. |
13 | Partial loss of two or more fingers, other than thumb or index finger, from one hand. |
13 | Partial loss of thumb or index finger from one hand. |
14 | Partial loss of great toe. |
14 | Partial loss of one finger, other than thumb or index finger, from one hand. |
15 | Loss of one toe, other than great toe, from one foot. |
Column (a) | Column (b) |
Level | Injury |
1 | Spinal cord injury, at or above vertebra C3. |
1 | Brain injury with persistent vegetative state.(a) |
1 | Brain injury where epilepsy is present (or where there is a high risk of epilepsy) and the claimant has reflex activity but has little or no meaningful response to the environment and requires full-time skilled nursing care.(b) |
2 | Spinal cord injury at vertebra C4 or C5. |
3 | Spinal cord injury at vertebra C6. |
3 | Brain injury where epilepsy is present (or where there is a high risk of epilepsy) where the claimant has limited response to environment and substantial physical, sensory, personality, behavioural or cognitive problems and requires regular skilled nursing care.(c) |
3 | Paralysis of both arms. |
3 | Paralysis of both legs. |
4 | Spinal cord injury at vertebra C7 or C8. |
4 | Brain injury where epilepsy is either present (or where there is a high risk of epilepsy) where the claimant has some limitation on response to environment and some sensory, personality, behavioural or cognitive problems but does not require skilled nursing care.(d) |
5 | Spinal cord injury at vertebra T1. |
5 | Hemiplegia. |
6 | Uncontrolled post-head-injury epilepsy. |
7 | Paralysis of one leg. |
7 | Paralysis of one arm. |
9 | Permanent damage to brachial plexus. |
9 | Permanent isolated damage to one cranial nerve. |
10 | Permanent foot or wrist drop. |
11 | Brain injury from which the claimant has made, or is expected to make, a substantial recovery beyond 26 weeks, except for residual vertigo.(e) |
11 | Brain haemorrhage or stroke which has caused, or is expected to cause, persistent functional limitation and restriction at 26 weeks, but where there has been, or is expected to be, a substantial recovery beyond that date. |
12 | Brain injury from which the claimant has made, or is expected to make, a substantial recovery beyond 26 weeks, except for problems with memory or concentration.(f) |
12 | Controlled post-head-injury epilepsy. |
12 | Permanent substantial peripheral sensory nerve damage. |
12 | Entrapment neuropathy which has not responded to treatment. |
13 | Permanent facial numbness including lip. |
13 | Entrapment neuropathy which has responded, or is expected to respond, to treatment. |
14 | Permanent facial numbness which does not include the lip. |
14 | Minor head injury which has caused or is expected to cause, impaired balance or post-traumatic syndrome for more than 6 weeks from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
15 | Permanent minor peripheral sensory nerve damage. |
Column (a) | Column (b) |
Level | Injury |
1 | Total deafness and loss of both eyes, or blindness in both eyes, or loss of one eye and blindness in the other eye. |
2 | Loss of eyes. |
2 | Blindness in both eyes. |
2 | Loss of one eye and blindness in the other eye. |
5 | Loss of one eye and permanent damage to the other eye, where visual acuity is correctable to 6/36. |
6 | Deafness in both ears. |
8 | Loss of one eye or blindness in one eye. |
9 | Bilateral permanent hearing loss of more than 75dB averaged over 1, 2 and 3kHz, with severe persistent tinnitus. |
9 | Partial loss of vision where binocular visual acuity is correctable to 6/60. |
9 | Permanent and inoperable cataracts in both eyes. |
10 | Deafness in one ear. |
10 | Partial loss of vision where binocular visual acuity is correctable to 6/36. |
10 | Bilateral permanent hearing loss of more than 75dB averaged over 1, 2 and 3kHz, with mild or no tinnitus. |
11 | Detached retina in both eyes. |
11 | Bilateral permanent hearing loss of 50-75dB averaged over 1, 2 and 3kHz, with severe tinnitus. |
11 | Partial loss of vision where binocular visual acuity is correctable to 6/24. |
12 | Partial loss of vision where binocular visual acuity is correctable to 6/18. |
12 | Permanent and inoperable cataract in one eye. |
12 | Operable cataracts in both eyes. |
13 | Bilateral permanent hearing loss of 50-75dB averaged over 1, 2 and 3kHz, with mild or no tinnitus. |
13 | Significant penetrating injury to both eyes. |
13 | Detached retina in one eye. |
13 | Retinal damage (not detached) to both eyes. |
13 | Partial loss of vision where binocular visual acuity is correctable to 6/12. |
13 | Dislocation of lens in one eye. |
13 | Degeneration of optic nerve in both eyes. |
13 | Permanent diplopia. |
14 | Blast injury to ears. |
14 | Diplopia which is present, or is expected to be present, at 13 weeks, from which the claimant has made, or is expected to make, a substantial recovery beyond that date. |
14 | Operable cataract in one eye. |
14 | Corneal abrasions in both eyes. |
14 | Hyphaema in both eyes which has required, or is expected to require, operative treatment. |
14 | Retinal damage (not detached) in one eye. |
14 | Significant penetrating injury in one eye. |
15 | Diplopia from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
15 | Corneal abrasions in one eye. |
15 | Hyphaema in one eye which has required, or is expected to require, operative treatment. |
Column (a) | Column(b) |
Level | Injury |
10 | Fractured heels of both feet causing permanent significant functional limitation and restriction. |
10 | Fractures or dislocations of both hips, both ankles, both shoulders, both elbows or both wrists causing permanent significant functional limitation and restriction. |
10 | Multiple face fractures causing permanent significant cosmetic effect and functional limitation and restriction despite treatment. |
11 | Fractures or dislocations of both hips, both ankles, both shoulders, both elbows or both wrists which have caused, or are expected to cause, significant functional limitation and restriction at 26 weeks, from which the claimant has made, or is expected to make a substantial recovery beyond that date. |
11 | Fracture of pelvis which has caused or is expected to cause significant functional limitation and restriction beyond 26 weeks. |
11 | Fractures of both great toes which have caused or are expected to cause significant functional limitation and restriction beyond 26 weeks. |
11 | Fractures of tarsal bones of both feet which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
11 | Fractures of both femurs, both tibiae, both humeri, both ulnae or both radii which have caused, or are expected to cause, continuing significant functional limitation and restriction beyond 26 weeks. |
11 | Multiple fractures to face, or face and neck where treatment has led, or is expected to lead, to a good cosmetic and functional outcome. |
11 | Fracture or dislocation of one hip, elbow, wrist, ankle or shoulder causing permanent significant functional limitation and restriction. |
12 | Fracture of one humerus, femur, radius, ulna or tibia which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Fracture of mandible or maxilla which has required or is expected to require operative treatment and which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Fracture of both hands which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Fracture of both scapulae or both clavicles which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Fracture of the skull with sub-dural or extra-dural haematoma which has required evacuation, from which the claimant has made, or is expected to make, a substantial functional recovery within 26 weeks. |
12 | Fractures or dislocations of both thumbs which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Fracture or dislocation of one hip, elbow, wrist, ankle or shoulder which has caused or is expected to cause significant functional limitation and restriction at 26 weeks with recovery thereafter. |
12 | Fractures or dislocations of index fingers on both hands which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Fracture of great toe which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Fracture of tarsal bones on one foot which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Fracture of heel which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Dislocated patellae in both knees which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Fracture of both femurs, both ulna, both tibiae, both humeri or both radii from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
13 | Fractured metatarsal bones on both feet which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Fracture of tarsal bones on both feet from which the claimant has made or is expected to make a substantial functional recovery within 26 weeks. |
13 | Fracture of both great toes from which the claimant has made or is expected to make a substantial functional recovery within 26 weeks. |
13 | Fracture of one femur, ulna, tibiae, humeri or radii from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
13 | Fracture of skull with sub-dural or extra-dural haematoma which has not required evacuation. |
13 | Fracture of ethmoid which has required or is expected to require operative treatment. |
13 | Fracture of zygoma which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Fracture or dislocation of one hip, ankle, shoulder, elbow or wrist from which the claimant has made or is expected to make a substantial recovery within 26 weeks. |
13 | Fracture of one hand which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Fractured of both heels where the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
13 | Fracture of both hands from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
13 | Blow-out fracture of orbit which has required, or is expected to require, operative treatment. |
13 | Dislocated jaw which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Fractured scapula or clavicle which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Fracture of both clavicles or both scapulae where the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
13 | Fracture of pelvis from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
13 | Fracture of sternum which has, or is expected to have, symptoms continuing beyond 26 weeks. |
13 | Fractures of two or more toes, other than great, of both feet which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Fracture or dislocation of thumb on one hand which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Fracture or dislocation of both thumbs from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
13 | Fractures or dislocations of index finger on both hands, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
13 | Fractures or dislocations of 2 or more fingers, other than index, on both hands which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Fracture or dislocation of index finger on one hand which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Fracture or dislocation of one finger, other than index, on both hands which has caused, or is expected to cause significant functional limitation and restriction beyond 26 weeks. |
13 | Fractures of metatarsal bones on both feet, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
13 | Fractures of metatarsal bones on one foot which have caused, or are expected to cause, significant functional limitation and restrictions beyond 26 weeks. |
13 | Dislocated patella which has caused, or is expected to cause significant functional limitation continuing beyond 26 weeks. |
14 | Dislocated jaw from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
14 | Fractured zygoma from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Fracture of index finger on both hands from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Fractured ethmoid which has not, or is not expected to require operative treatment. |
14 | Fracture of mandible or maxilla from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Fracture of hand from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Deviated nasal septum requiring corrective surgery. |
14 | Displaced fracture of nasal bones. |
14 | Simple skull fracture with no brain injury. |
14 | Fractured fibula which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
14 | Fracture or dislocation of thumb on one hand from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
14 | Fracture or dislocation of index finger from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
14 | Fracture or dislocation of one finger, other than index, of one hand which has caused, or is expected to cause continuing functional limitation and restriction beyond 26 weeks. |
14 | Fracture or dislocation of one finger, other than index, of both hands from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Fractures or dislocations of two or more fingers, other than index, on one hand, which have caused, or are expected to cause significant functional limitation and restriction beyond 26 weeks. |
14 | Fractures or dislocations of two or more fingers, other than index, on both hands from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
14 | Fractures of two or more toes, other than great toe, on one foot which has caused, or is expected to cause significant functional limitation and restriction beyond 26 weeks. |
14 | Fracture of two or more toes, other than great toe, on both feet from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Fracture of great toe from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Dislocated acromio-clavicular joint from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
14 | Fracture of coccyx from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
14 | Fracture of clavicle or scapulae from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Fracture of sternum from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Fractures of tarsal or metatarsal bones on one foot from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Fracture of heel from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Dislocated patellae in both knees from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
15 | Fracture of mastoid. |
15 | Undisplaced fracture of nasal bones. |
15 | Deviated nasal septum which has not required or is not expected to require operative treatment. |
15 | Dislocated patella from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
15 | Fracture of three or more ribs. |
15 | Fractures of two or more toes in one foot from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
15 | Stress fracture where symptoms have lasted, or are expected to last for, more than 6 weeks, where the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
15 | Fractures of two or more fingers, other than index, on one hand from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
15 | Fracture of one finger on two hands from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
15 | Fracture of index finger on one hand from which the claimant has made, or is expected to make a substantial recovery within 13 weeks. |
15 | Fracture of fibula from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
Column (a) | Column (b) |
Level | Injury |
10 | Permanent severely impaired grip in both hands. |
10 | Ligament injury which has resulted in rupture, affecting both knees, ankles, shoulders or elbows, causing permanent significant functional limitation and restriction. |
11 | Ligament injury which has resulted in rupture, affecting one knee, ankle, shoulder or elbow, causing permanent significant functional limitation and restriction. |
11 | Ligament injury which has resulted in rupture, affecting both knees, both ankles, both shoulders or both elbows, which has caused, or is expected to cause significant functional limitation and restriction at 26 weeks, from which the claimant is expected to make a substantial recovery beyond that date. |
11 | Traumatic back injury (with medically verified neurological signs and vertebral damage) extending over several levels of vertebrae, which has required, or is expected to require operative treatment and which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
11 | Radiologically confirmed juxta-articular aseptic necrosis of hip or shoulder. |
11 | Ligament injury short of rupture, to both knees, ankles, shoulders or elbows, causing permanent significant functional limitation and restriction. |
12 | Two frozen shoulders which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Ligament injury short of rupture, to both knees, ankles, shoulders or elbows, which has caused, or is expected to cause, significant functional limitation and restriction at 26 weeks, from which the claimant has made or is expected to make a substantial recovery beyond that date. |
12 | Ligament injury which has resulted in rupture, affecting one knee, ankle, shoulder or elbow, which has caused, or is expected to cause, significant functional limitation at 26 weeks, from which the claimant has made, or is expected to make a substantial recovery beyond that date. |
12 | Full thickness muscle or tendon unit rupture which has caused, or is expected to cause, significant functional limitation or restriction beyond 26 weeks. |
12 | Traumatic back injury including prolapsed interverterbal discs (with medically verified neurological signs and vertebral damage), which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
12 | Radiologically confirmed osteoarthritis of both knees, hips, ankles, shoulders or elbows (caused by a repetitive or attrition injury), causing permanent significant functional limitation and restriction. |
12 | Permanent severely impaired grip in one hand. |
13 | Frozen shoulder, which has caused, or is expected to cause, continuing significant functional limitation and restriction beyond 26 weeks. |
13 | Two frozen shoulders, which have caused or are expected to cause significant functional limitation at 6 weeks from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
13 | Ligament injury short of rupture, to both knees, ankles, shoulders or elbows from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
13 | Muscle or tendon unit injury short of full thickness rupture, which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Two muscle or tendon unit injuries, short of full thickness rupture, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
13 | Full thickness muscle or tendon unit rupture from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
13 | Ligament injury short of rupture, to one knee, shoulder, ankle or elbow which has caused, or is expected to cause, significant functional limitation and restriction at 26 weeks with substantial recovery beyond that date. |
13 | Back sprain or strain, with either more than one inter-vertebral disc prolapse, or more than one vertebral fracture, which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
13 | Radiologically confirmed osteoarthritis of knee, hip, ankle, shoulder or elbow (caused by repetitive and attrition injury) causing permanent significant functional limitation and restriction. |
13 | Compartment syndrome which has lasted, or is expected to last, beyond 6 weeks and which has required, or is expected to require, operative treatment. |
14 | Frozen shoulder which has caused, or is expected to cause, significant functional limitation at 6 weeks from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
14 | Ligament injury short of rupture to one knee, ankle, shoulder or elbow from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
14 | Muscle or tendon unit injury short of full thickness rupture from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
14 | Knee meniscus injury which has required, or is expected to require, operative treatment. |
14 | Tendon rupture of finger or thumb which has required, or is expected to require, operative reconstruction. |
14 | Back sprain or strain, with one vertebral fracture, which has caused, or is expected to cause significant functional limitation and restriction at 13 weeks, from which the claimant has made, or is expected to make a substantial recovery within 2 years. |
14 | Low back pain syndrome. |
14 | Anterior knee pain syndrome in both knees which has caused, or is expected to cause significant functional restriction and limitation at 6 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
15 | Knee meniscus injury which has caused, or is expected to cause, significant functional limitation and restriction at 6 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
15 | Anterior knee pain syndrome in one knee which has caused, or is expected to cause, significant functional restriction and limitation at 6 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
15 | Direct hernia which has required operative treatment. |
15 | Frozen shoulder which has caused, or is expected to cause, significant functional limitation at 6 weeks from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
Column (a) | Column (b) |
Level | Amount |
1 | £285,000 |
2 | £201,250 |
3 | £115,000 |
4 | £86,250 |
5 | £57,500 |
6 | £46,000 |
7 | £34,500 |
8 | £28,750 |
9 | £22,000 |
10 | £16,500 |
11 | £11,000 |
12 | £8,250 |
13 | £5,250 |
14 | £2,625 |
15 | £1,050 |
Age at last birthday | GIP Factor | Age at last birthday | GIP Factor |
16 | 0.905 | 37 | 0.790 |
17 | 0.902 | 38 | 0.781 |
18 | 0.898 | 39 | 0.772 |
19 | 0.894 | 40 | 0.762 |
20 | 0.891 | 41 | 0.751 |
21 | 0.887 | 42 | 0.740 |
22 | 0.882 | 43 | 0.728 |
23 | 0.878 | 44 | 0.715 |
24 | 0.873 | 45 | 0.702 |
25 | 0.869 | 46 | 0.687 |
26 | 0.864 | 47 | 0.672 |
27 | 0.859 | 48 | 0.656 |
28 | 0.853 | 49 | 0.638 |
29 | 0.847 | 50 | 0.619 |
30 | 0.841 | 51 | 0.599 |
31 | 0.835 | 52 | 0.577 |
32 | 0.829 | 53 | 0.554 |
33 | 0.822 | 54 | 0.528 |
34 | 0.814 | 55 | 0.500 |
35 | 0.807 | Over 55 | 0.500 |
36 | 0.799 |
[2] 1865 c.73; section 3 was amended by the Armed Forces (Pensions and Compensation) Act 2004 (c.32), section 4.back
[3] which is available from Her Majesty's Stationery Office.back
[7] World Health Organisation, Geneva. 10th Revision (1992).back
[8] American Psychiatric Association, Washington DC. 4th Edition, Text Revision (2000).back
[9] which is available from the Defence Storage and Distribution Centre, Mwrwg Road, Llangennech, Llanelli, Carmarthenshire, SA14 8YP.back
[10] which is available from Service Personnel Policy (Pensions), Ministry of Defence, Main Building, Whitehall, London, SW1A 2HB.back
[11] See section 6A(9) of the Pensions Appeal Tribunals Act 1943 (c.39) inserted by the Armed Forces (Pensions and Compensation) Act 2004 (c.32), section 5 and Schedule 1, paragraph 4.back
[12] World Health Organisation Press, Geneva. 10th Revision (1992).back
[13] American Psychiatric Association, Washington DC 20005 USA. 4th Edition, Text Revision (2000).back
[20] 1943 (c.39), section 6A was inserted by the Armed Forces (Pensions and Compensation) Act 2004 (c.32), section 5 and Schedule 1, paragraph 4.back
[21] Section 6C was inserted by the Armed Forces (Pensions and Compensation) Act 2004 (c.32), section 5 and Schedule 1, paragraph 4.back
[22] Section 6D was inserted by the Armed Forces (Pensions and Compensation) Act 2004 (c.32), section 5 and Schedule 1, paragraph 4.back
[26] 1993 c.48 as amended by the Welfare Reform and Pensions Act 1999 (c.30), section 18 and Schedule 2, paragraph 3(1)(a).back