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5.8.4 NEL Table 4 - Loss of Expectation of Life

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This table is not usually checked unless of course the condition (usually a disease) is likely to impact on life expectancy.

This rating should be based on the examining doctor's assessment of the impact of the condition and would have minimal input from the client. Wherever possible we should have the most up to date information relating to this NEL score so the client is compensated in this section in the most beneficial way. However there may be circumstances where this is not possible, such as if the client is not well enough to attend an assessment. This will require the delegate to make a decision based on the circumstances of the claim, and potentially source the information from a treating GP or specialist, rather than making a terminally ill client attend an assessment and wait for a report.

The relevant date to be applied when assessing a loss of life expectancy should be the day the delegate makes the determination in writing, not the date that the employee was assessed by a the doctor or the date of diagnosis. This is because the NEL score should take into account the relevant loss under the table at the time of determination for the purposes of a section 27 payment. The NEL scores therefore apply the statutory rate on the day of the determination, using the NEL scores validated at the assessment of degree of impairment by the doctor.

For example if during the investigation of a claim, the doctor provides a report dated 2 January 2017 confirming the person was diagnosed with melanoma in 2010. In January 2017 the doctor reported there was approximately a loss of life expectancy of 11 years. Where the claim is being determined in April 2018 (after approximately 16 months after the report) the client’s loss of life expectancy is now less than the reported 11 years. Therefore the appropriate NEL score is a 1, for a loss of 1 year to less than 10 years, as opposed to a score of 2 for a loss of 10 years but less than 20 years. Essentially a delegate is determining a claim and assessing the NEL entitlement based on the client’s actual loss at that time, and in this case the client has a loss of life expectancy of less than 10 years, and should be compensated accordingly.