NHS Injury Allowance Checker

If your injury or illness was caused or made worse by your NHS work, you may be owed a top-up to 85% of your pay for up to 12 months. Check whether you may qualify, estimate the amount and follow the claim steps.

Want to see when your sick pay runs out first? Try the sick pay runway calculator.

Your situation

Are you employed on NHS Terms and Conditions (Agenda for Change)?
What caused your absence?
Was it caused or seriously made worse by your own negligence or misconduct?
What is your pay situation now?

Injury allowance tops up reduced pay, so it matters most once you are on half pay or no pay.

Pay as it would be if you were at work, including regularly paid supplements such as unsocial hours, based on the previous three months (Handbook 14.4). Leave blank for the checks only.

Contributory state benefits received count towards the 85% (22.8, 22.10). Enter the weekly amount you actually receive, or 0.

Injury allowance is limited to up to 12 months per episode (22.12).

Your result

Worth claiming: you may qualify for injury allowance

Nothing on your answers rules you out. The employer decides whether your condition is wholly or mainly attributable to your NHS work, on the balance of probability, with medical advice (22.4). You can appeal through the local grievance procedure (22.16).

Handbook Section 22 checks

  • Are you employed on NHS Terms and Conditions (Agenda for Change)? (Fine on your answers)Section 22 is part of the Handbook, so it applies to you. (Handbook Section 22 notes)
  • Is the injury or illness wholly or mainly attributable to your NHS employment? (Needs checking)This could qualify. Your employer decides attribution, on the balance of probability (more likely than not), and should seek medical advice. (Handbook 22.3, 22.4)
  • Was it caused or seriously made worse by your own negligence or misconduct? (Fine on your answers)That exclusion should not apply. (Handbook 22.7)
  • Are you on authorised sickness absence or a phased return, with reduced pay or no pay? (Fine on your answers)The allowance tops up sick pay or earnings when you are on reduced pay, including a phased return. (Handbook 22.1, 22.8, 22.13)
  • Is this still within the 12 months allowed per episode? (Fine on your answers)Up to 12 months per episode, subject to local absence management policies. About 12 months could be left. (Handbook 22.12)
  • Do you need a minimum length of service? (Fine on your answers)No. Payment of injury allowance does not depend on length of service, so it can apply in your first year too. (Handbook 22.6)

Want an estimate of the top-up?

Enter your usual annual pay on the left and the tool will work out the top-up to 85% of pay for your pay situation.

How to claim, step by step

  1. Tell your manager and HR in writing that you are claiming injury allowanceSay what happened or what the condition is, when it started, and that you believe it is wholly or mainly attributable to your NHS work. Ask for your trust's injury allowance policy and claim form. (Handbook 22.3)
  2. Gather the evidenceIncident or accident report (often called a Datix), witness names, fit notes, GP or hospital letters, occupational health reports, and anything showing the link to your duties. You must give all relevant information, including medical evidence in your possession or that can reasonably be obtained. (Handbook 22.5)
  3. Ask for occupational health advice to be soughtThe employer decides attribution and should seek appropriate medical advice. Ask that OH is asked the specific question: is this condition wholly or mainly attributable to your NHS employment? (Handbook 22.4)
  4. Claim any contributory state benefits and tell payrollYou are required to claim contributory benefits you may be entitled to, and to declare them. Late declarations can mean overpayments, which employers recover. (Handbook 22.11, 22.15)
  5. Ask for a written decision with reasonsThe test is the balance of probability, which means more likely than not. Ask what evidence was considered and how long it will take. (Handbook 22.4)
  6. If it is refused, appeal through the local grievance procedureDisagreements with the employer's decision, and disputes about how injury allowance applies locally, are handled through the grievance procedure. Involve your union rep early. (Handbook 22.4, 22.16)
  7. Keep claiming through a phased returnIf you return on reduced hours and reduced pay during an employer-approved rehabilitation period, the top-up to 85% can continue, within the 12-month limit. (Handbook 22.13)
Free draft wording for your written claim
Subject: Injury allowance claim (NHS Terms and Conditions of Service Handbook, Section 22)

Dear [manager / HR contact],

I am currently absent from work with an injury I sustained at work, on [date], when [brief description]. I believe this is wholly or mainly attributable to my NHS employment (paragraph 22.3) and I would like to claim injury allowance.

I enclose [fit note / GP or hospital letter / incident report reference] and can provide further medical evidence on request (paragraph 22.5). I would be grateful if occupational health could be asked for advice on attribution (paragraph 22.4).

Please could you:
- send me your trust's injury allowance policy and any claim form;
- confirm in writing whether my claim is accepted, with reasons, and the date from which any allowance would be paid;
- confirm how the allowance will be calculated alongside my sick pay and any state benefits I receive (paragraphs 22.8 and 22.10).

If the claim is not accepted I would like to appeal through the local grievance procedure (paragraph 22.16).

Yours sincerely,
[name, job title, payroll number]

Short answer

NHS injury allowance tops sick pay or reduced pay up to 85% of your pay if you are off with an injury, illness or health condition that your employer accepts is wholly or mainly attributable to your NHS employment (Handbook Section 22). It lasts up to 12 months per episode, needs no minimum service, and is taxed but carries no pension deduction. It is not automatic: you have to claim, and the employer decides.

⚠A checker, not a decision

Only your employer can accept or refuse an injury allowance claim. This tool applies the Handbook wording to your answers so you know whether it is worth claiming, and what to say. It is not legal advice. Your trust may have a local policy, so ask HR for it.

What is NHS injury allowance?

Section 22 of the NHS Terms and Conditions of Service Handbook provides an injury allowance for eligible employees who, because of a work-related injury, illness or other health condition, are on authorised sickness absence or a phased return to work with reduced pay or no pay (paragraph 22.1). It also provides for protected pay if you have to move permanently to a lower-paid job because of the condition (22.14). It does not give an extra period of sickness absence on top of your normal entitlement (22.2): it works alongside the NHS sick pay scale.

Who can claim, and who cannot?

Eligible employees with injuries, diseases or other health conditions that are wholly or mainly attributable to their NHS employment can claim. The condition must have been sustained or contracted in the discharge of your duties, or be an injury that was not sustained on duty but is connected with or arising from your employment (paragraph 22.3). Your employer decides, on the balance of probability, seeking medical advice (22.4).

  • ✕ An injury on a normal journey to or from work, unless the journey is part of your contractual NHS duties (22.7)
  • ✕ Absence as a result of disputes about employment matters, conduct or job applications (22.7)
  • ✕ An injury, illness or condition due to or seriously aggravated by your own negligence or misconduct (22.7)

How much is NHS injury allowance? A worked example

The allowance tops your sick pay or earnings up to 85% of pay, counting contributory state benefits you receive (22.8, 22.10). These figures come from the checker for someone with usual pay of £28,000 a year, whose absence is accepted as work-related, with no earlier months used:

SituationPay each weekTop-up each weekTop-up each month
Half pay, no state benefits£268.49£187.94£817
Half pay, plus £100 a week of state benefit£268.49 plus £100£87.94£382
No pay, no state benefits£0.00£456.44£1,983

Weekly pay if at work is £536.98, so 85% is £456.44. Over the full 12 months on half pay the allowance in the first row could be worth about £9,800 gross. The allowance is taxable and subject to National Insurance but has no pension contribution taken from it (22.9). Pay for this purpose is as defined in paragraph 14.4: what you would have received at work, including regularly paid supplements, based on the previous three months or another locally agreed reference period.

How to claim injury allowance

The steps below are also in the checker with the paragraph references. In short:

  1. Tell your manager and HR in writing that you are claiming injury allowance. Say what happened or what the condition is, when it started, and that you believe it is wholly or mainly attributable to your NHS work. Ask for your trust's injury allowance policy and claim form. (Handbook 22.3)
  2. Gather the evidence. Incident or accident report (often called a Datix), witness names, fit notes, GP or hospital letters, occupational health reports, and anything showing the link to your duties. You must give all relevant information, including medical evidence in your possession or that can reasonably be obtained. (Handbook 22.5)
  3. Ask for occupational health advice to be sought. The employer decides attribution and should seek appropriate medical advice. Ask that OH is asked the specific question: is this condition wholly or mainly attributable to your NHS employment? (Handbook 22.4)
  4. Claim any contributory state benefits and tell payroll. You are required to claim contributory benefits you may be entitled to, and to declare them. Late declarations can mean overpayments, which employers recover. (Handbook 22.11, 22.15)
  5. Ask for a written decision with reasons. The test is the balance of probability, which means more likely than not. Ask what evidence was considered and how long it will take. (Handbook 22.4)
  6. If it is refused, appeal through the local grievance procedure. Disagreements with the employer's decision, and disputes about how injury allowance applies locally, are handled through the grievance procedure. Involve your union rep early. (Handbook 22.4, 22.16)
  7. Keep claiming through a phased return. If you return on reduced hours and reduced pay during an employer-approved rehabilitation period, the top-up to 85% can continue, within the 12-month limit. (Handbook 22.13)

Injury allowance and sick pay: how they fit together

Your sick pay still follows the scale in paragraph 14.2 for your length of service. Where the absence is work-related, pay is calculated as if you had been at work and includes regularly paid supplements (14.4), and the absence is disregarded when the previous 12 months are added up for later sick pay (14.7). Injury allowance then fills the gap between what you are paid and 85% of pay, for up to 12 months. See the whole picture month by month in our sick pay runway calculator, or use the sick pay calculator for the entitlement alone.

If your claim is refused or you are being managed out

You can appeal an attribution decision through the local grievance procedure (22.4, 22.16). If your absence is also leading to an absence review, capability or dismissal process, read what happens if you are dismissed from the NHS, and consider the dismissal guidance advisor. If you cannot return to work, the ill-health retirement guide explains the pension benefits that may be open to you.

Get NHS pay and pension updates

Occasional updates when something changes. Unsubscribe any time.

Free. Independent, not affiliated with the NHS. Every email has an unsubscribe link. See our privacy policy.

Where the rules come from

  • ✓ Every rule is from Section 22 of the NHS Terms and Conditions of Service Handbook, amendment 63 (published 1 October 2026), with Section 14 paragraphs 14.4 and 14.7 for pay and the look-back.
  • ✓ The checker never says you will be paid: attribution is the employer's decision (22.4), so the best answer it gives is "worth claiming".
  • ✓ The top-up estimate is 85% of weekly pay at 52.143 weeks a year, less your pay and any state benefits you enter. Take-home uses the same engine as our NHS Pay Calculator, without pension.
  • ✓ Runs entirely in your browser: nothing you enter is sent or saved. See our editorial policy. Last updated October 2026.

Related guides & tools

Sick Pay Runway Calculator

Month by month through full pay, half pay and SSP.

NHS Injury Allowance Explained

The full guide to Section 22, who qualifies and how to claim.

NHS Sick Pay Calculator

Your entitlement and what an absence costs.

Ill-Health Retirement Explained

Tier 1 and Tier 2 benefits if you cannot return.

Occupational Health Referrals Explained

What OH can advise on attribution and adjustments.

Work-Related Stress and the HSE Standards

When stress is linked to work, and what to ask for.

Frequently asked questions

What is NHS injury allowance? +
Injury allowance is a payment in Section 22 of the NHS Terms and Conditions of Service Handbook for eligible staff who are off sick, or on a phased return with reduced pay, because of an injury, illness or other health condition that is wholly or mainly attributable to their NHS employment. It tops up sick pay or reduced earnings, taking into account any contributory state benefits you receive, to 85% of your pay (paragraphs 22.1 and 22.8).
Who is eligible for injury allowance in the NHS? +
Staff on NHS Terms and Conditions whose condition was sustained or contracted in the discharge of their duties, or an injury not sustained on duty but connected with or arising from their employment, can be considered (paragraph 22.3). The employer decides whether it is wholly or mainly attributable to your NHS employment, using the balance of probability and seeking medical advice (22.4). There is no minimum length of service (22.6).
What does not qualify for injury allowance? +
Paragraph 22.7 excludes an injury on a normal journey to or from work (unless the journey is part of your contractual NHS duties), sickness absence as a result of disputes about employment matters, conduct or job applications, and an injury or illness due to or seriously aggravated by your own negligence or misconduct.
How much is injury allowance? +
It is a top-up to 85% of your pay, as pay is defined in paragraph 14.4, after counting your sick pay or reduced earnings and any contributory state benefits you receive (22.8, 22.10). For example, with usual pay of £28,000 a year, half pay is about £268.49 a week and 85% is about £456.44 a week, so the top-up is about £187.94 a week, or £817 a month gross.
How long does injury allowance last? +
It is restricted to a period of up to 12 months per episode, subject to local absence management, return to work and rehabilitation policies (paragraph 22.12). It does not give you an additional period of sickness absence entitlement (22.2), so it sits on top of the sick pay scale rather than extending it.
Is injury allowance taxed, and do I pay pension on it? +
It is subject to income tax and National Insurance, but it is not subject to pension contribution deductions (paragraph 22.9). The checker shows an indicative take-home figure for the monthly top-up.
Can I claim injury allowance for stress or a mental health condition? +
Section 22 refers to injuries, diseases or other health conditions, so a mental health condition is not excluded in the wording. The test is the same: it must be wholly or mainly attributable to your NHS employment, decided by the employer on the balance of probability with medical advice (22.3, 22.4). Occupational health advice and your GP's evidence matter a great deal. Absence arising from disputes about employment matters or conduct is excluded (22.7).
Does injury allowance work on a phased return to work? +
Yes. Eligible staff who make a phased return can receive the allowance as a top-up to 85% of pay if their pay is reduced during an employer-approved period of rehabilitation, within the 12-month limit (paragraph 22.13).
What if my employer refuses my claim? +
You can appeal. Where you disagree with the employer's decision on attribution, you are entitled to appeal through the local grievance procedure (paragraphs 22.4 and 22.16). Ask for the decision and the reasons in writing, take your union rep with you, and keep the medical evidence together. Our claim checklist above shows the steps in order.
Does injury allowance affect my sick pay entitlement or the 12-month look-back? +
Absence caused by a condition wholly or mainly attributable to your NHS employment is disregarded when your sick pay entitlement is worked out from the previous 12 months (paragraph 14.7), so it should not use up the sick pay you would need for a later, unrelated absence. For staff eligible for injury allowance, pay for sick pay purposes is calculated as if you had been at work and includes regularly paid supplements (14.4).
Does it apply in Scotland, Wales and Northern Ireland? +
Section 22 is a single section of the Handbook that refers to the Section 14 sickness provisions for England, Wales, and Scotland and Northern Ireland alike. Staff whose terms are not covered by the Handbook, or who no longer work for an NHS employer, get the provisions as specified in their contracts of employment. Check your own trust's policy.
Is there a time limit for claiming injury allowance? +
Section 22 does not set a claim deadline that we could find, but the allowance is limited to 12 months per episode and employers expect you to supply the evidence needed to decide your claim (22.5), so claim as soon as you can. Whether a late claim can be backdated is a question for your employer.