Organization : National Insurance Scheme
Type of Facility : Employment Injury Benefit
Country: Grenada
Website : https://www.nisgrenada.org/
Employment Injury Benefit :
Employment Injury Benefit is a payment to insured persons who are incapable of work because of an injury sustained as a result of an accident occurring on the job, or certain types of diseases contracted on the job.
Related : National Insurance Scheme Maternity Allowance & Grant Grenada : www.statusin.org/8867.html
Benefits included under Employment Injury are Disablement, Constant Attendance, Medical Expenses, Injury, Funeral and Death.
Injury Benefit is paid up to a maximum period of 52 weeks from the date of incapacity, as long as the incapacity exists. After that period, if the incapacity continues a medical doctor must re-assess the disability to determine eligibility for the Disablement Benefit.
The rate of Injury Benefit is 70% of average weekly insurable earnings.
Important steps in claiming Employment Injury Benefit:
** Report the accident to your employer or Supervisor immediately
** Employers are required to investigate the circumstances of an alleged accident and submit a written report to the Board as soon as possible
** Visit your doctor immediately, or go to the hospital. Ask the doctor to certify your injury on the NIS Employment Injury Claim Form
** Complete and sign the claim form and submit same to the National Insurance Board as soon as possible
** Provide an original copy of all receipts
Medical Expenses :
A person qualifies for a refund of prescribed expenses reasonably incurred in the treatment of an employment injury or a prescribed disease.
What payments are made?:
** Medical, surgical, dental and hospital treatment, skilled nursing services and the supply of medicines
** The supply of fittings, maintenance, repair and renewal of artificial limbs, dentures, spectacles and other apparatus and appliances
** The cost of traveling for the purpose of obtaining any of the above
** Fees for airfares, costs of hospitalization and operations undertaken abroad will be paid only if prior approval was received from the National Insurance Board. If this is not done, the claim will be restricted to E.C. $1000
When claiming Medical Expenses all original receipts for medication, doctor’s fees, travelling, hospitalization etc, must be submitted with your claim. Details of the nature of treatment which was received must be indicated on the form.
The Board may pay directly to a Medical Practitioner or Institution instead of refunding the insured person.
Disablement Benefit is paid to a person who has exhausted his or her entitlement to Injury benefits and suffers from a loss of physical or mental faculty which amounts to 1% or more.
The benefit may be paid as a Pension or a Grant, depending on the Doctor’s assessment of the degree of disablement. Thirty percent (30%) or more is equivalent to a Pension and less than 30% is equivalent to a Grant.
The rate of benefit is 70% of the average weekly insurable earning times the percentage degree of disablement.
Constant Attendance Benefit – where a Disablement Benefit is paid and the degree of disablement is 100% and the Director is satisfied that as a result of the relevant loss of faculty the beneficiary requires the constant attendance of another person, the rate of disablement pension shall be increased by 50%.
No such increase shall be payable in respect to a period for which the beneficiary is receiving medical treatment as an in-patient in a hospital or in a similar institution.
Employment Injury Benefit FAQs:
1) What is the time frame for submission of claims?:
** For Sickness benefit you have a period of 4 days from the date of illness
** In the case of a Maternity benefit the time frame is 3 weeks from the date of confinement
** For Invalidity, Age and Survivor benefits you have 3 months from the date of entitlement
** For Funeral benefits there is a period of 6 months from the date of death of the deceased
2) How many claims is an employee/self-employed person allowed to make in a year? :
Contributors are entitled to claim as many times as they meet the qualifying conditions for a benefit.
3) What benefits does a Self-employed person qualify for?:
Self-employed persons can qualify for all the benefits offered by the NIS.