Get Bi100-d Claim Form. Industrial Injuries Disablement Benefit For Occupational Deafne

The BI100-D claim form is an essential document for individuals seeking the Industrial Injuries Disablement Benefit due to occupational deafness. This guide provides step-by-step instructions on how to accurately complete each section of the form to ensure your application is processed smoothly.

Follow the steps to complete your claim form easily.

1. Press the ‘Get Form’ button to retrieve the BI100-D claim form and open it for editing.
2. Begin filling in your personal information in Part 1, including your surname, all other names, address, contact details, date of birth, and National Insurance number. Ensure that all provided information is accurate and complete.
3. In Part 2, if you are filling out the form on behalf of someone else, indicate the reason for this and provide your details as the representative.
4. Proceed to Part 3 where you will list all previous employment, including the names and addresses of employers, job titles, and the start and end dates of your employment.
5. Complete Part 4 by detailing your exposure to tools or machines that may have contributed to your deafness. Specify whether you used them directly or were close to someone else using them.
6. In Part 5, provide information about your medical history related to your deafness, including your doctor's details and any medical reports if available.
7. Part 6 focuses on any previous claims for benefits related to your condition. If applicable, outline your past claims.
8. Fill out Part 7 by disclosing any other benefits or allowances you are currently receiving or have received in the past.
9. In Part 8, select how you would like to receive your benefits and fill in your account details. Be sure to clearly specify your account preferences.
10. Utilize Part 9 to include any additional information that may support your claim.
11. Sign the declaration in Part 10, ensuring you understand the implications of the information provided.
12. Review the instructions in Part 11 and ensure you have completed all necessary parts of the form before submitting.
13. After completing the form, save your changes, and you may print or download a copy to keep for your records.

Complete your BI100-D claim form online to ensure timely processing of your Industrial Injuries Disablement Benefit.