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NHS injury allowance


NHS injury allowance can be used to top up your sick pay or earnings (if you are on a phased return). It can be paid for up to 12 months per episode. You may be able to claim if you meet all of the following:

  • you are employed within the NHS under the NHS terms and conditions of service handbook or where the injury allowance is provided for in your employment contract
  • you have had an accident or contracted an illness/disease that is ‘wholly or mainly attributable’ to your NHS employment
  • you are on authorised sickness absence or a phased return to work
  • you have had your earnings reduced to less than 85% of your pay because of your ill health.

For further guidance on eligibility, please see the NHS employers website and the NHS guidance in the submitting a claim section below.

If successful, you can receive up to 85% of your pay. Payment is not dependent on length of service, so all staff are covered from their first day of employment.

Please note: different arrangements apply if you injured yourself or contracted a disease at work before 31 March 2013. See the NHS employers website for more information.

You should notify your employer as soon as possible if you believe your sickness absence is work related. Ideally, the nature of your condition should be outlined in your fit note. You may also need to submit additional medical evidence and witness statements.

Local policy will outline the specific action to take and processes to follow. This may include submitting a claim form to your employer who will decide whether you are entitled to injury allowance. If your claim is successful, your employer should explain when the payment will start (as the allowance is only payable once your pay drops below 85%).

NHS Employers have detailed guidance below regarding the injury allowance which applies to NHS employees covered by the the NHS terms and conditions of service handbook and other staff who may no longer be working for the NHS but may have the injury allowance included with their employment contracts. The guidance also includes some helpful FAQs:

Injury allowance - a guide for staff

Injury allowance -a guide for employers

The NHS Terms and Conditions of Service Handbook contains provisions of the scheme in Section 22. This should be read in conjunction with the Section 14 which applies to your relevant part of the UK (i.e. England, Wales, Scotland and Northern Ireland), and annex 26. 

If your claim is refused and you disagree with your employer’s decision please, contact us for further advice and support.

Injury allowance may be paid if you suffer from:

  • a physical or psychiatric injury/illness due to a specific incident or series of incidents at work
  • an injury or disease that does not manifest itself for several years e.g. asbestosis, Hepatitis C following a needlestick injury
  • an injury whilst travelling on official duty such as a road traffic accident (RTA)
  • an injury sustained off duty for example, whilst providing treatment which requires professional skills at the scene of a RTA
  • an injury inflicted off duty which can still be attributed to your NHS employment (being assaulted on the way home from work by ex-patient).
  • an injury, illness or other health condition contracted due to a series of incidents relating to NHS employment (exposure to noxious substances causing injury, condition or disease over a period).

It cannot be considered if:

  • you are injured whilst on a normal journey travelling to and from work, except where the journey is part of your duties of employment
  • you are on sickness absence as a result of employment related matters (for example, you are the subject of investigation/capability/disciplinary procedures or as a result of a failed application for promotion or transfer)
  • you sustain an injury/disease at work which is due to, or aggravated, by your own negligence or misconduct.
It is not payable:
  • if your pay has not dropped below 85%
  • after your employment contract has ended.
If you are injured at work or have a work related illness, our health and safety concerns page can provide guidance and our sick leave and sick pay guidance may also be helpful. Our accidents at work guidance provides further information about what to do and who to contact after an accident at work.

You are entitled to a period of pay protection if you have to change jobs permanently to a position on lower pay, or have to reduce your hours due to a work related injury, or illness. Pay protection should be awarded in line with your employer’s organisational change policy.

RCN Welfare Rights and Guidance

NHSBSA Injury Benefit Scheme - for injuries/diseases contracted before 31 March 2013

Agenda for Change terms and conditions - section 22 and Annex 26

Please also see your contract of employment and relevant local policies.


Find out how to protect yourself, what you should expect from your employer and what to do if you have concerns.
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Page last updated - 12/06/2024