An analysis of degree of disablement by prescribed disease ...

1 Health and Safety Executive An analysis of degree of disablement by prescribed disease (PD) for Industrial Injuries disablement Benefit (IIDB) cases New cases assessed from April 2002 to December 2011 Contents Background 2 Main features of the data 2 Table 1: New cases of prescribed diseases (PDs) assessed from April 2002 to December 2011 3 Charts 1-20: New cases of disablement benefit assessed April 2002 December 2011, by percentage disablement , for selected PDs 4 This document is available from Page 1 of 13 Background This analysis has been carried out to provide background information in support of a review by the Industrial Injuries Advisory Council (IIAC) of medical assessments carried out within the Industrial Injuries disablement Benefit (IIDB) scheme. The Council were particularly interested in the distribution of assessments in relation to the payment points for IIDB, as representations had been made to the Council that assessments tended to cluster just below those payment points, to the disadvantage of claimants.

2 Data for new cases of IIDB during the period April 2002 to December 2011 was available in a format that permitted a detailed breakdown of the assessed degree of disablement (to the nearest percentage point) by prescribed disease (PD). The total number of new cases assessed for IIDB over the period for the 45 PDs where there were 3 or more cases from April 2002 to December 2011 is shown in Table 1. The charts that follow show the detailed distribution of the degree of disablement for the 19 PDs for which there were at least 30 new assessed cases during the period, and for which all cases are not automatically assessed at 100% disablement . The distribution of degree of disablement for all PDs combined (including those automatically assessed at 100%) is also shown (chart 20). These statistics are based on the degree of disablement awarded for each specific disease claim. It is not possible to take into account disablement aggregated across PDs for individuals with more than one PD.

3 Thus the number of cases represented in Table 1 and the following charts may exceed the number of actual individuals assessed during the period. Data in Table 1 and charts 1-20 are rounded to the nearest 5 in accordance with the standard arrangements for publication of IIDB data agreed between HSE and DWP. Main features of the data Not surprisingly, the distribution of degree of disablement awarded varies substantially within each PD and across PDs. The charts show that for most diseases the number of cases tends to increase as the percentage disability increases before reducing again at higher values. Occupation deafness (PD A10, chart 5) and pneumoconiosis (PD D1, chart 14) are exceptions to this pattern. This is likely to be because of different arrangements for these two diseases: for occupational deafness the definition of the disease is effectively linked to a minimum of 20% disablement , and for pneumoconiosis the percentage disability threshold for payment of benefit is 1%, compared with 14% for most other PDs.

4 For most of the musculoskeletal disorders (PDs A4, A6, A7, A11, A12, A14), allergic rhinitis (D4) and dermatitis (D5), in a majority of cases the degree of disablement awarded was less than 14%, the cut-off below which no benefit is paid. In contrast, for respiratory diseases the majority of cases were assessed at 14% disablement or above, with a substantial minority awarded at much higher levels. All of the charts show evidence of clustering in the degree of disablement around multiples of 5%. This is likely to be a reflection of medical judgements being necessarily formulated within broad, rather than fine divisions of precision. For all but two of the PDs there is evidence of a spike in the number of cases assessed at 14% disability, the cut-off below which no benefit is paid. The most obvious explanation for this effect is that medical assessors tend to err on the side of generosity in assessing claims when an assessment is close to a payment trigger point.

5 The two PDs that do not show spikes at 14% disablement are occupational deafness (PD A10, chart 5) for which there are different arrangements for payment and where the definition of the disease is effectively linked to a minimum of 20% disablement and anaphylaxis due to latex (PD B5, chart 12) for which the total number of cases was small. A spike in the number of cases assessed at 14% disability is also evident in chart 20 which shows the distribution for all PDs combined. This also shows a large spike at 100% reflecting the large number of cases of asbestos related disease in which the degree of disability is automatically assessed at 100%. This document is available from Page 2 of 13 Table 1: New cases of prescribed diseases (PDs) assessed from April 2002 to December 2011 1 disease Number of cases A1 Cancer due to exposure to radiation 10 A2 Cataract due to exposure to radiant heat 10 A3 Dysbarism, including decompression sickness.

6 Barotrauma and osteonecrosis 10 A4 Task-specific focal dystonia of the hand or forearm 330 A5 Subcutaneous cellulitis of the hand 10 A6 Bursitis or subcutaneous cellulitis affecting the knee 765 A7 Bursitis or subcutaneous cellulitis affecting the elbow 55 A8 Tendonitis of the hand or forearm 1710 A10 Occupational deafness 2280 A11 Vibration white finger 10155 A12 Carpal tunnel syndrome 5965 A13 Osteoarthritis of the hip 2 65 A14 Osteoarthritis of the knee 3 33950 B3 Leptospirosis 5 B5 Tuberculosis 45 B6 Extrinsic allergic alveolitis (including farmer's lung) 65 B7 Brucellosis 5 B8B Infection by hepatitis B or C virus 4 5 B10A Avian chlamydiosis 5 B11 Q fever 10 B14 Lyme disease 2 10 B15 Anaphylaxis due to exposure to rubber latex 2 30 C1 Effects of exposure to lead 15 C3 Effects of exposure to phosphorus and its compounds 10 C7 Acute non-lymphatic leukaemia due to benzene exposure 10 C18 Emphysema due to cadmium 5 C21 Primary carcinoma of the skin due to arsenic, tar, pitch, bitumen.

7 Mineral oil or soot 10 C23 Cancer of the bladder or urinary tract 245 C24A Raynaud's phenomenon due to exposure to vinyl chloride monomer 5 C24B Osteolysis of the terminal phalanges due to vinyl chloride monomer 5 C30 Chrome dermatitis/ulceration 30 D1 Pneumoconiosis 13760 D2 Byssinosis 20 D3 Diffuse mesothelioma 15465 D4 Allergic rhinitis 565 D5 Dermatitis (other than chrome dermatitis/ulceration) 1205 D6 Sino nasal cancer due to wood and leather dust 40 D7 Occupational asthma 1540 D8 Asbestos-related lung cancer (with asbestosis) 1050 D8A Other asbestos-related lung cancer 5 805 D9 Diffuse pleural thickening 6 4105 D10 Lung cancer in tin miners or due to exposure to bis(chloromethyl)ether or chromates 5 D11 Lung cancer where there is accompanying evidence of silicosis 10 D12 Chronic Obstructive Pulmonary disease in coal miners 2100 D13 Nasopharyngeal cancer 7 5 Total 96500 Notes 1.

8 Includes PDs with 3 or more cases during April 2002 December 2011 2. First prescribed 14/03/2005 3. First prescribed 13/07/2009 4. Includes cases prescribed under the current terms introduced on 14/03/2005 5. First prescribed 5/04/2006 6. Includes cases before and after the terms of prescription were amended to include unilateral cases from 6/04/2006 7. First prescribed 7/04/2008 This document is available from Page 3 of 13 Charts 1-20: New cases of disablement benefit assessed April 2002 December 2011, by percentage disablement , for selected PDs Chart 1: New cases of PD A4 (Task-specific focal dystonia of the hand or forearm) assessed April 2002 - December 2011, by percentage disablement0102030405060051015202530 Percentage disablementFrequency Ch a r t 2: Ne w ca se s o f P D A6 (Bursitis or subcutaneous cellulitis affecting the knee) assessed April 2002 - December 2011, by percentage disablement050100150200051015202530 Percentage disablementFrequency This document is available from Page 4 of 13 Ch a r t 3.

9 Ne w ca se s o f P D A7 (Bursitis or subcutaneous cellulitis affecting the elbow) assessed April 2002 - December 2011, by percentage disablement051015051015202530 Percentage disablem entFrequency Ch a r t 4: Ne w ca se s o f P D A8 (Tendonitis of the hand or forearm) a sse sse d Ap r i l 2002 - December 2011, by percentage disablement05010015020025030035040005101 5202530 Percentage disablementFrequency This document is available from Page 5 of 13 Ch a r t 5: Ne w ca se s o f P D A10 (Occupational deafness)a sse sse d Ap r i l 2002 - December 2011, by percentage disablement0501001502002503003504000 102030405060708 Percentage disablementFrequency0 Ch a r t 6: Ne w ca se s o f P D A11 (Vibration white finger) a sse sse d Ap r i l 2002 - December 2011, by percentage disablement050010001500200005101520 Percentage disablementFrequency This document is available from Page 6 of 13 Ch a r t 7: Ne w ca se s o f P D A12 (Carpal tunnel syndrome) a sse sse d Ap r i l 2002 - December 2011, by percentage disablement0200400600800100005101520 Percentage disablem entFrequency Ch a r t 8: Ne w ca se s o f P D A13 (Ose oa rthritis of the hip) a sse sse d M a r ch 2005 to December 2011, by percentage disablement01020300 10203040 Percentage disablem entFrequency50 This document is available from Page 7 of 13 Ch a r t 9.

10 Ne w ca se s o f P D A14 (Osteoarthritis of the knee) a sse sse d Ju ly 2009 to December 2011, by percentage disablement01000200030004000500060000 10203040506 Percentage disablementFrequency0 Cha rt 10: Ne w ca se s of PD B5 (Tuberculosis) assessed April 2002 - December 2011, by percentage disablement0246810051015202530 Percentage disablementFrequency This document is available from Page 8 of 13 Chart 11: New cases of PD B6 (Extrinisic allegric alveolitis) a sse sse d Ap r i l 2002 -December 2011, by percentage disablement0510152005101520253035404550 Percentage disablementFrequency Chart 12: New cases of PD B15 (Ana phylaxis due to latex) a sse sse d M a r ch 2005 -December 2011, by percentage disablement051015051015202530 Percentage disablem entFrequency This document is available from Page 9 of 13 Cha rt 13: Ne w ca se s of PD C23 (Cancer of the bladder or urinary tra ct) assessed April 2002 - December 2011, by percentage disablement010203040500 10203040506070809010 Percentage disablementFrequency0 Chart 14: New cases of PD D1 (Pneumoconiosis) a sse sse d Ap r i l 2002 - December 2011, by percentage disablement0500100015002000250030000 10203040 Percentage disablem entFrequency50 This document is available from Page 10 of 13 Cha rt 15: Ne w ca se s of PD D4 (Allergic rhinitis) a sse sse d Ap r i l 2002 - De ce m b e r 2011, by percentage disablement050100150200051015202530 Percentage disablem entFrequency Cha rt 16: Ne w ca se s of PD D5 (Dermatitis, non-chrome related) a sse sse d Ap r i l 2002 - December 2011, by percentage disablement05010015020025030035005101520 2530 Percentage disablem entFrequencyD This document is available from Page 11 of 13 Cha rt 17.