Osteoarthritis of the Knee

NUM GUIDANCE ON OSTEOARTHRITIS OF THE KNEE


Claim Form BI100PD can be obtained from your local DWP office.
Or by telephoning 0845 608 8779
Or collected in person from:
National Union of Mineworkers
Nottinghamshire Area
Byron House,
Commercial Street,
St Peters Retail Park,
Mansfield,
Notts,
NG18 1EE



SECTION 1

Industrial Injuries Benefits are paid if you were disabled as a result of an accident at work or a disease caused by your job.

THERE IS NO NEED TO USE A SOLICITOR

You must satisfy the industrial injury condition, that is:

You were an ‘employed earner’; and either
You have suffered a ‘personal injury’ in an industrial accident; or
You are suffering from a ‘prescribed industrial disease’; and
As a result of that accident/disease you have suffered a loss of faculty;
And
As a result of that loss of faculty you are disabled.

The percentage of disablements for 2 or more accidents/diseases can be added together. So if you have 7% for PDA11 (Vibration White Finger) and 15% for an accident to your leg, you have a total of 22%.

Assessments are either Final or Provisional. Provisional means you do not know what is going to happen in the future and you automatically get reassessed at the end of the period. Final means a fixed period but if you are still suffering at the end of that assessment period, you should ask for a review/appeal.

A new Prescribed Disease was added to the list on 13 July 2009. PDA14 is osteoarthritis of the knee in miners.

From13 July 2009 miners who worked underground for over 10 years before 1.1.1986 and miners who worked in certain other roles for 10 years since 1,1.1986 can make a claim for Industrial Injuries Disablement Benefit for this disease.

PDA14 – Osteoarthritis of the Knee – Prescription

Work underground in a coal mine for a period of, or periods of, or periods which amount in aggregate to, at least 10 years in any one or more of the following occupations:

a) before 1st January 1986 as a coal miner; or
b) on or after 1st January 1986 as a –
i) Face worker working on a non-mechanised coal face;
ii) Development worker;
iii) Face-salvage worker;
iv) Conveyor belt cleaner; or
v) Conveyor belt attendant

A “non-mechanised coal face” means a coal face without either powered roof supports or a power loader machine which simultaneously cuts and loads the coal or without both.

SECTION 2

ADVICE ON COMPLETING THE CLAIM FORM

• Put in as much detail as possible about the work that you did. Do not assume that the decision maker will know what your job entailed.

• If you have any medical reports, scan reports or x ray reports which support your claim, include a copy with your claim form.

• Include as much detail as you can about how the osteoarthritis in your knees affects your everyday life. Think about all the things you cannot do e.g. housework, decorating, gardening, playing with children/grandchildren, hobbies. All these limitations count when assessing a loss of faculty.

• If you are very old or very ill add that information into the box at the end of the claim form which asks for any other information. Ask that your claim be fast tracked.

• If you have any queries or need help to complete the claim form contact your local NUM

REMEMBER THAT YOU DO NOT NEED A SOLICITOR

VERY IMPORTANT

There is a one month deadline for appealing against any decision with which you do not agree. The one month period begins to run from the date on the letter giving you the decision. If you receive a decision with which you are not happy do not delay in seeking advice on lodging an appeal.

SECTION 3

QUESTION AND ANSWER

How will the 10 year period be calculated?

The 10 year period does not have to be continuous. Separate periods of work can be added together as long as the work done was underground before 1.1.86 or in one of the listed jobs after 1.1.86. Pre 1.1.86 periods and post 1.1.86 periods can be added together. The 10 years can be spent in a number of different roles as long as each role is covered by the prescription.

Short periods of absence will be ignored e.g. sickness but strike periods will not count towards the 10 years. It appears, however, that only the actual strike period will be deducted from the claimant’s working life.

Can I claim Reduced Earnings Allowance?

An assessment for PDA14 will not give rise to any claim for REA. This is because REA cannot be claimed for any new disease prescribed after 10.10. 94. PDA14 became a prescribed disease on 13.7.09

What percentage will I get?

We understand that even the most severe cases are liely to be assessed at less than 30% but each case will depend on its facts. An assessment for Industrial Injuries Disablement Benefit is made on the basis of the loss of faculty suffered by the claimant. It is possible to have osteoarthritis of the knee and have no symptoms. In this case there would be no percentage awarded. The percentage should reflect the severity of the symptoms.

What information will the DWP obtain?

The DWP will obtain copies of any x rays that have already been done or reports that have already been prepared. They will not send any claimant for an x ray or a scan.

What if I haven’t consulted my GP about my knees?

It does not matter if a claimant has not sought help for this problem before. The DWP doctor should be able to recognise signs of osteoarthritis of the knee. It will be accepted that a claimant may not have sought help knowing that the condition was due to wear and tear.

How will surgery such as cartilage removal or knee replacement affect the claim?

The need for a knee replacement because of osteoarthritis would show that the claimant had a problem. However, 97% of cases show improvement after the knee replacement. Each case will be assessed on the loss of faculty at the time of the claim thus the percentage awarded may be low.

If your cartilage removal was necessitated by an accident at work before 1.10.90 and this has led to osteoarthritis you would be better claiming under the accident rules as even an assessment of 1% would allow you to access REA.

Can my claim be back dated?

Yes, but only to 13.7.09. There can be no backdating before that date as the osteoarthritis did not become a Prescribed Disease until that date.

How long will it take to process my claim?

Because it is anticipated that there will be many claims, it may take up to 6 months for a claim to be processed. However, any benefit due will be backdated to the date of claim.

If the claimant is very old or very ill, the claim will be fast tracked but these matters need to be brought to the attention of the DWP in the claim form.

What if I have osteoarthritis in one knee?

For PDA14 it is most likely that both knees would be affected. However, there may be cases where a worker has favoured one knee. Although this would be unusual it should not put you off claiming

What if I have osteoarthritis in other parts of my body?

Make a claim for PDA14. The doctor who examines you will also take a history from you and will decide whether the osteoarthritis in your knees is constitutional (would have happened anyway) or whether it is linked to your employment.

What if I haven’t worked in a mine for over 20 years?

There are no time limits to making a claim. Osteoarthritis can develop over a long period.

Claim Form BI100PD can be obtained from your local DWP office.
Or by telephoning 0845 608 8779
Or collected in person from:
National Union of Mineworkers
Nottinghamshire Area
Byron House,
Commercial Street,
St Peters Retail Park,
Mansfield,
Notts,
NG18 1EE