Injury Benefit Application Form - IoMG Unified Scheme

Part 2 continued6. Pay Details(a) Annual Rate of pay on If lower paid employment has started, use pay on£last day of employmentlast day of original employment(b) Total Pensionable Pay £/ / to(TPP) for last 3 years£/ / to/ // /£/ /to/ /(c)Notional Whole-TimeEquivalent (part timers only)£If employment has ended and the officer was on unpaid sick leave at the end of their employment pleaseshow below details of any paid leave or paid notice granted after the unpaid sick leave.Paid Leave: from / / to / /Paid Notice: from / / to / /Payment in lieu of notice: from / / to / /TPP is 365 days to include paid employment, paid sick leave (including SSP), annual leave and paidnotice, but excludes unpaid sick leave, temporary injury allowances, strike days and payment in lieu of notice.7. If claiming for permanent benefit, has the claimant been inreceipt of Temporary Injury Allowance? No: Yes:8. Complete this part only if the applicant has changed to lower paid employment(a)What is the applicant’s job after the change to lower paid employment?(b)Where do they work? (eg Name of Department, unit etc)(c) Rate of pay in new job? £per annum(d) Rate of pay before change? £per annum(e) Is the pay protected? No: Yes: for how long(f) Is this employment part time? No: Yes: hours worked per weekTick here if hours vary