Improving the Ill Health decision making process

Scheme Member’s Appeals

Local Government Pension Funds (including Staffordshire Pension Fund) continue to receive Scheme members Internal Dispute Resolutions Procedure (IDRP) appealing against the Employer’s Ill Health decision making process. This has resulted in an increased number of IDRP’s and the involvement of the Pensions Ombudsman.

More often than not the member’s complaint is based on the medical evidence the Employer has based their decision on is unsound or missing key medical evidence.

Consequently, we would like to highlight the importance of scheme employers obtaining narrative reports from Independent Registered Medical Practitioners (IRMPs) in dealing with ill-health retirement cases.

Narrative Reports

Narrative reports are reports that help employers to understand the reasoning behind the medical opinion the IRMP has given. As the decision to award an ill-health retirement is that of the employer, a full understanding of the IRMP’s reasoning will be important to minimise the risk of the employer making a poor or flawed decision, potentially resulting in a mal-administration claim from the member.

Recommendation to Improve the Ill Health Process

Scheme Employers will have their own procedures in place. However we would like to remind employers that we have previously produced two guidelines and template forms (one for active members and a further one for deferred members) which may assist you when you consider a members ill health application (please see the attachments below ).

The guidelines / template sets out

  • the information / reports that the IRMP should provide employers with
  • the relevant test
  • the role of the employer

Ill Health Template

  • Please note the template has been produced to strengthen the Employer’s decision-making process and reduce the number of member appeals.
  • Completion of the template is optional and should be retained by the employer
  • Once completed the template will contain personal sensitive information, therefore under General Data Protection Regulations the template must not be sent to the Staffordshire Pension Fund, however the Fund will require our completed ‘Medical Certificate’ from the website.

Ill Health Guidance Active 2021 (395 Kb)

Ill Health Guidance Deferred 2021 (439 Kb)

If you have any questions in relation to the use of these Templates, please contact Simon Jackson (01785) 276450