Help Please - Ill Health Retirement Advice/ Experience

bufforpington

Hello :hello:

I wondered if anyone has experience of applying for ill health retirement due to RSI/ WRULD or a condition that is difficult to diagnosis/ give a prognosis for such as ME/ CFS or Fibromyalgia, please? Or simply struggled to be awarded IHR or had to appeal with any condition.

I would welcome any advice from you if so, as I have stage three non-specific RSI and as a result displaced pain in my upper limbs which has developed to the point were I am unable to walk due to the pain and have to be pushed in a wheelchair if I need to go out.

I am currently receiving DLA HRC and am in the ESA Support Group (for the time being at least – fingers crossed!) and my OH has to help me with everything (including typing this) due to the severity of my condition but despite what I thought was a comprehensive application for IHR I have been refused on the grounds that:

“in the absence of a clear pathological condition causing my pain symptoms it is very difficult to make a judgement about prognosis”

“Given (Buff’s) young age the scheme requires a judgement that (Buff) is likely to be incapacitated from undertaking (Buff’s) role or a similar role for the next 26 years. The evidence provided is not sufficient for the panel to make this judgement”

My consultant supported my IHR application and has stated this in his letter which was included with the application, he also said that:

“(Buff) is highly unlikely ever to return to any form of employment in the foreseeable future” and “I think any form of employment is a totally unachievable goal” along with “I do not think that conventional medicine has any further part to play in (Buff’s) condition and that (Buff) is purely looking at management issues”.

He also confirmed my diagnosis which all professionals I have seen have agreed on: “bilateral non specific work related upper limb disorder”.

Whilst I realise his statements could have been slightly stronger and more specific, the rest of his letter was in a similar vein and the health professionals who have seen it have all said it is a strong letter which must have been difficult for me to read given the 'end of the road' nature of it after constantly trying different treatments for 2 and 1/2 years.

Almost every medical person I have seen has been extremely supportive and recognised that I have tried absolutely everything I can to improve/ cure/ manage my condition with no improvement what so ever, and in fact it has worsened. And I included other such documents in my application from OT and Occ Health to this effect.

Due to my circumstances I must appeal the decision as there is no prospect of any improvement and I need the financial support to just survive as it is a struggle at the mo with only benefits.

My union rep has been fantastic throughout my illness and is very surprised/ disappointed/ angry that my application has been refused and will help me with my appeal. She is currently taking advice from colleagues about the decision etc.

I would welcome any advice from people who have been through this process especially an appeal, as it is so difficult to know the best approach and perhaps what I have missed in the initial application especially as this is my last chance.

The appeal consists of completing a letter with my grounds for appeal plus any further medical evidence submitted by my GP or Consultant.

I plan to approach my consultant to see if he can strengthen his letter, although I am not sure if he will, given he has already written one letter and is quite fierce. I had been thinking that perhaps I should see a consultant privately for a diagnosis and prognosis which would hopefully be more specific. Has anyone else done this? Do you have any advice about who, how etc?

Any advice, support or experiences would be gratefully received, as I am feeling so overwhelmed by what to do for the best and have no idea about how I might succeed! :think:

Thanks for reading and I hope someone out there may be able to help. :fingerscrossed:
Buff

PS. Sorry for the long post but I thought the detail may help....

DomRavioli

How old are you? You don't state in your post, therefore retirement may not be a feasible option.

mazza111

I was IHR last year, but I'm glad to say it was a very straight forward procedure. I was already under ATOS via telephone consultations for about a year, they then sent me for a medical. I finished up work a couple of weeks later.

Although I didn't receive my pension as yet, as they seemed to think I would be able to do other work. Unfortunately because of the condition I had, I got out the bath, knee gave way, and managed to do damage to my spine and shoulder. So a big BLAH!

rogerblack

bufforpington wrote: »

“Given (Buff’s) young age the scheme requires a judgement that (Buff) is likely to be incapacitated from undertaking (Buff’s) role or a similar role for the next 26 years. The evidence provided is not sufficient for the panel to make this judgement”[/I]

You need to find the original terms under which you signed up, and then see if there are any procedures they aren't following.

Is there any procedure to claim this only for a limited period?
Perhaps it could be granted for 5 years, with a review.

Then there are separate arguments - for example, have they treated other classes of people more favourably than you.

It may be useful to show the consultant the letter.

The problem is that he will may agree.

Your consultant can see no good reason for recovery.
This is not quite the same as what the panel is looking for 'recovery is unlikely in 26 years'.

What might be useful is if the consultant can say 'of the xx patients I have observed with this condition, y% of them have remained in a similar state for z years.'.

But it's unlikely he can, where y is over 51, and z is over 26.

Failing that, clinical studies may be of use.

http://www.ncbi.nlm.nih.gov/pubmed?term=%22repetitive%20strain%20injury%22 for example is a list of studies.
Most of these are going to be useless.

Saversue

gregbythesea wrote: »

It's a great pity that you don't work for the civil service.

A friend of my daughter aged 23, suffered a sports injury to his back when he was 18.
He obtained a similar report that said that it was most unlikely that he would ever be able to work again.

He was pensioned off immediately with a full pension - 40/60ths of his salary + a lump sum of 4 x his pension.

His salary was £23000pa - receives an annual pension (increases every year) of £15,333 a year plus a lump sum of £61,300.

He only worked there for 8 years!!

The best bit is that some 4 months after receiving his payoff he found new employment doing a similar job in private practice on a salary of £36,000pa!!!

They cannot recover his pension or lump sum as he says that it was a 'miraculous' recovery. Ummmm yes!

I don't think he would have got a full pension of 40/60th's for only working 8 years. In order to get that you usually have to work for 40 years or get an enhancement which when i was forcibly retired from teaching after 25 years I was given the maximum award of an extra 7 years, making a total of 32/60th's. So my Pension started out at just over half my final best years salary for my last 3 years of employment.Plus a lump sum which depended on how many years service was involved.

If he only worked for 8 years then the final pension should be something like 8/60th's of his final salary and if he can work again he is not entitled to that at all as it is given on the condition you will never be fit for work and if things change to have to inform your pension provider who will stop the pension

Parva

Saversue wrote: »

I don't think he would have got a full pension of 40/60th's for only working 8 years. In order to get that you usually have to work for 40 years or get an enhancement which when i was forcibly retired from teaching after 25 years I was given the maximum award of an extra 7 years, making a total of 32/60th's. So my Pension started out at just over half my final best years salary for my last 3 years of employment.Plus a lump sum which depended on how many years service was involved.

If he only worked for 8 years then the final pension should be something like 8/60th's of his final salary and if he can work again he is not entitled to that at all as it is given on the condition you will never be fit for work and if things change to have to inform your pension provider who will stop the pension

Wouldn't worry Saversue, it's only the resident troll in his latest guise attempting to get a rise out of people because he has nothing to do other than await PiP nailing him.

Debt_Free_Chick

bufforpington wrote: »

Hello :hello:

I wondered if anyone has experience of applying for ill health retirement due to RSI/ WRULD or a condition that is difficult to diagnosis/ give a prognosis for such as ME/ CFS or Fibromyalgia, please? Or simply struggled to be awarded IHR or had to appeal with any condition.

I would welcome any advice from you if so, as I have stage three non-specific RSI and as a result displaced pain in my upper limbs which has developed to the point were I am unable to walk due to the pain and have to be pushed in a wheelchair if I need to go out.

I am currently receiving DLA HRC and am in the ESA Support Group (for the time being at least – fingers crossed!) and my OH has to help me with everything (including typing this) due to the severity of my condition but despite what I thought was a comprehensive application for IHR I have been refused on the grounds that:

“in the absence of a clear pathological condition causing my pain symptoms it is very difficult to make a judgement about prognosis”

“Given (Buff’s) young age the scheme requires a judgement that (Buff) is likely to be incapacitated from undertaking (Buff’s) role or a similar role for the next 26 years. The evidence provided is not sufficient for the panel to make this judgement”

My consultant supported my IHR application and has stated this in his letter which was included with the application, he also said that:

“(Buff) is highly unlikely ever to return to any form of employment in the foreseeable future” and “I think any form of employment is a totally unachievable goal” along with “I do not think that conventional medicine has any further part to play in (Buff’s) condition and that (Buff) is purely looking at management issues”.

He also confirmed my diagnosis which all professionals I have seen have agreed on: “bilateral non specific work related upper limb disorder”.

Whilst I realise his statements could have been slightly stronger and more specific, the rest of his letter was in a similar vein and the health professionals who have seen it have all said it is a strong letter which must have been difficult for me to read given the 'end of the road' nature of it after constantly trying different treatments for 2 and 1/2 years.

Almost every medical person I have seen has been extremely supportive and recognised that I have tried absolutely everything I can to improve/ cure/ manage my condition with no improvement what so ever, and in fact it has worsened. And I included other such documents in my application from OT and Occ Health to this effect.

Due to my circumstances I must appeal the decision as there is no prospect of any improvement and I need the financial support to just survive as it is a struggle at the mo with only benefits.

My union rep has been fantastic throughout my illness and is very surprised/ disappointed/ angry that my application has been refused and will help me with my appeal. She is currently taking advice from colleagues about the decision etc.

I would welcome any advice from people who have been through this process especially an appeal, as it is so difficult to know the best approach and perhaps what I have missed in the initial application especially as this is my last chance.

The appeal consists of completing a letter with my grounds for appeal plus any further medical evidence submitted by my GP or Consultant.

I plan to approach my consultant to see if he can strengthen his letter, although I am not sure if he will, given he has already written one letter and is quite fierce. I had been thinking that perhaps I should see a consultant privately for a diagnosis and prognosis which would hopefully be more specific. Has anyone else done this? Do you have any advice about who, how etc?

Any advice, support or experiences would be gratefully received, as I am feeling so overwhelmed by what to do for the best and have no idea about how I might succeed! :think:

Thanks for reading and I hope someone out there may be able to help. :fingerscrossed:
Buff

PS. Sorry for the long post but I thought the detail may help....

Please post exactly what the scheme rules state as the definition of incapacity, or any other rule that relates to IH early retirement.

bufforpington

DomRavioli wrote: »

How old are you? You don't state in your post, therefore retirement may not be a feasible option.

DomRavioli,

Thank you for your reply. I am 34 years old. I am not quite sure what you mean about retirement not being a feasible option. Perhaps you could clarify please?

Thanks
Buff

bufforpington

gregbythesea wrote: »

It's a great pity that you don't work for the civil service.

A friend of my daughter aged 23, suffered a sports injury to his back when he was 18.
He obtained a similar report that said that it was most unlikely that he would ever be able to work again.

He was pensioned off immediately with a full pension - 40/60ths of his salary + a lump sum of 4 x his pension.

His salary was £23000pa - receives an annual pension (increases every year) of £15,333 a year plus a lump sum of £61,300.

He only worked there for 8 years!!

The best bit is that some 4 months after receiving his payoff he found new employment doing a similar job in private practice on a salary of £36,000pa!!!

They cannot recover his pension or lump sum as he says that it was a 'miraculous' recovery. Ummmm yes!

gregbythesea,

Thank you for posting about your daughter's friend and their experience, it's interesting to know how applying for IHR has worked out for others.

Thanks
Buff

bufforpington

mazza111 wrote: »

I was IHR last year, but I'm glad to say it was a very straight forward procedure. I was already under ATOS via telephone consultations for about a year, they then sent me for a medical. I finished up work a couple of weeks later.

Although I didn't receive my pension as yet, as they seemed to think I would be able to do other work. Unfortunately because of the condition I had, I got out the bath, knee gave way, and managed to do damage to my spine and shoulder. So a big BLAH!

mazza111,

Thank you for letting us know about how the IHR procedure went for you. I am pleased to hear it was straight forward. I am sorry to hear you haven't received your pension yet though, I hope that it is sorted out soon for you. Sorry to hear about your knee as well, I hope you are able to find a way to treat or manage with the additional damage.

Best wishes
Buff

bufforpington

rogerblack wrote: »

You need to find the original terms under which you signed up, and then see if there are any procedures they aren't following.

Is there any procedure to claim this only for a limited period?
Perhaps it could be granted for 5 years, with a review.

Then there are separate arguments - for example, have they treated other classes of people more favourably than you.

It may be useful to show the consultant the letter.

The problem is that he will may agree.

Your consultant can see no good reason for recovery.
This is not quite the same as what the panel is looking for 'recovery is unlikely in 26 years'.

What might be useful is if the consultant can say 'of the xx patients I have observed with this condition, y% of them have remained in a similar state for z years.'.

But it's unlikely he can, where y is over 51, and z is over 26.

Failing that, clinical studies may be of use.

for example is a list of studies.
Most of these are going to be useless.

rogerblack,

Thank you for your very comprehensive and helpful reply, it's much appreciated.

With regards to procedures, it is difficult to know if there are any they are not following, as the available rules and info about IHR do not seem to cover the medical panels decisions apart from to say that: "Any determination made by the trustee company under this rule shall be made on the balance of probabilities, having regard to a medical opinion.".

In terms of claiming for only a limited period, there is nothing in the rules to suggest this is possible, however it does state that: "the Trustee Company has discretion to review any incapacity pension, prior to reaching age 65, to reflect any changes to the medical condition giving rise to the incapacity retirement.". My thought is that it is probably worth including a point about this in the appeal. It probably won't be paid any heed to but I think it is an important consideration given the type of condition/ my age. I would be more than happy to have a medical every 5 years and would be the first to say I don't need a pension any more if only I could be well!

Yes I agree about the consultant, I will show him the letter, but as you say it is quite possible he will not want to clarify his statement or may agree with the letter. At the time he wrote the letter he was clear he had all the info needed. Your suggestion about X and Y is helpful though and could be a way forward, especially given he has a wealth of experience. Worth a try...

Thank you for the link about clinical studies. I will look in to that in more detail, although what I have found to date unfortunately does not support my circumstances as I am one of the small percentage who seems to have developed irreversible damage. But may be there will be something.

My union rep is following up with colleagues to try and find out if there is any that we can use whether it is rules, procedures, precedents that have been set from other cases, other points etc. Hopefully she will come up with something or at least some advice about how best to handle the appeal.

Thanks again
Buff