Understanding Non-Freezing Cold Injury (NFCI) Claims in the Armed Forces

Service personnel are often exposed to harsh weather conditions including prolonged exposure to wet and cold.  One serious but often misunderstood outcome of such exposure is Non-Freezing Cold Injury (NFCI) — historically known as ‘trench foot’ or ‘immersion foot’.

What Is NFCI?

NFCI occurs when body parts, especially the feet and hands, are exposed to wet cold for extended periods without being properly dried and warmed. It differs from frostbite in that tissue does not freeze — the condition can occur in temperatures just above freezing up to around 15°C, but moisture is essential for NFCI to develop.

The injury affects nerves, blood vessels, and soft tissue, progressing through four stages: cold exposure, post-exposure, hyperaemic, and post-hyperaemic. In some cases, long-term damage results, leading to persistent pain and cold sensitivity.

Symptoms and Lasting Impact

Initial signs of Non-Freezing Cold Injury may include:

• Pale, mottled skin and cold, numb limbs
• Weak pulses and swelling
• Redness and pain on rewarming
• Blisters in severe or complicated cases

Long-term effects can be debilitating:

• Chronic pain and hypersensitivity to cold
• Vasoconstriction and excessive sweating
• Symptoms resembling complex regional pain syndrome (CRPS)

In extreme cases, NFCI may lead to tissue loss or amputation. Many affected personnel cannot return to duties involving cold exposure, and the condition can be career-ending.

The MOD’s Duty of Care

The Ministry of Defence (MoD), like any employer, has a legal obligation to protect personnel from preventable injuries such as NFCI. This includes:

• Educating personnel on prevention and early symptoms
• Supplying appropriate clothing and equipment
• Limiting unnecessary exposure to cold and wet
• Ensuring time to warm and dry
• Conducting proper risk assessments and medical planning

Training on cold injury prevention is mandatory and varies by role. Dynamic risk assessments must be performed as conditions change, and all suspected injuries must be reported and investigated.

Making a Claim for NFCI

Since Crown Immunity was lifted in 1987, service personnel injured after this date may pursue civil claims for NFCI. These claims can be made in addition to or separately from Armed Forces Compensation Scheme (AFCS) or War Pension claims.

Key points include:

• Civil claims often succeed where other schemes fail
• Most claims settle after proceedings begin — very few go to trial
• Compensation can include pain and suffering, loss of career, and costs for additional clothing or care

Prevalence and Risk Factors

Between 2010 and 2022, 4,925 personnel were recorded as having NFCI in UK armed forces records. The risk of injury is increased by :

• Ethnicity
• Previous cold injury
• Inexperience or poor personal admin
• Prolonged wet cold exposure without adequate protection

We also encourage you to read our advice page on What Is a Non-Freezing Cold Injury (NFCI) Claim?

If you believe you’ve developed NFCI during service, seek medical advice and contact us at MilitaryInjuryClaim.co.uk for expert advice.