If your application for ill-health retirement under the NHS Pensions Scheme has been rejected or only partially successful at Tier 1 and you are thinking of appealing against the outcome, you may find the following information useful.

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The NHS Pension Scheme provides two levels of ill-health retirement benefits: Tier 1 and Tier 2.  Further information can be found at the following link: Applying for ill health pension benefits 

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Tier 1: The employee must be permanently incapable of carrying out the duties of their own job due to ill-health.

Tier 2: The employee must be permanently incapable of engaging in regular employment of like duration to their normal NHS Job due to ill-health.

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Appeals against the ill-health retirement outcome

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It is not uncommon for an ill-health retirement application to be unsuccessful or only partially successful. For example, in 2016, out of 3111 applications, only 1350 (44%) applicants were awarded Tier 2 benefits. Many employees do not appeal because the appeal process can be daunting. 

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If you wish to appeal against the outcome, you will have to follow an Internal Dispute Resolution (IDR) process, which has two stages. Stage 1 involves completing the DRP1 form, giving your details. You are expected to provide further medical evidence to support your appeal. You can request a medical report from your GP and/or hospital specialist for this purpose, but it is less likely that your GP or hospital specialist will have the knowledge of ill-health retirement criteria. Therefore, a comprehensive and specific occupational health report from a consultant occupational physician is likely to be more valuable to the success of your appeal. 

 

Seeking an expert occupational health report

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​Our consultant occupational physician has knowledge and extensive experience of the NHS pension scheme, its ill-health retirement criteria and appeal process.

 

We will

• review the available evidence, including medical and occupational health reports,

• carefully analyse the reasons given by the scheme's medical advisor for not supporting your ill-health retirement application.

• arrange an occupational health consultation and

• provide an expert report.

 

Our report will be comprehensive and cover the following:

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• List of evidence considered

• An overview of your health condition/s and functional capacity/limitations

• Aspects of your job activities that are relevant to IHR appeal considerations

• General approach to IHR assessment

• Analysis of a report from the NHS scheme medical advisor that you are disputing

• Application of the NHS IHR criteria and pension scheme rules

• Our recommendations on your IHR appeal

 

The report may strengthen your appeal and/or help you to consider whether to appeal against the outcome. If you wish to request an independent assessment and expert report, please complete an online self-referral form using the following link: IHR Appeal - Self-referral form

 

Please refer to our terms and conditions for this service.​

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