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Injury by process


This guide for RCN members provides examples of possible injury by process and includes information on how to report an injury by process to the Department of Work and Pensions. 


This is not a definite guide. Each incident will need to be assessed individually.


When is it an industrial injury?

Broadly speaking, injury by process is not recognised by the Department of Work and Pensions or the NHS Injury Benefit Scheme as an industrial injury. For example: a “nurses back” or wear and tear over several years of nursing will not be recognised.

However, there are some exceptions. The most recently recognised condition is repetitive strain injury involving the upper limb where the employee has been expected to work quickly at a repetitive task for long periods without breaks, such as inputting computer data.

Within nursing, the RCN’s Peer Support Group has become aware of situations where it can be acknowledged that repetitive injury has occurred over a short time scale.

Example 1

Nurses involved in drawing up and administering drugs/substances at frequent intervals over a shift e.g. cytotoxic drug administration to a number of clients. Repetitive strain occurs due to the effort involved in drawing up, often, viscous substances and the number of times this is repeated.

Staff noticing tenderness or pain in fingers, hand, wrist or arm during or after such a session should complete an incident/accident report and register it as an industrial injury with the Department of Work and Pensions (DWP). While the condition initially may settle down quickly, repeated sessions may eventually cause lasting and permanent problems.

Example 2

Nurses who develop back pain or (hip pain or sciatica or upper limb symptoms) over the course of a shift or series of shifts covering a period of a few days.

A typical history would involve the employee being on duty for several long shifts one after the other, e.g. Friday, Saturday, Sunday, usually on a busy unit with heavily dependent clients. The work load will be intense with few or no breaks and constant manual handling/repetitive tasks e.g. getting clients out of bed, toileting, moving to the dining area, dressing wounds, turning patients. Often these tasks are performed quickly, one after another, maybe in confined/awkward spaces, or involve stooping in uncomfortable positions etc.

At the end of the first shift the employee may be aware of tiredness and/or a slightly ‘sore’ back. By the end of the series of shifts (2-4 days) the discomfort is fairly constant but may be relieved for a while by rest.

It is essential that an incident/accident report is completed as soon as possible. In all situations it is essential that documentary evidence is available to prove that the injury is caused by work and not other cumulative factors. Whilst it may seem untenable to report each time you feel you suffer a minor injury, if you wish to claim compensation or benefit in the future this is exactly the kind of evidence you will rely on to prove your case.

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Medical support

You can refer yourself to Occupational Health or you may prefer to speak to your own GP in the first instance.

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Claiming industrial injury disablement by process

Form BI 100 A (Registration of an Industrial Injury) requires that an incident/accident be reported as occurring at a specific date and time. In order to report injury by process it is essential that the nurse gives a fairly detailed account on a separate sheet (dated and signed). When describing the process do remember that the Decision Maker (DM) is not medically trained and will have only a vague idea of what a nurse does in the course of a shift.

Points to highlight:

  • Length and frequency of shifts (e.g. 12 hour shifts over 3 consecutive days)
  • Nature of work place e.g. 6 bed intensive care unit, 24 bed elderly care ward
  • Number and dependency level of clients e.g. 6 totally dependent clients requiring constant monitoring/care, 24 elderly clients requiring high levels of assistance
  • Repetitive nature of tasks over the shift e.g. how many injections had to be prepared/given, nature of substance, e.g. how many patients required turning, at what frequency, how many clients were got up, put to bed, toileted.
  • Awkward aspects e.g. confined toilet area, stooping to renew dressings, give drugs by injection or stretching to renew IV/dialysis fluid bags.      

Use clear, unambiguous language and avoid jargon or medical terminology where possible. State when you became aware of symptoms, what they were e.g. discomfort at end of first shift, awareness of stiffness/pain during next shift, onset of acute pain when taking a break, etc.

For benefit and legal purposes the onus of proof is with you, the claimant/appellant.

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Further information

For further information see our advice on industrial injury benefit and Gov.uk.


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Call the RCN on: 03457726100