employment injury & benefits ni b representative

The National Insurance BoardOf Trinidad and Tobago

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The National Insurance Boardof Trinidad and Tobago

What is National InsuranceWhat is National Insurance

Employer ObligationsEmployer Obligations

National Insurance Benefits National Insurance Benefits


What is Social Security?“…the protection which society provides for its members…against the economic and social distress…resulting from

• Sickness, • Maternity, • Employment Injury• Invalidity• Old age and• Death…”

Excerpt from ILO 1984a definition of Social Security)


What is National Insurance in Trinidad and Tobago?


» It provides retirement income, sickness and disability coverage for eligible workers and their dependents.

» “Premiums” are a combination of contributions made by the employee and the employer

» Benefits are based on the contributions an individual makes during his or her lifetime.


Who Must Register?

Under the National Insurance Act, Chapter 32:01 as amended: – all employers– their employees and unpaid

apprentices, except those exempted under section 29:01 and 29:02 of the Act,

must register with the NIB.


Important Terms• Employee• Employer• Insurable Employment


Who is an Employee?

Employed person – a person in receipt of earnings in respect of employment and includes domestics, casual agricultural workers and paid apprentices

National Insurance Act 9 of 1999


Who is an Employer?

EMPLOYERS under the National Insurance Act, are persons or organisations who employ the following types of persons: -

– persons earning $150.00 or more per week

– paid and/or unpaid apprentices


Employer Obligations

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• Ensure that your company and all your existing employees are registered with the National Insurance Board

• Register yourself and your employees within fourteen days of hiring your first employee

• Register new employees within fourteen days of hiring them

• Prepare and maintain accurate pay records


• Every employer must be registered including those who employ only domestic and casual workers

• All insurable employees must be registered


Who is an Insurable Employee?

A person who earns at least $150 per week, is considered to be in insurable employment and therefore eligible for coverage under the National Insurance Act (Chapter 32:01)


Registration - Where

• Registration should take place at any National Insurance Service Centre

• Registration forms are also available online at

www.nibtt.co.tt


What Are Contributions?

• A contribution is a weekly payment fixed in relation to the wages/salaries of the insured person.

• Salaries and wages are structured into 16 earnings classes each of which carries an assumed average weekly earning.


Earnings

For National Insurance purposes, earnings include more than the basic wage or salary. Earnings also include but is not

limited to:

• Acting Allowances• Overtime payments• Cost of living allowances• Commission on Sales• Production or efficiency bonuses• Danger or dirt money• Payments for standby duty• Allowances for dependents


Contribution Rates


Employers are required by Law to pay contributions on behalf of all employees and unpaid apprentices and ; submit a monthly statement of contributions due and paid for all employed persons.


ImportantContributions for all employees and unpaid apprentices, are due from the start of their employment, apprenticeship or probationary period.


Multiple Employment

Where an employee has multiple employment all employers must pay contributions on behalf of the employee.


Contributions• Make the appropriate deductions from your

employees’ wages at source

• Remit the whole of the combined deduction to the National Insurance Board Service Centre on or before the last working day of the month

• Ensure that the required information relating to the employees for which the contributions are being paid is remitted to the NIB at the time that such contributions are being paid


ContributionsAn employed person who:

• Is under 16 yrs old • Over 65 yrs • In receipt of a Retirement Benefit and returns to

insurable employment

shall only be insured for the injury benefit. The contribution shall be paid only by the employer in class Z:


Guide to Benefits

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Benefits provided under the NISLong Term Short Term Employment

Injury

Retirement- Pension- Grant InvaliditySurvivors- Widow/Widower- Child / Orphan- Dependant

Parents

Sickness

Funeral GrantMaternity- Grant - Allowance

Special Maternity Grant

Injury AllowanceMedical ExpensesDisablement- Pension- GrantDeath Benefit- Widow/Widower- Child - Dependant

Parents


Employment Injury Benefits

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A unique type of benefit paid to:• An insured person who is rendered

incapable of work through personal injury or mental incapacity which arises out of and in the course of employment or

• through the development of a prescribed industrial disease caused by the nature of the job


Death Benefit


Injury Disable-ment

Medical Expenses


Injury

An insured person who is rendered incapable of work through:

• personal injury or mental incapacity which arises out of and in the course of employment or

• through the development a prescribed industrial disease caused by the nature of the job



Who can Apply?

An insured person who is away from the job for no less than 3 days as a result of injury arising out of and during the course of his employment.


Making the Application

Form to be completed:• Form NI 19– Application for Injury

Benefit and or • NI19A – Medical Certificate for

continuing injury/diseaseThe relevant section of the forms must

be completed by a registered medical practitoner.


BENEFIT DISQUALIFICATION

Employment Injury Benefit disqualification my occur where:

o Incapacity resulted from their own serious and willful misconduct.

o Without reasonable cause behaves in a manner likely to retard their recovery.

o Engages in work for which remuneration is or would ordinarily be payable.

o Refuses to respond to reasonable enquiries from the NIBTT


When to Apply?

• The Application must be made within 14 days of the date of the accident/prescribed disease or the start date of incapacity.

• Late submission of the claim can result in the loss of the benefit


How Much will be Paid?

The benefit payment is determined by using the class of contribution paid or due for the week of the accident or the week prior to the accident, whichever is higher


Benefit RatesEarnings Class Injury Pension Weekly Payments

Injury Pension Monthly Payments

Class I 133.33 577.76

Class II 193.33 837.76

Class III 260.00 1,126.67

Class IV 336.67 1,458.90

Class V 413.33 1,791.10

Class VI 500.00 2,166.67

Class VII 593.33 2,571.10

Class VIII 686.67 2,975.57

Class IX 786.67 3,408.90

Class X 890.00 3,856.67

Class XI 993.33 4,304.43

Class XII 1,106.67 4,795.57

Class XIII 1,226.67 5,315.57

Class XIV 1,360.00 5,893.33

Class XV 1,486.00 6,439.33

Class XVI 1,538.67 6,667.57


How long will the Benefit be Paid?

The benefit is paid for a maximum of 52 calendar weeks

If the incapacity continues beyond 52 weeks, the insured can be assessed to determine his or her entitlement for a Disablement benefit


Disablement Benefit

• The Disablement Pension — This benefit is paid until the disability ceases.

• The Disablement Grant — This grant is paid as one lump-sum


Qualifying Conditions

Disablement Pension is paid:• Where the insured is assessed as having a loss of

faculty of 20% and more

Disablement Grant is Paid:• Where the insured is assessed as having less than

20% loss of faculty or disability

• Where disablement is assessed at less than 1%, the insured shall be deemed as suffering no loss of faculty.



• Forms to Be Completed– NI 119 - Disablement Benefit Claim Form

• You must apply for the benefit within 3 months from the end date of the Injury Benefit Period.


Late Applications

• Failure to submit your claim to the Board within 3 months 3 months from the end date of the Injury Benefit Period may result in loss of benefit.

• A letter explaining the late submission is required.

Employment Injury

Benefits


How muchwill be paid?

Disablement Grant• One lump-sum payment will be made.


How much will be paid?

Disablement Pension:• You will be paid a percentage of the Injury

Benefit as a Disablement Pension.


How much will be paid?

• If you are already in receipt of Disablement Benefit and submit a subsequent claim for Disablement arising out of a new injury for which you are assessed at 20% or more…

• You shall be required to be re-assessed to establish a total permanent /partial disability and the current Disability Benefit revised to reflect the new assessment.


Life Certificates

• Once you begin to receive a Disablement Pension you must submit a Life Certificate in the months of July and January of every year. This is to ensure that there is no disruption in your payments.

• To do this you must:– Complete a copy of the Life Certificate and return it to

the Service Centre.


Medical Expenses

Medical Expenses are paid to :• an insured person who incurs the

cost of medical treatment for the personal injury or prescribed industrial disease arising out of and in the course of employment


Medical Expenses

• Medical expenses are paid up to a maximum of $33,750.00 per injury


Medical Expenses

• Medical expenses Include the Following:• a. Doctor's Fees • b. The cost of drugs and dressings • c. Hospital Expenses • d. Operations • e. The cost of necessary Para-medical

treatment e.g. physiotherapy, appliances • f. The cost of travel incidental to an

insured person receiving care and treatment. • g. Constant Care and Attendance

Allowance



The expenses must relate to medical attention received for injuries caused by an accident arising out of and in the course of employment or for a prescribed industrial disease



• N.I. 114 Application for Medical Expenses

• Submit the completed application form to any of our Service Centres within three months of the date on which the expenses were incurred


Failure to submit your claim to the Board within 12 months WILL

result in the loss of your benefit.



Death Benefit

• The Death Benefit is a periodical payment

• It is made to specific survivors of a deceased insured person who died as a result of an accident or of a prescribed industrial disease arising out of or in the course of employment.


Death Benefit

• Survivors include:– Widows– Widowers– Children– Dependent parents



The deceased insured person must have died as a result of an injury arising out of and in the course of his or her employment



• N.I. 117 Employment Injury Death Benefit Claim Form

• Copy of :– birth certificate, – marriage certificate and – death certificate


Supporting Documentation

• Death Certificate of deceased insured person• Birth Certificate of widow and eligible children• Medical Certificate for mentally or physically

disabled child• Medical Certificate for pregnant spouse, certifying

pregnancy and expected date of confinement.• Marriage Certificate for Legally Married Persons



When To Apply?• You must apply for the benefit within

12 months of the date of death of the insured person.

• Failure to submit the application on time can result in the loss of all or part of the benefit


How Much will be paid?

The value of the Death Benefit will be determined by the rate of contribution paid or due for the deceased insured in the week of or the week prior to the date of death whichever is greater.


How Long will the Benefit be paid?

• Spouse/Dependent Parent– The benefit is paid for life or until remarriage

• Dependent child:– The benefit is paid until age 19 – Marriage– Cessor of incapacity for an invalid child


Life Certificates• A recipient of the Death Benefit must

submit a Life Certificate at intervals identified by the Board.

• Where a Life Certificate is not received by the due date, the payment will be suspended.

• Upon receipt of the completed Life Certificate, the payment will be reinstated.

• No loss of payment will occur.

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