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Tier 1 appeal nonsense!

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Hi all, I'm looking some advice on an ill-health pension.

I was recently forced to retire on ill-health grounds from my nursing career of 20+ years. I have only had a pension from 2000/2001.

I was awarded a Tier 1 on the grounds I was incapable of doing my NHS job but deemed OK for other work. My GP, Occ Health Dr and a specialist all amended their reports to clarify that I'd never be fit to work again yet the result landed today, (been sent to the wrong dept and lay there for 2 months but managed to assess it and post out the result in less than 5 days that I still only am to receive a tier 1. :angry:

I left work due to M.E. but this is complicated by joint and back pain, RLS/WED and on top of that I've become depressed after loosing a much loved career and my ability to function/enjoy life.

How can this be if I have 3 Drs saying I'll never work again - 3 Drs who have all met me and fully assessed me, (my Occ Health Dr spent nearly 2 years seeing me and my GP has dealt with me for 30+ years)?

I am unable to see if there would be a big difference in the Tiers so don't even know if its worth fighting it?

Anyone able to shed any light or offer advice as to what to do now?

thanks for your time.

Comments

  • raffs
    raffs Posts: 25 Forumite
    Eighth Anniversary 10 Posts Combo Breaker
    Just to add at no time have I been given a reason as to why the Tier 2 has been refused. other than I don't satisfy requirements.
  • Have you made a formal complaint about the decision under the scheme's internal dispute resolution process (IDRP)?

    The Pensions Advisory Service (TPAS) can give you guidance on your options, how to frame any complaint and a steer on the likelihood of success.
  • raffs
    raffs Posts: 25 Forumite
    Eighth Anniversary 10 Posts Combo Breaker
    I've appealed once but I thought that was down to the Dr's saying I wouldn't be able to nurses again, in their revised letters all 3 said I'd never work at anything again.

    I've contacted TPAS and they have asked that I send them my info by post.

    Thanks for getting back to me so quickly.
  • System
    System Posts: 178,352 Community Admin
    10,000 Posts Photogenic Name Dropper
    Hi

    I suspect you can appeal and / or apply for a re-assesment based on any new evidence.

    http://www.nhsbsa.nhs.uk/Pensions/Documents/Pensions/Illhealth_Retirement_Guide_-_final_Jan_09.pdf

    8.3
    Movement between tiers (1)
    -
    movement from tier 1 to tier 2
    There may be limited circumstances where medical advisers assess that a member may
    become eligible for a tier 2 pension within a limited time
    -
    period of no more than 3 years after
    approval of a tier 1 pension. This
    is a decision that would be made at the time of initial
    application.
    It is agreed that the NHS BSA Pensions medical advisor will have the option of giving leave
    for a one off reassessment within 3 years to consider
    tier 2. In these instances, the NHS
    BS
    A Pensions medical advisor will be satisfied that the member meets the tier 1 criteria, but
    that the nature of the condition makes it difficult to assess the longer
    -
    term outcome in terms
    of ability to permanently undertake regular employment of like durati
    on. It is up to the
    member to request such a reassessment within 3 years at a time of their choosing and to
    submit further medical evidence. Such a reassessment would consider the condition(s) upon
    which the original decision was made and would be informed
    by the further medical
    evidence. Neither subsequent conditions, nor deterioration related to ageing would be taken
    into account.
    The central issue for the NHS BSA Pensions medical adviser will be the level of uncertainty
    about the prognosis of the relev
    ant medical condition and resultant incapacity for regular
    employment of like duration in the period to the NBA. These will be cases where a period of
    time, within 3 years may well give clarity about the likelihood or not of significant progression
    or imp
    rovement occurring or not. These will benefit from the 3 year reassessment.
    Any decision to award a tier 2 pension at reassessment would take effect from the date of
    reassessment.
    The recommendation of a Tier 1 with leave for a reassessment for the cons
    ideration of Tier 2
    within 3 years does not place any additional constraint on the pensioner‟s ability to engage in
    other work in comparison with a straight Tier 1 award; however, if the pensioner is mindful to
    request a reassessment, and is working at tha
    t time, then that pensioner should be aware of
    the requirement to make an earnings declaration should they be successful in attaining a Tier
    2 award. Whilst the Regulations require the pensioner to submit medical evidence at the
    time of the request for a
    reassessment, the NHS BSA Pensions medical adviser will also
    wish to have information about what the pensioner‟s occupational activities have been, since
    the Tier 1 award was made, in order to assess the likelihood of the Tier 2 criteria having now
    (at rea
    ssessment date) been reached in terms of permanence to NBA.
    Employer
    G
    uid
    e

    Ill
    Health Reti
    rement 01.2009
    21
    8.4
    Movement between tiers (2)
    -
    movement from tier 2 to tier 1
    Those in receipt of tier 2 pensions will be able to undertake some employment. However,
    earnings from employment may impact upon pensio
    n entitlement. The pensioner will be
    subject to an annual earnings declaration. This process would continue until age 60 for those
    who remain members of the Amended 1995 Section and 65 for new entrants and members
    who transfer to the 2008 Section.
    (1)
    Pensione
    rs in receipt of tier 2 benefits who return to substantive employment outside of
    the NHS. In these circumstances
    -
    (a)
    A pensioner has the ability to earn up to the equivalent of the National Insurance
    Lower Earnings Limit (LEL; stands at £4,680 in tax year 20
    08/9) each tax year
    without losing access to a tier 2 pension
    (b)
    If pensioners exceed the LEL they will move down to tier 1 entitlements
    -
    a
    substitute Tier 1 pension at the point the limit is exceeded
    (c)
    Pensioners will be afforded an opportunity before NBA to r
    e
    -
    access tier 2 benefits
    if it subsequently proves that they are unable to continue in that employment.
    (d)
    To support a reinstatement of the original Tier 2 pension from the substitute Tier
    1 pension, a pensioner must have supplied medical evidence. The NHS
    BSA
    Pensions medical adviser will consider this evidence, in relation to the original
    Tier 2 condition assessment and advise if it represents that the pensioner does
    meet the criterion of being permanently incapable of regular employment of like
    duration.
    (2)
    Pensioners in receipt of tier 2 benefits who return to substantive employment within the
    NHS
    -
    (a)
    Where a pensioner earns below LEL in any tax year from any NHS employment,
    entitlement to tier 2 will only remain for 12 months from the start of that
    employment
    . After that time any NHS earnings will lead to a reduction to a
    substitute tier 1 pension
    (b)
    If pensioners exceed the LEL during this 12 month period they will move to a
    substitute tier 1 pension at the point the limit is exceeded
    (c)
    Pensioners will be able to
    ask NHS BSA Pensions to be assessed for a return to
    the original Tier 2 pension if it subsequently proves that they are unable to
    continue in that employment.
    (d)
    The pensioner would have to apply to NHS BSA Pensions within this 12 month
    period to be assessed
    for a return to the original Tier 2 pension
    (e)
    To support a reinstatement of the original Tier 2 pension from the substitute Tier
    1 pension, a pensioner must have supplied medical evidence. The NHS BSA
    Pensions medical adviser will consider this evidence, in
    relation to the original
    Tier 2 condition assessment and advise if it represents that the pensioner does
    meet the criterion of being permanently incapable of regular employment of like duration
    This is a system account and does not represent a real person. To contact the Forum Team email forumteam@moneysavingexpert.com
  • raffs
    raffs Posts: 25 Forumite
    Eighth Anniversary 10 Posts Combo Breaker
    I have already supplied further information to the DWP with 3 Drs all clarifying that I wont be fit to work again so it is somewhat confusing that someone who hasn't seen me and is supposedly working on their information can come up with a different outcome!

    It is very frustrating and stressful and not good for my health!

    I've been told I should consider getting a solicitor, has anyone else gone down this route?

    There is a plethora of information/research on my conditions with much of it claiming they are progressive and in order to heal one condition I would have to get rid of another one!! Would there be any point in me sending off that research or are they likely to ignore that along with the Drs recommendations?
  • Unless you can get free legal representation it shouldn't be a necessity and it could be expensive. TPAS' help is free as is taking a case to the Pensions Ombudsman - although you need to complete the two stage IDRP in order to do this.
  • System
    System Posts: 178,352 Community Admin
    10,000 Posts Photogenic Name Dropper
    Hi

    The NHS pension is from your (ex-)employer, and they are the ones to deal with.

    IDRP is a good place to start.

    But the re-assessment would be with your (ex-)employer and their occupational health.

    I don't see where the DWP are involved in this, it is an ill-health retirement from the NHS and that is the focal point (IDRP).
    This is a system account and does not represent a real person. To contact the Forum Team email forumteam@moneysavingexpert.com
  • raffs
    raffs Posts: 25 Forumite
    Eighth Anniversary 10 Posts Combo Breaker
    johndough wrote: »
    Hi

    The NHS pension is from your (ex-)employer, and they are the ones to deal with.

    IDRP is a good place to start.

    But the re-assessment would be with your (ex-)employer and their occupational health.

    I don't see where the DWP are involved in this, it is an ill-health retirement from the NHS and that is the focal point (IDRP).

    I haven't been working since June of last year, would my old occupational health still see me?

    The OH Dr was very supportive at every step of the way and would imagine if they were to see me they would still be so.

    I suppose I have just said its the DWP, it is whomever 'assess' the application for ill-health retirement.
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