Miner's knee

This type of osteoarthritis is a prescribed disease, explain Dr Emma Lackey and Mr Ron Sutton

Osteoarthritis of the knee (Photograph: SPL)
Osteoarthritis of the knee (Photograph: SPL)

Miner's knee is an osteoarthritis (OA) of the knee, which became a prescribed disease in July 2009. Prescribed diseases are occupational illnesses for which benefits are payable.1

The industrial injuries disablement benefit (IIDB) is a 'no fault' tax-free and non-contributory benefit paid to people who become disabled due to an accident at work or due to certain prescribed diseases.

It is administered by the Department for Work and Pensions and is payable in addition to other incapacity and disability benefits but taken into account against income-related benefits.1

Miner's knee carries the descriptive code PD A14. Claimants apply through specified Jobcentre Plus IIDB delivery centres rather than through a solicitor.

Underground coal miners were found to be particularly at risk of knee joint OA as a consequence of prolonged and frequent heavy lifting, kneeling and squatting. Shovelling while squatting, installing track or pipe work, carrying heavy arched supports, manually setting roof supports or cleaning coal spillages by shovel in restricted access areas were particularly significant.

The decision to include miner's knee as a prescribed disease was taken after a full review showed that despite the high background incidence of OA in the general population, the excess risk for underground coal miners was more than doubled.2

Who qualifies for payment?
In order to qualify, specific conditions must be satisfied relating to both the knee joint and occupational conditions.2

Symptoms include knee pain, swelling, stiffness and reduced mobility. Where possible, there may be X-ray evidence of joint space narrowing, new bone formation and bone thickening (stage 3 to 4 on the Kellgren-Lawrence scale).

The diagnosis can also be accepted in those on a waiting list for knee replacement or those who have already had one. It is not necessary to arrange an X-ray to assist with entitlement.

Coal miners need to have worked underground for 10 years or more in total before 1 January 1986. After that date, miners had to work under any of the following conditions:2

  • Face working on a non-mechanised coal face (either without powered roof supports or a powered loader machine which cuts and loads coal).
  • Development worker.
  • Face-salvage worker.
  • Conveyor belt cleaner or conveyor belt attendant.

Knee joint OA is characterised by cartilage degradation and destruction exposing underlying bone, bone thickening, new bone regeneration and reduced joint space. Damage occurs either by gradual wear and tear or by meniscal injury, leaving the joint vulnerable to further damage.

Entitlement for miner's knee does not require documented individual knee injuries (single injuries are dealt with separately via accident provisions of the industrial injuries disablement scheme).1

  • Dr Lackey is a GP in North Tyneside and a medical member of First-Tier Tribunal (Social Entitlement Chamber). Mr Sutton is a retired orthopaedic surgeon and senior consultant at the Medical Appeals Tribunal

References
1. DWP. DB1 - A guide to Industrial Injuries Disablement Benefits. London, HMSO, August 2009. www.dwp.gov.uk/publications/specialist-guides/technical-guidance/db1-a-guide-to-industrial-injuries

2. DWP. Osteoarthritis of the knee in coal miners. London, HMSO, 2008. http://iiac.independent.gov.uk/pdf/command_papers/Cm7440.pdf

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