«Ill Health Retirement – Guide for Members Contents Page 1 Introduction 1.1 General 2 Before making an application for an ill health retirement ...»
Brief guidance on how applications are considered has been given at the end of the form as it may help your doctor or specialist provide the necessary information. You must make sure you return the form to your employer promptly. They will let you know of any deadline that applies. If your doctor or specialist would prefer an electronic version of this form please let your employer know. When the form is completed your doctor should enclose it in a sealed envelope clearly marked with your name and stating that it contains medical in confidence information to be opened only by Capita Health & Wellbeing medical personnel (see paragraph 25 for contact details).
Please note: It is important that any medical information provided by your doctor or specialist is legible - typed reports are preferable. Statements must be supported by first hand evidence from examining practitioners and/or objective testing. Complete documents must be submitted. Extracts from clinical notes or reports are not acceptable.
7.3 IHR – P2 in more detail This part is for your employer to complete This part asks for confirmation of your employer’s details to enable the Scheme Medical Adviser to process the application. It also asks for confirmation of your name and contact details (as your employer has on record) and which pension scheme you are in (or when you joined the scheme if you are in partnership).
It asks your employer to provide occupational information relevant to your
details of consideration given to job modifications and redeployment – (if redeployment has not been considered your employer should do this before submitting an application for ill health retirement);
Full Job Description Issue Date: 01/02/12 Sickness absences during last 5 years Occupational Health Records – see below Copies of any scheme medical adviser correspondence relating to your case.
Your employer’s Occupational Health Provider (OHP) will need to provide information to enable the Scheme Medical Adviser to reasonably assess your case. Such information will be contained in a ‘Medical in Confidence’ envelope that can only be opened by a medical professional such as the Scheme Medical Adviser with your permission (as requested on Medical Consent Form 1).
The completed IHR form along with occupational and medical evidence must be forwarded by your employer to the Scheme Medical Adviser.
8 What if I discover I am terminally ill?
If at any stage in the ill health retirement process you are told you have a terminal illness and that your life expectancy is less than twelve months, you must tell your employer or My Civil Service Pension (MyCSP) as quickly as possible. They will tell the medical adviser straight away so that the ill health retirement certificate is issued urgently.
9 Will my employment continue if I have been referred for an ill health retirement assessment?
If your employer has referred you for an assessment because your performance or attendance is poor (and may lead to dismissal for inefficiency), and either you or they consider that the causes of this may make ill health retirement appropriate, your employer should not normally take any action to dismiss you before the ill health retirement assessment has been completed.
Taking such action (unless you have refused to give consent for an ill health assessment to be carried out or for medical evidence to be obtained), could lead to your application being stopped.
There are some exceptional circumstances in which an ill health retirement assessment may be allowed to continue, or carried out retrospectively, if your employment is terminated before the ill health retirement assessment has been completed (see paragraph 11 below on ‘What happens if my employment is terminated before an ill health retirement assessment has been completed?’).
10 Can an ill health retirement referral be refused or stopped for any reason?
An ill health retirement referral can be refused or stopped in certain circumstances, for instance, if you are under investigation for alleged misconduct that could lead to your dismissal. In most cases a decision on ill Issue Date: 01/02/12 health retirement will be deferred until the investigation has been completed and then only progressed if you have not been dismissed for misconduct.
An ill health retirement application can also be rejected by your employer if you should refuse or withdraw consent for the Scheme Medical Adviser to issue the report and certificate to your employer confirming the outcome decision of your ill health retirement assessment. See paragraph 17 on ‘Withdrawing consent for the Scheme Medical Adviser to send their report to your employer’.
11 What happens if my employment is terminated before the ill health retirement assessment has been completed?
Your employment should not normally be terminated by you or your employer while an ill health retirement assessment is being done and the outcome has not been confirmed (see paragraph 9).
However, there may be occasions when such action has been taken in error –
a misunderstanding of the circumstances or procedures, or;
because your employment has been transferred out of the Civil Service as part of a departmental closure, or Machinery of Government change before your ill health retirement assessment has been completed, or;
your employer was running an early exit scheme and believed that they needed to give you the option of taking redundancy by an agreed deadline, in case your ill health retirement application was unsuccessful and you missed the chance to take redundancy. Although it should be possible to reach separate agreement on early exit departure dates in such circumstances until the outcome of your ill health retirement application is confirmed, your employer may not have realised this.
If such action has been taken in error, then your application should be allowed to continue, or carried out retrospectively. Your employer may need to seek authorisation from MyCSP to submit to the Scheme Medical Adviser, to confirm that agreement has been given for your assessment to continue, or to be carried out retrospectively. Retrospective ill health retirement will be applied from the last date of service if it is determined that you should have been given medical retirement at that date.
If you leave your employment due to ill health (and were a member of the Civil Service Pension Scheme prior to leaving), but an ill health retirement assessment was not carried out, there are exceptional circumstances in which you may be allowed to apply for ill health retirement retrospectively.
Retrospective ill health retirement is not the same as Early Payment of a Preserved Pension. See paragraph 21 below for more information about ‘Early Payment of Preserved Pension (EPPA)’. Considering ill health retirement retrospectively is an exceptional measure, usually only allowed when an error
has occurred in the original handling of a case. For example:
Issue Date: 01/02/12 the member left employment due to ill health without ill health retirement first being considered by the employer, or;
the member resigned or took redundancy due to ill health without realising they could have applied for ill health retirement.
In either case, there generally needs to have been some indication:
that you were ill at the time you left;
that your performance or attendance was affected by your ill health;
and that your employer was aware of this and intended to, or took action to, dismiss you for inefficiency.
In the above circumstances, your employer should have considered the appropriateness of ill health retirement before you left or told you of your right to apply for ill health retirement before you left (as mentioned in paragraph 6 on ‘How do I apply for ill health retirement?’). Not doing so would give grounds to allow a retrospective application to be made.
If you believe that you meet the conditions for a retrospective ill health retirement assessment to be made, you should contact your employer, explaining the background and justification for your request and ask your employer to seek permission for a retrospective application to be made. Your employer must ask MyCSP for advice and authorisation (if agreed), before referring a request for a retrospective application to the Scheme Medical Adviser. The Scheme Medical Adviser will not be able to consider any application for retrospective ill health retirement without authorisation from MyCSP.
12 Can I apply for ill health retirement if I have already left my employment and the Civil Service Pension Scheme (CSPS)?
No, you will not be eligible to apply for ill health retirement if you have already left your employment and the CSPS, apart from in exceptional circumstances which are explained in paragraph 11 on ‘What happens if my employment is terminated before an ill health retirement assessment has been completed?’ If you left the Civil Service with a preserved classic pension in the scheme and your health breaks down after leaving, you can apply to receive your pension early on ill health grounds. See paragraph 21 below for more information about ‘Early Payment of Preserved Pension (EPPA)’.
If you leave your employment and have a preserved pension in any CSPS scheme and you discover that you are terminally ill with a medically assessed life expectancy of less than twelve months, you can apply to receive your pension early. The Scheme Medical Adviser will still need to carry out a medical assessment to confirm that you are eligible to receive your pension early on severe ill health grounds, before any payments can be made.
However, the assessment should be completed very quickly in such circumstances.
Issue Date: 01/02/12 13 What happens after an application is sent to the Scheme Medical Adviser?
13.1 Scheme Medical Adviser Actions The Scheme Medical Adviser will review the application (order) form when it is received to make sure it is complete and that all the necessary paperwork has been sent. If anything is missing, they will contact your employer to ask for missing information to be provided if it is easily obtained. They will return applications that have substantial parts missing. The timescale for completing an assessment, will not start until all necessary and complete papers have been sent to them.
If the Scheme Medical Adviser decides that there is enough information to complete an assessment without them having to obtain further information, they will produce an outcome report and certificate within 10 working days of receipt of your application. See paragraph 14 for information about ‘The Scheme Medical Adviser’s assessment report’.
If the Scheme Medical Adviser needs further evidence they will obtain this:
o Through a personal consultation with you or;
o Through obtaining a third party report from your doctor and/or specialist.
Sometimes they will do both. They will keep you and your employer informed where this is happening.
13.2 If a personal consultation is needed The Scheme Medical Adviser will telephone you to arrange this, and send written confirmation of the appointment to you and to your employer. If you subsequently cancel a consultation, they will rearrange the appointment on one occasion only. If the second appointment is not attended or is cancelled, no further appointment will be offered. If you fail to attend a consultation or cancel with less than 24 hours notice, there will be a full charge made to your employer for the consultation. If a second consultation doesn’t take place due you cancelling or not attending then your case will be assessed without this additional information. It is unlikely to be in your best interests if the Scheme Medical Adviser is not able to obtain the medical evidence they believe they need to assess your case. Where they have requested a consultation they will complete their assessment and produce an outcome report and certificate within 30 working days of receipt of the case. The 30 day timescale will not include periods (for example if you have rearranged or not attended an appointment), where the service stops. See paragraph 14 for information about ‘The Scheme Medical Adviser’s assessment report’.
If you attended a medical consultation and the physician you saw is an authorised Pension Scheme Adviser, you will have been made aware of the proposed content of the outcome report.
Issue Date: 01/02/12 If you attended a medical consultation but the physician you saw is not an authorised Pension Scheme Adviser, or if no medical consultation took place either due to your non attendance or because the information they have received is sufficient to complete an assessment without having to see you, a Pension Scheme Adviser will provide a report based on information received. In such instances, it will not be possible to provide information about the proposed content of the outcome report before it is processed by the Scheme Medical Adviser.
Please note: The Scheme Medical Adviser will only make home visits to conduct a consultation in very exceptional circumstances, and at their discretion. If you identify that travel may be difficult your employer should actively consider assisting you with your travel arrangements. Your employer is advised to discourage requests for home visits and to tell you that they are rarely possible.
13.3 If a medical report from your doctor, or specialist, or both is needed If a medical report is needed from your doctor, or specialist, or both, (referred to as a third party report), the Scheme Medical Adviser will send the request for a report from your doctor and/or specialist (or both, if needed) within 5 working days of receipt of the case. They will send two chase letters if a report has not been received after 20 and then 25 days and will continue to process your case when the report has been received, or after 30 working days, if the report has not been received.
Where the Scheme Medical Adviser has requested a medical report they will complete their assessment and produce an outcome report and certificate within 45 working days of receipt of the case. See paragraph 14 for information about ‘The Scheme Medical Adviser’s assessment report’.