25/10/1941: Workmens Compensation Act, 1934.


COURT OF JUSTICE ACTS, 1924 and 1936, AND

IRELAND.

CIRCUIT COURT OF JUSTICE.

WE, THE CIRCUIT COURT RULES COMMITTEE, constituted pursuant to the provisions of Section 69 of the Courts of Justice Act, 1936 , by virtue of the powers conferred upon us by Section 66 of the Courts of Justice Act, 1924 , and Section 70 of the Courts of Justice Act, 1936 , and of all other powers enabling us in this behalf, do hereby, with the concurrence of the Minister for Justice, make the annexed Rules as the Rules of the Circuit Court of Justice for the purposes of the Workmen's Compensation Act, 1934 .

Dated this 25th day of October, 1941.

Signed Cahir Davitt, Chairman.

James Sealy,

W. J. Gleeson,

George C. Cullinan,

Arthur E. Corbett,

Thomas H. R. Craig.

John J. Horgan,

Séamus Ó Conchubhair,

Secretary.

I concur in the making

of the foregoing Rules.

(Sgd.) G. Boland,

Minister for Justice,

4th November, 1941.

CONTENTS.

RULE

PAGE

1.

Preliminary

1

2.

Parties

2

3.

Commencement of Proceedings

3

4.

Time for, and mode of, Service

3

5.

County in which Proceedings may be instituted

5

6.

Filing of Originating Summons

5

7.

Statement of Defence by Respondent

6

8-12.

Defence admitting liability to make weekly payment

6

13.

Third Party Procedure Section 19

7

14.

Third Party Procedure, Section 61

8

15.

Claim to Indemnity as between Respondents

9

16.

Default of Defence

9

17.

Review and Redemption of Weekly Payments payable under an Order of the Court

9

18.

Review and Redemption of Weekly Payments payable under a Registered Agreement or Certificate of a Court or Appellate Tribunal

10

19.

Review by Third Party

11

20.

Applications Ex Parte

11

21.

Applications on Notice

11

22.

Insurers, Bankruptcy of Employer

13

23.

Masters, Seamen, Apprentices and Pilots

14

24.

Detention of Ships

14

25.

Industrial Diseases

16

26.

Agreements

17

27.

Application for Cancellation of Registration of Agreement

20

28.

Rectification of the Register

21

29.

Application for Reference to Medical Referee, Section 34

21

30.

Application to Determine effect of Medical Referee's Certificate

23

31.

Submission to Medical Referee for Report

23

32.

Summoning Medical Referee as Assessor

23

33.

Summoning of, and Reference to Medical Referee, General

24

34.

Suspension of Weekly 13 Payments or Workmen's Right to Compensation

24

35.

Certificate under Section 60

25

36.

Form of Orders

25

37.

Execution

26

38.

Payment of Money into Court

26

39.

Payment into Court of Weekly Payment payable to Person under Legal Disability

27

40.

Payment into Court of Weekly Payment Pending Settlement of Dispute by Medical Referee

28

41.

Payment into Court of Lump Sum payable under Agreement to Person under Legal Disability

28

42.

Payment into Court of Lump Sum payable under a Redemption Order

29

43.

Payment into Court of Lump Sum in Fatal Cases

29

CONTENTS.

RULE

PAGE

44.

Investment, Payment out, and Application of Money Paid into Court

29

45.

Application for Variation of Order

30

46.

Application for Disposal of Money in Court, belonging to Deceased Dependant

30

47.

Workman in Receipt of Weekly Payment ceasing to Reside in Ireland

30

48.

Payment of Arrears on Death of Workman outside Ireland

32

49.

Application by Medical Practitioner for Fees

33

50.

Transfer of Proceedings and Money in Court

33

51.

Costs

33

52.

Authority of Solicitor to Receive Sum Paid for Costs

36

53.

Review of Taxation by Court

36

54.

Application by Person Claiming Compensation to Determine Costs payable to his Solicitor

36

55.

Record of Proceedings

38

56.

Forms

38

57.

Filing and Service of Documents and Notices

38

58.

General

39

59.

Venue

41

60.

Jurisdiction

41

APPENDIX :

Scales of Costs

42

Schedule of Forms

47

Workmen's Compensation (Provisional Arrangement with Great Britain) Rules, 1942.

Rule 1.—Preliminary

122

Rule 2.—Transfer of Money in Court to Courts in Great Britain or Northern Ireland

122

Rule 3.—Administration of Moneys Transferred from Courts in Great Britain or Northern Ireland

123

Form of Order Transferring Compensation Moneys to Great Britain or Northern Ireland

124

IRELAND.

CIRCUIT COURT (WORKMEN'S COMPENSATION) RULES, 1942.

PRELIMINARY.

1.—(1) The following rules shall have effect under the Workmen's Compensation Act, 1934 (in these Rules hereinafter referred to as the Act), with reference to any matter or proceeding under the Act for the regulation of which Rules of Court may be made under the provisions of the Courts of Justice Acts, 1924 and 1936 ; and generally for carrying the Act into effect so far as it affects the Circuit Court and proceedings in the Circuit Court.

(2) These Rules may be cited as the Circuit Court (Workmen's Compensation) Rules, 1942, and shall come into operation on the 30th day of March, 1942. They shall not apply to any case where the accident occurred before the first day of August, 1934 ; and in every such case the Consolidated Workmen's Compensation (Ireland) Rules, 1917, shall continue to apply.

(3) Subject as aforesaid the Consolidated Workmen's Compensation (Ireland) Rules, 1917, are hereby annulled.

(4) In these Rules :—

The word " Ireland," in so far as it denotes geographical limitation, means that portion of the National territory to which, under the provisions of the third Article of the Constitution, the laws of Ireland have application.

The word " County " includes County Borough.

(5) Subject as aforesaid, words and expressions used in these Rules shall have the same meaning as when used in the Act.

(6) The Interpretation Act, 1923 , shall apply for the purpose of the interpretation of these Rules in the same way as it applies to the interpretation of an Act of the Oireachtas.

(7) These Rules shall be read and construed with the Courts of Justice Acts, 1924 and 1936, and any Act amending the same ; and with the Circuit Court Rules, 1930.

PARTIES.

2.—(1) Whenever proceedings are instituted in the Court, whether :

(a) by or on behalf of a workman to recover compensation ; or

(b) by or on behalf of the dependants of a deceased workman to recover compensation ; or

(c) to recover the expenses of the medical attendance on, and burial of, a deceased workman who leaves no dependants ; or

(d) to review or redeem a weekly payment ; or

(e) otherwise as provided by these Rules ;

the person instituting the proceedings shall be called the Applicant, and, subject to these Rules, any other person who may be affected by any order made in such proceedings, or against whom any relief is claimed, or any order sought, shall be made a party to the proceedings and shall be called the Respondent.

(2) Where proceedings are instituted to recover compensation in respect of injuries to a workman which result in his death, such proceedings may, subject to the provisions of paragraph (5) of this Rule, be instituted by the legal personal representative, if any, of the deceased workman on behalf of the dependants of the workman, or by any of the dependants themselves.

(3) Any person in whom, as dependant of a deceased workman, a claim for compensation is alleged to exist, may be joined as an applicant in the proceedings ; and every person who claims or may be entitled to claim compensation as a dependant, if not joined as an applicant, shall be made a respondent.

(4) In any case in which, under the provisions of Section 19 of the Act relating to sub-contracting, the applicant is in doubt as to whether the principal or the contractor is the person against whom he is entitled to relief, he may join both the principal and the contractor as respondents to the intent that the question as to which, if either, of such respondents is liable to pay compensation may be determined by the Court.

(5) Proceedings to recover compensation in the case of a deceased workman who leaves no dependants, limited, as provided in Section 22 (1) (d) of the Act, to the amount of the expenses of his medical attendance and burial, shall be instituted by the legal personal representative of the workman, or, where there is no legal personal representative, by any person to whom any such expenses are due, or by whom any such expenses have been paid. In the latter case, any other person known to the applicant as a person to whom any such expenses are due, or by whom any such expenses have been paid, shall be joined either as applicant or respondent.

The compensation shall, if necessary, be apportioned among those found to be entitled, as the Court shall order.

COMMENCEMENT OF PROCEEDINGS.

3.—(1) Proceedings in the Court to recover compensation under the Act shall be instituted by the issue of an originating summons. The originating summons shall be issued for hearing at the sittings of the Court to be held next after the expiration of twenty-one clear days from the date of issue thereof.

Form No. 1.

(2) The originating summons shall be entitled as in Form No. 1 in the Appendix and shall state :—

(a) the name of the County and Circuit in which the proceedings are being instituted ;

(b) the Christian name, surname, address and description of the applicant ;

(c) the name and place of business of his solicitor if any ;

(d) the surname of the respondent by which he is known to the applicant ; his residence or place of business ; and where known, his Christian name, and his occupation or description.

(3) The originating summons shall call upon the respondent to file a statement of defence to the claim of the applicant not later than eleven days after service upon him of the originating summons, and to appear upon the hearing of the summons, and shall warn him of the consequences of failure to do so.

(4) The originating summons shall be signed by the applicant or by or in the name of his solicitor.

Forms Nos 2 to 9 (a).

(5) The originating summons shall be according to such one of the forms in the Appendix as shall be applicable to the case, with such modifications as the nature of the case may require, and shall contain full particulars of all details of the applicant's claim as specified in the form applicable. A copy of the Notice of the Accident shall be appended or annexed to the particulars. If this requirement of this Rule cannot be complied with the reason therefor shall be stated in the particulars.

(6) The originating summons shall contain a notice to the respondent stating the sittings of the Court at which the same will in the ordinary course be heard, which shall be the sittings next ensuing after the expiration of twenty-one clear days from the date of issue of the originating summons. The first day of such sittings is hereinafter referred to as the return day.

TIME FOR, AND MODE OF, SERVICE.

4.—(1) The respondent shall be served with a copy of the originating summons not later than twenty-one days before the return day.

(2) Subject to the provisions of these Rules, the Rules of the Circuit Court, 1930, relating to the service of Civil Bills shall, with the necessary modifications, apply to the service of originating summonses.

(3) In the application of such Rules references to the Civil Bill shall be construed as references to the originating summons ; references to the defendant shall be construed as references to the respondent.

(4) No service of the originating summons shall be required when the respondent by his solicitor, in writing endorsed upon the original originating summons, undertakes to accept service and appear upon the hearing thereof. A solicitor failing to appear in pursuance of his written undertaking so to do shall be liable to an attachment.

(5) Where the respondent to be served is the Minister for Finance, service may be effected by sending a copy of the originating summons by post in a registered letter addressed to the Secretary of the Department of Finance.

(6) Where the respondent to be served is a body of persons whether corporate or incorporate, the originating summons may be served by delivering the same at, or by sending it by post in a registered letter addressed to such respondent at the office, or, if there be more than one office, any one of the offices of such body, situate within the jurisdiction.

Service of an originating summons on members of the managing committee of a club as employer under Section 8, sub-section 4 of the Act, shall be sufficiently made if the summons is served on any member of such committee, or on the manager or secretary of the club, and upon the club premises, in such manner as would be valid and sufficient if such person were the sole employer.

(7) Where the accident occurred in Ireland and the respondent does not reside in Ireland, or is a body of persons without an office in Ireland, the provisions of Order XXXVII of the Rules of the Circuit Court, 1930, shall apply, and service of an originating summons or notice thereof may be effected in accordance therewith out of the jurisdiction upon such respondent. In the case of a workman who is in receipt of, or entitled to receive, a weekly payment under a registered agreement, service of a summons to review or redeem may be effected out of the jurisdiction in accordance with the provisions of the said Order upon the party against whom review or redemption is sought, where such party does not reside in Ireland or is a body of persons without an office in Ireland.

(8) Where service of the originating summons is effected by registered post, it shall, unless the contrary be proved, be deemed to have been served at the time when the letter containing the same would have been delivered in the ordinary course of post ; and in proving such service it shall be sufficient to prove that such letter was properly addressed, registered and posted, and has not been returned as undelivered.

(9) Where an originating summons is served by registered post, the date, place and time of posting shall be endorsed upon the original, and the certificate of registration of the letter containing the same shall be annexed or appended to the original before the same is filed, as hereinafter provided, with the County Registrar.

(10) The originating summons shall be deemed to be issued when it is handed to or sent by post to a Summons Server for service upon the respondent.

(11) When the originating summons is served by post it shall be deemed to be issued when it is posted.

COUNTY IN WHICH PROCEEDINGS MAY BE INSTITUTED.

5.—(1) Proceedings shall be instituted in the county prescribed by the following provisions of this Rule :—

(a) the county in which all the parties reside or carry on business ;

(b) if the parties do not reside or carry on business in the same county—(i) the county in which the accident occurred, or (ii) the county in which the respondent or one of the respondents resides or carries on business.

Proceedings against the Owners of a Ship.

(2) Where the accident occurred at sea and it is alleged in the originating summons that the owners of any ship are liable as such to pay compensation under the Act, proceedings may, notwithstanding the foregoing provisions of this Rule, be instituted in :—

(a) the county in which the ship shall be, or

(b) the county comprising the port of registry of the ship, or

(c) the county in which the workman resides, or, where death results from the injury, the county in which his dependants or any of them reside.

Proceedings against Persons giving Security.

(3) Where it is alleged in the summons that the owners of a ship are liable as such to pay compensation under the Act and such compensation is being claimed against a person giving security pursuant to the provisions of Section 69 of the Act, proceedings may, notwithstanding the foregoing provisions of this Rule, be instituted in—

(a) the county in which the ship is or was detained, or in which the order for detention was made or applied for, or

(b) the county in which the workman resides, or, where death results from the injury the county in which his dependants or any of them reside.

(4) The provisions of this Rule shall be without prejudice to any transfer in manner provided by Rule 50.

FILING OF ORIGINATING SUMMONS.

6. The originating summons duly endorsed as to service, as provided by these Rules, shall be filed by the applicant with the County Registrar not later than fourteen days before the return day.

STATEMENT OF DEFENCE BY RESPONDENT.

7.—(1) A respondent to an originating summons who intends in any way to dispute the claim of the applicant shall, not later than eleven days after the service upon him of such originating summons, give or send by post to the applicant or his solicitor, and at the same time file with the County Registrar, a statement of defence setting forth briefly the grounds upon which he intends to dispute the applicant's claim.

(2) The statement of defence shall state clearly the precise grounds upon which the respondent disputes the applicant's claim, and no defence shall be admitted to defeat the applicant's claim nor any part thereof unless in the opinion of the Court it could fairly have been inferred from the particulars given in the statement of defence.

Forms Nos. 10 and 11.

(3) The statement of defence shall be according to such one of the forms in the Appendix as shall be applicable to the case, with such modifications as the nature of the case shall require, and shall contain full particulars of the respondent's defence as specified in the form applicable.

DEFENCE ADMITTING LIABILITY TO MAKE WEEKLY PAYMENT.

8. Where a respondent does not dispute his liability to pay compensation by way of weekly payment, he may in his statement of defence admit his liability to make a specified weekly payment and submit accordingly to an order for the payment of the same. The statement of defence shall contain full particulars as to how the specified weekly payment is computed.

9. Where the respondent files such a statement of defence admitting liability, he shall thereupon pay into Court a sum in respect of the applicant's costs up to and including the service of a notice of acceptance of the specified weekly payment.

10. Where the respondent admits that arrears of compensation have become due at the date of the filing of the statement of defence, he shall include therein full particulars as to how the amount of the same is computed, and the said amount shall thereupon be paid into Court.

Form No. 12.

11. If the applicant elects to accept in satisfaction of his claim the amount of the weekly payment specified in the respondent's statement of defence, he shall serve on the respondent, and at the same time file with the County Registrar, not later than five days after the service upon him of such defence, a notice of acceptance of the same, in accordance with the form in the Appendix.

Form No. 42 (a)

12.—(a) Where the applicant has, in accordance with Rule 11, served and filed a notice of acceptance, the Court or County Registrar may, on application, forthwith make an order directing :—

(i) payment out of Court to the applicant or his solicitor of the amount (if any) paid into Court as arrears of compensation, and of the amount paid into Court in respect of the applicant's costs ;

(ii) payment to the applicant by the respondent of the weekly payment specified in the respondent's statement of defence in accordance with the terms of the respondent's submission to an order for such payment therein contained.

(b) If the applicant does not, in accordance with Rule 11, file and serve a notice of acceptance, then if no greater payment is ordered on the hearing of the originating summons, than that specified in the statement of defence, the respondent shall not be ordered to pay any greater sum for costs than the amount paid into Court in respect of costs in accordance with Rule 9. In every such case the Court may award to the respondent his costs, according to the scale in the Appendix, incurred after filing of his defence, and may order :—

(a) that the applicant pay the amount of such costs to the respondent ; or,

(b) that the amount of such costs be set off pro tanto against any sum or sums ordered to be paid by the respondent to the applicant ; or,

(c) that the amount of such costs be paid to the respondent out of moneys in Court belonging to the applicant.

THIRD PARTY PROCEDURE.

A.—Where Respondent claims to be Indemnified under Section 19

13.—(1) Where the respondent claims to be entitled under Section 19 of the Act to be indemnified by any person not a party to the proceedings, he shall, not later than seven days after the service upon him of the originating summons, serve upon the person against whom he claims such indemnity, hereinafter referred to as the Third Party, a third party notice of his claim, together with a copy of the originating summons.

Such third party notice shall set forth briefly the grounds upon which the respondent claims to be indemnified by the third party, and shall be according to the form in the Appendix.

Form No. 13.

Service of the third party notice shall be effected in the manner prescribed by these Rules for the service of an originating summons. The respondent shall, at the same time, file a copy with the County Registrar.

(2) If the third party desires to dispute the applicant's claim against the respondent, or his own liability to the respondent, he shall, not later than seven days after service upon him of the third party notice, give or send by post to the other parties or their solicitors, and at the same time file with the County Registrar, a statement of defence, setting forth briefly the grounds upon which he intends to dispute the claim of the applicant, and his own liability to indemnify the respondent.

Form No. 14

(3) The provisions of these Rules relating to the respondent's statement of defence shall, with the necessary modifications, apply to a third party's statement of defence.

(4) Upon the service and filing in accordance with these Rules of a statement of defence by a third party, he shall be thereupon entitled to appear in the proceedings and shall be bound thereby in all respects as if he had been originally made a respondent.

(5) Where the respondent has served a third party notice, the Court may, before or at the hearing of the originating summons, direct that the issue of liability between the respondent and the third party be determined at the same time as or after the applicant's claim against the respondent ; and may give the third party leave to take such part in resisting the applicant's claim against the respondent as the Court may think fit, and generally may give such directions as the Court may think fit for having all issues most conveniently decided.

(6) The Court may decide all questions of costs as between the third party and all other parties, and may order any one party to pay the costs of any other party, and generally may make such order as to costs as the justice of the case may require.

B.—Where Respondent claims to be Indemnified under Section 61.

14. The provisions of Rule 13 shall apply to the case where a respondent claims, under the provisions of Section 61, to be indemnified by a person not a party to the proceedings, with the following modifications :—

Forms Nos. 15 and 16

(a) the word " respondent " shall include a person who has been made a third party to the proceedings under the provisions of Rule 13 ;

(b) the third party may defend only by leave of the Court and his defence shall be limited to disputing the applicant's claim against the respondent ;

(c) an order giving liberty to the third party to defend shall be made only on the application of the third party made on notice.

(d) nothing in this Rule shall empower the Court to decide any question as to the liability of the third party to indemnify the respondent, or to make any order in favour of the respondent against the third party, or to make any further or other order than that the third party be at liberty to defend, and such liberty having been given, that the third party, in any future action in the Circuit Court brought by the respondent against the third party claiming to be indemnified by him in respect of compensation recovered in the proceedings by the applicant, shall not be at liberty to dispute the validity of any Order made by the Court within its jurisdiction in the proceedings as between the applicant and the respondent.

CLAIM TO INDEMNITY AS BETWEEN RESPONDENTS.

15.—(1) Where one respondent claims to be entitled to be indemnified by any other respondent he may in all respects proceed as if such other respondent were not already a party to the proceedings.

(2) Nothing herein contained shall prejudice the right of the applicant against any respondent.

DEFAULT OF DEFENCE.

16. In default of defence by a respondent, whether an original respondent or a respondent added under the provisions of Rule 25, or by a third party, the Court at the hearing of the summons may (subject to the provisions of Rule 14) deem such party in default to have admitted the claim made against him and may make such order within its jurisdiction against a party in default as may be just, or may adjourn the hearing to enable a party in default to defend, upon such terms as to costs and otherwise as it shall think fit.

REVIEW AND REDEMPTION OF WEEKLY PAYMENTS UNDER SECTIONS 24, 25, AND 27.

A.—Where a Workman is in receipt of a Weekly Payment under an Order of the Court.

17. Where a workman is in receipt of, or entitled to receive, a weekly payment under an Order of the Court, and

(a) either the workman or the employer desires to apply to the Court to have the same reviewed ; or

(b) the employer desires to apply to the Court to have the same redeemed ;

the following provisions shall have effect :—

(1) Such application shall be by summons in the proceedings in which the order directing the weekly payment was made.

(2) The summons shall not contain any notice requiring any party to file a statement of defence to the claim contained in the summons.

Form No. 17.

(3) The summons shall state clearly the precise grounds upon which a review is sought. It shall be in accordance with such one of the forms in the Appendix as shall be applicable to the case, with such modifications as the nature of the case may require, and shall contain full particulars of the matters specified in the form applicable. The summons shall be issued for hearing at the sittings of the Court to be held next after the expiration of fourteen clear days from the date of issue thereof. The first day of such sittings is hereinafter referred to as the return day.

(4) Where a review is sought under the provision of Section 25 (2) the summons shall contain particulars of the date of birth of the workman. Where a review is sought under the provisions of Section 25 (3) the summons shall contain particulars of the average weekly earnings which it is claimed the workman would have received during the twelve months immediately preceding the review if he had remained uninjured and continued in the same class of employment as that in which he was employed at the date of the accident.

(5) The summons shall be filed with the County Registrar and served upon all parties interested not later than fourteen days before the return day.

(6) Subject as aforesaid the provisions of Rules 3 and 4 relating to originating summons shall, with the necessary modifications, apply to summonses to review or redeem.

(7) On the hearing of a summons to review a weekly payment the Court may confirm, end, diminish or increase the weekly payment ; and except where a workman's right to compensation is ended by the Order made on such hearing, such Order shall reserve liberty to both workman and employer to apply to review the weekly payment thereby ordered.

(8) The onus of proof of facts necessary to justify a review shall be on the party seeking a review.

B.—Where a Workman is in receipt of a Weekly Payment under a Registered Agreement, or under a Certificate of a Court or Appellate Tribunal, given under Section 60 (4).

18. Where a workman is in receipt of, or entitled to receive, a weekly payment, under a Registered Agreement, or under a certificate given by a Court or Appellate Tribunal, under the provisions of Section 60, sub-section (4) of the Act, and

(a) either the workman or the employer desires to apply to the Court to have the same reviewed ; or

(b) the employer desires to apply to the Court to have the same redeemed ;

the following provisions shall have effect :—

(1) Proceedings to have such weekly payment reviewed or redeemed shall be instituted by the issue of a summons.

(2) The provisions of paragraphs (2) to (8) inclusive of Rule 17 shall apply.

(3) Where the weekly payment is payable under a registered agreement the proceedings shall be instituted in the county in which the agreement is registered.

Where the weekly payment is payable under a certificate of a Court or Appellate Tribunal the proceedings shall be instituted in :—

(a) the county in which all the parties reside or carry on business ;

(b) if the parties do not reside or carry on business in the same county, (i) the county in which the accident occurred, or (ii) the county in which the respondent or one of the respondents resides or carries on business. In this context the word " respondent " means, where the application is to review, the party against whom the review is sought, and where the application is to redeem, the workman.

REVIEW BY THIRD PARTY.

19. Where a workman is in receipt of, or entitled to receive, a weekly payment from an employer under an order of the Court or under a registered agreement, and a third party has by order of a Court been ordered to indemnify, or has agreed to indemnify, such employer in respect of his liability to make such weekly payment, such third party may apply to the Court to have such payment reviewed or redeemed in the same manner as if he were the employer.

APPLICATIONS TO THE COURT OTHERWISE THAN BY ORIGINATING SUMMONS OR SUMMONS TO REVIEW OR REDEEM.

A.—Applications Ex Parte.

20.—(1) Wherever by any of these Rules it is provided that an application to the Court may be made ex parte, or where no mode of application is specified, the application may be made without notice to any party, and the provisions of Order X of the Rules of the Circuit Court, 1930, shall, with the necessary modifications, apply accordingly.

(2) An ex parte application may be supported by evidence on affidavit, or by viva voce evidence on oath according to the circumstances of the case or both as the Court shall consider just and convenient.

B.—Applications on Notice.

21.—(1) Wherever :—

(a) the Act provides for an application to be made to the Court, and no other mode of application is prescribed by these Rules ; or,

(b) by any of these Rules it is provided that an application shall be made to the Court on notice ;

the application shall be made to the Court on notice accordingly and the following provisions of this Rule shall apply.

(2) Where the circumstances of the case so require the application may be made to the Court ex parte in the first instance, and the Court may thereupon make such order as it shall consider just to make ex parte, or may direct the party applying to apply on notice, and give such other directions as it shall consider just and necessary.

(3) Where proceedings have been instituted the notice shall be in writing and shall be entitled in the same manner as in the summons instituting the proceedings.

(4) Where proceedings have not been instituted the notice shall be in writing and shall be entitled as in Form No. 1 in the Appendix of Forms, and in the matter in which the application is being made.

Forms Nos. 34 and 35.

(5) The notice shall be according to the form in the Appendix, with such variations as the circumstances may require. It shall be addressed to every person likely to have an interest in or to be affected by the relief or order sought, and shall call upon the party addressed to take notice that upon the day specified application for such relief or order will be made to the Court.

(6) The notice shall contain :—

(a) the name and address of the person making the application ;

(b) the name and place of business of his solicitor if any ;

(c) the name and address of the person to whom it is addressed ;

(d) the name and place of business of his solicitor if any ;

(e) mention of the affidavit to be used on the hearing of the application.

(7) The notice shall set forth briefly the nature of the relief or order sought.

(8) The notice shall be served upon the party to whom it is addressed not less than four clear days before the date specified for making the application, and a copy thereof shall at the same time be filed with the County Registrar.

(9) Where a notice is served by post, it shall be deemed to be served upon the date upon which in the ordinary course of post it would be delivered.

(10) The notice shall be dated of the day upon which it shall be served.

(11) A copy of every affidavit to be used upon the hearing of the application shall be filed and served with the notice.

(12) A party served with the notice may serve and file an affidavit in reply at any time before the hearing and use the same upon the hearing.

(13) On the hearing of the application :—

(a) Evidence in support thereof shall, save by leave of the Court, be restricted to the affidavits mentioned in thenotice and served and filed therewith, and evidence in reply shall be restricted to the affidavits already filed.

(b) The Court may give leave to any party to adduce further or other evidence on affidavit or viva voce or both. Where evidence is given viva voce, witnesses may be examined and cross-examined as on the hearing of an originating summons.

(c) The Court may grant or refuse in whole or in part the relief or order sought, or may adjourn the matter, or refer the matter to the County Registrar for inquiry and report.

RULES OF PROCEDURE RELATING TO SPECIAL CLASSES OF PERSONS.

Insurers—Bankruptcy of Employer.

22.—(1) Where a workman who is or claims to be entitled to compensation from an employer to whom Section 20 of the Act applies is unable to ascertain whether such employer has entered into a contract with insurers in respect of his liability under the Act to such workman the Court may, whether or not any proceedings have been commenced by such workman against such employer, on application by the workman make an order for the attendance of such employer, or if the employer be a company, of any officer thereof, for examination as to whether any, and if so what, contracts with insurers have been entered into by such employer in respect of such liability, and for the production by such employer or officer of books and documents, and may give such directions generally in the matter as the Court shall think fit. Such application by the workman shall be made to the Court on notice.

(2) Where an employer to whom Section 20 of the Act applies has in fact entered into a contract of insurance as therein defined, and his rights thereunder under the provisions of the said section, are transferred to and vest in a workman, the following provisions shall have effect :

(a) Subject to the terms and conditions of the contract of insurance as to the settlement of differences or disputes between the employer and the insurers, the procedure provided by the Act and these Rules for the determination by the Court of claims for compensation and other questions and matters arising under the Act shall, with the necessary modifications, apply for the determination of all questions and issues as to rights, liabilities and remedies under the Act as between such workman and such insurers.

(b) The Court may where necessary order the title of the proceedings to be amended by joining such insurers as respondents and may thereupon give such directions as to the service of documents upon the insurers and may adjourn any hearing to enable the insurers to appear and make defence to the workman's or the applicant's claim as the justice of the case may require.

Masters, Seamen, Apprentices, and Pilots—Section 66.

23. In the application of the Act and these Rules to members of the crew of any ship to which Section 66 of the Act applies, and, to other persons employed on ships to which Section 67 applies, the following special provisions shall have effect :—

(1) In any summons, notice or other document, it shall be sufficient to describe the owners of the ship as " The owners of the ship. . . . . . . ." and any party to the proceedings may, at any time, apply to the Court for a disclosure of the names of the owners of such ship, to be furnished in such manner as the Court may direct, and the Court may make an Order accordingly.

(2) (a) Subject to the provisions of sub-section (1) (a) of Section 66 of the Act as to service of notice of accident, any summons, Order, or other document to be served on the owners of a ship, shall be deemed sufficiently served if served on the managing owner, or manager, or (except where a master is claiming compensation) on the master of the ship.

(b) Service on the master of a ship, where there is one, may be made personally, or by leaving the same for him on board that ship with a person being, or appearing to be, in command or charge of the ship.

(c) Service of any document on the managing owner, or manager, may be made personally, or, where there is no managing owner, or manager residing in Ireland, or some agent of the owner residing in Ireland, or, where no such agent is known or can be found, and the ship is found in any port, or river, of Ireland, or within three miles of the coast thereof, by fixing a copy of the document to the main mast, or on the single mast of the ship.

(3) A statement of defence by the owners of a ship shall set out the names and addresses of the owners of the ship.

DETENTION OF SHIPS.—SECTION 69.

Form No. 17.

24.—(1) Subject as is in this Rule hereinafter provided, an application to the Court for an order for the detention of a ship under the provisions of Section 69 of the Act may be made ex parte.

Form No. 18.

(2) The Court may, before granting the application, require the applicant to give or procure an undertaking to the satisfaction of the Court to abide any Order as to damages and costs which may thereafter be made, in case any person, affected by the Order for detention, shall sustain any damages by reason of the Order, which, in the opinion of the Court, the applicant ought to pay.

Form No. 19.

(3) An Order for detention shall specify the amount for which security shall be given, and, shall be according to the form in the Appendix, and, shall be issued in triplicate, one copy shall be delivered to the applicant and the other two copies to the officer named by the Court, and one of such last mentioned copies shallbe delivered by such officer to the person who is, at the time of execution of the Order, apparently in charge of the ship, or, shall be nailed or affixed to the main mast or on the single mast of the ship, and the other copy shall be retained by the officer.

(4) The Court may, at any time, on good cause shown, rescind any Order for detention made by it.

Form No. 20.

(5) The provisions of Order 28 of the Circuit Court Rules, 1930, as to security shall, with the necessary modifications, apply to the giving of security under this Rule. Where security is given by bond, the bond shall be in accordance with the form in the Appendix.

Form No. 21.

(6) If the Court rescinds any Order for detention, or, is satisfied that satisfaction has been made, or, when security has been given and approved, or, in any other case, the Court may deliver on application to the party applying an Order according to the form in the Appendix directed to the officer named in the Order for detention, authorising him and directing him upon payment of all costs charges and expenses attending the custody of the ship, to release it forthwith.

(7) With respect to notices of application for Orders for detention, and to undertakings to give security, the following provisions shall have effect :—

(a) Notwithstanding anything in this Rule contained, a person intending to apply for an Order for detention shall, if the name and address of an agent in Ireland for the owner of the ship, or of his solicitor in Ireland authorised to act for the owner, agent, master or charterers of the ship, are known to him, give to such agent, or solicitor, by post, telegram or otherwise, such notice of the time and place at which the application for an Order for detention is intended to be made as may be practicable in the circumstances of the case.

Form No. 22.

(b) If a solicitor in Ireland represents that he is authorised to act for the owners, agent, master, or charterers of the ship, and signs an undertaking according to the form in the Appendix to pay in or give security for the amount agreed upon between the parties or fixed by the Court, then, on such undertaking being filed in Court, the Court may, in its discretion, either refuse to make an Order for detention, or, if an Order for detention has been made but not executed, rescind same, or, if an Order for detention has been made and executed may deliver to the party applying for same, an Order to release in accordance with paragraph (6) of this Rule.

(c) An undertaking, given in accordance with the last preceding paragraph shall be filed in the Court to which the application for Order of detention is made, or is intended to be made.

(d) A solicitor who fails to pay in, or to give security in pursuance of his undertaking to do so shall be liable to attachment.

(8) In any legal proceedings taken for the recovery of compensation against a person giving security, full particulars shall be given of the circumstances under which the proceedings are taken against such person.

(9) Where an Order for the detention of a ship is made in one county and proceedings in the matter are instituted in another county, the County Registrar of the county first mentioned shall, on request, transmit by registered post all original documents filed, a certified copy of all records made, and any bond by way of security given in the matter, and shall transfer any money paid into Court by way of security in the matter, to the County Registrar of the county last mentioned.

The cost of such copies and the cost of transmission shall be paid by the party by whom such proceedings were commenced without prejudice to the determination of the question as to what party shall ultimately be liable to pay such costs.

(10) The provisions of this Rule shall apply to claims against charterers under sub-section (5) of Section 69 of the Act, as they apply to claims against the owners of a ship, with the substitution of charterers for owners.

INDUSTRIAL DISEASES.

25.—(1) In the application of the Act and these Rules in the case of a workman disabled by or suspended on account of his having contracted any disease mentioned in Section 76 of and the Sixth Schedule to the Act, or, in any Order of the Minister made under sub-section (3) of the said section, or disabled by or suspended on account of his having sustained any injury due to the nature of any employment specified in any such Order, not being an injury by accident or, in the case of a workman whose death has been caused by any such disease or injury as above mentioned, the following provisions shall have effect :—

(a) The notice required by Section 28 of the Act shall state the date and cause of the disablement or suspension, and where a certificate of disablement, or a certificate as to the reason of suspension has been given, a copy thereof shall, on demand, be furnished to the employer.

Forms Nos. 23 and 24.

(b) If the employer desires to add any other employer as a party, pursuant to paragraph (iii) (II) of sub-section (1) of Section 76 of the Act, he shall file with the County Registrar in duplicate a notice according to the form in the Appendix, and, thereupon, the County Registrar shall make an order in the form in the Appendix adding such other employer as a respondent, and may, if necessary, adjourn the hearing for such time as may be necessary to enable such other employer to be duly served.

Forms Nos. 24a and 25.

(c) Where a respondent is added under the last precedingparagraph, a notice according to the form in the Appendix together with copies of the notices, pursuant to which he is so added, and of the Order, shall be served on all other parties, and the like copies, together with a notice according to the form in the Appendix and a copy of the applicant's originating summons and of the original respondent's statement of defence, shall be served by the party obtaining the order on the added respondent. Service shall be effected on the added respondent in accordance with the provisions of Rule 4, with such modifications as may be necessary, and with the substitution of the original respondent for the applicant.

(2) The provisions of these Rules as to respondents shall apply to an added respondent from the date of service on him as if he had been originally made a respondent.

(3) At the hearing of the proceedings, the Court shall decide all questions as between the applicant and the original and added respondents, and may make such Order as may be necessary effectively and completely to adjudicate upon and settle all the questions involved in the proceedings, and may make such Order as to costs as between the applicant and the respondents, and as between the respondents themselves, as the Court may think fit.

Form No. 26.

(4) Where the employer claims under Section 76 (1) (iii) III, of the Act to be entitled to contribution from any other employer, he may bring in such other employer as a third party in accordance with Rule 13, and the provisions of that rule shall, with the necessary modifications apply to any such claim to contribution in like manner as they apply to claims to indemnity under Section 19.

AGREEMENTS IN RELATION TO COMPENSATION.

26. Where an employer and a workman have entered into an agreement and it is intended to apply to have the same registered in the Register of Agreements, the following provisions shall have effect :—

Forms Nos. 27 to 31.

(1) The agreement shall be in writing, signed by the parties thereto, and shall be in accordance with such one of the forms in the Appendix as may be applicable, and shall be left with, or sent by post to the County Registrar, together with a copy thereof for every party interested.

(2) Every such agreement shall disclose the amount (if any) paid or payable under, or in respect of such agreement, by the employer to the solicitor for the workman as costs, and shall state whether the workman who is a party to the agreement is an insured person or not, and, in the event of his being an insured person, shall state the name and address of the approved society by which sickness or disablement benefit, under the National Health Insurance Acts, 1911-1936, payable to such workman, is administered, and his membership number in such society, and shall also contain such of the particulars mentioned in the forms in the Appendix as are applicable to the circumstances of the case.

(3) An application to the County Registrar for the registration of an agreement shall be in writing, signed by the party applying therefor, or by a solicitor on his behalf.

(4) The application shall be made to the County Registrar of the county in which the workman resides, or where proceedings have been instituted, the County Registrar of the county where such proceedings have been instituted.

Forms No. 31a

(5) On receipt of any such agreement and application, the County Registrar shall serve notice of the reception of such application, together with a copy of the agreement on all parties interested therein, and, if the workman is an insured person, also upon the approved society concerned, and no such agreement shall be registered under the Act until the expiration of seven days after the date of the service of such notice.

Forms No. 32.

(6) Any person to whom notice of an application to register an agreement has been given by the County Registrar, may, within seven days after the service of such notice, send a notice of objection to the County Registrar objecting to the registration of such agreement. Such notice of objection shall be in writing and shall be signed by the person so objecting, and shall be in accordance with the form in the Appendix, and shall state clearly the statutory ground or grounds mentioned in Section 54 of the Act upon which the objection is based.

Form No. 31d.

(7) Where no notice of objection based on a statutory ground of objection is received by the County Registrar, under the last preceding Rule, the County Registrar shall, unless he refers such application to the Court under the provisions of Section 55 of the Act, forthwith register such agreement in the Register of Agreements, and shall notify all notice parties accordingly.

(8) Where no notice of objection based on a statutory ground of objection is received by the County Registrar within the time limited by the last preceding Rule but the County Registrar is, for any reason which seems to him sufficient, of opinion that such agreement should not be registered except in pursuance of an Order of Court, he shall refer the application to the Court on a report in writing setting out any information which he may have obtained, and the grounds upon which it appears to him that such agreement ought not to be registered.

Form No. 31c.

(9) The County Registrar shall send notice to the parties interested, or their respective solicitors, of his intention to refer the application to the Court, seven clear days at least before the day fixed by him for the determination of such application. The notice shall state the grounds upon which it appears to the County Registrar that such agreement ought not to be registered.

Form No. 31b.

(10) The County Registrar may require any party to the agreement, by notice in writing, to furnish him with such further particulars as he may require to enable him to decide whether any agreement should be registered by him, or whether he should refer the application for registration to the Court, and, for this purpose,he may require any party to the agreement to furnish him with any medical reports as to the condition of the workman and his capacity for work, as are available.

(11) Where an application for registration of an agreement is made subsequent to any Order of the Court fixing compensation or deciding any question or matter relating to the condition of the workman, or his fitness for employment, or, where any dispute between a workman and an employer has been referred to a medical referee under Section 34 of the Act, particulars of such Order of Court, and of the certificate of the medical referee shall, in the first instance, be set out in the notice of application for registration.

(12) Where any party to an agreement, in respect of which an application for registration is made, fails to comply with any request of the County Registrar to supply information or particulars required by him, or to furnish him with any medical reports which may be available, the County Registrar may deem such failure sufficient reason to refer the application to the Court.

Procedure where Objection is made to Registration.

Form No. 33.

(13) If a notice of objection based on a statutory ground of objection to the registration of an agreement the subject of an application for registration under the Act is received by the County Registrar within the time limited by the Act, the County Registrar shall refuse to register such agreement and shall notify all notice parties of such refusal, and shall serve a copy of such notice on all notice parties, other than the party objecting. The notice of refusal to register such an agreement shall be in accordance with the form in the Appendix.

Forms No. 35 (1)

(14) Where the County Registrar refuses to register an agreement on account of a notice of objection having been served, any notice party may apply to the Court on notice to have the same registered.

(15) Where the County Registrar refers an application for registration of an agreement to the Court under Section 55 of the Act, on the hearing of the application witnesses may be examined in the same manner as on the hearing of an action, and the Court may make such Order or give such directions as it may think just, and may thereupon either direct the agreement to be registered, or, confirm the refusal of the County Registrar. If the Court directs the agreement to be registered, the County Registrar shall forthwith register the same in the Register of Agreements and notify all parties accordingly.

(16) On the hearing of any application under either of the last two preceding paragraphs of this Rule, the Court may make such Order as to costs of such application as may be just.

(17) Where it appears to the County Registrar that the amount paid or payable by the employer to the solicitor for the workman as costs under or in respect of an agreement the subjectmatter of an application for registration under Section 52 of the Act is excessive, he shall not, on that ground alone, refuse to register the agreement, but may do any of the following things :—

(a) by consent of the parties measure the amount of such costs, amend the agreement accordingly and register the same as amended ;

(b) require the solicitor for the workman to furnish him with information showing how the amount of such costs have been determined, and on consideration of such information accept such amount as just and reasonable and register the agreement accordingly ;

(c) by notice in writing accordingly direct such solicitor to furnish a bill of such costs within seven days of such notice.

Upon such bill of costs being so furnished the County Registrar shall, subject to review by the Court, tax such costs in accordance with these Rules and the scales in the Appendix.

If the amount of such bill is reduced on taxation, then, failing agreement between the parties as to the amount of such reduction being applied and dealt with for the benefit of the workman, or paid to the employer, the County Registrar shall refer to the Court the question as to how such amount shall be dealt with, and shall notify the parties or their solicitors of the date on which the Court will determine such question. If the parties agree that the amount of such reduction shall be applied and dealt with for the benefit of the workman or paid to the employer, the agreement shall be amended accordingly and registered.

If the amount of such bill is reduced by the Court on review of the taxation, the question as to how the amount of such reduction shall be dealt with shall be determined on such review.

In this sub-rule the expression " amount of such bill," means the amount of the bill exclusive of taxation items.

An application to the Court to review the taxation of such costs shall be made on notice.

(18) A lump sum agreement with a workman under any legal disability shall not be registered unless and until the amount payable thereunder shall have been paid into Court.

APPLICATION FOR CANCELLATION OF REGISTRATION UNDER SECTION 56 (2).

Form No. 35(2)

27.—(1) Where an agreement made with a person under a disability, or a commutation agreement, redemption agreement, or agreement by way of compromise, has been registered by the County Registrar, any notice party may, within six months from the date of such registration, apply to the Court on notice to have such registration cancelled.

(2) On the hearing of the application the Court may either cancel or refuse to cancel the registration, and may make such Order in the matter and as to the costs of the application as the Court shall think fit.

RECTIFICATION OF THE REGISTER, SECTION 59.

28. An application to the Court, under the provisions of Section 59 of the Act, to rectify the Register shall be made on notice.

APPLICATIONS FOR REFERENCE TO MEDICAL REFEREE UNDER SECTION 34.

29.—(1) With respect to applications to the County Registrar or the Court pursuant to Section 34 of the Act to refer any matter to a medical referee, the following provisions shall have effect.

(2) The report of the medical practitioner to be furnished for the purpose of an application under Section 34 of the Act shall state the date of his examination and whether such examination is by the employer's or the workman's medical practitioner, and—

(a) shall certify his opinion as to the condition of the workman and his fitness for employment, or,

(b) where the question in dispute between the employer and the workman is whether or to what extent the workman's incapacity is due to the accident the subject matter of the workman's claim for compensation, shall certify his opinion on such question, and,

(c) shall set out the grounds of the opinion of the medical practitioner.

(3) A copy of such report shall be furnished by the employer or the workman, as the case may be, to the other party, within six days from the date of the examination.

Form No. 35 (3). Form No. 36.

(4) An application for a Reference Order shall be in writing signed by the party or parties applying and shall be in accordance with such of the forms in the Appendix as is applicable to the case. Two copies of the application shall be filed with the County Registrar together with a copy of the report of every medical practitioner who has examined the workman, whether provided by the employer or by the workman himself. Where the application is by one of the parties only, it shall be made on not less than four days' notice in writing to the other party.

(5) Where the application for a Reference Order is made by both parties the County Registrar shall, on receipt thereof, forthwith make such Reference Order.

Form No. 37.

Form No. 35 (4)

(6) If the application for a Reference Order is made by one party only, the County Registrar shall appoint a date for bearing the application and shall notify the parties, or their solicitor, inwriting, three clear days at least before such date. The parties shall be entitled to appear at the hearing in person, or by solicitor or counsel, and, at the conclusion of the hearing, the County Registrar shall forthwith give his decision. A party aggrieved by the decision of the County Registrar making or refusing to make a reference order may appeal therefrom to the Court. Such appeal shall be on notice and shall be taken within seven days from the giving of the decision. When the County Registrar makes a Reference Order under this paragraph, the same shall issue after the expiration of seven days unless within that time an appeal is taken.

(7) An application for a Reference Order under this Rule by an employer only who has served a notice of intention to end or diminish a weekly payment under Section 26 of the Act shall not be made before the expiration of twenty-one days from the service of such notice.

Form No. 37 (a).

(8) A Reference Order shall not be issued by the County Registrar until payment of the fee fixed by regulations made by the Minister for justice under Section 34 of the Act.

Form No. 38.

(9) Where a Reference Order, whether made by the Court or the County Registrar, is issued by the County Registrar, he shall forward by registered post to the medical referee with the Order for Reference, copies of the application and of the medical reports filed with the application, and shall also, subject to regulations made by the Minister for Justice, make and serve by registered post upon the workman an Order directing the workman to submit himself for examination by the medical referee.

(10) Before making such Order the County Registrar shall inquire if the workman is in a fit condition to travel for the purpose of examination, and if satisfied that he is in a fit condition shall by the Order direct him to attend at such time and place as the referee may fix, and if satisfied that he is not in a fit condition to travel shall so state in the Order of Reference ; and it shall be the duty of the workman, on being served with the Order, to submit himself for examination accordingly.

(11) On receipt by the County Registrar of the certificate of the medical referee, he shall deliver or send by registered post to the parties, copies of the certificate, and shall permit any party to inspect the original and take a copy thereof at his office during office hours.

(12)—(a) The costs of an application to the County Registrar for a Reference Order may be allowed to any party in any subsequent proceedings in Court between the parties in the matter.

(b) Where an application for a Reference Order is determined by the Court, the Court may make such order as to the costs of such application as the Court may think just.

(13) All references to a medical referee under this Rule shall be subject to and in accordance with any regulations made by theMinister for Industry and Commerce, and such regulations shall, in so far as they affect the Court and proceedings in the Court, have effect as Rules of Court.

APPLICATION TO DETERMINE EFFECT OF MEDICAL REFEREE'S CERTIFICATE.

30.—(1) Where a certificate of a medical referee has been obtained, in pursuance of the provisions of Section 34 of the Act, but the effect of that certificate is disputed, either the workman or the employer may, within five days of the receipt of the certificate, apply to the Court, under the provisions of Section 26 (4) of the Act, on notice for the determination by the Court of the effect of the Referee's certificate.

(2) On the determination by the Court of the effect of the medical referee's certificate, any payments made into Court by the employer on the application for the Reference Order, shall be paid out to the employer or to the workman or otherwise dealt with in accordance with the decision of the Court.

SUBMISSION TO MEDICAL REFEREE FOR REPORT. SECTION 39 (4).

31.—(1) Subject to and in accordance with the regulations made by the Minister for Justice with the concurrence of the Minister for Finance, the Court may submit to a medical referee any matter which seems material to any question arising in proceedings in Court under the Act.

(2) Where any matter is submitted as aforesaid, the Court may, subject to and in accordance with such regulations order the injured workman to submit himself for examination by the medical referee ; and it shall be the duty of the workman on being served with such order, to submit himself for examination accordingly.

SUMMONING MEDICAL REFEREE AS ASSESSOR. SECTION 39 (2).

32.—(1) Where the Court requires a medical referee to sit as assessor in any case, the County Registrar shall summon a medical referee accordingly.

Forms Nos. 39 and 40.

(2) Any party to any proceedings under the Act may apply to the Court through the County Registrar in writing according to the form in the Appendix, seven clear days at least before the hearing to have a medical referee summoned to sit as assessor to the Court on the hearing of such proceedings. On such application being made the Court shall forthwith direct the County Registrar to summon a medical referee accordingly on the requisite fee being paid. The County Registrar, upon the receipt of the fee prescribed by regulations made by the Minister for Justice with the concurrence of the Minister for Finance, shall thereupon summon a medical referee by sending him by registered post a summons according to the form in the Appendix.

SUMMONING OF AND REFERENCE TO MEDICAL REFEREE. GENERAL.

33.—(1) Where a medical referee is summoned to sit as assessor or any matter is submitted or referred to a medical referee, the referee to be summoned, or to whom the matter is to be submitted or referred, shall in the absence of special circumstances be the referee hereinafter mentioned, that is to say :—

(a) if proceedings have been instituted, a referee appointed by the Minister for the county in which the proceedings have been instituted, or

(b) if no proceedings have been instituted, the referee appointed by such Minister for the county in which any proceedings arising out of the matter the subject of the reference or submission may under the provisions of these Rules be instituted.

Provided always, that where more than one referee has been appointed for a county, the referee to be summoned or to whom the matter is to be submitted or referred shall, subject to the foregoing provisions of this Rule, be such referee as the Court, or the County Registrar as the case may be, shall in all the circumstances consider fit, having due regard to any practice in the matter which may have obtained prior to the coming into operation of these Rules.

(2) In special circumstances, subject to the provisions of the Act, the Court may summon as assessor or submit any matter to, and the County Registrar may refer any matter to such duly qualified medical practitioner as the Minister for Justice shall specially appoint as referee for the purpose.

(3) Where a medical referee is summoned as an assessor or any matter is submitted or referred to a medical referee, such referee shall be summoned, or the matter shall be submitted or referred subject to and in accordance with any regulations made by the Minister for Justice with the consent of the Minister for Finance and any such regulations shall, in so far as they affect the Court and proceedings in the Court, have effect as Rules of Court.

Forms No. 26 (c).

(4) Where regulations made by the Minister for Industry and Commerce provide for a reference to a medical referee under Section 76 (1) (vi) of the Act, it shall be the duty of the County Registrar to make the reference in accordance with such regulations.

SUSPENSION OF WEEKLY PAYMENTS, OR WORKMEN'S RIGHT TO TAKE PROCEEDINGS, SECTIONS 33 AND 34.

34.—(1) Application by an employer for suspension of the workman's right to compensation, or to take any proceedings under the Act in relation to compensation on the ground of the workman's refusal to submit himself for medical examination, under Sections 33 and 34, shall be made on notice.

(2) Where proceedings have been instituted the application shall be made to the Court in the county in which they are pending. In all other cases the application shall be made to the Court in the county in which the workman resides.

CERTIFICATE UNDER SECTION 60.

Form No. 55.

35.— (1) Where an action is brought in the Circuit Court to recover damages independently of the Act for injury caused by any accident and the Court proceeds under Section 60 of the Act to assess compensation, the certificate given by the Court shall be according to the form in the Appendix.

(2) Where the certificate is given by the High Court or Supreme Court the County Registrar shall, on the certificate being lodged with him, record the same in like manner as if such certificate were an Order of the Court awarding compensation in proceedings under the Act.

(3) Where the High Court or Supreme Court remit the case to the Circuit Court for assessment of compensation under sub-section 5 of Section 60, the plaintiff shall lodge with the County Registrar the pleadings in the action and the Order remitting the case, whereupon the County Registrar shall enter the case for assessment of compensation by the Court and shall notify the parties by post of the date upon which the Court will sit to assess the compensation at least ten days prior thereto.

The Order of the High Court or Supreme Court remitting the case and the Order of the Circuit Court assessing the compensation shall be recorded in like manner as an Order of the Circuit Court awarding compensation in proceedings under the Act.

FORM OF ORDERS.

Forms Nos. 42 and 43.

36.—(1) Every Order of the Court whereby a respondent is ordered to pay compensation to a workman by weekly payment shall order such respondent to continue to make such weekly payment until further order or until the same be ended or diminished in accordance with the provisions of the Act. Every such Order shall likewise reserve liberty to either party to apply to the Court to review such weekly payment.

(2) The provisions of Order I, Rule 3, of the Rules of the Circuit Court, 1930, shall apply to every Order made by the Court under the Act. Every such Order shall be settled by the County Registrar.

(3) The Court shall have power at any time to correct any clerical error or mistake in such Order arising from any accidental slip or omission.

(4) An attested copy of an Order of the Court may be obtained from the County Registrar by any person on payment of the prescribed fee, if any.

EXECUTION.

37.—(1) Subject to the provisions of these Rules every Order of the Court made under the Act, whereby any person is ordered to pay any money, shall have the same force and effect as a Decree of the Court made in a civil action.

(2) The provisions of these Rules relating to the execution of Orders shall, with the necessary modifications, apply to execution on foot of an agreement, which, under the provisions of Section 47 or 48 of the Act has the effect of an Order of the Court.

(3) Execution on foot of an Order or agreement for the payment of compensation by weekly payment to a workman shall not issue except by leave of the Court, or the County Registrar.

Form No. 35 (5).

(4) An application for liberty to issue execution shall be made on notice. When the Court is sitting in the County in which the Order was made, or the agreement registered, on foot of which execution is sought, the application shall be made to the Judge. When the Court is not so sitting the application may be made to the County Registrar.

(5) Where a workman applies for liberty to issue execution, and the party against whom execution is sought alleges that the workman has ceased to be totally and is only partially incapacitated, or that he has ceased to be incapacitated, the Court or the County Registrar may, on such terms (including payment of the compensation into Court) as it or he may consider just, adjourn the application for such time as it or he may think fit, to enable such party to apply to the Court to review such weekly payment, or to end or diminish the same in accordance with the provisions of the Act. Any such adjournment shall be without prejudice to the right of the workman to renew his application.

(6) Subject to the provisions of these Rules, the Rules of the Circuit Court relating to the execution of judgments or Orders, including the procedure by way of garnishee and the appointment of a receiver by way of equitable execution, shall with the necessary modifications apply to the execution of Orders under the Act and these Rules. A separate execution order may be issued for costs.

Form No. 44.

(7) An Order giving liberty to issue execution shall be in accordance with the form in the Appendix with such variations as the circumstances may require.

PAYMENT OF MONEY INTO COURT.

38.—(1) Save as provided by sub-rule 7 of this Rule, where, under the provisions of the Act or these Rules, any payment is to be madeinto Court, the money shall be lodged, in the manner prescribed by these Rules, to the credit of the Circuit Judge and the County Registrar and to the credit of the matter, in the bank prescribed by the Minister for Justice in accordance with the provisions of Section 41 of the Courts of Justice Act, 1936 .

(2) The money shall be lodged to the credit of :—(a) the County Registrar by whom any agreement in respect of such money has been or is sought to be registered ; or the County Registrar of the County in which proceedings in respect of which the money is being paid have been, or may by these Rules be instituted ; and (b) the Judge for the time being assigned to the Circuit comprising such County.

Form No. 45.

(3) The person making the payment shall obtain a privity from the County Registrar and lodge the money in accordance with the provisions of this Rule and the terms of the privity.

Form No. 46.

(4) The person making the payment shall obtain from the bank a receipt for the lodgment and shall forthwith file the same with the County Registrar, and shall, if he so desires, receive from him a copy of the same.

(5) Where the money to be paid into Court is a weekly payment payable to a person under legal disability, or a weekly payment payable into Court under the provisions of Section 26 (4) of the Act, it shall not be necessary to obtain separate forms of privity and receipt for each weekly payment and the Forms numbered 47 and 48 in the Appendix shall be used.

(6) Payment of money into Court shall be made only where the amount of such payment, weekly or otherwise, has been determined by the Court or by agreement duly registered, or of which registration is sought in accordance with the Act and these Rules, or with a statement of defence admitting liability in accordance with these Rules.

(7) The provisions of sub-rules (1) and (2) (b) shall not apply to the payment of moneys into Court with a statement of defence admitting liability, under the provision of Rules 9 and 10, or to the payment into Court of a weekly payment under the provisions of Rule 40. Moneys so paid into Court may be lodged to the credit of the County Registrar and to the credit of the matter.

PAYMENT INTO COURT OF WEEKLY PAYMENTS PAYABLE TO A PERSON UNDER LEGAL DISABILITY, SECTION 41 (3).

39.—(1) An application for an Order under Section 41 (3) of the Act that a weekly payment payable under an Order of the Court or registered agreement to a person under any legal disability shall during such disability be paid into Court may be made either by the person liable to make such payment or by or on behalf of the person entitled to such payment.

(2) If the weekly payment is payable under an Order of Court the application may be made at or immediately after the hearing atwhich such Order was made. Otherwise, or if the weekly payment is payable under a registered agreement the application shall be made on notice.

(3) Upon the hearing of the application the Court may make such Order and give such directions as it may think fit and may order that any sums paid into Court under the Order may be paid out to or otherwise applied for the benefit of the person entitled thereto in such manner as the Court may direct. The provisions of Rule 44 as to the investment payment out or application of payments into Court shall apply to weekly payments paid into Court under this Rule.

PAYMENT INTO COURT OF WEEKLY PAYMENTS PENDING SETTLEMENT OF A DISPUTE BY MEDICAL REFEREE, SECTION 26.

40.—(1) Where under Section 26 of the Act an employer seeks to end or diminish a weekly payment payable under an Order of Court or registered agreement and application has been made for a reference to a medical referee pursuant to the provisions of Section 34 of the Act the employer shall forthwith be entitled in accordance with the provisions of Rule 38 to pay into Court pending the settlement of the dispute the whole of such weekly payment where the notice served by the employer under Section 26 of the Act was to end such weekly payment, or so much of the weekly payment as is in dispute where an employer's notice under Section 26 of the Act was to diminish such weekly payment.

(2) Money paid into Court under this Rule shall not be invested.

(3) Unless within the time limited by Rule 30 either party notifies the County Registrar that the effect of the certificate of the medical referee is disputed and files and serves the notice required by the said Rule to have the effect of such certificate determined by the Court the County Registrar shall pay out to the employer or the workman as the case may be in accordance with the effect of such certificate all payments made into Court under this Rule.

(4) Where the effect of the medical referee's certificate is disputed and an application is duly made to the Court to have the effect of such certificate determined by the Court all payments made into Court under this Rule shall be paid out either to the employer or the workman (or otherwise dealt with) in accordance with the determination by the Court of the effect of such certificate.

PAYMENT INTO COURT OF LUMP SUM PAYABLE TO A PERSON UNDER ANY LEGAL DISABILITY UNDER A REDEMPTION OR COMMUTATION AGREEMENT OR AGREEMENT BY WAY OF COMPROMISE OF DISPUTED CLAIM.

41.—(1) Where any lump sum is payable to a person under any legal disability under a redemption agreement, compromise agreement,or agreement by way of compromise of disputed claim and it is determined by the County Registrar, or where the matter is referred to the Court by the Court that such agreement should be registered, the employer shall pay such lump sum into Court in accordance with the provisions of Rule 38 and thereupon such agreement shall be registered.

(2) The payment of such lump sum into Court under this Rule shall be deemed to be a recovery from the employer of the lump sum payable under such agreement.

PAYMENT INTO COURT OF LUMP SUM PAYABLE UNDER A REDEMPTION ORDER, SECTION 27.

42. Where the Court makes an Order that the employer's liability to make a weekly payment shall be redeemed by the payment of a lump sum under Section 27 of the Act, and orders that such lump sum be invested for the benefit of the person entitled thereto, the employer shall forthwith pay such lump sum into Court in accordance with the provisions of Rule 38.

PAYMENT INTO COURT OF LUMP SUM IN FATAL CASES.

43.—(1) Where compensation payable under the Act is, or consists of, the children's lump sum, such lump sum when the amount thereof is determined by the Court, shall forthwith be paid into Court in accordance with the provisions of Rule 38.

(2) Where compensation payable under the Act is, or consists of, the adult's lump sum, such lump sum, when the amount thereof is determined by the Court, shall if the Court so orders be forthwith paid into Court in accordance with the provisions of Rule 38.

INVESTMENT, PAYMENT OUT, AND APPLICATION OF MONEY PAID INTO COURT.

44.—(1) Where by an Order of the Court any money is directed to be paid into Court, on the hearing at which such Order is made application may be made by or on behalf of any person entitled thereto for the investment, payment out, or application of such money, and the Court may make such Order as to the investment, payment out, or application thereof as it may think fit.

(2) Where application is not so made or in any other case, an application to the Court to have money in Court invested, paid out, or otherwise dealt with, shall be made on notice.

(3) Every Order of the Court for the investment, payment out, or application of money paid into Court shall reserve liberty to all parties to apply to the Court as they may be advised.

(4) Where a person entitled to the benefit of money paid into Court under the Act and these Rules is a person under any legal disability the Court may, subject to the provisions of the Fifth Schedule of the Act, order such money (and any interest or dividends payable in respect thereof) to be paid out or applied for the benefit of the person entitled thereto by weekly or other periodical payments.

(5) Subject to the provisions of these Rules no payment shall be made out of monies in Court save in accordance with an Order of the Court.

APPLICATION FOR VARIATION OF ORDER UNDER SECTION 40.

45. An application to the Court to have an order of the Court varied, under the provisions of Section 40 of the Act, shall be made on notice.

APPLICATION ON DEATH OF DEPENDANT FOR DISPOSAL OF MONEY IN COURT TO WHICH SUCH DECEASED DEPENDANT WAS ENTITLED.

46.—(1) On the death of an adult dependant entitled to money paid into Court under the Act, any person who may be entitled thereto under paragraph (2) of the Fifth Schedule to the Act may apply to the Court on notice for an order for the distribution or other disposal of the same in accordance with the provisions of the said paragraph.

(2) On the death under fifteen years of age of a juvenile dependant entitled to money paid into Court under the Act, any application to the Court for the addition of the amount of such money to the share of another juvenile dependant, or for the division and allocation of such money among the other juvenile dependants, may be made ex parte. Any application for the distribution of such money among the next of kin of such juvenile dependant shall be on notice.

PROCEEDINGS WHERE A WORKMAN IN RECEIPT OF WEEKLY PAYMENTS INTENDS TO CEASE TO RESIDE IN IRELAND, SECTION 32.

47.—When a workman in receipt of a weekly payment intends to cease to reside in Ireland the following provisions shall have effect as under Section 32 of the Act :

(1) If the workman obtains from the employer a certificate of the employer's medical practitioner that it is desirable, owing to the condition of health of the workman, that the workman should cease to reside in Ireland the procedure to obtain the payment of the weekly payments quarterly as set out in paragraphs (4) to (8) inclusive of this Rule shall be adopted.

Form No. 49 (a).

(2) If the workman cannot obtain such certificate from the employer's medical practitioner he may apply to the County Registrarto refer to a medical referee the question whether his condition is such that the incapacity resulting from the injury is likely to be of a permanent nature. The application for a Reference Order shall be made in accordance with the provisions of Section 34 of the Act and Rule 29 paragraphs (1) to (6) inclusive, and (8) to (12) inclusive of these Rules, limited to the question whether the condition of the workman is such that his incapacity is likely to be of a permanent nature and the nature of the incapacity.

(3) Where the workman has obtained the required certificate of the employer's medical practitioner or a certificate of the medical referee under this Rule certifying that the incapacity resulting from the injury is likely to be of a permanent nature, the County Registrar shall on request furnish to the workman—

(a) a copy of the certificate of the employer's medical practitioner or of the medical referee, as the case may be, sealed with the seal of the Court ; and certified by the County Registrar ; and

(b) a copy of the Order of Court or registered agreement under which the weekly payment is payable, sealed with the seal of the Court, and certified by the County Registrar ; and

Form No. 49.

(c) a certificate of identity according to the Form in the Appendix ; and

Forms Nos. 50, 51 and 52.

(d) a notice according to the form in the Appendix annexing thereto forms of certificate and declaration according to the forms in the Appendix (Forms 52 and 53) and shall obtain from the workman a specimen of his signature and file the same for reference.

Form No. 51.

(4) A workman who desires to receive the weekly payment payable to him while residing outside Ireland shall at intervals of three months from the date to which such payments were last made, submit himself to examination by a medical practitioner in the place where he is residing, and shall produce to him the sealed copy of the certificate of the employer's medical practitioner, or medical referee, as the case may be, and his certificate of identity, and shall obtain from him a certificate in the form in the Appendix that the incapacity resulting from the injury continues ; and such certificate shall be verified by declaration by the medical practitioner in the presence of the workman, before a person having authority to administer an oath.

Form No. 52

Form No. 53

(5) The workman shall also make a declaration of identity according to the form in the Appendix before a person having authority to administer an oath, producing to such person the sealed copy medical certificate and copy certificate of identity and the certificate of the medical practitioner by whom he has been examined ; which declaration of identity and last mentioned certificate he shall forward to the County Registrar together with a request according to the form in the Appendix completed by him and signed in his own handwriting.

(6) On receipt of the certificate, declaration and request the County Registrar shall examine the same, and may, if not satisfied that the same are in order, return the same for correction.

Form No. 54

(7) The County Registrar on being satisfied that the certificate, declaration and request are in order shall send to the employer a notice according to the form in the Appendix requesting him to forward the amount due ; and the employer shall thereupon forward the amount due to the County Registrar who shall remit the same less any fees payable to the County Registrar and the costs of transmission, to the workman at the address and in the manner requested by him, such remittance being in all cases at the cost and risk of the workman.

PAYMENT OF ARREARS OF WEEKLY PAYMENTS ON DEATH OF WORKMAN RESIDING OUTSIDE IRELAND.

48.—(a) (1) In the event of the death of a workman entitled to receive payments while residing outside Ireland, his representatives shall, for the purpose of obtaining any arrears due to the workman, forward to the County Registrar a certificate of the death of such workman and documents showing that they are entitled to such arrears, verified by declaration before a person having authority to administer an oath, with a request for payment of such arrears, specifying the place where and the manner in which the amount is to be remitted to them.

(2) For the purposes of this Rule the expression " representatives " shall mean—

(a) where a workman leaves a will, the executor, or person to whom a grant of probate or administration with the will annexed has been made ;

(b) where the workman dies intestate the person to whom a grant of administration has been made, or the persons who are according to law entitled to his personal estate.

(3) Where a grant of probate or administration has been made, payment of the arrears shall be made only on production of the same.

(4) On receipt of the certificate and documents mentioned in this Rule, the County Registrar shall examine the same, and may, if not satisfied that the same are in order, return the same for correction.

(5) The County Registrar, on being satisfied that the documents are in order, shall send to the employer a notice requesting him to forward the amount of arrears due, and the employer shall thereupon forward the amount to the County Registrar who shall transmit the same, less any fees payable to the County Registrar and the cost of transmission, to the representatives of the workman at the address and in the manner requested by them, such remittance being in all cases at the cost and risk of the representatives.

APPLICATION BY MEDICAL PRACTITIONER UNDER SECTION 73.

49. An application to the Court by a medical practitioner under the provisions of Section 73 of the Act may be made by such medical practitioner personally, or by a solicitor on his behalf, or with his consent in writing by the workman or his solicitor.

TRANSFER OF PROCEEDINGS AND MONEY IN COURT.

50.—(1) Where proceedings have been instituted, or an agreement has been registered, or any application is made to the Court or County Registrar in one county, and the Court is of opinion that the matter could more conveniently be dealt with in some other county, it may, of its own motion, or on the application of any interested party, order that such matter be transferred to such other county.

(2) Where such other county is comprised in another circuit a transfer order shall be made only on evidence, as hereinafter provided, of the consent of the Judge for the time being assigned to such other circuit to accept such transfer.

Form No. 56.

(3) An application for a transfer order under this Rule shall be made on notice supported by evidence of the convenience of such transfer, and, where necessary, by a certificate according to the form in the Appendix evidencing the consent required by paragraph (2) of this Rule.

(4) On such transfer order being made the County Registrar shall by registered post transmit all original documents filed in, a certified copy of all records made with reference to, and any money or investments standing to the credit of such matter. Thenceforth such matter shall be dealt with in the county to which it is transferred in all respects as if it had originated therein.

COSTS.

51.—(1) Save as otherwise provided by the Act, or by these Rules the awarding or withholding of the costs of any party to any proceedings or matter shall be in the discretion of the Judge.

(2) In dealing with the question of costs the Judge may, where the same is relevant, take into consideration any offer of compensation at any time made by or on behalf of an employer to a workman.

(3) The costs of any ex parte or other application, motion or order may be awarded by the Judge irrespective of the final judgment in the proceedings, or may be made costs in the proceedings, or may be reserved to be dealt with on the conclusion of the proceedings.

(4) Costs awarded in any proceedings or matter against two or more persons or parties shall have effect against them, and be payable by them severally as well as jointly unless the Judge otherwise orders.

(5) Where costs are ordered to be paid by any party to any other party, the amount of the same shall, in default of agreement, be determined in the manner hereinafter provided.

In every such case the party to whom such costs shall have been awarded, or his solicitor, on applying to take out the decree or order shall furnish to the County Registrar a memorandum of his costs, ascertained in accordance with the appropriate scale in the Appendix, together with Court and service fees (if any) actually paid, and such other outlay (if any) as he shall be entitled to be allowed under these Rules, or shall have been allowed by the Judge.

The County Registrar shall thereupon check the accuracy of such memorandum with reference to these Rules and the appropriate scale in the Appendix, and correct the same where necessary. The costs and outlay so checked, and where necessary corrected, shall then be included in the Order.

From such ascertainment of the costs by the County Registrar there shall be no appeal.

(6) The costs set forth in the scales in the Appendix shall in every case be exclusive of and in addition to all actual and necessary outlay.

(7) Save as is hereinafter provided, the costs set forth in each scale in the Appendix shall be deemed to be the only lawful fees, costs, charges and emoluments for the business therein indicated or described, as between party and party, and no other costs shall be payable or recoverable therefor.

The scales and each of them shall be deemed to be exhaustive as to all or any work or services in respect of which costs may be recovered in any proceedings or matter in the Court.

Where, having regard to the work actually and necessarily performed, or the exceptional difficulty or complexity of the case, or the interests involved, the costs allowable under the appropriate scale would, in the opinion of the Judge be inadequate, he may, on application being made to him on behalf of any party to whom costs are awarded, allow, in addition to the appropriate scale costs, such special remuneration as in all the circumstances of the case he considers fair and reasonable. The sum so allowed shall not in any case exceed the sum of £20 in addition to the appropriate scale costs, and the Judge, before considering the application may require detailed particulars of the matters relied upon as justifying such application.

(8) No costs, other than actual and necessary outlay, shall be allowed or awarded to any party unless a solicitor has been instructed to conduct the proceedings on his behalf.

(9) In the ascertainment of costs disbursements shall be vouched in such manner as the County Registrar may consider proper.

(10) The costs of any proceedings or matter shall not be required to be taxed save and except where the Act so requires. Where in accordance with the provisions of the Act, costs are required to be taxed, the following provisions shall have effect:

The party entitled to such costs, (hereinafter called the first party), shall furnish to the party liable to pay such costs, (hereinafter called the second party), a bill of such costs, and shall give at least seven days' notice of taxation for a day and hour to be fixed, either generally or specially, by the County Registrar. The first party shall include in such bill all outlay actually incurred by him, and which he is entitled to be allowed under these Rules or shall have been allowed by the Judge. On such bill being furnished the second party may tender a lump sum in satisfaction. If such tender is made and refused, and the amount of the bill, as hereinafter defined, when taxed does not exceed the amount tendered, the second party's costs of taxation shall be deducted from the amount of the bill. Where there is no tender, or where the amount tendered is less than the amount of the bill when taxed, the first party's costs of taxation shall be added to the amount of the bill. The expression " amount of the bill " means the amount of the bill exclusive of taxation items.

All such costs shall be taxed by the County Registrar in accordance with the appropriate scale in the Appendix, subject to an appeal to the judge, by way of application on notice, within seven days from the conclusion of taxation. For the purposes of such taxation the County Registrar shall have all the powers of a Taxing Master of the High Court of Justice.

Where under the provisions of the Act the County Registrar is required to tax the costs of any proceedings or matter which have not been the subject of a hearing before the Judge in such a way as to permit the exercise of his discretion to allow additional remuneration under the provisions of Rule 51(7), the County Registrar on such taxation shall have the same power to allow additional remuneration as is conferred upon the Judge by the said Rule, and may exercise the same in all respects as if the words " County Registrar " were substituted for the word " Judge " in the said Rule.

(11) Save as provided otherwise in these Rules the provisions of this Rule and the scales of costs in the Appendix shall apply only to costs as between party and party of proceedings or matters instituted in the Court, and nothing in this Rule or in the Appendix contained shall limit or affect the right of a solicitor to charge costs as between solicitor and client for work done or professional services rendered.

(12) The Court may allow the amount of any actual and necessary expenses incurred by a witness in respect of travelling, board, and lodging, in attending Court to give evidence on the hearing of any proceeding or matter under the Act or these Rules. Whenallowing such expenses the Court shall determine the witness in respect of whom and the party against whom such expenses are allowed. The amount of such expenses shall be such as the Court, or, where the matter is referred to him, the County Registrar considers just and reasonable.

(13) In like manner the Court may allow a fee in respect of the attendance of an expert witness. In default of agreement between the parties the amount of such fee shall be such as the Court (or the County Registrar as the case may be) in the circumstances shall consider to be reasonable. In fixing the amount of such fee the Court or the County Registrar may take into consideration any report made and any work done by the witness in qualifying himself to give evidence.

(14) Where the workman is examined by a medical referee on a reference under Section 34 of the Act, and the certificate of the medical referee is used in any subsequent proceedings, any reasonable expenses incurred by the workman in attending such examination and obtaining such certificate not otherwise provided for may be allowed by the Court.

(15) Where a workman is ordered to submit himself for examination by a medical referee appointed to report under Section 39 of the Act, any reasonable expenses incurred by the workman in attending such examination may be allowed by the Court.

AUTHORITY OF SOLICITOR TO RECEIVE SUM PAID FOR COSTS

52. Where any party to whom costs are awarded acts by a solicitor, such solicitor shall have the same authority to take out of Court or to receive any sum paid into Court or payable in respect of such costs by the party against whom such costs are awarded, as he would have if such costs were awarded in an action.

REVIEW OF TAXATION BY THE COURT

53. Any taxation of costs by the County Registrar shall be subject to review by the Court on application made on notice, under the provisions of the Act, and Rule 51 (10).

APPLICATION TO DETERMINE COSTS PAYABLE TO HIS SOLICITOR BY A PERSON CLAIMING COMPENSATION, SECTION 43.

54.—(1) An application to the Court under the provisions of Section 43 of the Act to have determined the amount of costs to be paid to his solicitor by a person claiming compensation may be made immediately after the hearing at which compensation was awarded or was refused. If not so made, or where compensation is payable under a registered agreement, such application shall be made on notice.

(2) On the hearing of the application the Court may award to such solicitor such sum for costs, including the costs of the application, as may be allowed by the County Registrar on taxationin accordance with the scales of costs in the Appendix ; and may (a) order that such solicitor be entitled to a lien for such sum on any compensation awarded or agreed to be paid ; or (b) order that such solicitor be entitled to deduct such sum from such compensation ; or (c) order that such solicitor recover such sum from the person claiming compensation ; or (d) make such order or give such direction as may be just.

(3) Where (i) an Order is made by the Court awarding costs to a solicitor under the provisions of Section 43 of the Act, and (ii) the person claiming compensation is entitled to compensation under an Order of the Court or registered agreement, and (iii) such solicitor is declared by such Order to be entitled to recover such costs from such person, or to be entitled to a lien for such costs upon such compensation, or to be entitled to deduct such costs from such compensation, the following provisions shall have effect :

(a) the County Registrar shall, on the application of such solicitor, tax such costs and, at his request and cost, issue his certificate of such taxation ;

(b) a record of the Order awarding costs and of the certificate of taxation shall be made in the books of the Court, as provided in Rule 55, and the Order awarding compensation or agreement shall have effect subject to such costs ;

(c) copies of the Order awarding costs and the certificate of taxation shall be served upon the person liable to pay the compensation ;

(d) such service having been effected the person liable to pay the compensation shall on demand pay to such solicitor the amount of the costs as taxed but so that he shall not be liable to pay any amount in excess of what he is liable to pay as compensation, or to pay such amount by any instalments other than those by which he is liable to pay such compensation ;

(e) if the person liable to pay the compensation fails on demand to pay the amount of such costs or any part thereof such solicitor may apply to the Court under the provisions of Rule 37 for liberty to issue execution for the amount of such costs so unpaid ;

(f) payment made by or execution levied on the person liable to pay the compensation shall be a valid discharge to him as against the person entitled to the compensation up to the amount so paid or levied ;

(g) where the compensation has been paid into Court the amount of such costs shall be paid thereout to such solicitor.

(4) Where (i) an Order is made by the Court under the provisions of Section 43 of the Act awarding costs to a solicitor and ordering that he recover such costs from the person claiming compensation, and (ii) such person is not entitled to compensation ; the provisions of sub-paragraphs (a) and (b) of the immediately preceding Rule shall have effect, mutatis mutandis, and in addition the following provisions :—

(a) copies of the Order awarding compensation and of the certificate of taxation shall be served on the person claiming compensation ;

(b) such service having been effected such person shall on demand pay such solicitor the amount of such costs as taxed ;

(c) if such person fails on demand to pay such costs or any part thereof such solicitor may apply to the Court under the provisions of Rule 37 for liberty to issue execution for the amount of such costs so unpaid.

RECORD OF PROCEEDINGS.

55.—(1) All proceedings in Court under the Act shall be recorded in the books of the Court in the like manner in which other proceedings in the Court are recorded.

(2) All agreements required by the Act to be registered, or directed by the Court to be registered pursuant to the Act shall be registered in the Register of Agreements set up and kept under the provisions of the "Register of Agreements under the Workmen's Compensation Act, 1934 , Regulations, 1934."

FORMS.

56.—(1) The Schedule of forms to these Rules shall be taken to be part of the Rules, and all forms therein contained or suitable forms to the like effect may be used where same are applicable, and shall be good and sufficient.

(2) Where by these Rules any party is required to give notice according to a form in the Schedule it shall be sufficient if the notice comply substantially with such form.

(3) Where no forms are provided parties shall frame the documents, using as guides the forms in the Schedule.

FILING AND SERVICE OF DOCUMENTS AND NOTICES.

57.—(1) Where any document is to be filed with the County Registrar under these Rules it may be so filed by delivering it at the office of the County Registrar, or by sending it by post addressed to the County Registrar at his office.

(2) Where any document is to be filed with the County Registrar there shall be filed with it in addition a copy for the use of the Court. Where by these Rules any party is required to serve or furnish the County Registrar with any document, and the County Registrar is in turn required to serve or furnish any other party with a copy of the same, the County Registrar shall be served with the requisite number of copies.

(3) Where any document is, under these Rules, to be sent to any person by the County Registrar, it may be sent by post.

(4) Any notice or document which under these Rules is to be served on any party may be served by the opposite party or his solicitor, and where no special provision as to the mode of service is made by these Rules, may be served on such party, or, where he acts by a solicitor, on his solicitor, in manner provided by subsection (5) and (6) of Section 28 of the Act with reference to service of notice in respect of an injury, namely by registered post.

GENERAL

58.—(1) Subject to these Rules, the provisions of Order XLI of the Rules of the Circuit Court, 1930, shall, with the necessary modifications, apply to proceedings and matters under the Act and these Rules.

(2) Where any notice or other document is served by post it shall be deemed to be served upon the date upon which in the ordinary course of post it would be delivered.

(3) Clerical mistakes in orders or errors arising therein from any accidental slip or omission may, at any time be corrected by the Court on application made on notice without an appeal.

(4) The Court, or the County Registrar, shall have a discretionary power to enlarge or abridge the time fixed by these Rules for filing or serving any summons, statement of defence by respondent, third party notice, statement of defence by third party, or notice of application, provided that this power shall be in addition to, and not in substitution for the power of the Court in the Circuit Court Rules, 1930, Order XLI.

(5) The hearing of any Originating Summons, Summons to Review, Application on Notice, application ex parte or other proceeding or matter under the Act may be from time to time adjourned upon such terms, if any, as the Court shall think fit.

(6) The Court may at any stage of any proceeding or matter permit any party to amend or alter any Originating Summons, Summons to Review, Notice of Application, Third Party Notice, Statement of Defence, or other document, on such terms, if any, as it shall think fit, and all consequential amendments shall be made, and directions given for the purpose of determining the real question at issue between the parties.

(7) A party to any proceedings or matter under the Act may appear either in person or by solicitor, or by solicitor and counsel.

(8) Upon the hearing of an Originating Summons or Summons to Review (or Redeem), evidence shall be given viva voce on oath, and witnesses may be examined and cross-examined as upon the hearing of an action, and the procedure generally upon the hearing of such Summons shall be similar to that upon the hearing of an action without a jury.

(9) Where in these Rules reference is made to the Rules of the Circuit Court, 1930, or to any particular Rule thereof, such reference shall, where necessary, be construed as a reference to any Rules or Orders made in substitution therefor, and to include any Rules or Orders altering or amending the same.

(10) The County Registrar may, of his own motion, refer to the Court any matter on which he considers it advisable to have the ruling of the Court.

(11) Every document served or filed by a solicitor on behalf of any person or party shall state the name and place of business of such solicitor.

(12) Subject to these Rules an appeal shall lie to the Court from every Order made by the County Registrar. Such appeal shall be by way of application on notice.

(13) Notwithstanding anything to the contrary in these Rules otherwise provided the Judge may at any convenient time and place in Ireland hear any ex parte application.

(14) Notwithstanding anything to the contrary in these Rules otherwise provided the Judge, on application made to him by any party, may, with the consent of all parties Order that any Originating Summons, Summons to Review or Redeem, application on notice or other proceeding or matter under the Act or these Rules be heard at some convenient time and place in Ireland other than the time and place otherwise provided in accordance with these Rules.

(15) Upon such Order being made the summons, application, proceeding or matter may be heard at the time and place specified therein.

(16) On or after :—

(a) the hearing of an ex parte application under the provisions of sub-rule (13), or,

(b) the making of an Order under the provisions of sub-rule (14), or,

(c) the hearing of a summons, application, proceeding or matter under the provisions of sub-rule (15),

the Judge shall give full directions as to :—

(i) the settling of all Orders made and the County Registrar by whom they are to be settled ;

(ii) the filing or transfer of all documents, and the County Registrar with whom they are to be filed, and the County Registrar by whom, and the County Registrar to whom they are to be transferred

And shall give such further and other directions as may be necessary.

VENUE.

59. Where by the Act or these Rules it is provided that anything shall or may be done with reference to any matter, and no provision is made as to the place where, or the County Registrar by, to, or before whom such thing is to be done, such thing may be done in the county, or by, to or before the County Registrar prescribed by the following provisions of this Rule :—

(a) Where proceedings with reference to such matter have been instituted, the county in which they have been instituted, or the County Registrar of such county, as the case may be ;

(b) where no proceedings have been instituted, but an agreement with reference to such matter has been registered, the county in which the same is registered, or the County Registrar of such county as the case may be ;

(c) where no proceedings have been instituted, and no agreement has been registered with reference to such matter, the county where the workman resides, or, if he is dead, the county where his dependants or any of them reside, or the County Registrar of such county as the case may be.

JURISDICTION.

60. Wherever by these Rules it is provided that proceedings may be instituted or that anything shall or may be done with reference to any matter in any county, or by to or before the County Registrar of any county, all jurisdiction conferred by the Act upon the Court with reference to such matter may be exercised by the Judge for the time being assigned to the Circuit comprising such county and at the place in such county where heretofore jurisdiction in matters under the Workmen's Compensation Acts has been exercised by the Court.

APPENDIX.

SCALES OF COSTS.

SCALE I.—ORIGINATING SUMMONS.—CLAIM FOR WEEKLY PAYMENT.—COSTS AND CHARGES OF APPLICANT'S SOLICITOR.

1. Taking instructions for Originating Summons ; advising, drawing, and issuing same ; serving and filing same with County Registrar ; preparing, perfecting and perusing all necessary documents ; inclusive fee to cover all charges for work done up to filing of summons, including all attendances and correspondence

£

s.

d.

3

0

0

2. (a) Where Respondent admits liability and submits to Order for weekly payment which applicant accepts : Perusing statement of defence ; advising ; preparing notice of acceptance ; serving and filing same ; preparing, perfecting and perusing all necessary documents ; attending Court or County Registrar on application for Order for payment ; taking out Order ; inclusive fee to cover all charges for work done from filing of Summons to taking out Order, including all attendances and correspondence

3

0

0

(b) Where Respondent does not admit liability, or having submitted to Order for weekly payment same is not accepted and payment of a greater amount is ordered : Perusing statement of defence ; taking instructions for hearing of Summons ; preparing, perfecting and perusing all necessary documents ; preparing all proofs ; attending witnesses ; taking statements ; considering evidence : Inclusive fee to cover all charges for work done from filing of Summons to hearing of same including all attendances and correspondence

4

0

0

3. Attending hearing of Summons and taking out Order

2

0

0

4. Where Counsel is allowed : Inclusive fee to cover all charges for additional work necessitated by instruction of Counsel including preparation of brief, case to advise, and all attendances and correspondence

2

0

0

SCALE II.—ORIGINATING SUMMONS.—CLAIM FOR WEEKLY PAYMENT.—COSTS AND CHARGES OF RESPONDENT'S SOLICITOR.

1. Taking instructions for defence; perusing Summons ; advising drawing statement of defence ; serving and filing same with County Registrar ; preparing, perfecting and perusing all necessary documents ; making payment into Court under Rules 9 and 10 : Inclusive fee to cover all charges for work done up to filing of statement of defence, including all attendances and correspondence

3

0

0

2. Taking instructions for hearing of Summons ; preparing proofs ; attending witnesses ; taking statements ; considering evidence ; preparing, perfecting and perusing all necessary documents : Inclusive fee to cover all charges for work done from filing of statement of defence up to hearing of Summons including all attendances and correspondence

2

0

0

3. Attending hearing of Summons and taking out Order

2

0

0

4. Where Counsel is allowed : Inclusive fee to cover all charges for additional work necessitated by instruction of Counsel. including preparation of brief ; case to advise ; and all attendances and correspondence

2

0

0

SCALE III.—ORIGINATING SUMMONS.—CLAIM FOR LUMP SUM.—COSTS AND CHARGES OF APPLICANT'S SOLICITOR.

1. Taking instructions for Originating Summons ; advising; drawing and issuing same ; serving and filing same with County Registrar ; preparing, perfecting and perusing all necessary documents : Inclusive fee to cover all charges for work done up to filing of Summons, including all attendances and correspondence

£

s.

d.

4

0

0

2. Perusing statement of defence ; taking instructions for hearing of Summons ; preparing, perfecting and perusing all necessary documents ; preparing all proofs ; attending witnesess ; taking statements ; considering evidence ; Inclusive fee to cover all charges for work done from filing of Summons to hearing of same including all attendances and correspondence

4

0

0

3. Attending hearing of Summons and taking out Order

2

0

0

4. Where Counsel is allowed : Inclusive fee to cover all charges for additional work necessitated by instruction of Counsel including preparation of brief, case to advise, and all attendances and correspondence

2

0

0

SCALE IV.—ORIGINATING SUMMONS.—CLAIM FOR LUMP SUM.—COSTS AND CHARGES OF RESPONDENT'S SOLICITOR.

1. Taking instructions for defence ; perusing Summons ; advising ; drawing statement of defence ; serving and filing same with County Registrar ; preparing, perfecting and perusing all necessary documents ; taking instruction for hearing of Summons ; preparing proofs ; attending witnesses ; taking statements ; considering evidence : Inclusive fee to cover all charges for work done up to hearing of Summons, including all attendances and correspondence

4

0

0

2. Attending hearing of Summons and taking out Order

2

0

0

3. Where Counsel is allowed : Inclusive fee to cover all charges for additional work necessitated by instruction of Counsel, including preparation of brief, case to advise, and all attendances and correspondence

2

0

0

SCALE V —ORIGINATING SUMMONS.—CLAIM FOR WEEKLY PAYMENT.—COSTS AND CHARGES OF SOLICITOR FOR THIRD PARTY.

1. Taking instructions for defence ; perusing third party notice and Summons ; advising ; drawing statement of defence ; serving and filing same with County Registrar ; making payment into Court under Rules 9 and 10 ; preparing, perfecting and perusing all necessary documents : Inclusive fee to cover all charges for work done up to filing of statement of defence including all attendances and correspondence

4

0

0

2. Taking instructions for hearing of Summons ; preparing proofs ; attending witnesses ; taking statements ; considering evidence ; preparing, perfecting and perusing all necessary documents : Inclusive fee to cover all charges for work done from filing of Statement of defence up to hearing of Summons including all attendances and correspondence

2

0

0

3. Attending hearing of Summons and taking out Order

2

0

0

4. Where same is not determined on hearing of Summons, attending further hearing at which question of liability to indemnify is determined ; taking out Order

2

0

0

5. Where Counsel is allowed : Inclusive fee to cover all charges for additional work necessitated by instruction of Counsel, including preparation of brief, case to advise, and all attendances and correspondence

2

0

0

SCALE VI.—ORIGINATING SUMMONS.—CLAIM FOR LUMP SUM.—COSTS AND CHARGES OF SOLICITOR FOR THIRD PARTY.

1. Taking instructions for defence ; perusing Summons ; advising ; drawing statement of defence ; serving and filing same with County Registrar ; preparing, perfecting and perusing all necessary documents ; taking instructions for hearing of Summons ; preparing proofs ; attending witnesses ; taking statements : Inclusive fee to cover all charges for work done up to hearing of Summons including all attendances and correspondence

5

0

0

2. Attending hearing of Summons and taking out Order

2

0

0

3. Where same is not determined on hearing of Summons ; attending further hearing at which question of liability to indemnify is determined

2

0

0

4. Where Counsel is allowed : Inclusive fee to cover all charges for additional work necessitated by instruction of Counsel, including preparation of brief and case to advise, including all attendances and correspondence

2

0

0

SCALE VII.—ORIGINATING SUMMONS.—THIRD PARTY PROCEDURE.—ADDITIONAL COSTS AND CHARGES OF RESPONDENT'S SOLICITOR.

1. Taking instructions for service of third party notice ; advising ; drawing third party notice ; serving and filing same with County Registrar ; preparing, perfecting and perusing all necessary documents ; taking instructions for hearing of Summons ; preparing proofs ; attending witnesses ; taking statements ; considering evidence : Inclusive fee to cover all charges for work done up to hearing at which question of liability to indemnify is determined

3

0

0

2. Where same is not determined on hearing of originating summons, attending further hearing at which question of liability to indemnify is determined ; taking out Order

2

0

0

3. Where Counsel is allowed : Inclusive fee to cover all charges for additional work necessitated by instruction of Counsel, including preparation of brief, case to advise, and all attendances and correspondence

2

0

0

SCALE VIII.—SUMMONS TO REVIEW OR REDEEM.

COSTS AND CHARGES OF SOLICITOR FOR PARTY SEEKING TO REVIEW OR REDEEM.

1. Taking instructions for issue of Summons ; advising, drawing and issuing same ; serving and filing same with County Registrar ; perfecting and perusing all necessary documents : Inclusive fee to cover all charges for work done up to filing of Summons including all attendances and correspondence

2

10

0

2. Taking instructions for hearing of Summons ; preparing, perfecting and perusing all necessary documents ; preparing proofs ; attending witnesses ; taking statements ; considering evidence : Inclusive fee to cover all charges for work done from filing of Summons to hearing of same including all attendances and correspondence

£

s.

d.

2

0

0

3. Attending hearing of Summons and taking out Order

2

0

0

4. Where Counsel is allowed : Inclusive fee to cover all charges for additional work necessitated by instruction of Counsel, including preparation of brief, case to advise, and all attendances and correspondence

2

0

0

SCALE IX.—SUMMONS TO REVIEW OR REDEEM.

COSTS AND CHARGES OF SOLICITOR FOR PARTY OPPOSING REVIEW, OR IN CASE OF SUMMONS TO REDEEM, OF SOLICITOR FOR WORKMAN.

1. Taking instructions ; perusing Summons ; advising ; preparing perfecting and perusing all necessary documents ; taking instructions for hearing ; preparing proofs ; attending witnesses ; taking statements ; considering evidence : Inclusive fee to cover all charges for work done up to hearing of Summons, including all attendances and correspondence

2

10

0

2. Attending hearing and taking out Order

2

0

0

3. Where Counsel is allowed : Inclusive fee to cover all charges for additional work necessitated by instruction of Counsel, including preparation of brief ; case to advise, and all attendances and correspondence

2

0

0

SCALE X.—MISCELLANEOUS.

A.—APPLICATION TO THE COURT OTHERWISE THAN BY SUMMONS.

1. Application on Notice :—Taking instructions ; advising ; drawing notice ; serving and filing same with County Registrar ; preparing, perfecting and perusing all necessary documents ; preparing proofs ; settling affidavit ; attending on hearing ; taking out Order : Inclusive fee to cover all charges for work done including all attendances and correspondence

2

0

0

2. Ex parte application :—Inclusive fee to cover all charges

1

0

0

3. Where Counsel is allowed : Inclusive fee to cover all charges for additional work

0

10

0

B.—APPLICATIONS TO COUNTY REGISTRAR.

4. Application on behalf of employer under Rule 25 (1) (b) to add another employer as Respondent : Inclusive fee to cover all charges

0

10

0

5. Application under Rule 29 for Reference Order to Medical Referee : Inclusive fee to cover all charges

1

0

0

6. Application under Rule 47 (2) by workman intending to reside outside Ireland for Reference Order as to whether incapacity is likely to be permanent : Inclusive fee to cover all charges

1

10

0

£

s.

d.

7.

Application under Rule 37 (4) for liberty to issue execution : Inclusive fee to cover all charges

C.—ADJOURNMENTS : ORIGINATING SUMMONS, SUMMONS TO REVIEW OR REDEEM: DETERMINATION OF LIABILITY OF THIRD PARTY.

8.

Attending adjourned hearing where full costs of original hearing have been allowed

1

0

0

9.

Attending adjourned hearing where only costs of day have been allowed at original hearing

2

0

0

10.

Costs of the day

1

0

0

D.—ADJOURNMENTS : APPLICATION TO COURT OTHERWISE THAN BY SUMMONS.

11.

Costs of the day

1

0

0

E.—CONSULTATIONS.

12.

Where consultation with Counsel is allowed : Solicitor's fee for attending same

1

0

0

F.—AGREEMENTS.

13.

Taking instructions ; advising ; negotiating ; preparing or approving draft agreement ; applying to the County Registrar to have same registered : Inclusive fee to cover all charges for work done up to Registration of Agreement (when same is not referred to the Court) including all attendances and correspondence.

}

Such fee not exceeding £15 as the County Registrar may allow.

14.

Attending hearing in Court when application to register has been referred to Court under Rule 26 and determined by the Court

2

0

0

15.

Where on such hearing Counsel is allowed : Inclusive fee to to cover all charges for additional work, including preparation of brief, case to advise, and all attendances and correspondence

1

0

0

G.—SUMMONS SERVER'S FEES.

16.

Same as in case of Civil Bills.

SCALE XI.—COUNSEL'S FEES.

The following fees shall be allowed only where the Judge at the hearing specifically rules that they shall be allowed :—

£

s.

d.

1.On application ex parte

1

1

0

2. On application on notice

1

1

0

3. On application on notice where Judge certifies for additional fee, total fee

2

2

0

4. On hearing of Originating Summons

3

3

0

5. On hearing of Summons to Review or Redeem

3

3

0

6. On hearing at which liability of third party is determined when same is not determined on hearing of Originating Summons

3

3

0

7. Where the costs of the day are allowed

1

1

0

£

s.

d.

8.

Advising and settling originating Summons and directing proofs

1

1

0

9.

Advising and settling statement of Defence and directing proofs

1

1

0

10.

Consultation

2

2

0

11.

The Judge may, on the hearing of an Originating Summons, Summons to Review or Redeem, or on a hearing at which the liability of a third party is determined, where same is not determined on the hearing of the Originating Summons, allow to Counsel an increased fee if of opinion that the difficulty of the case justifies such an increase, by an amount not exceeding

9

9

0

SCHEDULE OF FORMS.

FORM No. 1.

[HEADING FOR ALL FORMS.]

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

...........................................................Circuit    County of............................................................ ..................

FORM No. 2.

ORIGINATING SUMMONS—INJURY BY ACCIDENT—CLAIM FOR WEEKLY PAYMENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ Circuit.    County of............................................................ ..................

BETWEEN

(Name)............................................................ ............................................................ .....................................................

(Address)............................................................ ............................................................ ..................................................

(Description)............................................................ ............................................................ .............................................

Applicant.

AND

(Name)............................................................ ............................................................ ......................................................

(Address)............................................................ ............................................................ ...................................................

(Description)............................................................ ............................................................ .............................................

Respondent.

TO THE RESPONDENT :—

YOU ARE HEREBY REQUIRED—

(A) Not later than eleven days after the service upon you of this Originating Summons, to file, or cause to be filed with the County Registrar of.......................... at his Office at.............................. in the said County, a statement of defence to the claim of the applicant hereinafter set forth. You may send such statement to the County Registrar by post.

(B) At the same time to serve a copy of such statement of defence upon the applicant or his solicitor. You may send such statement by post.

(C) On the ........day of.............................. 19...... , or as soon thereafter as this Originating Summons may be heard, to appear at the Courthouse...................... upon the hearing thereof, to answer the claim of the applicant.

AND TAKE NOTICE that in default of your so doing you may be held to have admitted the applicant's claim, and the applicant may proceed therein and the Court may make, in your absence and without further notice to you, such order in the matter as it may think just.

N.B.—This Originating Summons will be heard at the Courthouse............ at the sittings commencing the............day of................. 19......

INDORSEMENT OF CLAIM:

The applicant is a workman to whom was caused personal injury by accident arising out of and in the course of his employment with you, the respondent, and he claims compensation from you in respect of the said injury in accordance with the provisions of the Act above mentioned.

PARTICULARS OF CLAIM.

1. Name and address of the applicant.

1. ............................................................ .................

2. Name, place of business, and nature of business of respondent(s).

2. ............................................................ .................

3. Date and place of accident.

3. ............................................................ .................

4. Nature of employment of applicant at time of accident.

4. ............................................................ .................

5. Whether employed directly under respondent or under contractor with him.

5. ............................................................ .................

6. If contractor is not a respondent, name, place of business, and nature of business of contractor.

6. ............................................................ .................

7. Nature of accident and cause of injury.

7. ............................................................ .................

8. Nature of injury.

8. ............................................................ ..................

9. Particulars of incapacity for work, whether total or partial and duration or estimated duration of incapacity.

9. ............................................................ ..................

10. If incapacity is partial, state whether applicant claims to have same treated as total incapacity.

10. ............................................................ ...............

11. Average weekly earnings during the twelve months immediately preceding the accident, if so long employed by the respondent.

11. ............................................................ ...............

12. If not so long employed, then average weekly earnings during such shorter period of employment.

12. ............................................................ ..............

13. Average weekly amount which applicant is earning or able to earn in some suitable employment or business after the accident.

13. ............................................................ ...............

14. Weekly payment claimed as compensation.

14. ............................................................ ...............

15. Date of giving of notice in writing of accident, and to whom given (copy of notice to be annexed).

15. ............................................................ ...............

16. If notice in writing not given in accordance with the Act, reason for failure to give same.

16. ............................................................ ...............

Dated this................................... day of................................... 19......

Signed............................................................ ......................................

Applicant.

or

Name............................................................ ......................................

Place of business............................................................ .................

Solicitor for Applicant.

Filed this...................................... day of......................................... 19.....

............................................................ ............................................................ 

County Registrar.

FORM No. 3.

ORIGINATING SUMMONS—DISABLEMENT OR SUSPENSION ON ACCOUNT OF INDUSTRIAL DISEASE—CLAIM FOR WEEKLY PAYMENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .......Circuit.  County of............................................................ ..................

BETWEEN

(Name)............................................................ ............................................................ .....................................................

(Address)............................................................ ............................................................ ..................................................

(Description)............................................................ ............................................................ ............................................

Applicant.

AND

(Name)............................................................ ............................................................ .....................................................

(Address)............................................................ ............................................................ ..................................................

(Description)............................................................ ............................................................ ............................................

Respondent.

TO THE RESPONDENT :—

YOU ARE HEREBY REQUIRED—

(A) Not later than eleven days after the service upon you of this Originating Summons, to file, or cause to be filed with the County Registrar of.......................... at his Office at.............................. in the said County, a statement of defence to the claim of the applicant hereinafter set forth. You may send such statement to the County Registrar by post.

(B) At the same time to serve a copy of such statement of defence upon the applicant or his solicitor. You may send such statement by post.

(C) On the ........day of.............................. 19......, or as soon thereafter as this Originating Summons may be heard, to appear at the Courthouse...................... upon the hearing thereof, to answer the claim of the applicant.

AND TAKE NOTICE that in default of your so doing you may be held to have admitted the applicant's claim, and the applicant may proceed therein and the Court may make, in your absence and without further notice to you, such order in the matter as it may think just.

N.B.—This Originating Summons will be heard at the Courthouse............ at the sittings commencing the............day of................. 19......

INDORSEMENT OF CLAIM

The applicant is a workman who contracted a scheduled industrial disease due to the nature of his employment with you the Respondent. He claims compensation from you in respect of the said disease in accordance with the provisions of the Act above mentioned.

PARTICULARS OF CLAIM.

1. Name and address of the applicant.

1. .......................................................

2. Name, place of business, and nature of business of respondent(s).

2. .......................................................

3. Nature of disease.

3. .......................................................

4. Nature of employment of applicant under respondent to which disease was due.

4. .......................................................

5. Names and places of business of all other employers by whom applicant was employed in the same employment as that mentioned in 4 during the 12 months previous to the date of disablement or suspension.

5. .......................................................

6. Whether employed directly under respondent or under contractor with him.

6. .......................................................

7. If contractor not a respondent, name, place of business and nature of business of contractor.

7. .......................................................

8. State whether applicant was (a) certified as being disabled, or (b) suspended from his usual employment under Rules or Regulations made under the Factory and Workshop Act, 1901.

8. .......................................................

9. If disabled, give name and district of Certifying Surgeon, or Medical Referee who gave certificate of disablement, and date of disablement and certificate.

9. .......................................................

or

or

[9 State whether respondent has agreed with applicant that he is liable to pay compensation in respect of disablement, and date of disablement and agreement.]

9. .......................................................

10. If suspended give date of suspension.

10. .....................................................

11. Particulars of incapacity for work, whether total or partial, and duration or estimated duration of same.

11. .....................................................

12. If incapacity is partial state whether applicant claims to have same treated as total.

12. .....................................................

13. Average weekly earnings during the 12 months immediately preceding the date of disablement or suspension, if the applicant has been so long employed under the respondent.

13. .....................................................

14. If not so long employed then average weekly earnings during such shorter period of employment.

14. .....................................................

15. Average weekly amount which applicant is earning or able to earn in some suitable employment or business, after disablement or suspension.

15. .....................................................

16. Weekly payment claimed as compensation.

16. .....................................................

17. Date of giving notice in writing of disablement or suspension, and to whom given. (Copy of notice to be annexed.)

17. .....................................................

18. If notice in writing not given in accordance with the Act, reason for failure to give same.

18. .....................................................

Dated this.................................... day of.............................................. 19......

Signed............................................................ ...........................

Applicant.

or

Name............................................................ ..................................................

Place of business............................................................ .............................

Solicitor for Applicant.

Filed this............................day of........................................................... 19.....

............................................................ ...................................................

County Registrar.

FORM No. 4.

ORIGINATING SUMMONS BY OR ON BEHALF OF DEPENDANTS OF DECEASED WORKMAN—INJURY BY ACCIDENT RESULTING IN DEATH—CLAIM FOR PAYMET OF LUMP SUMS AND APPORTIONMENT AND APPLICATION.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ............Circuit. County of..........................................................

BETWEEN

(Name)............................................................ ............................................................ ........................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Applicants.

Legal personal representative and all dependants joined as applicants.

AND

(Name)............................................................ ............................................................ ........................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Respondent (Employer).

AND

(Name)............................................................ ............................................................ ........................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Respondents.

To the Respondent C................................................... D............................................................ ............... (Employer).

All dependants joined as respondents.

YOU ARE HEREBY REQUIRED—

(A) Not later than eleven days after the service upon you of this Originating Summons, to file or cause to be filed with the County Registrar of........................... at his Office at.................................... in the said County, a statement of defence to the claim of the applicant hereinafter set forth. You may send such statement to the County Registrar by post.

(B) At the same time to serve a copy of such statement of defence upon the applicant or his solicitor. You may send such statement by post.

(C) On the ........day of.............................19......, or as soon thereafter as this Originating Summons may be heard, to appear at the Courthouse........................... upon the hearing thereof, to answer the claim of the applicant.

AND TAKE NOTICE that in default of your so doing you may be held to have admitted the applicant's claim, and the applicant may proceed therein and the Court may make, in your absence and without further notice to you such order in the matter as it may think just.

To the Respondents E............................... F............................. G............................ H............................... etc.

(Dependants).

TAKE NOTICE that you and each of you are joined as respondents in these proceedings only because you are persons who claim, or may be entitled to claim compensation from the Respondent C.................... D......................... as dependants of the deceased workman A............................. B......................and as persons who may be interested in the amount, apportionment and application of any compensation that may be ordered to be paid.

N.B.—This Originating Summons will be heard at the Courthouse.............................. at the sittings commencing the........... day of................. , 19.....

INDORSEMENT OF CLAIM.

A.................... B..................., deceased, was a workman to whom was caused personal injury by accident arising out of and in the course of his employment with you the respondent C.................... D................., which injury resulted in his death. The applicants are dependants of the said workman. They claim compensation from you, the said C........................... D............................... in accordance with the provisions of the Act above mentioned, in respect of the said injury resulting in the death of the said workman.

Or, the Applicant, X........................... Y.................. is a dependant of the said workman and his legal personal representative. He brings these proceedings on his own behalf, and on behalf of the other dependants of the said workman who are herein named as applicants. He and they claim compensation, etc.

PARTICULARS OF CLAIM.

A.—General.

1. Name and late address of deceased workman.

1. .....................................................

2. Name, and place of business, and nature of business of respondent from whom compensation is claimed.

2. .....................................................

3. Date and place of accident.

3. .....................................................

4. Nature of employment of deceased at time of accident.

4. .....................................................

5. Whether employed directly under respondent or under contractor with him.

5. .....................................................

6. If contractor is not a respondent, name, place of business, and nature of business of contractor.

6. .....................................................

7. Nature of accident and cause of injury to deceased.

7. .....................................................

8. Nature of injury.

8. .....................................................

9. Date of death.

9. .....................................................

10. Earnings of deceased during the three years next preceding the injury, in employment of the employer by whom he was immediately employed at the date of injury.

10. ...................................................

11. If not so long employed, average weekly earnings during such shorter period of employment.

11. ...................................................

12. Amount of any weekly payments made to the deceased by way of compensation in respect of the said injury, before his death.

12. ...................................................

13. Amount of any lump sum paid to deceased in redemption of weekly payments, or of liability to make such payments, or under agreement by way of compromise of disputed claim.

13. ...................................................

14. Date of service of notice of accident in writing, and to whom given. (Copy of notice to be annexed.)

14. ...................................................

15. If notice of accident not given in accordance with the Act, reason for failure to give same.

15. ...................................................

B.—As to Dependants.

16. Adult dependants (over 15 years) who were members of deceased's family, and who were wholly dependent on his earnings.

Name.Address.Relationship.

16. ...................................................

17. Adult dependants, other than members of the deceased's family resident with him, and who were wholly dependent upon his earnings.

Name. Address.

17. ...................................................

18. Juvenile dependants, members of the deceased's family, who were wholly dependent upon his earnings.

Name.Address.Relationship.

Date of Birth.

18. ...................................................

19. Juvenile dependants, other than members of the deceased's family, who were resident with him, and who were wholly dependent upon his earnings.

NameAddress.Date of Birth.

19. ...................................................

20. Persons joined as respondents as claiming or entitled to claim compensation as dependants.

Name Address Relationship.

Date of Birth (if juvenile).

20. ...................................................

C.—Particulars of Amount claimed, Apportionment and Application.

21. Adult's lump sum£s.d.

Children's lump sum£s.d.

21. ...................................................

22. Apportionment of Adults' lump sum.Name.Amount.

22. ...................................................

23. Apportionment of Children's lump sum.Name.Amount.

23. ...................................................

Set out how it is desired that the several shares be disposed of.

{

24. Application of shares of adult dependants.

24. ...................................................

25. Application of shares of juvenile dependants.

25. ...................................................

Dated this......................... day of.............................................. 19......

Signed............................................................ .........................................

Applicant(s).

or

Name............................................................ .........................................

Place of business............................................................ ....................

Solicitor for Applicant(s).

Filed this....................................... day of...................................................... 19......

............................................................ ...........................................................

County Registrar.

FORM No. 5.

ORIGINATING SUMMONS BY OR ON BEHALF OF DEPENDANTS OF DECEASED WORKMAN—DEATH CAUSED BY INDUSTRIAL DISEASE—CLAIM FOR PAYMENT OF LUMP SUMS AND APPORTIONMENT AND APPLICATION.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .....................Circuit. County of............................................................ .........

BETWEEN

(Name)............................................................ ............................................................ ........................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Applicants.

AND

(Name)............................................................ ............................................................ ........................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Respondent (Employer).

AND

(Name)............................................................ ............................................................ ........................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Respondents.

To the Respondent C............................................. D........................................................ (Employer).

YOU ARE HEREBY REQUIRED—

(A) Not later than eleven days after the service upon you of this Originating Summons, to file, or cause to be filed with the County Registrar of........................... at his Office at.................................... in the said County, a statement of defence to the claim of the applicant hereinafter set forth. You may send such statement to the County Registrar by post.

(B) At the same time to serve a copy of such statement of defence upon the applicant or his solicitor. You may send such statement by post.

(C) On the ........day of.............................19......, or as soon thereafter as this Originating Summons may be heard, to appear at the Courthouse........................... upon the hearing thereof, to answer the claim of the applicant.

AND TAKE NOTICE that in default of your so doing you may be held to have admitted the applicant's claim, and the applicant may proceed therein and the Court may make, in your absence and without further notice to you such order in the matter as it may think just.

To the Respondents E.................................. F........................... G............................ H................................. etc.

(Dependants).

TAKE NOTICE that you and each of you are joined as respondents in these proceedings only because you are persons who claim, or may be entitled to claim compensation from the Respondent C.................... D........................, as dependants of the deceased workman A............................. B....................., and as persons who may be interested in the amount, apportionment and application of any compensation that may be ordered to be paid.

N.B.—This Originating Summons will be heard at the Courthouse....................at the sittings commencing the..........day of...............19,...

INDORSEMENT OF CLAIM.

A.................... B...................., deceased, was a workman who contracted a scheduled industrial disease due to the nature of his employment with you the respondent, C.................... D...................., (employer), and whose death was caused by such disease. The applicants are the dependants of the said workman. They claim compensation from you the said C.................... D...................., in accordance with the provisions of the Act above mentioned, in respect of the death of the said workman.

Or, the applicant, X.................... Y...................., is a dependant of the said workman and his legal personal representative. He brings these proceedings on his own behalf and on behalf of the other dependants of the said workman who are herein named as applicants. He and they claim compensation, etc.

A.—GENERAL.

1. Name and late address of deceased workman.

1. .....................................................

2. Name, and place of business, and nature of business of respondent from whom compensation is claimed.

2. .....................................................

3. Nature of disease.

3. .....................................................

4. Nature of employment of deceased workman to which disease was due.

4. .....................................................

5. Names and places of business of all other employers by whom deceased was employed in the same employment as that mentioned in 4, during the 12 months previous to the disablement or suspension (or where the workman dies without having obtained a certificate of disablement, previous to the date of death of deceased).

5. .....................................................

6. Whether employed directly under respondent or under contractor with him.

6. .....................................................

7. If contractor is not a respondent, name, place of business, and nature of business of contractor.

7. .....................................................

8. State whether deceased workman was (a) certified as being disabled, or (b) suspended from his usual employment in pursuance of Rules or Regulations under the Factory and Workshop Act, 1901.

8. .....................................................

9. If disabled, state name and district of Certifying Surgeon, or Medical Referee who gave certificate of disablement, and date of disablement and certificate.

9. .....................................................

or

9. State whether respondent agreed with deceased workman that he was liable to pay compensation in respect of disablement, and date of disablement and agreement.

9. .....................................................

10. If suspended, give date of suspension.

10. .....................................................

11. Date of death.

11. .....................................................

12. Earnings of deceased during the three years next preceding the disablement, suspension or death (as the case may be), in the employment of the employer by whom deceased was immediately employed at the date of such disablement, etc.

12. .....................................................

13. If not so long employed, average weekly earnings during such shorter period of employment.

13. .....................................................

14. Amount of any weekly payments made to deceased by way of compensation in respect of such disease, before his death.

14. .....................................................

15. Amount of any lump sum paid to deceased in redemption of weekly payments, or of liability to make such payments, or under agreement by way of compromise of disputed claim.

15. .....................................................

16. Date of giving notice in writing of disablement or suspension, and to whom given (a copy of notice to be annexed).

16. .....................................................

17. If notice not given in accordance with Act, reason for failure to give same.

17. .....................................................

B.—As to Dependants.

18. Adult dependants (over 15 years) who were members of deceased's family, and who were wholly dependent on his earnings.

Name.Address.Relationship

18. .....................................................

19. Adult dependants, other than members of the deceased family, resident with him, and who were wholly dependent upon his earnings.

Name. Address.

19. .....................................................

20. Juvenile dependants, members of the deceased's family, who were wholly dependent upon his earnings.

Name.Address.Relationship.

Date of Birth.

20. .....................................................

21. Juvenile dependants, other than members of the deceased's family, who were resident with him, and who were wholly dependent upon his earnings.

Name.Address.Date of Birth.

21. .....................................................

22. Persons joined as respondents as claiming or entitled to claim compensation as dependants.

Name. Address. Relationship. Date of Birth (if juvenile).

22. .....................................................

C.—Particulars of Amount claimed, Apportionment and Application.

23. Adults' lump sum£s.d.

Children's lump sum.£s.d.

23. ............................................................ ...................

24. Apportionment of Adults' lump sumName.Amount.

24. ............................................................ ...................

25. Apportionment of Children's lump sum.Name.Amount.

25. ............................................................ ...................

26. Application of shares of adult dependants.

26. ..................................

}

Set out how it is desired that the several shares be disposed of.

27. Application of shares of juvenile dependants.

27. .................................

Dated this............................day of...................................19......

Signed............................................................ ..............................

Applicant(s).

or

Name............................................................ ...............................

Place of business............................................................ ..........

Solicitor for Applicant(s).

Filed this..................day of................................................19......

............................................................ .........................

County Registrar.

FORM No. 6.

ORIGINATING SUMMONS—INJURY BY ACCIDENT—CLAIM FOR WEEKLY PAYMENT BY MASTER, SEAMAN, APPRENTICE, OR PILOT AGAINST OWNERS OF SHIP.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ....................Circuit County of............................................................ ...........

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

Description) ............................................................ ............................................................ .............................................

Applicant.

AND

The Owners of the Ship "............................................................ ............................................................ ....................."

Respondents.

PERSON SERVED WITH THE ORIGINATING SUMMONS AS REPRESENTING THE OWNERS OF THE SHIP :

(Here set out the name, address, and description of the managing owner, manager, or, except where a master is claiming compensation, master of the ship.)

To the Owners of the Ship "............................................................ ............................................................ .................."

Respondents ;

YOU ARE HEREBY REQUIRED—

(A) Not later than eleven days after the service upon you of this Originating Summons, to file, or cause to be filed with the County Registrar of....................at his Office at....................in the said County, a statement of defence to the claim of the applicant hereinafter set forth. You may send such statement to the County Registrar by post.

(B) At the same time to serve a copy of such statement of defence upon the applicant or his solicitor. You may send such statement by post.

(C) On the ..........day of....................19......, or as soon thereafter as this Originating Summons may be heard, to appear at the Courthouse..................... upon the hearing thereof, to answer the claim of the applicant.

AND TAKE NOTICE that in default of your so doing you may be held to have admitted the applicant's claim, and the applicant may proceed therein and the Court may make, in your absence and without further notice to you such order in the matter as it may think just.

N.B.—This Originating Summons will be heard at the Courthouse.................... at the sittings commencing the..........day of....................19......

INDORSEMENT OF CLAIM.

The applicant is a workman and a member of the crew of the ship above mentioned (or was employed on the ship above mentioned as...............) to whom was caused personal injury by accident arising out of and in the course, of his employment on the said ship. He claims compensation from the Owners of the said ship in respect of the said injury in accordance with the provisions of the Act above mentioned.

PARTICULARS OF CLAIM.

1. Name and address of applicant.

1. .....................................................

2. Name of ship on which applicant was employed at time of accident, and port of registry.

2. .....................................................

3. Nature of employment of applicant (e.g. whether as master, seaman apprentice to the sea service, apprentice to the sea fishing service, or otherwise than as member of the crew).

3. .....................................................

4. Date and place of accident.

4. .....................................................

5. Nature of the work on which applicant was engaged at the time of the accident.

5. .....................................................

6. Nature of the accident and cause of injury.

6. .....................................................

7. Nature of injury.

7. .....................................................

8. Particulars of incapacity for work whether total or partial, and duration or estimated duration of same.

8. .....................................................

9. If incapacity is partial, state whether applicant claims to have same treated as total.

9. .....................................................

10. Average weekly earnings during the 12 months immediately preceding the accident, if so long employed under the same owners.

10. ...................................................

11. If not so long employed, then average weekly earnings during such shorter period of employment.

11. ...................................................

12. Average weekly amount which applicant is earning or is able to earn in some suitable employment or business after the accident.

12. ...................................................

13. Weekly payment claimed as compensation.

13. ...................................................

14. Date of giving notice in writing of accident, and to whom given. (Copy of notice to be annexed.)

14. ...................................

}

(Where applicable.)

15. If notice not given in accordance with Act, state reason for failure to give same.

.......................................

Dated this....................day of.................................................19......

Signed............................................................ ....................................

Applicant.

or

Name............................................................ ........................................

Place of business............................................................ ....................

Solicitor for Applicant.

Filed this....................day of..........................................................19......

............................................................ .......................................

County Registrar.

FORM No. 7.

ORIGINATING SUMMONS BY OR ON BEHALF OF DEPENDANTS OF DECEASED MASTER SEAMAN, APPRENTICE, OR PILOT—INJURY BY ACCIDENT RESULTING IN DEATH CLAIM FOR LUMP SUMS, APPORTIONMENT AND APPLICATION.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ..........................Circuit. County of............................................................ .

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

(Description) ............................................................ ............................................................ ............................................

Legal personal representative and all dependants joined as applicants.

AND

To the Owners of the Ship "............................................................ ............................................................ .................."

Respondents (Employers).

AND

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

(Description) ............................................................ ............................................................ ............................................

Respondents.

All dependants joined as respondents.

Person served with Originating Summons as Representing the Owners of the Ship :

(Here set out the name, address and description of the managing owner, manager, or master as the case may be.)

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

(Description) ............................................................ ............................................................ ............................................

To the Owners of the Ship "............................................................ ............................................................ ................."

YOU ARE HEREBY REQUIRED—

(A) Not later than eleven days after the service upon you of this Originating Summons, to file, or cause to be filed with the County Registrar of.................... at his Office at.................... in the said County, a statement of defence to the claim of the applicant hereinafter set forth. You may send such statement to the County Registrar by post.

(B) At the same time to serve a copy of such statement of defence upon the applicant or his solicitor. You may send such statement by post.

(C) On the ..........day of....................19......, or as soon thereafter as this Originating Summons may be heard, to appear at the Courthouse.................... upon the hearing thereof, to answer the claim of the applicant.

AND TAKE NOTICE that in default of your so doing you may be held to have admitted the applicant's claim, and the applicant may proceed therein and the Court may make, in your absence and without further notice to you such order in the matter as it may think just.

To the Respondents E.................................. F.................................., G.................................. H.......................... etc.

Dependants

TAKE NOTICE : That you and each of you are joined as respondents only because you are persons who claim, or may be entitled to claim compensation from the owners of the Ship "...................." as dependants of the deceased workmen A.................... B...................., and as persons who may be interested in the amount, apportionment, and application of any compensation that may be ordered to be paid.

N.B.—This Originating Summons will be heard at the Courthouse.................... at the sittings commencing the ..........day of.................... 19......

INDORSEMENT OF CLAIM.

A.......... B.........., deceased, was a workman and a member of the crew of the ship above mentioned (or was a workman employed uponthe ship above mentioned) to whom was caused personal injury by accident arising out of and in the course of his employment on the said ship, which injury resulted in his death. The applicants are dependants of the said workman. They claim compensation from the owners of the said ship in accordance with the provisions of the Act above mentioned in respect of the said injury resulting in the death of the said workman. [Or, the applicant, X.................... Y.................... is a dependant of the said workman, and his legal personal representative. He brings these proceedings on his own behalf and on behalf of the other dependants of the said workman who are herein named as applicants. He and they claim compensation, etc.]

PARTICULARS OF CLAIM.

A.—General.

1. Name and late address of deceased

2. Name of ship on which deceased workman was employed at the time of accident, and port of registry.

2. .....................................................

3. Nature of employment of deceased (e.g. whether as master, seaman, apprentice to the sea service, apprentice to the sea fishing service, or otherwise than as member of the crew.)

3. .....................................................

4. Date and place of accident.

4. .....................................................

5. Nature of work upon which deceased was employed at time of accident.

5. .....................................................

6. Nature of accident and cause of injury.

6. .....................................................

7. Mature of injury.

7. .....................................................

8. Date of death, and date upon which news of death was received by claimant.

8. .....................................................

9. Earnings of deceased during the three years next preceding the injury, if so long employed under the same owners.

9. .....................................................

10. If not so long employed then average weekly earnings during such shorter period of employment.

10. ...................................................

11. Amount of any weekly payments made to deceased by way of compensation in respect of the said injury before his death.

11. ...................................................

12. Amount of any lump sum paid to deceased in redemption of weekly payments, or of liability to make such payments, or by way of compromise of disputed claim.

12. ...................................................

Where applicable.

{

13. Date of giving notice in writing of accident and to whom given. (Copy of notice to be annexed.)

13. ...................................................

14. If notice not given according to the Act, state reason for failure to give same.

14. ...................................................

B.—As to Dependants.

15. Adult dependants (over 15 years) who were members of deceased's family, and who were wholly dependent on his earnings.Name. Address.Relationship.

15. ...................................................

16. Adult dependants, other than members of the deceased's family, resident with him, and who were wholly dependent upon his earnings.NameAddress.

16. ...................................................

17. Juvenile dependants, members of the deceased's family, who were wholly dependent upon his earnings. Name. Address. Relationship. Date of birth.

17. ...................................................

18. Juvenile dependants, other than members of the deceased's family, who were resident with him, and who were wholly dependent upon his earnings.Name.Address.Date of Birth.

18. ...................................................

19. Persons joined as Respondents as claiming or entitled to claim compensation as dependants.Name. Address.Relationship.Date of Birth (if juvenile).

19. ...................................................

C.—Particulars of Amount claimed, Apportionment and Application.

20. Adults' lump sum £......s......d.

Children's lump Sum £......s......d......

20. ...................................................

21. Apportionment of Adults' lump sum. Name.Amount.

21. ...................................................

22. Apportionment of Children's lump sum.Name.Amount.

22. ...................................................

23. Application of shares of adult dependants.

23. .........................................

}

Set out how it is desired that the several shares be disposed of.

24. Application of shares of juvenile dependants.

24. .........................................

Dated this...............................day of...............................................19......

Signed............................................................ .............................................

Applicant(s).

or

Name............................................................ ..............................................

Place of business............................................................ .........................

Solicitor for Applicant(s).

Filed this.......................day of.............................................19......

............................................................ ..............................................

County Registrar.

FORM No. 8.

ORIGINATING SUMMONS BY OR ON BEHALF OF DEPENDANTS OF DECEASED MASTER SEAMAN, APPRENTICE PILOT, ETC.—SHIP LOST OR DEEMED TO HAVE BEEN LOST.—CLAIM FOR LUMP SUMS, APPORTIONMENT AND APPLICATION

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ..........................Circuit County of............................................................ ......

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

(Description) ............................................................ ............................................................ ............................................

Legal personal representative and all dependants joined as applicants.

AND

To the Owners of the Ship "............................................................ ............................................................ ................."

Respondents (Employers)

AND

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

(Description) ............................................................ ............................................................ ............................................

Respondents

All dependants joined as respondents.

Person Served with Originating Summons As Representing the Owners of the Ship :

(Here set out the name, address and description of the managing owner, manager, or master as the case may be.)

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

(Description) ............................................................ ............................................................ ............................................

To the Owners of the Ship "............................................................ ............................................................ ................."

YOU ARE HEREBY REQUIRED—

(A) Not later than eleven days after the service upon you of this Originating Summons, to file, or cause to be filed with the County Registrar of.................... at his Office at.................... in the said County, a statement of defence to the claim of the applicant hereinafter set forth. You may send such statement to the County Registrar by post.

(B) At the same time to serve a copy of such statement of defence upon the applicant or his solicitor. You may send such statement by post.

(C) On the ..........day of....................19......, or as soon thereafter as this Originating Summons may be heard, to appear at the Courthouse.................... upon the hearing thereof, to answer the claim of the applicant.

AND TAKE NOTICE that in default of your so doing you may be held to have admitted the applicant's claim, and the applicant may proceed thereinand the Court may make, in your absence and without further notice to you such order in the matter as it may think just.

To the Respondents, E..........F.........., G..........H.......... etc.

(Dependants)

TAKE NOTICE that you and each of you are joined as respondents only because you are persons who claim, or may be entitled to claim compensation from the owners of the Ship " .................... " as dependants of the deceased workman A.......... B.........., and as persons who may be interested in the amount, apportionment, and application of any compensation that may be ordered to be paid.

N.B.—This Originating Summons will be heard at the Courthouse.................... at the sittings commencing the ..........day of....................19......

INDORSEMENT OF CLAIM.

A.......... B.........., deceased, was a workman and a member of the crew of the ship above mentioned. (Or, was a workman employed upon the ship above mentioned.) The said ship was lost with all hands on or about the ..........day of....................19...... (Or, was last heard of on or about the ..........day of....................19......, at...................., and is believed to have been lost with all hands.) The applicants are dependants of the said workman. They claim compensation from the owners of the said ship in accordance with the provisions of the Act above mentioned, in respect of the death of the said workman. [Or, the applicant X.......... Y.......... is a dependant of the said workman and his legal personal representative. He brings these proceedings on his own behalf and on behalf of the other dependants of the said workman who are herein named as applicants. He and they claim compensation, etc.].

PARTICULARS OF CLAIM.

A.—General.

1. Name and late address of deceased workman.

1. ..............................................

2. Name of ship and port of registry.

2. ...............................................

3. Nature of employment of deceased. (e.g. whether as master, seaman, apprentice to the sea service, apprentice to the sea fishing service, pilot, or otherwise than as member of the crew).

3. ...............................................

4. Date and place of loss of ship (or date when and place where ship was last heard of).

4. ...............................................

5. Earnings of deceased during the three years next preceding the date of the loss of ship if so long employed under the same owners.

5. ...............................................

6. If not so long employed then average weekly earnings during such shorter period of employment.

6. ...............................................

B.—As to Dependants.

7. Adult dependants (over 15 years) who were members of deceased's family, and who were wholly dependent on his earnings. Name. Address. Relationship.

7. ...............................................

8. Adult dependants, other than members of the deceased's family, resident with him, and who were wholly dependent upon his earnings. Name.Address.

9. Juvenile dependants, members of the deceased's family, who were wholly dependent upon his earnings. Name.Address.Relationship.Date of Birth.

9. .....................................................

10. Juvenile dependants, other than members of the deceased's family, who were resident with him, and who were wholly dependent upon his earnings.Name.Address.Date of Birth.

10. ...................................................

11. Persons joined as respondents as claiming or entitled to claim compensation as dependants. Name. Address. Relationship. Date of Birth (if juvenile).

11. ...................................................

C.—Particulars of Amount Claimed, Apportionment and Application.

12. Adults' lump sum £...s.............d.

Children's lump sum £...s.............d.

12. ...................................................

13. Apportionment of Adults' lump sum.

13. ...................................................

14. Apportionment of Children's lump sum.Name Amount.

14. ...................................................

Set out how it is desired that the several shares be disposed of.

{

15. Application of shares of adult dependants.

15. ...................................................

16. Application of shares of juvenile dependants.

16. ...................................................

Dated this.............................day of .....................................................19......

Signed............................................................ ................................................

Applicant(s).

or

Name............................................................ .................................................

Place of business............................................................ ............................

Solicitor for Applicant(s).

Filed this.............................day of.....................................................19......

............................................................ ............................................................ ..

County Registrar.

FORM No. 9.

ORIGINATING SUMMONS — CLAIM BY MASTER, SEAMAN, APPRENTICE, OR PILOT AGAINST PERSONS GIVING SECURITY ON BEHALF OF OWNERS OF SHIP.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ............................Circuit. County of............................................................ 

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Applicant.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Respondents.

Here insert names, etc., of persons who have given security.

TO THE RESPONDENTS :—

YOU ARE HEREBY REQUIRED—

(A) Not later than eleven days after the service upon you of this Originating Summons, to file, or cause to be filed with the County Registrar of.......................... at his Office at..............................in the said County, a statement of defence to the claim of the applicant hereinafter set forth. You may send such statement to the County Registrar by post.

(B) At the same time to serve a copy of such statement of defence upon the applicant or his solicitor. You may send such statement by post.

(C) On the .........day of..............................19......, or as soon thereafter as this Originating Summons may be heard, to appear at the Courthouse...........................upon the hearing thereof, to answer the claim of the applicant.

AND TAKE NOTICE that in default of your so doing you may be held to have admitted the applicant's claim, and the applicant may proceed therein and the Court may make, in your absence and without further notice to you such order in the matter as it may think just.

N.B.—This Originating Summons will be heard at the Courthouse.................. at the sittings commencing the .........day of....................................19.......

INDORSEMENT OF CLAIM.

The applicant is a workman and a member of the crew of the ship above mentioned (or was employed on the ship above mentioned as........................) to whom was caused personal injury by accident arising out of and in the course of his employment on the said ship. He claims compensation from the Owners of the said ship in respect of the said injury in accordance with the provisions of the Act above mentioned.

The Respondents have given security to abide the event of any proceedings that may be instituted under the Act in respect of the said injury, and to pay such compensation and costs as may be ordered to be paid in respect thereof.

PARTICULARS OF CLAIM.

1. Name and address of applicant.

1. .......................................................

2. Name of ship on which applicant was employed at time of accident, and port of registry.

2. ........................................................

3. Nature of employment of applicant (e.g. whether as master, seaman, apprentice to the sea service, apprentice to the sea fishing service, or otherwise than as member of the crew).

3. .......................................................

4. Date and place of accident.

4. .......................................................

5. Nature of the work on which applicant was engaged at the time of the accident.

5. .......................................................

6. Nature of the accident and cause of injury.

6. .......................................................

7. Nature of injury.

7. .......................................................

8. Particulars of incapacity for work, whether total or partial, and duration or estimated duration of same.

8. .......................................................

9. If incapacity is partial, state whether applicant claims to have same treated as total.

9. .......................................................

10. Average weekly earnings during the 12 months immediately preceding the accident, if so long employed under the same owners.

10. .....................................................

11. If not so long employed, then average weekly earnings during such shorter period of employment.

11. .....................................................

12. Average weeky amount which applicant is earning or is able to earn in some suitable employment or business after the accident.

12. .....................................................

13. Weekly payment claimed as compensation.

13. .....................................................

Where applicable.

{

14. Date of giving notice in writing of accident, and to whom given. (Copy of notice to be annexed.)

14. .....................................................

15. If notice not given in accordance with Act, state reason for failure to give same.

15. .....................................................

Dated this.............................day of.....................................................19......

Signed............................................................ ................................................

Applicant.

or

Name............................................................ ................................................

Place of business............................................................ ...........................

Solicitor for Applicant.

Filed this.............................day of.........................................................19......

............................................................ ............................................................ ......

County Registrar.

Note—This precedent can be easily adapted to a fatal case by combination with Form No. 7.

FORM No. 9 (a).

INDORSEMENT OF CLAIM IN ORIGINATING SUMMONS WHERE RIGHTS OF EMPLOYER AGAINST INSURERS ARE TRANSFERRED TO WORKMAN UNDER THE PROVISIONS OF SECTION 20.

INDORSEMENT OF CLAIM.

1. The Applicant is a workman to whom was caused injury by accident arising out of and in the course of his employment with....................................... (employer).

2. The Respondents are insurers of the said..........................................(employer) in respect of his liability under the Act above mentioned to pay compensation to the Applicant in respect of his said injury.

3. The said............................................................ ... (employer) has become a bankrupt (or made a composition or arrangement with his creditors) (or if the employer is a company, The said........................................................has commenced to be wound up, or as the case may be) ; and the rights of the said ............................................. (employer) against the Respondents as such insurers in respect of his liability to the Applicant have, by virtue of the provisions of Section 20 of the Act above mentioned, been transferred to and vested in the Applicant.

4. The Applicant claims compensation from you the said Respondent as such insurers in respect of the said injury in accordance with the provisions of the Act above mentioned.

FORM No. 10.

STATEMENT OF DEFENCE BY RESPONDENT TO ORIGINATING SUMMONS—GENERAL FORM.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............. Circuit. County of............................................................ ...............

[Title as in the Originating Summons to which defence is being made.]

The respondent refers to the applicant's (applicants') claim for compensation in his (their) Originating Summons served herein the............day of................... 19......, and says that he denies that he is liable to pay compensation to the applicant (applicants or any of them) on the grounds which are hereinafter specified.

(Specimen Grounds of Defence.)

That the applicant is (or the deceased workman was) not a workman to whom the Act applies ;

or,

That the injury to the applicant (or to the deceased workman) was not caused by accident arising out of and in the course of his employment ;

or,

That the disease mentioned in the applicant's particulars was not contracted while the applicant (deceased workman) was in the employment of the respondent.

or,

That the disease mentioned in the applicant's particulars was not due to the nature of the employment in which the applicant (deceased workman) was employed by the respondent ;

or,

That the injury to the applicant was due to his serious and wilful misconduct and did not result in his serious and permanent disablement ;

or,

That the death of the deceased workman did not result from the alleged injury (or was not caused by the alleged disease) ;

or,

That at the time of the alleged accident the applicant (or the deceased workman) was not immediately employed by the respondent, but was employed by.................. of...................., a contractor with the respondent for the execution by or under such contractor of work undertaken by the respondent, and the accident occurred elsewhere than in, on, or about premises on which the respondent had undertaken to execute the work, or which were otherwise under the control or management of the respondent ;

or,

That the injury to the applicant (or to the deceased workman) was caused under circumstances creating a legal liability in a person other than the respondent, to wit :............................................(Name and Address of such person) to pay damages in respect thereof, and the applicant has taken (or the deceased workman took) proceedings against the said...................... and has recovered damages from him ;

or,

That the applicant (or the deceased workman) at the time of entering the employment of the respondent wilfully and falsely represented himself in writing as not having previously suffered from the disease mentioned in the applicant's particulars ;

or,

That the applicant refuses to submit himself to a medical examination as required by the respondent (or has obstructed the medical examination required by the respondent) in accordance with the Act ;

or,

That the applicant has been required to submit himself to a medical examination by a medical referee as ordered and has refused to do so (or has obstructed such medical examination) ;

or,

That notice of the alleged accident (or of death, disablement or suspension) as required by the Act, was not given to the respondent, and the respondent had no knowledge of the same until the............day of...................., 19......, and has been and will be thereby prejudiced in his defence ;

or,

That the proceedings were not commenced within the time limited by the Act ;

or,

That the applicants or any of them were not dependants of the, deceased workman within the meaning of the Act ;

or,

If the applicant was not incapacitated as a result of the alleged accident ;

or,

If the applicant was incapacitated as a result of the alleged accident all incapacity ceased on the............day of..............................19......, up to which date he has been paid all compensation to which he is entitled under the Act.

Dated this...............day of..................................................... 19.......

Signed............................................................ .....................................

Respondent.

or

Name............................................................ ......................................

Place of business............................................................ .................

Solicitor for Respondent.

Filed this..............................day of....................................................19......

............................................................ ...........................................................

County Registrar.

FORM No. 11.

STATEMENT OF DEFENCE TO ORIGINATING SUMMONS ADMITTING LIABILITY TO PAY COMPENSATION BUT DISPUTING THE AMOUNT CLAIMED.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit. County of............................................................ ...............

[Title as in Originating Summons to which defence is being made.]

The respondent refers to the applicant's claim for compensation in his Originating Summons served the .........day of.....................19......, and says that he admits his liability to pay compensation to the applicant in respect of the injury specified in the applicant's particulars, but disputes the amount claimed as compensation.

GROUNDS ON WHICH RESPONDENT DISPUTES THE APPLICANT'S CLAIM.

(Specimen Grounds)

The applicant ceased to be totally incapacitated on the......... day of ........................19......, and had been since only partially incapacitated ;

or,

The applicant ceased to be totally incapacitated on the ............ day of ........................ 19......, and became partially incapacitated. All incapacity deceased on the ............day of......................... 19....... ;

or,

The applicant was not totally incapacitated, he was only partially incapacitated ;

or,

The applicant's incapacity ceased on the............day of...................... 19......;

or,

The applicant's average weekly earnings were not as stated in the applicant's particulars.

(Specimen Particulars.)

1. Applicant's average weekly earnings before the accident.

1. .....................................................

2. Applicant is now (or has been since the......day of.................. 19......, earning (or able to earn) £s.d. a week as a........................... (or in business as.....................).

2.....................................................

3. Period of total incapacity.

3. .....................................................

4. Period of partial incapacity.

4. .....................................................

5. Compensation during total incapacity is computed at 75% (80%) of £ s. d.

5. .....................................................

6. Compensation during partial incapacity is computed as the difference between £ s. d. and £ s. d.

6.....................................................

TAKE NOTICE:

A.—That the respondent admits his liability to pay as arrears of compesation the sum of £............s.......d. computed as follows :

and brings the said sum into Court in satisfaction of the applicant's claim.

B.—That the respondent admits his liability to pay as compensation to the applicant during the period of his total/partial incapacity the weekly payment hereinafter specified, and hereby submits to an order for the payment of the same henceforth until further order, or until the same be ended or diminished in accordance with the provisions of the Act : viz., a weekly payment of £............s......d.

C.—That the respondent brings into Court the sum of £............s.......d in satisfaction of the applicant's costs up to and including the filing and service of a notice of acceptance in accordance with the Rules, of the weekly payment herein specified.

Dated this.............................day of.....................................................19......

Signed............................................................ .................................................

Respondent.

or

Name............................................................ ....................................................

Place of business............................................................ ...............................

Solicitor for Respondent.

Filed this.............................day of..................................................19......

............................................................ ..........................................................

County Registrar.

Note.—This form can be easily adapted to the simple case where the respondent admits liability to make the weekly payment claimed.

FORM No. 12.

NOTICE OF APPLICANT OF ACCEPTANCE OF WEEKLY PAYMENT SPECIFIED IN STATEMENT OF DEFENCE ADMITTING LIABILITY.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit. County of............................................................ ...............

[Title as in Statement of Defence.]

TO THE RESPONDENT :

TAKE NOTICE that in pursuance of your statement of defence and notice of submission to an order for the payment of compensation by weekly payment, served herein the .........day of ........................... 19......, the applicant accepts the amount of the weekly payment specified therein, and will at the first opportunity apply to the Court or to the County Registrar for an order directing :—

(i) Payment to him out of Court of the amount £......... s..................d. lodged as arrears of compensation.

(ii) Payment to him out of Court of the amount £.........s...................d. lodged in satisfaction of applicant's costs.

(iii) Payment by the respondent to the applicant until further order or until the same is ended or diminished in accordance with the Act, of the said weekly payment of £.........s....................d.

Dated this...............day of.....................................................19......

Signed............................................................ ...................................

Applicant.

or

Name............................................................ .....................................

Place of business............................................................ .................

Solicitor for Applicant.

Filed this...............day of............................................................ ..19......

............................................................ ..........................................................

County Registrar.

FORM No. 13.

THIRD PARTY NOTICE UNDER SECTION 19.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit. County of............................................................ ...............

[Title as in the Originating Summons.]

TAKE NOTICE that A.................. B.................., of ........................... has filed an Originating Summons (a copy whereof is hereunto annexed) claiming compensation against the respondent C.................. D.................. in respectof personal injury by accident arising out of and in the course of his employment with the said C.................. D.................. (or as the case maybe).

The said respondent claims to be indemnified by you against his liability to pay such compensation on the ground that at the time of the injury in respect of which compensation is claimed, the said A.................. B.................. was not immediately employed by the said C.................. D.................. but was employed by you in execution of work undertaken by the said C.................. D.................. in respect of which the said C.................. D.................. had contracted with you for the execution thereof by or under you.

AND TAKE FURTHER NOTICE that if you wish to dispute the applecant's claim as against the respondent C.................. D.................., or your own liability to indemnify the said C.................. D.................. you must file and serve a statement of defence, and appear before the Court at the time and place mentioned in the said Originating Summons, or you may be deemed to have admitted the validity of any order made as to any proceedings which the Court has jurisdiction to decide between the applicant and the respondent Court has jurisdiction to decide between the applicant and the respondent C.................. D.................., whether such order is made by consent or otherwise, as well as your own liability to indemnify the said C.................. D................... Such statement of defence must be filed with the County Registrar, and served upon the other parties to these proceedings not later than seven days after the service upon you of this notice. Such statement of defence may be sent to the County Registrar and served upon the other parties by post.

Dated this............... day of............................................................ .......19......

Signed............................................................ ..................................................

Respondent.

or

Name............................................................ ......................................................

Place of business............................................................ ..................................

Solicitor for Respondent.

Filed this...............day of............................................................ .......19......

............................................................ ............................................................ ..

County Registrar.

FORM No. 14.

STATEMENT OF DEFENCE BY THIRD PARTY ADDED UNDERSECTION 19.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ..........Circuit. County of............................................................ ...............

[Title as in the Originating Summons, and add :]

AND

(Name)............................................................ ............................................................ ........................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Third Party.

The above-named third party refers to the applicant's claim for compensation in his Originating Summons served the .........day of ........................... 19......, and says that he disputes the same on the following grounds :—

(For specimen grounds of defence see Form No. 10.)

The above-named third party refers to the Third Party Notice of the respondent C.................. D.................. (filed the ......... day of........................... 19......) and says that he denies that he is liable to indemnify the said respondent on the following grounds :—

(Set out grounds.)

Dated this...............day of............................................................ .......19......

Signed............................................................ ................................................

Third Party

or

Name............................................................ ...................................................

Place of business............................................................ ...............................

Solicitor for Third Party.

Filed this............... day of............................................................ ....... 19......

............................................................ ............................................................ ....

County Registrar.

FORM No. 15.

THIRD PARTY NOTICE UNDER SECTION 61.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit County of............................................................ ...............

[Title as in the Originating Summons.]

TAKE NOTICE that A.................. B.................. of.................. has filed an Originating Summons (a copy whereof is hereunto annexed), claiming compensation against the respondent C..................D..................in respect of personal injury by accident arising out of and in the course of his employment with the said C..................D.................. (or as the case may be).

The said respondent claims to be indemnified by you against his liability to pay such compensation, on the ground that the injury for which compensation is claimed was caused in circumstances creating a legal liability in you to pay damages in respect thereof.

AND TAKE FURTHER NOTICE that if you wish to appear in these proceedings and dispute the claim of the applicant as against the said respondent C..................D..................you must apply to the Court for liberty to defend, and such liberty having been given, you must file and serve a statement of defence to the said Originating Summons, and appear before the Court at the time and place mentioned therein. Such statement of defence must be filed with the County Registrar, and served upon the other parties to these proceedings not later than seven days after the date of order giving liberty to defend. Such statement may be sent to the County Registrar and served upon the other parties by post.

Dated this........................day of...........................................19.....

Signed............................................................ ................................................

Respondent.

or

Name............................................................ ....................................................

Place of business............................................................ ...............................

Solicitor for Respondent.

Filed this........................day of............................................................ 19.....

............................................................ ........................................................

County Registrar

FORM No. 16.

STATEMENT OF DEFENCE BY THIRD PARTY ADDED UNDER SECTION 61.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ............Circuit. County of............................................................ .........................

[Title as in the Originating Summons, and add.]

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ...................................................

(Description)............................................................ ............................................................ ............................................

Third Party.

The above-named third party refers to the applicant's claim for compensation in his Originating Summons served herein the .....day of............... 19......, and says that he disputes the same on the following grounds:—

(For specimen grounds of defence see Form No. 10)

Dated this..........................day of.......................................................... 19.....

Signed............................................................ ...................................................

Third Party.

or

Name............................................................ ......................................................

Place of business............................................................ .................................

Solicitor for Third Party.

Filed this........................day of.........................................................19.....

............................................................ ...........................................................

County Registrar.

FORM No. 17.

APPLICATION FOR ORDER FOR DETENTION OF SHIP—INJURY BY ACCIDENT WHICH DOES NOT RESULT IN WORKMAN'S DEATH.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .......Circuit. County of............................................................ ........................

The Ship " ."

APPLICATION IS HEREBY made on behalf of................... of................, who alleges that the owners of the ship " " which has been found in the port (or river) of.............., (or within three miles of the coast of Ireland) are liable as such owners to pay compensation under the Act in respect of personal injury by accident arising out of and in the course of his employment caused to..........................of................... on the......... day of........................in the port (or harbour) of............................., and who claims compensation in respect of such injury and alleges that none of the owners of the said ship reside in Ireland, for an Order directed to an Officer of Customs, or other person named by the Court, requiring him to detain the said ship until such time as the owners, agent, master, or consignee thereof have paid such compensation, or have given security, to be approved by the Court, to abide the event of any proceedings that may be instituted to recover such compensation, and to pay such compensation and costs as may be awarded thereon, or until the said ship shall be otherwise released in due course of law.

The grounds on which this application is made are set forth in the affidavit of............................filed herewith (or will be given in evidence at the hearing of the application).

Dated, this...................day of............................................................ .......19......

Signed :............................................................ .......................................

(Name and address of Applicant or Applicant's Solicitor.)

To

County Registrar.

Filed, the.............day of............................................................ .... 19.....

............................................................ ................................................

County Registrar.

FORM No. 18.

UNDERTAKING AS TO DAMAGES.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit.   County of............................................................ ..........

The Ship " ."

I, THE UNDERSIGNED,.................. of.................... hereby undertake to abide by any Order which may hereafter be made as todamages and costs, in case any person affected by the Order to be made on my application for the detention of the ship " " shall sustain any damages by reason of such Order which I ought to pay.

Dated, this......................... day of..................................... 19.....

Signed : ............................................................ ...............

............................................................ ..............

Signature and address of Applicant.)

Filed, the........................ day of ............................................................ ......., 19.....

............................................................ .........................................

County Registrar.

FORM No. 19.

ORDER FOR DETENTION OF SHIP.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ...........Circuit.  County of............................................................ ..................

The Ship "      ."

WHEREAS, it is alleged that the owners of the ship "................ " are liable as such owners to pay compensation in respect of personal injury by accident arising out of and in the course of his employment caused to...........................of....................in the port (or harbour) of................................and that the said ship has been found in the port (or river) of.......................or within three miles of the coast of Ireland ;

AND WHEREAS it has been shown to me, on the application of................................of.......................who claims compensation in respect of such injury, that the owners of the said ship are probably liable as such to pay such compensation, and that none of the owners reside in Ireland ;

(AND WHEREAS the said..............................has filed an undertaking to abide by any Order which may hereafter be made as to damages and costs, in case any person affected by this Order shall sustain any damage by reason of this Order which the said..............................ought to pay) :

NOW I DO HEREBY issue this Order directed to you, the Chief Officer of Customs at.................................(or other person named by the Court) requiring you to detain the said ship until such time as the owners, agent, master or consignee thereof shall have paid compensation in respect of the said injury, or have given security in the sum of £......................., to be approved by the Court, to abide the event of any proceedings that may be instituted to recover such compensation and to pay such compensation and costs as may be awarded thereon, or until the Court rescind any Order for detention made by it.

Dated, this..................................... day of............................................................ ..... 19.....

(Seal)     County Registrar.

To

The Chief Officer of Customs at............................................................ ............................................................ ........

(or other person named by the Court).

FORM No. 20.

BOND BY WAY OF SECURITY.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ............Circuit. County of............................................................ .............

The Ship "      ."

WHEREAS it is alleged that the owners of the ship " ................." are liable as such owners to pay compensation in respect of personal injury by accident arising out of and in the course of his employment caused to......................of.................... in the port (or harbour) of........................... :

AND WHEREAS the Court has issued an Order directed to the Chief Officer of Customs at......................, (or other person named by the Court) requiring him to detain the said ship until such time as the owners, agent, master or consignee thereof have paid compensation in respect of the said injury, or have given security in the sum of £.............., to be approved by the Court, to abide the event of any proceedings that may be instituted to recover such compensation, and costs as may be awarded, or until the Court rescind any Order for detention made by it :

NOW, THEREFORE, WE (state names, addresses and descriptions of sureties) jointly and severally submit ourselves to the jurisdiction of this Court, and consent that if the owner, agent, master, or consignee of the said ship shall not pay all such compensation and costs as may be awarded thereon, execution may issue forthwith against us, our heirs, executors, and administrators, goods and chattels, for a sum not exceeding..............pounds.

(Signatures of Sureties.)

............................................................ ............................................................ ......

............................................................ ............................................................ ......

............................................................ ............................................................ ......

............................................................ ............................................

This Bail Bond was signed by the said...................... and........................ the Sureties, the........... day of ......................., 19......

Before me, ............................................................ ..............................................

County Registrar.

Filed, the............................. day of............................................................ ......................................................, 19.....

County Registrar.

FORM No. 21.

ORDER TO RELEASE SHIP.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit. County of............................................................ ..............

The Ship "..............."

YOU ARE HEREBY AUTHORISED and directed to release the ship ".................." now under detention by virtue of an Order made on the..........day of....................., upon the payment of all costs, charges and expenses attending the custody thereof.

Dated, this.............................day of.................................................., 19.....

............................................................ ...............................................

(Seal)      County Registrar.

To—

The Chief Officer of Customs at............................................................ ............................................................ ....

(or other person named by the Court).

FORM No. 22.

SOLICITOR'S UNDERTAKING TO GIVE SECURITY.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit. County of............................................................ ..............

The Ship " ."

WHEREAS it is alleged that the owners of the ship "....................." are liable as such owners to pay compensation in respect of personal injury by accident arising out of and in the coarse of his employment to.........................................of .........................in the port (or harbour) of.......................................

NOW, THEREFORE, I,.....................of................. solicitor for the owners (agent, master, or consignee) of the said ship, hereby undertake within.................days from the date hereof to pay in or give security for the sum of £.........., as agreed upon between the parties hereto, or to be fixed by the Court, to abide the event of any proceedings that may be instituted to recover such compensation and to pay such compensation and costs as may be awarded thereon.

Dated, this..........................day of..................................................., 19.....

Signed : ............................................................ .............................

Filed, the..........................day of............................................................  19.....

............................................................ ...........................................................

County Registrar.

Note.—Forms Nos. 17 to 22 inclusive, can be easily adapted to the case of injury to a workman which results in his death.

FORM No 23.

APPLICATION FOR ADDITION OF EMPLOYER AS RESPONDENT UNDER SECTION 76 (1) (iii) II.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit. County of............................................................ .............

[Title as in the Originating Summons.]

TO THE COUNTY REGISTRAR:

TAKE NOTICE that the respondent, C.................. D.................... alleges that the disease mentioned in the particulars mentioned in the applicant's Originating Summons filed herein the .......day of.............19....., was in fact contracted whilst the applicant (or the deceased workman) was in the employment of.................. of.............., and not whilst in the employment of the said C........................ D...................

AND the said C.................... D.................. hereby applies for an order that the said................... be joined as a respondent in these proceedings, and if necessary for an adjournment of the hearing of the said Originating Summons.

Dated this...........................day of.................................................19......

Signed............................................................ ...............................

Respondent.

or

Name............................................................ .............................

Place of business............................................................ ........

Solicitor for Respondent.

To the County Registrar.

Filed this.................day of............................................................ ........................19......

............................................................ ............................................................ ..................

County Registrar.

FORM No. 24.

ORDER ADDING RESPONDENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ...............Circuit. County of............................................................ ...............

[Title as in the Originating Summons.]

IT IS THIS DAY ORDERED on the application of the Respondent C...................... D.................. that............of...................... be added as a respondent in these proceedings. [And that the hearing of the Originating Summons herein be adjourned to the.............day of............... 19........... (or to the sittings fixed for the hearing of proceedings under the Act, commencing the .............day of................19.....)]

Dated this..............day of....................................................19.....,

Signed............................................................ .................................

County Registrar.

FORM No. 24 (A).

NOTICE TO APPLICANT AND ORIGINAL RESPONDENT OF ADDITION OF RESPONDENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ......................Circuit. County of............................................................ ........

[Title as in the Originating Summons.]

TAKE NOTICE that by Order dated the...........day of................... 19...., it was ordered on the application of the respondent, C.................... D..................(a copy of which is hereunto annexed) that............... of..................... be added as a respondent in these proceedings. [And that the hearing of the Originating Summons be adjourned to the..........day of...................19...... (or to the sittings fixed for the hearing of proceedings under the Act, commencing the............. day of................ 19.....)]

Dated this.......................day of................................................19.....

Signed............................................................ .....................................

Respondent.

or

Name............................................................ ......................................

Place of business............................................................ ................

Solicitor for Respondent.

To

The Applicant..................................................

The Respondent, E................... F...................

(or as the case may be).

FORM No. 25.

NOTICE TO ADDED RESPONDENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ...........................Circuit. County of............................................................ ..

[Title as in the Originating Summons, and add:]

TO—

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ...................................................

(Description)............................................................ ............................................................ ............................................

Added Respondent.

TAKE NOTICE that by order of the Court made the........day of.....................19......... it was ordered that you be added as a respondent in these proceedings.

Copies of the following documents are served on you herewith:—

(a) The order adding you as respondent ;

(b) The notice of application pursuant to which the said order was made ;

(c) The applicant's Originating Summons instituting the proceedings ;

(d) eThe statement of defence of the respondent C........... D........... ;

AND TAKE FURTHER NOTICE.—If you wish to dispute in any way the applicant's claim, or in any way to deny that you are liable to pay compensation to him in respect of the disease mentioned in the particulars in the Originating Summons, you must file and serve a statement of defence and appear before the Court on the.............day of...........19..... (set out the date of hearing, original or adjourned, as the case may be), at the Courthouse.............upon the hearing of the said Originating Summons, or you may be held to have admitted the applicant's claim as against you, and the applicant may proceed therein, and the Court may make in your absence and without further notice to you, such order in the matter as it may think just.

Such statement of defence must be filed with the County Registrar and served upon the other parties to these proceedings not later than eleven days after the service upon you of this notice. Service may be effected by ordinary post.

Dated this.............day of............................................................ ..19.....

Signed............................................................ .........................................

Respondent.

or

Name............................................................ ............................................

Place of business............................................................ .......................

Solicitor for Respondent.

FORM No. 26.

THIRD PARTY NOTICE UNDER SECTION 76 (I) (iii) III.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .......................Circuit. County of............................................................ ...

[Title as in the Originating Summons, and add:]

TO—

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ...................................................

(Description)............................................................ ............................................................ ............................................

Third Party.

TAKE NOTICE that A.............. B............ of............. has filed an Originating Summons (a copy of which is hereunto annexed) claiming compensation against the respondent C.................. D.................. in respect of having contracted a scheduled industrial disease, viz.: (set out the disease) which he alleges is due to the nature of his employment with the said .............. D................. viz. (set out nature of employment). Therespondent C.......... D............... claims to be entitled to contribution from you in respect of the compensation claimed from him, on the ground that the said disease is of such a nature as to be contracted by a gradual process, and that the said A........... B.............. was employed by you during the twelve months previous to the date of disablement or suspension in the employment to the nature of which the disease is due.

AND TAKE FURTHER NOTICE that if you wish to dispute the applicant's claim as against the respondent C............... D..............., or your own liability to the said respondent, you must file and serve a statement of defence and appear before the Court at the time and place mentioned in the said Originating Summons, or you may be deemed to admit the validity of any order made as to any matter that the Court has jurisdiction to decide as between the applicant and the respondent C............. D.............. whether such order is made by consent or otherwise and as to your own liability to make such contribution as aforesaid. Such statement of defence must be filed with the County Registrar and served upon the other parties to these proceedings not later than seven days after the service upon you of this notice. Such statement of defence may be sent to the County Registrar, and served upon the other parties by post.

Dated this.............day of............................................................ ..19.....

Signed............................................................ .........................................

Respondent.

or

Name............................................................ ............................................

Place of business............................................................ .......................

Solicitor for Respondent.

Filed this.........day of............................................................ ......................19.......

............................................................ ........................................................

County Registrar.

FORM No. 26 (a).

APPLICATION BY WORKMAN FOR REFERENCE TO MEDICAL REFEREE.

(Section 76.)

Note.—Whatever words are inapplicable should be struck out.

[Heading as in Form No. I. See note as to title, Form No. 34.]

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

AND

In the Matter of a Refusal of a Certifying (or Appointed) Surgeon to give a Certificate of Disablement to (or to suspend) *................................... ..................................................... in pursuance of the provisions of Part X of the above-mentioned Act and the regulations made thereunder by the Minister for Industry and Commerce.

Application for a reference in the above-mentioned matter to a medical referee, pursuant to Section 76, sub-section (I) (vi), of the said Act and to the above-mentioned regulations, is hereby made on behalf of the said..........................................who states :—

*Name and address of applicant.

1. That on the........day of...................the applicant applied to †........................residing at.................... (full address) the certifying surgeon under the Factory and Workshop Act, 1901, for the district of................. (or a medical practitioner appointed by the Minister for Industry and Commerce to have the powers and duties of a certifying surgeon for the purposes of Part X of the said Act, or a surgeon appointed in pursuance of..................................... (describe special rules or regulations under Factory Act) at................. (name of factory or other place of employment) for a certificate of disablement (or to be suspended) in respect of......................... a disease to which the provisions of Part X of the Workmen's Compensation Act apply.

2. That the said †.........................refused to give the applicant a certificate of disablement (or to suspend the applicant) and certified to such refusal by a certificate dated the......... day of.................. which is annexed to this application.

3. That the applicant is aggrieved by the action of the said †.....................................in refusing to give him a certificate of disablement (or to suspend him) and claims that he was suffering from the said disease, and was thereby disabled from earning full wages at the work at which he was employed (or, in the case of a refusal to suspend, that he had contracted the said disease and was thereby entitled, in accordance with the special rules (or regulations) made under the Factory and Workshop Act, 1901, for the process in which he was employed, to be suspended), in support of which claim he mentions the following circumstances :—(*)........................................... .......................................................

4. That the employer on whom the applicant, if the matter is referred to a medical referee and decided in favour of the applicant, would serve the statutory notice of disablement (or suspension) is ‡...................................... ........................................................

Two copies of this application and the certificate of the surgeon (together with the above-mentioned report of the medical practitioner employed by the applicant and two copies thereof) are annexed hereto.

Dated this.....................day of........................................................, 19.....

..........................................................Applicant

To the County Registrar.

†Name of surgeon.

*State grounds of claim, e.g., report, if any, of doctor employed by applicant.

‡Name and place of business of employer.

FORM No. 26 (b).

APPLICATION BY EMPLOYER FOR REFERENCE TO MEDICAL REFEREE.

(Section 76.)

Note.—Whatever words are inapplicable should be struck out.

[Heading as in Form No. I. See note as to title, Form No. 34.]

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 ,

AND

In the Matter of a Certificate of Disablement (or Suspension) granted in the case of *.................. ...................................................... in pursuance of the provisions of Part X of the above-mentioned Act and the regulations made thereunder by the Minister for Industry and Commerce.

*Name and address of workman

Application for a reference in the above-mentioned matter to a medical referee, pursuant to Section 76, sub-section (1) (vi), of the Act and to the above-mentioned regulations, is hereby made on behalf of †............................................................ ............................................................ ..........................................who states :—

1. That on the.........day of..................................notice of disablement (or suspension) was given to the applicant by the above-mentioned............................................................ .....under the provisions of the said Act.

2. That the said notice was consequent on a certificate of disablement given (or order of suspension made) on the.........day of................................................, in pursuance of the said Act and regulations, by ‡..........................................residing at............................................................ ................................ (full address), the certifying surgeon under the Factory and Workshop Act, 1901, for the district of............................................................ .......(or a medical practitioner appointed by the Minister for Industry and Commerce to have the powers and duties of a certifying surgeon under Part X. of the said Act, or a surgeon appointed in pursuance of ............................................................ ....) (describe special rules or regulations under the Factory Act) at............................................................ .........(name of factory or other Place of employment).

3. That the applicant is aggrieved by the action of the above mentioned ‡ ............................................................ ......................in giving the said certificate (or in making the said order of suspension) and claims that the said *.........................................................had not contracted the disease in respect of which the said certificate was given (or in respect of which the said order was made) (or, in the case of a certificate of disablement, was not suffering from the disease therein specified so as to be disabled from earning full wages at the work at which he was employed), in support of which claim he mentions the following circumstances :—(*)............................................................ ............................................................ ...................................................

And the applicant hereby undertakes, if the matter is referred to a medical referee, to repay to the said *............................................................ ..........any reasonable traveling expenses he may incur in attending for examination by such referee.

Two copies of this application are annexed hereto, together with a copy of the notice and certificate of disablement (or suspension). The above-mentioned report of the medical practitioner employed by me and two copies thereof, are also annexed.

Dated this..........................day of............................................................ ......., 19......

............................................................ ...........................Applicant.

To the County Registrar.

†Name and place of business of applicant.

‡Name of surgeon.

(*)State grounds for claim, e.g., report of any doctor employed by applicant.

FORM No. 26 (c).

ORDER OF REFERENCE TO MEDICAL REFEREE.

(Section 76.)

[Heading as in Form. No. I. See note as to title, Form No. 34.]

On the application of............................................................ .................(a copy of which is hereto annexed), I hereby appoint Mr................................of.......................................................one of the Medical Referees appointed by the Minister for Industry and Commerce for the purposes of the Workmen's Compensation Act, 1934 , to decide on the matter arising on the said application.

Copies of the notice and certificate of disablement (or suspension) (and of areport of a medical practitioner by whom the workman referred to in the application has been examined) are hereto annexed.

NOTE—Insert same heading as in the application for the Reference.

Or, if the workman is the applicant.

A copy of the certificate of the surgeon referred to in the application (together with a copy of a report of a medical practitioner by whom applicant has been examined), is hereto annexed.

The said............................................................ ...., who is now at.................................................., has been directed to submit himself for examination by the referee.

I am satisfied that the said............................................................ .....is in a fit condition to travel for the purpose of being examined, and he has been directed to attend on the referee for examination at such time and place as may be fixed by the referee.

(Or The said............................................................ does not appear to be in a fit condition to travel for the purpose of being examined.)

Dated this...........day of............................................................ .................,19......

............................................................ ................................................County Registrar.

FORM No. 27.

WEEKLY PAYMENT AGREEMENT (SECTION 47).

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .................Circuit. County of............................................................ ......

IN THE MATTER OF AN AGREEMENT.

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

AGREEMENT.

IT IS HEREBY AGREED by and between the parties as testified by their signatures hereto, as follows :—

1. The workman is entitled to compensation payable by the employer in respect of an injury by accident sustained by him on the.........day of.............., arising out of and in the course of his employment with the employer.

2. The workman was /images/v28p0465.jpg incapacitated as a result of the said accident from the date thereof until the...............day of.............................., and is still incapacitated (here insert full particulars of workman's incapacity).

3. The pre-accident average weekly earnings of the workman are £ s. d.

4. The weekly payments of compensation to which the workman is entitled in respect of the said /images/v28p0466a.jpg incapacity is the sum of £ s. d.

5. On the registration hereof the workman shall be entitled to recover from the employer the said weekly payment of £ s. d., during the period of the said /images/v28p0466b.jpg incapacity until the same shall be ended, diminished, increased, or redeemed, in accordance with the provisions of the Act.

6. The employer shall pay to..............................the workman's solicitor, the sum of £...............as and for his costs of this Agreement.

7. The age of the workman is.................... He was born the.................. day of......................................19.......

(If applicable) The said..............................(workman) is an insured person within the meaning of the National Health Insurance Acts, 1911 to 1936, and the name and address of his Approved Society and his membership number are as follows :—

Dated this...............day of......................................................19.........

Signed............................................................ ....Workman

Signed............................................................ ....Employer

FORM No. 28.

VARIATION AGREEMENT (SECTION 48).

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .................Circuit.   County of............................................................ ......

IN THE MATTER OF AN AGREEMENT.

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

AGREEMENT.

IT IS HEREBY AGREED by and between the parties as testified by their signatures hereto, as follows:—

1. The workman is entitled to compensation payable by the employer under an Order of Court made herein, on the...............day of..............................., or (under an Agreement made between the parties hereto and registered herein on the..............day of................................) in respect of an injury by accident sustained by him on the...............day of................................, arising out of and in the course of his employment with the employer.

2. On the...............day of............................................................ .........[here set out full particulars of the change in the workman's capacity for work since the date of the Order of Court (or Registered Agreement) fixing the weekly payment which justify a variation of the weekly payment].

3. The weekly payment of compensation to which the workman is entitled from the date mentioned in the last paragraph is the sum of s. d.

4. On the registration hereof the workman shall be entitled to recover from the employer the said weekly payment of £ s. d. during the period of the said /images/v28p0467.jpg incapacity until the game shall be ended, diminished, increased, or redeemed, in accordance with the provisions of the Act.

5. The employer shall pay to.............................., the workman's solicitor, the sum of £...............as and for the costs of this Agreement.

6. The age of the workman is................... He was born on the............day of...................................... 19.......

(If applicable) The said.............................workman is an insured person within the meaning of the National Health Insurance Acts, 1911 to 1936, and the name and address of his Approved Society and his membership number are as follows —

Dated this...............day of........................................19......

Signed............................................................ .............................Workman.

Signed............................................................ .............................Employer

FORM No. 29.

REDEMPTION AGREEMENT (SECTION 49).

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ...................Circuit.  County of............................................................ ......

IN THE MATTER OF AN AGREEMENT

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

AGREEMENT.

IT IS HEREBY AGREED by and between the parties as testified by their signatures hereto, as follows :—

1. The workman is entitled to compensation payable by the employer under an Order of Court made herein on the...............day of.............................or (under an agreement made between the parties hereto and registered herein on the ...............day of.......................................) in respect of an injury by accident sustained by him on the...............day of......................................arising out of and in the course of his employment with the employer.

2. The weekly payment to which the workman is entitled under the said Order of Court (or Registered Agreement) is the sum of £............s.............d.

3. (Here are set out full particulars of the workman's injuries and past, present and probable future incapacity and the probable duration of same.)

4. The employer shall pay to the workman the sum of £...............in consideration of which the workman hereby releases the employer from his liability to continue to make the weekly payment from the...............day of.............................................fixed by the said Order of Court (or Registered Agreement).

5. On the registration hereof the workman shall be entitled to recover from the employer the said sum of £...............

6. The employer shall pay to.......................................the workman's solicitor, the sum of £................as and for his costs of this agreement.

7. The age of the workman is.................... He was born on the............day of.......................................19.......

(If applicable) The said.......................................................workman, is an insured person within the meaning of the National Health Insurance Acts, 1911 to 1936, and the name and address of his Approved Society and his membership number are as follows :—

Dated this...............day of..................................................19......

Signed :............................................................ .....................Workman.

Signed :............................................................ .....................Employer.

FORM No. 30.

COMMUTATION AGREEMENT (SECTION 50).

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER Of THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .....................Circuit.  County of............................................................ .......

IN THE MATTER OF AN AGREEMENT.

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

AGREEMENT.

IT IS HEREBY AGREED by and between the parties as testified by their signatures hereto, as follows :—

1. The workman is entitled to compensation payable by the employer in respect of an injury by accident sustained by him on the ............... day of .........................................., arising out of and in the course of his employment with the employer.

2. The workman was /images/v28p0469.jpg incapacitated as a result of the said accident from the date thereof until the...............day of........................................and is still incapacitated. (Here insert full particulars of workman's injuries and past, present, and probable future incapacity and the probable duration of same.)

3. The pre-accident average weekly earnings of the workman are £......s.......d.

4. The employer admits his liability to make a weekly payment under the Act to the workman but the amount of such weekly payment has not been fixed by the Court or by Agreement.

5. The employer shall pay to the workman the sum of £............... in consideration of which the workman hereby releases the employer from his liability to make the said weekly payment.

6. On the registration hereof the workman shall be entitled to recover from the employer the said sum of £...............

7. The employer shall pay to.............................. the workman's solicitor the sum of £............... as and for his costs of this Agreement.

8. The age of the workman is................... He was born on the............day of.......................................19.......

(If applicable) The said .............................. workman, is an insured person within the meaning of the National Health Insurance Acts, 1911, to 1936, and the name and address of his Approved Society and his membership number are as follows :—

Dated this...............day of.....................................................19......

Signed : ............................................................ ..............Workman.

Signed ............................................................ ................Employer.

FORM No. 31.

AGREEMENT BY WAY OF COMPROMISE OF DISPUTED CLAIM (SECTION 51).

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ....................Circuit.  County of............................................................ ......

IN THE MATTER OF AN AGREEMENT.

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

AGREEMENT.

IT IS HEREBY AGREED by and between the parties as testified by their signatures hereto, as follows :—

1. The workman alleges that he is entitled to compensation payable by the employer in respect of an injury by accident sustained by him on the...............day of...................................arising out of and in the course of his employment with the employer.

2. (Here set out full particulars of the workmen's alleged injuries and alleged past, present, and probable future incapacity and the probable duration of same.)

3. The employer disputes his liability to the workman to make a weekly payment under the Act on the following grounds :—

(Here set out grounds upon which employer disputes liability).

4. The employer shall pay to the workman the sum of £............... in consideration of which the workman hereby releases the employer from his liability (if any) to make a weekly payment under the Act.

5. On the registration hereof the workman shall be entitled to receive front the employer the said sum of £...............

6. The employer shall pay to..........................................the workman's solicitor, the sum of £............... as and for the costs of this Agreement.

7. The age of the workman is................... He was born on............the day of.......................................19.......

(If applicable). The said.................................................workman, is an insured person within the meaning of the National Health Insurance Acts, 1911 to 1936, and the name and address of his Approved Society and his membership number are as follows :—

Dated...............this day of...................................................... 19......

Signed : ............................................................ ...............Workman.

Signed : ............................................................ ...............Employer.

FORM No. 31A.

NOTICE TO PARTIES OF RECEIPT OF AGREEMENT BY COUNTY REGISTRAR.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .....................Circuit. County of............................................................ .......

IN THE MATTER OF AN AGREEMENT.

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

TAKE NOTICE that an Agreement, a copy of which is hereto annexed, has been sent to me for registration.

You appear to be a party interested in this Agreement.

You are entitled within seven days of the service of this Notice to object to the registration of this Agreement on any of the following grounds :—

1. That no such Agreement was in fact entered into.

2. That the sum to be paid under such Agreement is inadequate.

3. That such Agreement was obtained by fraud, undue influence or other improper means.

4. That the terms agreed upon by the parties are not correctly stated in such agreement.

5. That such Agreement is no longer subsisting or enforceable.

6. Any other ground upon which if such agreement were the subject of a suit for specific performance a Court of Equity would refuse to decree specific performance thereof (or in the case of a weekly payment agreement sought to be registered by the workman, the employer may object to such registration on the ground

7. That the workman has returned to work and is earning the same wages as he did before the accident).

If you do not send me a Notice of Objection objecting to the registration of such agreement and setting out the ground or grounds upon which you object within seven days from the service hereof upon you it may be registered in due course and will be enforceable accordingly.

Dated this...............day of........................................19......

...................... ...................................

County Registrar.

(ALL Parties Concerned.)

FORM No. 31B.

NOTICE BY COUNTY REGISTRAR REQUIRING INFORMATION IN RELATION TO AGREEMENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ...................Circuit.  County of............................................................ .......

IN THE MATTER OF AN AGREEMENT.

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

With reference to the Memorandum of Agreement in the above-mentioned matter which has been sent to me for registration, I have to request you toinform me, by letter or by personal interview at my office situate at Circuit Court Offices............................................................ ...................of any fact relating to the Agreement and the circumstances in which it was arrived at which you may desire to bring to my notice, and which may assist me in deciding whether the Agreement may properly be registered.

Dated this...............day of............................................................ .....19......

............................................................ ..................................

County Registrar.

To

FORM No. 31C.

NOTICE OF REFUSAL TO REGISTER AGREEMENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .....................Circuit. County of............................................................ .......

IN THE MATTER OF AN AGREEMENT.

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

Employer.

TAKE NOTICE that I have refused to register the Agreement sent to me in this matter for registration, and have referred the matter to the Court pursuant to Section 55 of the Workmen's Compensation Act, 1934 , it appearing to me that the said Agreement ought not to be registered by reason of :

............................................................ ............................................................ ............................................................ .......

............................................................ ............................................................ ............................................................ .......

............................................................ ............................................................ ............................................................ .......

AND FURTHER TAKE NOTICE that you are hereby summoned to attend before the Circuit Court to be holden at......................................... on the...............day of................................................, at the hour of 11 o'clock in the forenoon, when the matter will be enquired into by the Court.

And that if you do not attend either in person or by your Solicitor on the day and at the hour above mentioned, such order will be made and proceedings taken as the Court may think just.

Dated this...............day of............................................................ ...................., 19......

............................................................ ....................................

County Registrar.

To

FORM No. 31D.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ...................Circuit. County of............................................................ ............

IN THE MATTER OF AN AGREEMENT.

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

TAKE NOTICE that I have this day registered the Agreement herein dated the...............day of................................................, 19......, lodged with me for registration pursuant to Part VI of the above Act.

Dated this...............day of............................................................ ..., 19......

............................................................ ...................

County Registrar.

To

The above-named Parties

and

The National Health Insurance Society,

Upper O'Connell Street, Dublin.

FORM No. 32.

NOTICE OF OBJECTION TO REGISTRATION OF AGREEMENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ....................Circuit.  County of............................................................ .......

IN THE MATTER OF AN AGREEMENT

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address) ............................................................ ............................................................ ...................................................

Employer.

TAKE NOTICE that..............................a party interested objects to the registration of this Agreement upon the following grounds :—

(Here state grounds.)

Dated, this...............day of............................................................ ..19......

Signed:...............................................................................................

............................................................ ......................................

To the County Registrar.

Filed this...............day of............................................................ ..19......

............................................................ .............................................

County Registrar.

FORM No. 33.

NOTICE OF RECEIPT OF OBJECTION TO REGISTRATION OF AGREEMENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit. County of............................................................ ..................

IN THE MATTER OF AN AGREEMENT

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Workman.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

TAKE NOTICE that..............................of..............................a party interested in the registration of this Agreement sent to me for registration in the above-mentioned matter has filed with me a notice copy of which is sent herewith that he objects to the registration of the Agreement on the grounds stated in the said notice. The Agreement will therefore not be registered except by Order of the Court.

Dated, this...............day of............................................................ ..19......

Signed :.............................................................................................

County Registrar.

To—

(All parties interested).

FORM No. 34.

NOTICE OF APPLICATION—GENERAL FORM.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .................Circuit. County of............................................................ .........

[TITLE.—Where proceedings have been instituted the title will be the same as in the Originating Summons. Where proceedings have not been instituted the title will be—" In the Matter of.............................." setting out the matter in which the application is being made, e.g., " In the Matter of an Agreement between A.B. and C.D.," as in Form No. 27.]

TAKE NOTICE that on the...............day of..............................19......, or so soon thereafter as the same may be heard, application will be made to the Court (or to the County Registrar, as the case may be) by or on behalf of..................................................for the following relief or Order ;

(Here set out briefly the relief or order sought, as in the examples set out in the following Form.)

The said application will be grounded on the affidavit of..............................filed herein on the...............day of..............................19......, a copy of which is served herewith. Any affidavit intended to be used in reply thereto, should be filed and delivered before the hearing of the application.

Dated this...............day of.......................................19......

Signed............................................................ ............................................................ ..

Address............................................................ ...........................................................

or

Name............................................................ ............................................................ 

Place of Business............................................................ ......................................

Solicitor for the said............................................................ ..................................

To—

Name............................................................ ...................

Address............................................................ ................

or

Name............................................................ ...................

Place of Business............................................................ ......

Solicitor for the said...........................................................

And to—

Name............................................................ ...................

Address............................................................ ................

County Registrar.

Filed this...............day of..............................................19......

County Registrar.

FORM No. 35

EXAMPLES OF RELIEF OR ORDER SOUGHT IN NOTICE OF APPLICATION.

1. Registration of an Agreement :

An Order for the registration of the above Agreement notwithstanding the notice of objection dated the............day of...........................19......filed herein by.....................................

2. Cancellation of the Registration of an Agreement, under Section 56 (2).

An order for the cancellation of the registration of the above mentioned agreement, registered the............day of...........................19......, which order is sought under Section 56 (2) of the Act on the grounds that the said Agreement was procured by fraud (or undue influence or other improper means as the case may be) as set forth in the following particulars.

3. A reference order, to a Medical Referee, under Section 34, where the application is made by one party only.

An order referring to a Medical Referee for his certificate the matter of the condition of the said..............................(workman) and his fitness for employment, specifying, if necessary, the kind of employment for which he is fit (or for his certificate whether and to what extent the incapacity of the said workman is due to the accident) ; having regard to the following circumstances :

(Here set out relevant particulars as in Form No. 36)

4. Appeal from the Making or Refusal to make a Reference Order.

That on appeal from the Order of the County Registrar, made herein the............day of...........................19......, the said Order be set aside and annulled (or continue, " and in lieu thereof that an order be made referring to a Medical Referee....................." and continue as in example 3).

5. Liberty to Issue Execution.

An Order that Execution may issue against you in respect of.....................(here set out the weekly payment or lump sum in respect of which execution is sought) payable by you under Order of the Court made herein the............day of...........................19......, whereby it was ordered...............(here set out the operative parts of the Order)...............(Or payable by you under an agreement registered herein the...........day of...........................19......, to the effect that...............(here set out operative parts of the agreement)..............................and in respect of which default in payment has been made by you, as set out in the particulars hereto annexed,

6. Variation of Order as to apportionment of adults' lump sum, or as to investment or application thereof, as the case made be.

That the Order of the Court made herein the.........day of...............19......be varied as follows : (Here set out variation sought.) Such variation is sought on account of the following facts and circumstances : (Here set out the facts and circumstances relied on, e.g., neglect of children by the widow, variation of circumstances of the dependents, or any other sufficient cause.)

7. Payment of weekly payment into Court during disability.

That the weekly payment payable under the Act above-mentioned by A.........B.........to C.........D.........under the Order of the Court made herein the............day of....................................19......, (or under the Agreement made between A.........B........., and C.........D.........registered the.........day of...................................19......, or as the case may be) be paid into Court during the legal disability of the said C.........D........., viz :—(Here set out the nature of the disability.).

AND

For such other Order as to the Court shall seem just, and for the costs of this application.

PARTICULARS

FORM No. 36.

APPLICATION BY BOTH PARTIES FOR REFERENCE TO MEDICAL REFEREE UNDER SECTION 34.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .................Circuit. County of............................................................ ...............

[For title, see note as to same, Form No. 34]

Application is hereby made on behalf of the above-named..............................(workman) and..............................(employer) for a reference in the above-mentioned matter to a medical referee pursuant to Section 34 of the Act in the following circumstances :—

(1) On the...............day of..............................notice was given by or on behalf of the above-mentioned...................................(workman) to the above-mentioned...................................(employer) of personal injury caused to the said workman by accident arising out of and in the course of his employment in respect of which injury the said workman claims compensation from the said employer under the said Act ;

(Or (1) Personal injury was caused to the said...................................(workman) by accident arising out of and in the course of his employment with..................(employer) in respect of which the said workman claims compensation from the said employer under the said Act and in respect of which accident the necessity of giving notice under the Act is dispensed with) ;

(Or (1)...................................(workman) is receiving weekly payments under the Act from...................................(employer) in respect of personal injury caused to the said workman by accident arising out of and in the course of his employment with the said employer which weekly payments are payable under (..............................Here set out particulars of the Order of Court, or registered agreement under which weekly payments are payable).

(2) The said workman has been examined by a medical practitioner provided by the employer in accordance with the provisions of the Act (or has been examined by a medical practitioner provided by himself) and such employer (workman) has within six days after such examination furnished the other with a copy of the report of such medical practitioner as to such workman's condition, and no agreement has been come to between said employer and said workman as to the workman's condition or fitness for employment, or as to whether and to what extent the incapacity of such workman is due to the accident.

(3) Copies of the reports of the medical practitioners who examined the workman are annexed hereto.

We request that an Order be made by the County Registrar referring the matter to a medical referee for his certificate as to the condition of the said...................................(workman) and his fitness for employment, specifying if necessary the kind of employment for which he is fit (or whether and to what extent the incapacity of the said..............................(workman) is due to the accident).

Dated, this...............day of....................................................19......

Signed............................................................ .......................

Workman.

............................................................ .......................

Employer.

To—The County Registrar.

Filed this.................day of............................................................ ........19......

............................................................ ................................................

County Registrar.

FORM No. 37.

NOTICE OF HEARING BY COUNTY REGISTRAR OF APPLICATION FOR A REFERENCE ORDER.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .................Circuit. County of............................................................ ...............

[For title, see note as to same, Form No. 34.]

TAKE NOTICE that the application of..............................for a reference order herein, dated...............day of.............................., will be heard by me at..............................on...............day of.............................., at......a.m.

Signed:..................................................................................

County Registrar.

To—

............................................................ ............................................................ ............................................................ .........

Workman.

............................................................ ............................................................ ............................................................ .........

Employer.

Or—To their respective Solicitors.

FORM No. 37 (a).

REFERENCE ORDER.

(Section 34.)

[Heading as in Form No. I. See note as to title, Form. 34.]

On the application of............................................................ ............................................................ ...........................

of............................................................ ................... and ............................................................ ...................................

of ............................................. (a copy of which is hereto annexed), I hereby appoint Mr..............................................of...................................one of the Medical Referees appointed by the Minister for Industry Commerce for the purposes of the Workmen's Compensation Act, 1934 , to examine the said...................................and to give his certificate as to the condition of the said............................................................ ...............and his fitness for employment, specifying if necessary the kind of employment for which he is fit [or his certificate] whether or to what extent the incapacity of the said............................................................ ...............is due to the said accident.

Name of workman.

Copies of the reports of the medical practitioners by whom the said............................................................ ...............had been examined are hereto annexed.

The said............................................................ ..............., who is now at.............................................has been directed to submit himself for examination by the referee.

I am satisfied that the said............................................................ ...............is in a fit condition to travel for the purpose of being examined, and he has been directed to attend on the referee for examination at such time and place as may be fixed by the referee [or The said.............................................does not appear to be in a fit condition to travel for the Purpose of being examined].

The referee is requested to forward his certificate to the County Registrar at the Circuit Court Office, situate at....................................on or before the.........day of....................................

Dated this.........day of.............................................

......................................................County Registrar.

FORM No. 38.

ORDER ON INJURED WORKMAN TO SUBMIT HIMSELF FOR EXAMINATION BY MEDICAL REFEREE.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .......Circuit. County of............................................................ .................

[For title, see note as to same, Form No. 34.]

TAKE NOTICE that I have appointed Mr..........................................of......................................., one of the medical referees appointed by the Minister for Industry Commerce for the purpose of the Workmen's Compensation Act, 1934 , to examine you in accordance with the application in the above-mentioned matter for a reference to a medical referee.

You are hereby required to submit yourself for examination by the referee.

(Add where workman is in a fit condition to travel) and to attend for that purpose at such time and place as may be fixed by him.

Dated, this...............day of............................................................ .19......

Signed........................................................................................

County Registrar.

To............................................................ ......of............................................................ ..............

FORM No. 39.

APPLICATION TO COURT FOR ATTENDANCE OF MEDICAL REFEREE TO SIT AS ASSESSOR, AND ORDER THEREON.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .....................Circuit. County of............................................................ ............

[For title, see note as to same, Form No. 34.]

The above-named applicant (or respondent) hereby applies to the Court to summon a medical referee to sit as assessor on the hearing of the above matter.

Dated, this...............day of................................19......

Signed............................................................ ......

Applicant (or Respondent).

Or............................................................ ............

Solicitor for...........................................................

To............................................................ ............

County Registrar.

Filed this...............day of......................................................19......

............................................................ ......................................

County Registrar.

ENDORSEMENT TO BE MADE BY CIRCUIT JUDGE.

It is hereby ordered that a medical referee be summoned to sit as assessor to the Court on the hearing of the above matter on payment by the applicant (or respondent) of the fee prescribed by Regulations made by the Minister for Justice with the consent of the Minister for Finance

By the Court.

............................................................ ............................................................ 

County Registrar.

FORM No. 40.

SUMMONS TO MEDICAL REFEREE TO SIT AS ASSESSOR.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit. County of............................................................ .................

[For title, see note as to same, Form No. 34.]

You are hereby required to attend and sit with the Circuit Judge as an assessor in the above matter at.................on the...........day of.............................at the hour of.........in the............noon.

............................................................ ............................................................ 

County Registrar.

To—

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

FORM No. 41.

SUMMONS TO REVIEW OR TO REDEEM A WEEKLY PAYMENT.

(Where proceedings have been instituted, the Summons to review or redeem will be a summons in the proceedings, as provided by Rule 17, and accordingly whoever was applicant in the summons instituting the proceedings will remain applicant in the summons to review or redeem, and likewise with regard to the respondent. Where no proceedings have been instituted, then the issue of the Summons to Review or Redeem is itself the institution of proceedings, and accordingly whoever issues the Summons will be Applicant and the other party Respondent.)

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ...............Circuit. County of............................................................ .................

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Applicant.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description)............................................................ ............................................................ .............................................

Respondent.

To the Respondent (or the Applicant, as the case may be) :

YOU ARE HEREBY REQUIRED on the...........day of........................19......, or as soon thereafter as this Summons may be heard, to appear at the Courthouse..........................................., on the hearing of this Summons to answer the claim of the applicant (or the respondent, as the case may be).

AND TAKE NOTICE that in default of your so doing the applicant (respondent) may proceed therein, and the Court may make, in your absence and without further notice to you, such order in the matter as it may think just.

N.B.—This Summons will be heard at the Courthouse.............................at the sittings commencing the...........day of.............................19......

ENDORSEMENT OF CLAIM.

The applicant's (respondent's) claim is for a review of the weekly payment of which the applicant (respondent) is in receipt under an Order of the Court made herein the...........day of.............................................19......, or under an Agreement registered the...........day of.....................................19......, and for the increase (or diminution, ending, or redemption) of the same.

PARTICULARS.

1. Name and address of injured workman.

1. .....................................................

2. Name and place of business of employer by whom compensation is payable.

2. .....................................................

3. Date and nature of accident

3. .....................................................

4. Date of Order or Agreement fixing weekly payment.

4. .....................................................

5. Date from which payment commenced.

5. .....................................................

6. Amount of weekly payment

6. .....................................................

7. Relief sought, whether ending, diminution, increase or redemption.

7. ......................................................

PARTICULARS.

8. Grounds on which ending, diminu

8. .....................................................

9. Amount to which it is claimed todiminish or increase weekly payment.

9. .....................................................

10. Date from which it is claimed

10. ...................................................

Dated this...............day of............................................................ .....19......

Signed............................................................ ...............................................

Respondent (Applicant)

or,

Name............................................................ ...............................................

Place of business............................................................ ..........................

Solicitor for Respondent (Applicant).

Filed this...............day of............................................................ ...19.......

............................................................ ..........................................................

County Registrar.

FORM No. 42.

FORM OF ORDER FOR WEEKLY PAYMENT.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .........................Circuit. County of............................................................ ........

[Title as in the Originating Summons.]

This matter coming on for hearing on the...........day of........................19......and it appearing to the Court that the applicant had caused the respondent to be served with an Originating Summons requiring him to attend before this Court the.............day of...........................19......, whereupon, upon reading the said Originating Summons, the respondent's Statement of Defence, and etc., and upon hearing, etc., etc.

The Court doth find as follows :—

1. The applicant was on the...........day of........................19......, in the employment of the respondent as a workman within the meaning of the Act.

2. On the said date personal injury by accident arising out of and in the course of his employment was caused to the applicant.

or

(2) X..................Y..................a certifying surgeon appointed under the Factory Workshop Act, 1901, has, on the...........day of......................., 19......, certified that the applicant was, on the said date suffering from........................(set out scheduled disease) and was thereby disabled from earning full wages at the work at which he was employed as from the...........day of.........................., 19......

or,

(2) On the said date the applicant was, in pursuance of special rules (or regulations) made under the Factory Workshop Act, 1901, suspended from his usual employment on account of his having contracted.............................(set out scheduled disease).

3. As a result of the said injury the applicant was totally incapacitated from the...........day of...................................19......and is still totally incapacitated :

or

3. As a result of the said injury the applicant was totally incapacitated from the...........day of...................................19......to the...........day of...................................19......and thereafter partially incapacitated and is still partially incapacitated ;

or

3. As a result of the said injury the applicant was totally incapacitated from the...........day of...................................19......to the...........day of...................................19......and thereafter partially incapacitated until the...........day of...................................19......;

or

3. As a result of the said injury the applicant was partially incapacitated from the...........day of...................................19......and is still partially incapacitated ;

or

3. As a result of the said injury tile applicant was partially incapacitated from the...........day of...................................19......to the...........day of...................................19......;

4. The applicant's pre-accident average weekly earnings were £......s......d.

5. The applicant is now earning (or able to earn) £......s............d, as a.............................(or in business as a.............................).

6. As compensation under the Act the respondent is liable to make to the applicant a weekly payment of £......s............d

THE COURT DOTH THEREFORE ORDER :—

1. That the respondent do pay to the applicant forthwith the sum of £......s......d......, being arrears of compensation at the said weekly rate from the...........day of............................., 19......, to date.

2. That the respondent do make to the applicant a weekly payment of £......s.........d each week, commencing the...........day of........................19......, and the same do continue to make (during the period of such total (partial) incapacity) until further order, or until the same be ended or diminished in accordance with the Act.

3. That the respondent do pay to the applicant the sum of £......s............d as and for the applicant's costs in this matter.

And the Court doth further order that any party shall be at liberty to apply for any further order or relief in this matter as they may be entitled to in accordance with the Act and the Rules made thereunder.

Dated this...........day of............................................................ ., 19......

Signed............................................................ .........................................

County Registrar.

(SEAL.)

FORM 42 (a).

FORM OF ORDER FOR WEEKLY PAYMENT WHERE RESPONDENT FILES DEFENCE SUBMITTING TO ORDER FOR WEEKLY PAYMENT WHICH APPLICANT ACCEPTS.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ..........Circuit.   County of............................................................ .....

[Title as in Originating Summons.]

The applicant having caused the respondent to be served with an Originating Summons, filed herein the............day of....................................19......., claiming compensation by weekly payment under the provisions of the Act above-mentioned, and the respondent having by his statement of defence, filed herein the............day of....................................19......, admitted his liability to pay compensation to the applicant and submitted to an Order for the payment by him to the applicant of the weekly sum of £.........s.........d., and having paid into Court the sum of £.........s..........d. in respect of arrears of compensation, and the applicant having caused the respondent to be served with a notice of acceptance of the said weekly payment, filed the............day of.....................................19......, and the respondent having paid into Court the sum of £.........s..........d. in respect of the applicant's costs up to and including the service of the said notice of acceptance, whereupon, upon reading the said Originating Summons, statement of defence, and Notice of acceptance, and it appearing that:—

1. The applicant was on the............day of....................................19......in the employment of the respondent as a workman within the meaning of the Act above-mentioned;

2. On the said date injury by accident arising out of and in the course of his said employment was caused to the applicant;

3. As a result of the said injury the applicant was totally incapacitated from the............day of....................................19......and is still totally incapacitated;

Or,

(3) As a result of the said injury the applicant was totally incapacitated from the............day of....................................19...... to the............day of....................................19...... and thereafter partially incapacitated, and is still partially incapacitated;

Or,

(3) As a result of the said injury the applicant was totally incapacitated from the............day of....................................19...... to the............day of....................................19......, and thereafter partially incapacitated until the............day of....................................19......;

Or,

(3) As a result of the said injury the applicant was partially incapacitated from the............day of....................................19...... and is still partially incapacitated;

Or,

(3) As a result of the said injury the applicant was partially incapacitated from the............day of....................................19...... to the............day of..................................19......;

4. The applicant's pre-accident average weekly earnings were £......s.......d;

5. The applicant is now earning (or able to earn) £..........s..........d. as a ............................... (or in business as a ..............................);

6. As compensation under the Act the respondent is liable to make to the applicant a weekly payment of £..........s..........d;

It is so Found and it is accordingly Ordered as follows:—

1. That the sum of £..........s..........d. be paid out of Court to the applicant in satisfaction of his claim for arrears of compensation in respect of the said injury and incapacity, calculated from the............day of....................................19...... to the............day of....................................19......;

2. That the sum of £..........s..........d. be paid out of Court to the applicant in satisfaction of his costs up to and including the service of the said notice of acceptance;

3. That the respondent do make to the applicant a weekly payment of £..........s..........d. each week commencing the............day of....................................19...... and the same do continue to make during the period of such total (partial) incapacity until further Order, or until the same be ended or diminished in accordance with the Act;

AND IT IS FURTHER ORDERED that any party shall be at liberty to apply for any further Order or relief as they may be entitled to, in accordance with the Act and the Rules made thereunder.

Dated this............day of..........................................................19.......

Signed............................................................ .

County Registrar.

(SEAL).

FORM No. 43.

FORM OF ORDER IN FATAL CASES FOR PAYMENT OF LUMP SUMS.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ............Circuit.  County of............................................................ ..............

[Title as in the Originating Summons.]

This matter coming on for hearing on the............day of...................................., 19......, and it appearing to the Court that the applicant had caused the respondent to be served with an Originating Summons requiring him to attend before this Court the............day of....................................19......, whereupon, upon reading the said Originating Summons, the respondent's Statement of Defence, and etc., and upon hearing, etc.,

The Court cloth find as follows:—

1. The deceased workman A..................B.................. (hereinafter called the workman) was, on the............day of....................................19...... in the employment of the respondent C..................D.................., as a workman within the meaning of the Act.

2. On the said date personal injury by accident arising out of and in the course of his employment with the said respondent was caused to the workman.

3. The said injury resulted in the death of the workman on the............day of....................................19......

4. The workman was in the employment of the said respondent during the three years next preceding the date of the said injury, and the sum of his earnings during that period was £..........s..........d..........(or exceeded £300, as the case may be).

or

(4) The workman was in the employment of the said respondent during a period of only...........................(set out period)...........................and his average weekly earnings during that period were £..........s..........d.

5. Before his death weekly payments to the amount of £...............s..........d. were made to the workman by way of compensation for the said injury.

or

(5) Before his death weekly payments payable to the workman as compensation for the said injury were redeemed by Order of the Court made the............day of....................................19......, (or by Agreement registered the..........day of....................................19......) for the sum of £...............s.......d.

or

(5) By Agreement by way of compromise of disputed claim, registered the............day of....................................19......, the workman agreed with the said respondent in consideration of the payment of a sum of £...............s.......d. to release him from his liability (if any) to make weekly payments as compensation for the said injury, and the said sum was paid to the workman on the............day of....................................19.......

(6) The workman left the following dependants:—

(a) Adult dependants who were wholly dependent...........................

(b) Adult dependants who were partially dependent...........................

(c) Juvenile dependants who were wholly dependent...........................

(d) Juvenile dependants who were partially dependent.......................

Set out the names and addresses.

7. The said respondent is liable to pay as compensation the sum of £...............s.......d. made up as follows:—

(a) Adults' lump sum £...............s.......d.

(b) Children's lump sum £...............s.......d.

8. The persons entitled to the said compensation, and the shares to which they are respectively entitled are as follows:—

(a) Adults' lump sum.    (a).............................................

(b) Children's lump sum.   (b).............................................

Set out the names and shares in schedule form.

THE COURT DOTH THEREFORE ORDER:—

1. That the said Respondent do forthwith pay into Court the sum of £...............s.......d., being the total of the said children's lump sum and the sum of the shares of the following adult dependants:

(Here set out the names and respective shares of the adult dependants whose shares it is proposed to have paid into Court.)

2. That the said respondent do forthwith pay to the several adult dependants following whose shares are not to be paid into Court under this Order the sums set out respectively opposite their names as follows:—(Here set out the names and respective shares of the adult dependants whose shares are not to be paid into Court.)

3. That the sum so paid into Court be applied as follows:

(Here set out particulars as to investments, deposit in Savings Bank, payment out in instalments, etc.)

4. That the dividends or interest arising from the sums so invested be from time to time paid out as follows, until further Order:

to be by him (her, them) applied for the maintenance education and benefit of the persons respectively entitled.

or

(4) That the dividends or interest arising from the sums so invested be accumulated and reinvested for the benefit of the persons respectively entitled.

That the said respondent do pay to...................................................... as and for his (her, their) costs of this matter the sum of £...............s.......d. and the Court Doth Further Order that any party shall be at liberty to apply to the Court for any further order or relief to which they may be entitled in accordance with the Act, and the Rules made thereunder.

Dated............................................................ ..............................................

Signed ............................................................ ...........................................

County Registrar.

SEAL.

Note.—Forms 42 and 43 are intended for use in ordinary cases only. The Order in any special case must be settled in accordance with Rule 30.

FORM NO. 44.

ORDER GIVING LIBERTY TO ISSUE EXECUTION.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit.  County of............................................................ ...............

[For title, see note as to same, Form No. 34.]

The application of the applicant (workman) above named for liberty to issue execution under the Order of the Court made herein the............day of....................................19......, whereby it was ordered that the respondent do make to the applicant a weekly payment of £...s....d. each week, commencing the............day of....................................19......, and the same do continue to make until further order, or until the same be ended or diminished in accordance with the Act, (or execution under an agreement registered the............day of....................................19......, whereby it was agreed that the workman should be entitled to recover from the employer the weekly payment of £...s....d., during the period of total partial incapacity until the same shall be ended, diminished,increased or redeemed, in accordance with the provisions of the Act), coming on for hearing this (the)............day of....................................19......, and it appearing that the said respondent (employer) had been duly served with notice of the same, whereupon, upon reading the said notice, Order (Agreement) and etc., etc., and upon hearing, etc., the Court doth find that the said respondent (employer) has made default in making the said weekly payment, and that upon the date of service of the said notice the sum of £...............s.......d. was and is now due and owing by the said respondent (employer) to the said applicant, (workman).

THE COURT DOTH THEREFORE ORDER—

That the applicant (workman) be at liberty forthwith to issue execution against the goods of the said respondent (employer) for the said sum of £.......s....d

That the applicant (workman) do recover against the said respondent (employer) the sum of £.......s.......d., as and for his costs of this Order.

Dated this...............day of.....................................................19......

Signed............................................................ ................................

County Registrar.

(SEAL)

FORM NO. 45.

AUTHORITY TO LODGE MONEY.

[Heading as in Form No. 1. For title, see note as to same, Form No. 34.]

To The Governor and Company of the Bank of Ireland.

LET.............................................of.................................................. lodge in the Bank of Ireland at.................................the sum of £............... to the credit of the Circuit Judge and County Registrar, and to the separate credit of the above matter.

Dated, this...............day of....................................................19......

Signed............................................................ ..................................

County Registrar.

FORM NO. 46.

RECEIPT BY BANK.

[Heading as in Form No. 1. For title, see note as to same, Form No. 34.]

The Bank of Ireland, the......................day of...............................................

Pursuant to the Authority to Lodge issued in this matter and bearing date the............day of........................ The above-mentioned employers have lodged in this Bank the sum of £...............which has been placed to the credit of the Circuit Judge and County Registrar, and to the separate credit of the above matter.

Signed............................................................ ......

To—The County Registrar.

FORM No. 47.

AUTHORITY TO LODGE MONEY.

[Heading as in Form No. 1. For title, see note as to same, Form No. 34.]

To The Governor and Company of the Bank of Ireland.

LET............................................., of............................................. lodge in the Bank of Ireland at.............................., to the credit of the Circuit Judge and County Registrar, and to the separate credit of the above matter weekly payments of................................., the first payment thereof to be lodged on or before the...............day of..........................., and thereafter weekly until this authority is withdrawn by notice in writing under my hand.

Dated, this...............day of............................................................ .......19......

Signed............................................................ ..................................

County Registrar.

FORM No. 48.

RECEIPT BY THE BANK.

[Heading as in Form No. 1. For title, see note as to same, Form No. 34.]

The Bank of Ireland,...............day of.................................

Pursuant to the Authority to Lodge issued in this Matter, and bearing date the...............day of..........................., 19.........of................................., the above-mentioned employers, had lodged in this bank the weekly sums of........................................as appearing in the Schedule hereto. Such weekly sums have been placed to the credit of the Circuit Court Account for the County of........................... and to the separate credit of the above matter.

Date

Weekly Sums Paid

Date Stamp and Signature of Bank Official

........................................

............................................................ ....

............................................................ ....

........................................

............................................................ ....

............................................................ ....

........................................

............................................................ ....

............................................................ ....

........................................

............................................................ .....

............................................................ ....

........................................

............................................................ ....

............................................................ ....

........................................

............................................................ ....

............................................................ ....

........................................

............................................................ ....

............................................................ ....

........................................

............................................................ ....

............................................................ ....

FORM No. 49.

(To be printed on thick foolscap.)

CERTIFICATE OF IDENTITY.

(To be carefully preserved.)

Notice.—This Certificate is no security whatever for a debt.

No. of Certificate................

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .............Circuit.  County of............................................................ ...............

[For title, see note as to same, Form No. 34.]

This is to certify that.............................., late of.............................. (particulars and description of workman) is entitled to a weekly payment of ............shillings............pence from..............................(name and address of employer) as compensation payable to the said..............................................in respect of personal injury caused to him by accident arising out of and in the course of his employment, such weekly payment to continue during the total or partial incapacity of the said..............................for work, and that the description of the said...........................and his incapacity for work are certified by the medical referee appointed in this matter (or by the medical certificate of the employer's medical practitioner dated......day of..................) to be as follows :—

Age............................................................ ..........

Height............................................................ ......

Hair............................................................ .........

Eyes............................................................ .........

Nature of Incapacity...............................................

(Describe nature of incapacity as in certificate of medical referee, or certificate of employer's medical practitioner).

Dated, this...............day of............................................................ ....19......

............................................................ ...........................................

County Registrar.

FORM NO. 49 (a).

ORDER OF REFERENCE.

(Section 32.)

[Heading as in Form No. 1 See note as to title, Form No. 34.]

On the application of............................................................ ............... of................................................ (a copy of which is hereto annexed), I hereby appoint Mr............................................................ .................... of............................................................ .. one of the medical referees appointed by the Minister for Industry and Commerce for the purposes of the  Workmen's Compensation Act, 1934 , to examine the said..................................................and to give his certificate as to whether the incapacity of the said............................................................ ... resulting from the... injury is likely to be of a permanent nature.

(Name of workman.) (Name of workman.)

A copy [or copies] of the report [or reports] of the medical practitioner [or practitioners] by whom the said............................................................ ... has been examined is [or are] hereto annexed. [Add, if so, Copies of the statement submitted to me by the parties are also hereto annexed.]

The said............................................................ ............................................................ ............................, who is

now at............................................................ ........................has been directed to submit himself for examination by the referee.

I am satisfied that the said............................................................ ... is in a fit condition to travel for the purpose of being examined, and he has been directed to attend on the referee for examination at such time and place as may be fixed by the referee.

[or The said............................................................ ...............does not appear to be in a fit condition to travel for the purpose of being examined.]

The referee is requested to forward his certificate to the County Registrar at the Circuit Court office situate at...................................................... on or before the............day of..... ...............................,specifying therein the nature of the incapacity of the said.................................................... resulting from the injury, and whether such incapacity is likely to be of a permanent nature.

Dated this..........................day of............................................................ 

Judge [or County Registrar.]

FORM No. 50.

NOTICE TO BE GIVEN TO WORKMAN INTENDING TO CEASE TO RESIDE IN IRELAND

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .....................Circuit. County of............................................................ ............

[For title, see note as to same, Form No. 34.]

TAKE NOTICE that if you desire to obtain payment of the weekly payments payable to you under the Order of the Court (or Registered Agreement) hereto annexed while you are residing out of Ireland you must at intervals of three months of the date up to which such payments have been made submit yourself to examination by a medical practitioner in the place where you are residing and produce to him the copy of the certificate of the medical referee (or copy of the certificate of the employer's medical practitioner) and the certificate of identity hereto annexed, and you must obtain from the medical practitioner by whom you are examined a certificate in the form hereto annexed that he has examined you and that your incapacity resulting from the injury specified in the certificate of the medical referee (or in the certificate of the employer's medical practitioner) continues (or that it is still desirable owing to your condition of health that you should continue to reside outside Ireland), and suchcertificate must be verified by the medical practitioner by declaration in your presence before some such person as is hereinafter mentioned.

You must also attend before some such person as is hereinafter mentioned and make a declaration in the form hereto annexed that you are the same person as mentioned in the copy of the certificate of the medical referee (or certificate of employer's medical practitioner) and in the certificate of identity hereto annexed, and in the certificate of the medical practitioner by whom you have been examined, producing to such person copy and certificates above-mentioned.

You must then transmit to me at my office situated at.............................. the certificate of the medical practitioner by whom you have been examined and your declaration, together with a request for the transmission to you of the weekly payments due to you, specifying the place where and the manner in which the amount is to be transmitted, according to the form hereto annexed, which request must be signed in your own handwriting.

In the event of your death while residing out of Ireland, your representatives must, in order to obtain payment of the arrears due to you, transmit to me at my office, situate at.............................., a certificate of your death, and documents showing that they are entitled to such arrears, verified by declaration before a person having authority to administer an oath, with a request for transmission to them of the amount of such arrears, specifying the place where and the manner in which such amount is to be transmitted to them.

The expression " your representatives " means :—

(a) if you leave a will, the executor of the will, or person to whom a grant of probate, or administration with the will annexed is made ; or

(b) if you die without having made a will, i.e., intestate, the person to whom a grant of administration is made, or the persons who are according to law entitled to your personal estate.

Where a grant of probate or administration has been made, payment of the arrears will be made only on production of the grant to me. Where no such grant has been made it will not be necessary to apply for any such grant in order to obtain payment of the arrears.

Persons before whom a certificate may be verified or declaration made are :—

(1) Any person having authority to administer an oath in the place in which you reside.

(2) Any Minister, Consul, or Consular Agent holding office under the Government of Ireland and exercising his functions in any foreign place in which you reside.

Dated, this......................day of...................................................19......

............................................................ ...........................................

County Registrar.

To—

(Name)............................................................ ............................................................ ...................................................

(Address)............................................................ ............................................................ ...............................................

Workman.

FORM No. 51.

MEDICAL CERTIFICATE TO BE OBTAINED BY WORKMAN RESIDING OUT OF IRELAND.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ...........................Circuit. County of............................................................ .

[For title, see note as to same, Form No. 34.]

I,.................................... (name and address and medical qualification of medical practitioner) hereby certify that I have this day examined.................., of...........................,... whom I conscientiously believe to be the same person as..........................., of........................, described in the copy of the certificate of the medical referee (or certificate of employer's medical practitioner) in the above-mentioned matter, dated...............day of.............................., and in the certificate of identity, dated...............day of..........................., produced to me by the said.............................., and that in my opinion the incapacity of the said.................................resulting from the injury described in the said certificate of the medical referee (or employer's medical practitioner) still continues (or that it is desirable owing to the condition of health of the said....................................that he should continue to reside outside Ireland.)

Dated, this.................., day of..................................................19......

(Signature)............................................................ .................

Declared at...........................this...............day of.............................. in the presence of the said.................................(workman) the copy of the certificate of the medical referee (or certificate of the employer's medical practitioner) and the certificate of identity above-mentioned being at the same time produced before me.

............................................................ ............................................................ ............................................................ ......

(Signature, Seal and description of person before whom declaration is made).

FORM No. 52.

DECLARATION OF IDENTITY OF WORKMAN RESIDING OUT OF IRELAND.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .......................Circuit. County of............................................................ ..........

[For title, see note as to same, Form No. 34.]

I,..........................................of....................................hereby declare that I am the same person as............................................................ ...... of......................................described in the copy of the certificate of the medical referee (or certificate of the employer's medical practitioner) in the above-mentioned matter, dated...............day of..........................., nowproduced by me and in the Certificate of Identity dated...............day of..........................................now produced by me, and the same person as................................................of.......................................described in the certificate of.......................................................... of declared by the said..............................................in my presence on the...............day of....................................and now produced by me.

(Signed) ............................................................ ...

Workman.

Declared at...................................................this.........................day of..............................the certificates above mentioned being at the same time produced before me.

............................................................ ............................................................ .......................................

(Signature, seal and description of person before whom declaration is made.)

FORM No. 53.

REQUEST FOR TRANSMISSION OF AMOUNT OF WEEKLY PAYMENTS BY WORKMAN RESIDING OUT OF IRELAND.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ .....................Circuit. County of............................................................ ..........

[For title, see note as to same, Form No. 34.]

I hereby request that the amount of the weekly payments due to me in the above-mentioned matter may be transmitted to me at...........................(Give full address).

(State how transmission is to be made: if by Post Office Order payable at..............................(name of Post Office), or by Banker's draft on.............................................(name and address of Bank).

Enclosed herewith is medical certificate and declaration of Identity.

Dated, this...............day of...............................................

............................................................ ........

Workman.

(To be signed by workman in his own handwriting)

To............................................................ ............................................................ ............................................................ ....

County Registrar for the Circuit Court area for the County of............................................................ ..

Add address of County Registrar's Office.

FORM No. 54.

NOTICE BY COUNTY REGISTRAR TO EMPLOYER OF THE RECEIPT OF MEDICAL CERTIFICATE AND DECLARATION OF IDENTITY.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934

............................................................ ..................Circuit. County of............................................................ ............

[For title, see note as to same, Form No. 34.]

TAKE NOTICE that I have received proof that the incapacity of the above named.............................................still continues (or that it is desirable owing to the condition of health of the above-named....................................that he should continue to reside outside Ireland) and that I have also received proof of identity. You are hereby required to transmit the sum of..................pounds, being the amount of the weekly payments payable to the said............................................in the above matter from........................day of........................, the date to which they were last paid, to............day of.........................(thirteen weeks from that date) to me so that I may remit same to the said...................................................

Dated, this...............day of............................................

............................................................ ..............

County Registrar.

To (Name)............................................................ ............................................................ ..................................................

(Address)............................................................ ............................................................ ....................................................

Employer.

FORM No. 55.

CERTIFICATE OF COURT UNDER SECTION 60.

[Heading and title as in Plaintiff's Civil Bill, and continue:]

AND

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

I hereby certify that on the............day of...........................19,......the above named plaintiff instituted the action in the title hereof mentioned against the defendants above named, claiming

(Here state plaintiff's claim.)

And that on the trial of the said action on the............day of........................19......, it was determined that the injury in respect of which the plaintiff claimed damages in the said action was one for which the defendant was not liable in such action, but that he would have been liable to pay compensation in respect of such injury under the provisions of the Act above mentioned:

And that thereupon the said action was dismissed, but the Court, on the application of the plaintiff, proceeded to assess such compensation:

And that the Court assessed such compensation and made the following order:—

(Here insert order of the Court following the precedent of Form No. 42 or Form No. 43, or as the case may be, and dealing with the costs of the Action, (and deduction of same from compensation.)

Dated this...............day of...................................................19......

Signed............................................................ ................................

County Registrar.

(SEAL)

FORM No. 56.

CERTIFICATE OF COUNTY REGISTRAR EVIDENCING CONSENT OF CIRCUIT JUDGE TO ACCEPT TRANSFER OF PROCEEDINGS

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ............Circuit. County of............................................................ .................

[For title, see note as to same, Form No. 34.]

I HEREBY CERTIFY that the judge for the time being assigned to the...........................Circuit has consented to accept a transfer of the proceedings named in the title hereof.

Dated this...............day of.......................................19......

Signed............................................................ ..................

County Registrar.

County of...................................................

To the County Registrar.

County of..........................................

FORM No. 57.

REFERENCE TO A MEDICAL REFEREE UNDER SECTION 39 (4).

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ..................Circuit. County of............................................................ ......

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description) ............................................................ ............................................................ ............................................

Applicant.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description) ............................................................ ............................................................ ............................................

Respondent.

I............................................., Judge of the above named Circuit, having heard the evidence tendered by both parties, hereby certify that in my opinion the medical evidence given before me is conflicting (or insufficient) on a matter which seems to me to be material to a question arising in these proceedings and that it is desirable to obtain a report from a medical referee on such matter as follows:—

(a) On the............day of............................................, personal injury was (or is alleged) to have been caused to*.............................................by accident arising out of and in the course of his employment, under the following circumstances:—

†p497dag

Or, in a case of industrial disease to which the Act applies:—

(a) On the............ day of............................................ the said*............................................. was, under Section 76 of the above named Act, certified to be disabled by, or suspended from his usual employment on account of his having contracted, a disease to which the said section applies, namely‡

(b) The matter on which I am satisfied that it is desirable to obtain a report is:

(c) Such matter seems to be material to the following question arising in the proceedings, viz.:—

I therefore appoint............................................................ .............one of the Medical Referees appointed by the Minister for Industry and Commerce for the purposes of the Workmen's Compensation Act, I934, to examine the said............................................................ ..........

Insert name of injured workman.

and to report on the matter specified above.

A statement of the medical evidence given before me is appended

I am satisfied that the said............................................................ ..........................................who is now at............................................................ ...............................................is in a fit condition to travel for the purpose of being examined, and he has been directed to attend on the Referee for examination at such time and place as shall be fixed by the Referee (or does not appear to be in a fit condition to travel for the purpose of being examined).

The Referee is requested to forward his report to:

The County Registrar,

Court House,

at............................................................ ..........................

on or before the............day of......................................19......

Dated this............ day......................................of 19......

(Signed)............................................................ ......................

For signature of Judge.

A previous reference was made to a Medical Referee in this case on the............day of.............................................19......and a copy of the report is attached.

* Insert name of injured workman.

† Here state the facts of the accident as ascertained from the evidence.

‡ Name disease.

FORM No. 58.

ORDER TO INJURED WORKMAN TO SUBMIT HIMSELF FOR EXAMINATION BY MEDICAL REFEREE

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934

NOTE.—This Order after being signed by the Judge is to be detached, and delivered to the injured workman at the same time that the reference is received by the County Registrar

............................................................ ..........................Circuit. County of............................................................ ..

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description) ............................................................ ............................................................ ............................................

Applicant.

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description) ............................................................ ............................................................ ............................................

Respondent.

To............................................................ .............................................. of............................................................ ........

Strike out from "and to attend," when the injured workman does not appear to be in a fit condition to travel.

TAKE NOTICE

That the Circuit Judge has appointed one of the Medical Referees under the Workmen's Compensation Act, 1934 , to examine you for the purposes of the above mentioned proceedings and to report to him.

You are hereby required to submit yourself for examination by such Referee,* and to attend for that purpose at such time and place as may be fixed by him.

Dated this............day of......................................19......

Signed†.....................................................

† For signature of Judge.

FORM No. 59.

NOTICE BY MEDICAL REFEREE TO INJURED WORKMAN.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

NOTE:—This form is to be sent by the Referee to the injured workman. The place to be fixed for the examination will depend on whether the workman is or is not reported by the Judge to be fit to travel.

............................................................ ...............Circuit. County of............................................................ ................

BETWEEN

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description) ............................................................ ............................................................ ............................................

Applicant

AND

(Name) ............................................................ ............................................................ .......................................................

(Address)............................................................ ............................................................ ....................................................

(Description) ............................................................ ............................................................ ............................................

Respondent.

To............................................................ † For signature of Judge.

I hereby give you notice that I have been appointed to examine and report on your case under Section 39 (4) of the above-named Act, and that I propose to make such examination at............................................................ ... on the............day of...............................................19......, at. o'clock.

(Signed)............................................................ ......

Medical Referee

FORM No. 60.

REPORT OF MEDICAL REFEREE.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ......................Circuit. County of............................................................ .........

BETWEEN

............................................................ ............................................................ .................................................Applicant.

and............................................................ ............................................................ ..................................... Respondent.

In accordance with the foregoing Reference I have examined .............................................at ......................................................... on.......................................................and I beg to report as follows on the questions submitted to me:—

IRELAND.

CIRCUIT COURT OF JUSTICE.

WE, THE CIRCUIT COURT RULES COMMITTEE, constituted pursuant to the provisions of Section 69 of the Courts of Justice Act, 1936 , by virtue of the powers conferred upon us by Section 66 of the Courts of Justice Act, 1924 , and Section 70 of the Courts of Justice Act, 1936 , and of all other powers enabling us in this behalf, do hereby, with the concurrence of the Minister for Justice, make the annexed Rules as the Rules of the Circuit Court of Justice for the purposes of Section 71 of the Workmen's Compensation Act, 1934 .

Dated this 25th day of October, 1941.

Signed CAFIR DAVITT, Chairman,

JAMES SEALY,

W. J. GLEESON,

GEORGE C. CULLINAN,

ARTHUR E. CORBETT,

THOMAS H. R. CRAIG,

JOHN J. HORGAN,

SÉAMUS O CONCHUBHAIR, Secretary.

I concur in the making of the foregoing Rules.

(Sgd.) G. Boland,

Minister for Justice,

4th November, 1941.

IRELAND.

COURTS OF JUSTICE ACTS, 1924 AND 1936,

AND

[ WORKMEN'S COMPENSATION ACT, 1934 .]

WORKMEN'S COMPENSATION (PROVISIONAL ARRANGEMENT WITH THE UNITED KINGDOM) RULES 1942.

PRELIMINARY.

1. The following Rules shall be read and construed with the Circuit Court (Workmen's Compensation) Rules, 1942. They shall come into operation on the 30th day of March, 1942. They may be cited as the Workmen's Compensation (Provisional Arrangement with Great Britain) Rules, 1942,

TRANSFER OF MONEYS IN COURT TO COURTS IN GREAT BRITAIN OR NORTHERN IRELAND.

2—(1) Where (a) Moneys other than a weekly payment or arrears of a weekly payment have been paid into Court as compensation under the Act for the benefit of a workman or the dependant of a workman;

And

(b) such workman or dependant is resident or about to reside in Great Britain or Northern Ireland the Court may, on application ex parte by or on behalf of such workman or dependant

(a) Order that such moneys be transferred to the appropriate Court in Great Britain or Northern Ireland, to be by such Court administered for the benefit of such workman or dependant as such Court shall think fit.

(b) in such Order make such request regarding the administration of such moneys as to the Court shall appear fit.

(2) Where such an Order is made and

(a) the workmans or dependant is resident in or about to reside in England or Wales the County Registrar shall send in an envelope addressed to the Superintendent. County Courts Branch, Lord Chancellor's Department, House of Lords, London, a sealed copy of the Order and a crossed cheque for the amount of the moneys made payable to Paymaster General, The Treasury, Whitehall, London, S.W.1;

(b) the workman or dependant is resident in or about to reside in Scotland the County Registrar shall send in an envelope addressed to the Kings's and Lord Treasurer's Remembrancer Exchequer, Edinburgh, a sealed copy of the Order and a crossed cheque for the amount of the moneys made payable to such Remembrancer;

(c) the workman or dependant is resident in or about to reside in Northern Ireland the County Registrar shall send in an envelope addressed to the Accountant, Ministry of Home Affairs for Northern Ireland, Belfast, a sealed copy of the Order and a crossed cheque for the amount of the moneys made payable to such Accountant.

ADMINISTRATION OF MONEYS TRANSFERRED FROM COURTS IN GREAT BRITAIN OR NORTHERN IRELAND.

3.—(1) Where under the terms of a Provisional Arrangement made the 19th day of May, 1941 between the Government of Ireland and the Government of the United Kingdom of Great Britain and Northern Ireland, moneys being compensation payable under the Workmen's Compensation Act, 1925, and the Workmen's Compensation (Transfer of Funds) Act, 1927, or under the Workmen's Compensation (Northern Ireland) Act, 1927, to a workman or the dependant of a workman resident or about to reside in Ireland, are transferred to the Court, through the Secretary of the Department of Justice from a Court in Great Britain or Northern Ireland, the Court shall receive the said moneys and on the application ex parte of such workman or dependant may make an Order directing such moneys to be paid to or applied for the benefit of such workman, or dependant, as the Court shall think fit and shall as far as possible have regard to any request made by the Court from which such moneys have been transferred as to the administration of the same.

(2) The County Registrar shall as soon as possible after the receipt of such moneys:—

(a) notify such workman or dependant of such receipt;

(b) subject to the direction of the Judge, inform him of any request made by the Court from which such moneys have been transferred as to the administration thereof;

(c) notify him that he may apply to the Court for an Order directing the payment of such moneys to him, or the application of such moneys for his benefit; and attend to give evidence in support of such application;

(d) notify him of the time when such application may be made and such evidence given.

FORM OF ORDER TRANSFERRING COMPENSATION MONEYS TO GREAT BRITAIN OR NORTHERN IRELAND.

IRELAND.

CIRCUIT COURT OF JUSTICE.

IN THE MATTER OF THE WORKMEN'S COMPENSATION ACT, 1934 .

............................................................ ..................Circuit. County of............................................................ .........

[Title as in Originating Summons.]

WHEREAS by Order (or agreement) dated, etc.:—(Here recite Order awarding compensation and directing payment into Court, or agreement on foot of which money was paid into Court). And it appearing by the Certificate of the County Registrar that there is now in Court to the credit of the said (workman or dependant) the sum of £....................invested in (set out investment, if any) And it appearing to the Court that the said (workman or dependant) is now resident (or about to reside) at (set out address) in (England or as the case may be) And application having been made to the Court by (or on behalf of) the said (workman or dependant) for an Order directing the transfer of the said moneys in Court to the appropriate Court in (England or as the case may be) Whereupon on hearing what was offered on behalf of the said (workman or dependant) the Court doth Order as follows:—

1.—That the said (investment) be sold, and that the moneys resulting from such sale be transferred to the appropriate Court in (England, etc.) to be by such Court administered for the benefit of the said (workman or dependant) as such Court shall think fit;

Or,

(1) That the moneys in Court to the credit of the said (workman or dependant) be transferred to the appropriate Court in (England, etc.) to be by such Court administered for the benefit of the said (workman or dependant) as such Court shall think fit.

2. That the said Court be respectfully requested as follows:—(Here set out any request it is desired to make as to the administration of the moneys).

And the County Registrar is hereby directed to transmit a copy of this Order and the said moneys to the proper Officer in (Great Britain or as the case may be) in accordance with Rule 2 of the Workmen's Compensation (Provisional Arrangement with the United Kingdom) Rules, 1942.

Dated............................................................ .....................

Signed............................................................ ...................

County Registrar.

(SEAL).