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values | section stringclasses 457
values | question_number stringclasses 729
values | question_sub_type stringclasses 3
values | question_text stringlengths 2 1.77k ⌀ | input_type stringclasses 8
values | tick_options listlengths 0 16 ⌀ | guidance_notes stringclasses 562
values | evidence_required bool 2
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classes | general_instructions stringclasses 79
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|---|---|---|---|---|---|---|---|---|---|---|---|
BI100PD | form | Part 5: About earlier claims for Industrial Injuries Disablement Benefit | Q65 | standard | If you claimed for an industrial disease before, what is the name of the disease? | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 5: About earlier claims for Industrial Injuries Disablement Benefit | Q66 | standard | If you claimed for an industrial accident before, what was the date of the accident? | date | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 5: About earlier claims for Industrial Injuries Disablement Benefit | Q67 | standard | When did you claim? If you are not sure, give an approximate date. | date | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 5: About earlier claims for Industrial Injuries Disablement Benefit | Q68 | standard | If you claimed for an industrial disease before, what is the name of the disease? | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 5: About earlier claims for Industrial Injuries Disablement Benefit | Q69 | standard | If you claimed for an industrial accident before, what was the date of the accident? | date | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 5: About earlier claims for Industrial Injuries Disablement Benefit | Q70 | standard | When did you claim? If you are not sure, give an approximate date. | date | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q71 | standard | Are you claiming for D3 - diffuse mesothelioma D8 - primary carcinoma of the lung D8A - primary carcinoma of the lung D10 - primary carcinoma of the lung D11 - primary carcinoma of the lung C4 - primary carcinoma of the bronchus or lung, or C22(b) - primary carcinoma of the bronchus or lung, or C24(a) - angiosarcoma of... | tick_box | [
"No",
"Yes"
] | Please tell us about the hospital or clinic you have been to because of the disease. If you need to tell us about more than one hospital or clinic, tell us about them in Part 9 Other information. | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 6: About medical details | Q72 | standard | GP’s name | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q73 | standard | GP’s address Postcode | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q74 | standard | GP’s phone number If you know it | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q75 | standard | Have you attended a hospital or clinic with evidence of asbestosis because of the disease? | tick_box | [
"No",
"Yes"
] | Please read page 8 of B I100PD Notes. | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 6: About medical details | Q76 | standard | Name of the hospital or clinic | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q77 | standard | Hospital or clinic address Postcode | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q78 | standard | Department or ward | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q79 | standard | Reference number or admission number | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q80 | standard | Name of specialist If you know their name | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q81 | standard | Dates of treatment From To | date | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q82 | standard | Did you have an x-ray? | tick_box | [
"No",
"Yes"
] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 6: About medical details | Q83 | standard | We may ask you to go for an assessment with a doctor or health care professional | open_text | [] | If you have any problems with going for an assessment, please tell us about them. Please provide full details of why you need a home visit, and send us any medical evidence you already have to support this request. Do not ask or pay for new evidence. Also tell us any dates and times that you may not be able to go for a... | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 7: About other benefits and entitlements | Q84 | standard | Are you getting either a War Disablement Pension or a payment from the Armed Forces Compensation Scheme? | tick_box | [
"You are getting a War Disablement Pension",
"You are getting Armed Forces Compensation Scheme payments"
] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 8: How we pay you | Q85 | standard | Please tell us how often you want us to pay your Industrial Injuries Disablement Benefit | list | [
"Every week – in advance",
"Every 4 weeks – in arrears",
"Every 13 weeks – in arrears"
] | If you want more information, get in touch with the Industrial Injuries Disablement Benefit office. You can find the office mailing addresses and contact phone number at the end of the BI 100PD Notes which we sent you with this form. | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 8: How we pay you | Q86 | standard | Name of the account holder | open_text | [] | Please tell us the name of the account holder exactly as it is shown on the bank card or account statement. | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 8: How we pay you | Q87 | standard | Name of the bank or building society | open_text | [] | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 8: How we pay you | Q88 | standard | Sort code | open_text | [] | Tell us all 6 numbers, for example 12-23-56. | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 8: How we pay you | Q89 | standard | Account number | open_text | [] | This must be between 6 and 10 numbers. | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 8: How we pay you | Q90 | standard | Building society roll or reference number | open_text | [] | You may get other benefits and entitlements we do not pay into an account. If you want us to pay them into the account above, please tick this box. | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 9: Other information | Q91 | standard | Please use this space to tell us anything else you think we might need to know. | open_text | [] | If there is not enough space, please use a separate sheet of paper. Make sure that you: • put your full name and National Insurance number on each sheet of paper, and • sign and date each sheet that you use. | false | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 10: Declaration | Q92 | standard | I declare I understand Industrial Injuries Disablement Benefit Notes, and that the information provided on this claim form is correct and complete. | signature | [] | To make sure you get the benefit you are entitled to, it is important that the information you provide is correct and complete. You will be asked to sign this form to declare the answers you have given are correct. • I understand that I must report all changes in my circumstances which may affect my entitlement promptl... | true | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... |
BI100PD | form | Part 10: Declaration | Q93 | standard | Signature | signature | [] | true | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100PD | form | Part 10: Declaration | Q94 | standard | Date DD/MM/YYYY | date | [] | true | true | Answer all the questions that apply to you and your partner, if you have one. If you are filling in this form with a pen, write in black ink and use CAPITAL LETTERS. Please make sure that you complete the Consent in Part 2 and sign the Declaration in Part 10. If you do not fill this in, we will contact you and it may d... | |
BI100OAE | form | About you | 01 | standard | First name | open_text | [] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About you | 02 | standard | Last name | open_text | [] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About you | 03 | standard | National Insurance (N I) number | open_text | [] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About you | 04 | standard | Are you claiming for: Occupational asthma (prescribed disease D7), or Allergic rhinitis (prescribed disease D4) | tick_box | [
"Occupational asthma (prescribed disease D7)",
"Allergic rhinitis (prescribed disease D4)"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05a | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05a | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05b | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05b | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05c | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05c | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05d | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05d | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05e | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05e | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05f | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05f | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05g | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05g | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05h | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05h | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05i | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05i | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05j | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05j | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05k | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05k | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05l | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05l | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05m | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05m | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05n | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05n | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05o | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05o | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05p | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05p | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05q | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05q | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05r | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05r | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05s | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05s | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05t | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05t | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05u | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05u | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05v | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05v | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05w | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05w | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05x | standard | In any of the jobs or training schemes c: fumes or dusts arising from you have told us about on form the manufacture, transport or use of hardening agents (including epoxy resin curing agents) based on phthalic anhydride, tetrachlorophthalic anhydride, trimellitic anhydride or triethylenetetramine | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 05x | detail | Who was your employer or training provider at the date of exposure | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 06 | standard | Do you think your asthma or allergic rhinitis was caused by any other substance you were exposed to at work or whilst on an approved training scheme? | tick_box | [
"Yes",
"No"
] | false | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 06 | detail | What was the substance? Please be as precise as possible. General terms such as smoke, fumes or dust will not be good enough | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OAE | form | About your employment or your approved training scheme or course | 06 | detail | Who was your employer or training provider at the date of exposure? | open_text | [] | true | true | If you are claiming Industrial Injuries Disablement Benefit for: • occupational asthma (Prescribed Diseases D7), or • allergic rhinitis (Prescribed Diseases D4). Please fill in this form and send with a completed BI100PD claim form to Barnsley Industrial Injuries Disablement Benefit Centre: Barnsley IIDB Centre Mail Ha... | |
BI100OD | form | About you | Q1 | standard | First name | open_text | [] | false | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... | |
BI100OD | form | About you | Q2 | standard | Last name | open_text | [] | false | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... | |
BI100OD | form | About you | Q3 | standard | National Insurance (N I) number | open_text | [] | false | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... | |
BI100OD | form | About your employment or approved training scheme or course | Q4 | standard | Have you used any of these tools or machines or have you worked close to someone using them? Powered, but not hand powered, grinding tools used on metal other than sheet metal or plate metal | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q5 | standard | Band saws, circular saws or cutting discs for cutting metal in the metal founding or forging industries | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q6 | standard | Circular saws for cutting products in the manufacture of steel | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q7 | standard | Burners or torches for cutting or dressing steel-based products | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q8 | standard | Pneumatic percussive tools: On metal | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q9 | standard | Machines engaged in cutting, shaping or cleaning metal nails for cleaning | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q10 | standard | Plasma spray guns to spray molten metal | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q11 | standard | Vibrating metal moulding boxes in the concrete products industry | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q12 | standard | Firearms as a police firearms training officer | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q13 | standard | Automatic moulding, automatic blow moulding or automatic glass pressing and forming machines used in the manufacture of glass containers or hollow ware | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q14 | standard | Circular saws for cutting concrete masonry blocks | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
BI100OD | form | About your employment or approved training scheme or course | Q15 | standard | Spinning machines using compressed air to produce glass wool or mineral wool | tick_box | [
"Used",
"Not used, but worked close to someone using it"
] | Tell us the distance feet
Number of hours daily hours | true | true | If you are claiming Industrial Injuries Disablement Benefit (IIDB) for prescribed disease A10 Occupational deafness you need to fill in this form. Send it with a completed BI100PD claim form to: Barnsley IIDB Centre, Mail Handling Site A, Wolverhampton, WV98 1SY. Remember, if you need help filling in this form, or any ... |
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