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Health and Safety Leave

Application form for Health and Safety Benefit (pdf, 189 kb)

You must return this form to the Department of Social Protection to claim the health and safety benefit if you are going to be on health and safety leave in excess of 21 days

Please find further information regarding the benefit on the Citizens Information website here http://www.citizensinformation.ie/en/social_welfare/social_welfare_payments/social_welfare_payments_to_families_and_children/health_safety_benefit.html