Get Bi100a

The Bi100a form is essential for claiming Industrial Injuries Disablement Benefit for accidents that occur at work or during approved training. This guide will provide you with clear steps to effectively complete the form online.

Follow the steps to successfully complete your Bi100a form online.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. Start with Part 1: About you. Fill in your surname, address, contact numbers, date of birth, and National Insurance number. Ensure all information is accurate.
3. Proceed to Part 2: Filling in the form and signing it for someone else, only if applicable. Provide details explaining why the claimant cannot fill out the form.
4. In Part 3: About your work, provide information about your employer during the time of the accident, including their name, address, phone number, and your job title.
5. In Part 4: About the accident, detail what happened during the accident, where it took place, and if it was reported to your employer. Include witness details if applicable.
6. Part 5: Details of the accident requires a thorough description of the incident and the injuries sustained. Be as detailed as possible.
7. Part 6: About earlier claims for Industrial Injuries Disablement Benefit should be filled out if you have previously claimed for other incidents. Provide accurate information about past claims.
8. In Part 7: About medical details, include your GP's contact information and any treatments related to the injury.
9. Part 8: About other benefits and entitlements should be checked to see if you or your partner are receiving other benefits. Provide the necessary details.
10. In Part 9: How we pay you, select your preferred payment frequency and provide your bank account details for direct deposit.
11. Use Part 10: Other information to include any relevant details that were not addressed in other sections.
12. Finally, sign and date the Declaration in Part 11. Ensure you've answered all questions and included all necessary documents.
13. Submit the completed form to your regional disablement benefit office as soon as possible to avoid delays in benefit processing.

Complete your Bi100a claim form online today to ensure your benefits are processed without delay.