NHS Permanent Injury Benefit (PIB): table, lump sum and calculator
Last updated · By Mustafa Bilgic · Table from regulation 4 of the National Health Service (Injury Benefits) Regulations 1995, rules as amended and as applied by NHS Pensions
PIB is not compensation for the injury itself. It is an income guarantee: the scheme tops up the income you get from pensions and certain Department for Work and Pensions benefits to a set percentage of your former pay. This page sets out the table, the rules on what counts as income, the lump sum, reviews and death benefits, and the calculator applies them to your figures.
NHS Permanent Injury Benefit table
The scheme's medical adviser assesses the permanent reduction in your earning ability, which picks the row. Your length of NHS service picks the column. The percentage is the income the scheme guarantees, and the last column is the lump sum, which does not depend on service.
| Permanent reduction in earning ability | Less than 5 years | 5 years and over but less than 15 years | 15 years and over but less than 25 years | 25 years and over | Lump sum |
|---|---|---|---|---|---|
| More than 10% but not more than 25% | 15% | 30% | 45% | 60% | One-eighth (12.5%) |
| More than 25% but not more than 50% | 40% | 50% | 60% | 70% | One-quarter (25%) |
| More than 50% but not more than 75% | 65% | 70% | 75% | 80% | Three-eighths (37.5%) |
| More than 75% | 85% | 85% | 85% | 85% | One-half (50%) |
NHS Permanent Injury Benefit calculator
Guaranteed income, deductions and lump sum
Counted benefits are Industrial Injuries Disablement Benefit for this injury (without Constant Attendance or Exceptionally Severe Disablement Allowance), Employment and Support Allowance, Incapacity Benefit, Severe Disablement Allowance, Reduced Earnings Allowance and Retirement Allowance. Use the rates in force when your employment ended.
Who can get Permanent Injury Benefit
Since the 2013 amending regulations, the scheme only applies to an injury sustained, or a disease contracted, before 31 March 2013. It must be wholly or mainly attributable to your NHS employment or duties, and NHS Business Services Authority, which runs the scheme in England and Wales, lists the kinds of case it considers: an injury or disease from a specific incident or series of incidents, a condition that does not show itself for several years, an injury while travelling on official duty or while volunteering at an accident or emergency, an off-duty assault caused by your NHS work, and physical or psychiatric injury from exposure to noxious substances or overwork. It does not cover an injury on a normal journey to and from work (community nurses may be an exception), sickness caused by investigations or disciplinary action, or an injury due to your own culpable negligence or misconduct.
Almost all NHS employees are covered from their first day, whether or not they are in the NHS Pension Scheme, along with GPs, dental and ophthalmic practitioners working for the NHS. GP practice staff, dental practice staff, freelance locums, agency staff and most Direction employees are not. PIB can be paid if the number of hours you can work is permanently reduced, if you have to move to a permanent lower-paid NHS job, or if you have to leave NHS employment. It is not payable if the reduction in your earning ability is assessed at 10% or less.
Deadlines: 2018 and 2038
The amended regulation 4 pays PIB in the ordinary way where you left NHS employment, or your pay was reduced, before 31 March 2018. Where that happens on or after 31 March 2018 but before 31 March 2038, the Secretary of State may pay only if satisfied that your evidence is compelling, meaning reliable, of substantial value and highly probative of the claim. NHS Business Services Authority puts it this way: it only processes applications received after 30 March 2018 from people who can show a delayed onset of symptoms, and it will not accept new applications on or after 31 March 2038.
If you left the NHS for another reason before normal benefit age and your earning ability is permanently reduced later because of the injury, regulation 4(3) allows an allowance from normal benefit age, or earlier if the Secretary of State allows. Normal benefit age is 60 for the 1995 Section of the NHS Pension Scheme, 65 for the 2008 Section, and State Pension age or 65 if higher for the 2015 Scheme.
How PIB is worked out
Average pay. Regulation 2C defines average remuneration by pension scheme. For most staff in the 1995 Section it is final year's pensionable pay under that Section's rules, and NHS Business Services Authority's example uses the best of the last three years' pensionable pay. For the 2015 Scheme it is the greater of the best year of re-valued pensionable earnings in the reference period and the annual rate of pay when employment ended. Service counts all periods of NHS employment and any other periods counted for a relevant pension scheme.
What is deducted. The allowance is whatever is needed, added to the pensions and benefits in regulation 4(6), to reach the guaranteed income. Those are any pension under a relevant pension scheme, counted before any reduction for exchanging pension for a lump sum and without later Pensions Increase uprating, and these benefits for the injury: Industrial Injuries Disablement Benefit (but not its Constant Attendance or Exceptionally Severe Disablement increases), Incapacity Benefit, Severe Disablement Allowance, Reduced Earnings Allowance, Retirement Allowance, Employment and Support Allowance and an NHS injury allowance. The benefits are counted at the rates in force when your employment ended or your pay was reduced. If these already reach the guaranteed income, no allowance is paid, but NHS Business Services Authority says the case can be reviewed if a pension or benefit stops or your earning ability falls further.
Lump sum. NHS Business Services Authority says a lump sum may also be payable if your NHS employment ends because of the injury or disease, and regulation 4(9) sets it at the proportion of average pay in the table, whatever your service. It is not payable if you move to a lower-paid job with the same employer, and the HSC Pension Service notes that a lump sum cannot be reviewed.
Reviews, re-employment and damages
Under regulation 13 the allowance is reviewed if your earning ability is further reduced by the injury, if a counted benefit starts or stops, or if a pension starts. NHS Business Services Authority adds that it is not reviewed just because benefit rates go up or down. If you work for the NHS again, regulation 13(4) abates the allowance so that it, your new NHS pay and your NHS pension together do not exceed your former earnings, which means the higher of your average pay and your rate of pay when the allowance started. The calculator takes former earnings as your average pay.
Regulation 17 lets the Secretary of State take into account any damages or compensation you recover for the same injury, withhold or reduce benefits, and recover benefits already paid up to the net amount of the damages. You must tell NHS Pensions when a claim settles, and the HSC Pension Service asks for notice within 14 days. If you are claiming against an employer, see claiming against your employer and future loss of earnings.
Benefits after a death
If a person covered by the scheme dies as a result of the injury or disease, or their death is substantially hastened by it, regulations 7 to 11 provide allowances for the family, topping up any NHS survivor pension to a percentage of the deceased's average pay. All the allowances and counted pensions together cannot exceed the deceased's average pay (regulation 10).
| Who | Guaranteed income |
|---|---|
| Surviving spouse, civil partner or qualifying partner | 45% |
| Each dependent child, up to four | 10%, or 20% if there is no surviving parent |
| A dependent parent, or an adult child permanently unable to earn a living | 20%, or 45% if there is no surviving partner or parent |
| Lump sum to the first eligible person | One-half of average pay, unless a lump sum was already paid for the injury |
Tax and index linking
All injury benefit allowances are index linked, according to the NHS Business Services Authority, SPPA and HSC Pension Service guides. On tax, NHS Business Services Authority's scheme guide says Temporary Injury Allowance is subject to income tax and National Insurance, and SPPA's factsheet for Scotland heads its PIB section "Permanent Injury Benefit (non-taxable)". NHS Business Services Authority's guide does not state the tax position of PIB, so check it with NHS Pensions or HMRC.
Scotland and Northern Ireland
Scotland has its own NHS injury benefits regulations, run by the Scottish Public Pensions Agency, with the same table and lump sums and the same dates: injuries on or before 30 March 2013, applications by 30 March 2018, or by 30 March 2038 with evidence of delayed onset. Northern Ireland's HSC Injury Benefits Scheme, run by the HSC Pension Service, publishes the same table and death benefits in its scheme guide.
Worked examples
NHS Business Services Authority's example. A person leaves the NHS after 7 years because of an injury wholly or mainly attributable to their NHS duties. The reduction in earning ability is more than 25% and up to 50%, and the best of the last three years' pensionable pay was £10,000.00. The guaranteed income is 50% of that, £5,000.00 a year. With an NHS pension of £1,000 and social security benefits of £3,200 a year, PIB of £800 a year is payable, plus a lump sum of 25%, £2,500.00.
A longer career. A healthcare assistant with 23 years of service leaves with average pay of £28,000 and a reduction in earning ability assessed at 60%. The guarantee is 75% of pay, £21,000. With an NHS ill-health pension of £9,000 and Employment and Support Allowance of £4,970 a year, PIB is £7,030 a year, and the lump sum is three-eighths of pay, £10,500. This second example is our own calculation.
Sources and methodology
The table was read from regulation 4 on legislation.gov.uk and compared with the NHS Business Services Authority, SPPA and HSC Pension Service tables, which match. The calculator applies regulation 4(2), (6) and (9) and the re-employment rule in regulation 13(4), and was tested on every cell of the table, the service boundaries and the official examples.
- National Health Service (Injury Benefits) Regulations 1995, regulation 4, on legislation.gov.uk, and the amending S.I. 2013/413, Part 5, on legislation.gov.uk.
- 1995 Injury Benefits Regulations, informal consolidation to 20 December 2023, NHS Business Services Authority.
- Permanent Injury Benefit and About the Injury Benefits Scheme, NHS Business Services Authority.
- Injury benefits, Scottish Public Pensions Agency.
- HSC Injury Benefits Scheme guide, HSC Pension Service.
Frequently asked questions
How is NHS Permanent Injury Benefit calculated?
Find your row from the permanent reduction in your earning ability and your column from your NHS service. That gives a guaranteed income as a percentage of average pay. Take off your NHS pension and certain DWP benefits, and the rest is your yearly PIB.
Can I still apply for NHS Permanent Injury Benefit?
Only for an injury or disease from before 31 March 2013. Applications received after 30 March 2018 are only considered with evidence of a delayed onset of symptoms, and no new applications are accepted on or after 31 March 2038.
How much is the NHS injury benefit lump sum?
One-eighth, one-quarter, three-eighths or one-half of average pay, depending on the reduction in earning ability. It is paid if your NHS employment ends because of the injury, whatever your length of service.
Does my NHS pension reduce Permanent Injury Benefit?
Yes. Any pension under a relevant pension scheme is counted towards the guaranteed income, before any reduction for exchanging pension for a lump sum. Industrial Injuries Disablement Benefit, ESA and some other benefits for the injury also count.
Is NHS Permanent Injury Benefit paid for life?
The Scottish Public Pensions Agency says PIB is payable for life. It is still reviewed if a counted benefit or pension starts or stops, if your earning ability falls further, or if you work for the NHS again.
What is the difference between PIB and injury allowance?
PIB is part of the old NHS Injury Benefits Scheme for injuries before 31 March 2013 and guarantees a long-term income. Injury allowance, for injuries from 31 March 2013, is paid by your employer during sickness absence for up to 12 months.