Ill health retirement from the NHS

[FARS4514]

I can see that this question has been covered several times in the past, however there is no harm is asking the question again, has anyone been successful in gaining ill health retirement from the NHS with fibromyalgia, we are going through this process at the moment with my wife, she is register disabled, suffers with fibromyalgia, FND, and NEAD and we have been informed that none of these conditions account for ill health retirement within the NHS.

[releasethemagic]

The pension scheme rules should tell you what you need to know. They will spell out the definition of disability for ill-health retirement and how you qualify for it. If you have had previous jobs and have final salary or career average pensions with those employers that come into payment at age 60, 65 or at State Pension Age if later, you should read the rules of those schemes too. Many pension schemes will allow a deferred pension to be paid early for health reasons, if you satisfy their definition of ill-health. They may ask you to see an Occupational Health Doctor to assess this. If the pension is paid early, sometimes it is reduced because it is being paid for more years. It depends on the rules of the scheme. Many schemes do not reduce the payments.

Evidence you will need to claim an ill-health pension could include GP records, letters from Hospitals and Consultants, any medical reports on your health, benefit assessments for ESA, PIP or DLA, insurance reports on your health, blue badge and so on. The onus is on you to demonstrate clearly that you meet the criteria for ill -health retirement.

If you have a defined contribution pension arrangement, the rules will differ. You can access it from age 55 in any case, regardless of health. To access it earlier, you need to meet the ill-health definition used by the provider of the scheme.

If you are in a Trades Union, involve them as they will have expertise in all of this.

Ill-health retirement costs pension schemes a small fortune. Just the pension can cost over £1 million for a 40 year old for the rest of their lifetime. For each £1,000 of Pension, the scheme has to set aside £40,000 in capital for you. That is why employers are so reluctant to give retirement to younger staff. When they do grant it, some carry out regular health reviews to see if you could return to some sort of work. The pension is not always for life. Private sector employers tend to be far meaner than the public sector pension schemes.

You will find some useful info about the NHS scheme here rcn.org.uk/get-help/rcn-adv...

[Hidden]

I worked for the council and you'll find that the illnesses might not count but the effects of the illnesses might. For example, when I was a manager I was told that depression isn't recognised as an illness but migraines and all the conditions that are due to depression are. Break down all of her illnesses and you'll see it looks more serious than a few illnesses written down. Just a thought. I've been medically retired for about 2 years now and I'm 53! I did have a great company occupational health doctor.

[CannibalSurfBabe in reply to Hidden]

Hello. I have had fibromyalgia for years. Living with the constant pain has left me with depression, lack of confidence and anxiety. That’s without even getting into 24/7 pain ranging from agony to just about manageable, the exhaustion from lack of sleep, migraines, etc etc

I work for the council managing public health, it’s a stressful job, exacerbated by the last two years of responding to the pandemic.

I have been working at home during all of that time. Which is an absolute godsend and has enabled me to just about manage.

I’ve had 3 substantial spells of fibromyalgia related sickness in the past 3 years. I’m teetering on the edge of going off again as I am so bad. I have started using a walking stick - reluctantly. And I have a wheelchair for times when I physically can’t walk.

I turned 60 in January and have taken the decision to ask my employer about ill health retirement. It’s a shame as I love my job and never expected to be in this situation.

My manager and my director have said that they are very supportive, although sorry to lose me.

So….. it’s very early stages. But any advice on what to expect, anything I can do to help get a good outcome, I’m pretty sure I qualify for Tier 1 and I’ve been very objective with informal online questionnaires.

I know you offered to help another poster but if you could help and guide me I’d be so grateful.

Thank you so much xx

[Ijo1]

Good Morning. I worked for a local council as a manager, I was employed by them for 35 years and I was retired on ill heath grounds in July last year at the age of 51. I have spinal degeneration and fibromyalgia but it was the fibromyalgia diagnosed January 2020 and it's effects that made them put me forward for the early retirement. There are 3 tiers of retirement and after my telephone consultation with the pension funds doctor I was awarded tier 1, which means I got full pension made up to normal retirement age and I receive that for life.

I had my GP and neurology consultant on my side and they both wrote fantastic reports to be presented to the pension fund via the councils occupational health unit. The doctor at the occupational health unit also supported the decision.

Your pension fund will have a booklet both hard copy and online that will tell you the criteria for early retirement on grounds of ill health so get a copy of that and understand the criteria. It is more about the ability to carry on working or not rather than the actual condition. The main thing I had to prove was that I wasn't fit to carry out my role any longer and that I wouldn't be able to get gainful employment in the future.

Get all the information you can and please message me if you require further information. Initially my HR department and occupational health nurse kept telling me that I would never get tier 1 as I was to young. That isn't part of the rules as age doesn't come in to it at all. You have to prove your not capable of holding down any employment for a minimum of 30 hours per week, well that was my pension funds rules. I found that the people putting obstacles in the way were jealous in some way of the fact that I was being put forward for retirement. I did actually say to the occupational health nurse and HR officer who were negative that if it was possible I would swap spinal condition and the fibromyalgia diagnosis with them for life and I would carry on in my career pain free. That shut them up and they then worked with me and stopped being negative.

I had tried working with the spinal condition for 3 years and changed my working pattern so I only went to the office 3 days and worked from home the rest of the time. I had had a new chair and a rise and fall desk so I could stand to work. I had tried counselling and physio and acupuncture through occupational health and worked with HR to try to stay in the workplace as retiring was the last thing I wanted to do as I loved my job. Try to work with them and ask them for help to stay in the workplace as they have to make reasonable adjustments for you. It also goes in your favour at the point of retirement that you have tried all these things. Make sure occupational health are involved as soon as possible.

Hope this help you in some way.

[Tjba]

Hi, I haven’t got experience of ill health retirement due to from the NHS but I did get ill health retirement due to Fibromyalgia from the civil service, and there are a lot of similarity between the rules for each. It was a long drawn out and stressful process. I went through two appeals and was turned down for both lower and upper tier pensions each time but I took it all the way to a final appeal panel at which I was awarded full upper tier ill health pension. My advice would be to persevere and go through all stages of appeal if necessary and also consider paying for a private rheumatologist to do an independent examination and report -it only costs a couple of hundred pounds and was vital evidence in my case, as the Rheumatologist put in his report that I had tried all possible remedies, was unlikely to improve and was unable to do any work - which ticked off all of my pensions schemes ill health criteria. Good luck.

[ButtercupDaisy in reply to Tjba]

Hi Tjba,

I hope that now you are retired you are not suffering from your fibro as much and are enjoying life that but more. Do you feel better and are you symptoms improving as a result?

I am also CS and considering applying for IHR subject to a second OH referral. I had a Fibro diagnosis from a rheumatologist a few years ago and I remain under his care but due to COVID haven’t seen him for a year and all physical therapies have been on hold. Tried all the usual meds, therapies and Pain Management clinics but am progressively getting physically and mentally worse. Concentration) and focus levels are plummeting. Similar reasonable adjustments to yours have been made and I can’t see what else they can do so it will be interesting to see if OH come up with anything new. Sick absences are many and frequent with Attendance Management procedures and half pay looming.

Do you mind me asking on what grounds they initially turned you down, how old you were when they retired you and did you get enhancement on your pension? I want to go for it but am worried if I don’t get it they will get rid of me on capability grounds. What finally nailed it for you?

TIA

[Tjba in reply to ButtercupDaisy]

Hi DustyBlues, I’m finding life much less stressful now I’m retired and that seems to help with reducing flares. Though this cold weather isn’t helping just now as it seems to make my symptoms much worse.

They initially turned me down on two issues-firstly because they thought there may still be treatments which could help me return to work and secondly because my anxiety (which has never been particularly severe) could be making the fibromyalgia worse (this was despite a note from my gp and from my rheumatologist saying I had severe fibromyalgia and was unlikely to improve). I then appealed and provided further info from both the pain clinic and my gp, giving details of all the treatments I’d already had but they turned down the first appeal, saying they still believed that further treatment for my anxiety might help my fibromyalgia get better (even though I’d had one to one counselling and CBT as part of my pain management programme).

I almost gave up at that point but I persevered and sent in my second appeal. I included a note from yet another rheumatologist which stated that my condition was severe, I’d undertaken all relevant treatments and was likely to remain in a severe condition til pension age. I also included a note from the psychologist who had delivered my pain management programme, saying that I had responded really positively to the pain management programme and had the tools to manage my pain but that did not mean the pain would go away etc. Believe it or not that second appeal was also rejected. At that point they said they accepted that my condition was permanent but they still thought that better treatment for my anxiety might improve my symptoms! But they offered an opportunity to go to an independent panel. The independent panel comprised of two people, one of whom was a psychologist. They made it clear at the beginning of the meeting that they couldn’t understand why I hadn’t already been awarded my pension. They asked me a few questions and then told me my anxiety was minor, had no impact on my fibromyalgia, they didn’t believe I could sustain any meaningful work and were going to award me upper tier (I was in the alpha scheme).

On the capability issue, if you’re CS your employer shouldn’t dismiss you whilst you’re going through the ill health retirement application process. Once your full and half sick pay finished, they should offer to sick pay at pension rate until your ill health retirement process as finished.

Hope this helps, happy to help with any further questions, Tracy

[Tjba in reply to Tjba]

Oh and I was 49 when awarded my pension

[ButtercupDaisy in reply to Tjba]

Hi Tjba,

That is all very useful information. Thank for taking the time to explain. We are a similar age too so I strike a few chords with you. Had you had your diagnosis for a long time before you applied for IHR? I had mine 3 years ago from the rheumatologist but GP noted it over five years ago. Also and you had a lot of sick absences?

The cold plays havoc with my symptoms too. Stress also induces flares but it's never been stated on a fit note. Is this best avoided given what you said about quoting anxiety?

In your experience, am I better off asking my GP and Rheumatologist to write supporting letter to go with my initial application as I really can't face 3 goes at this! My marriage is on the rocks and my son seriously ill with a life threatening condition which significantly affects our lives. Life and work is very stressful as a result and my fatigue never goes away. Yet I sleep well, which I understand is unusual for Fibro sufferers.

These stress factors are no doubt exacerbating the Fibro but if quoted as inducing Fibro on any IHR application would probably work against me as they are not 'permanent' issues, just difficult personal ones.

Sorry for so many questions - I have a racing mind when I start in this vein!

Thanks

[Tjba in reply to ButtercupDaisy]

No problem, ask as many questions as you like. So sorry you’re going through such a horrendous time just now

I was only diagnosed with Fibro about eight months before my Ill health retirement but I’d had problems going back around 12 years. I’d had a few sickness absences due to muscle pain and Trigeminal neuralgia, both of which I know now are linked to my Fibro. But no long term sickness absence until I went off sick in sept 2018 with a huge Fibro flare and never went back to work. Diagnosed with Fibro (and Joint Hypermobility Syndrome) shortly after, did a pain management programme early 2019 and applied for ill health retirement in April 2019, two appeals and an independent panel later and I was awarded the pension in Nov 2019.

I can’t really advise re the anxiety issue but certainly it seemed they were looking for any reason as to why I might get better.

If you are able to, I would get both your gp and Rheumatologist to give you a note for your initial application. If possible, show them the actual Ill health criteria for whichever pension scheme you are in and ask them to refer to that in their notes. If they turn you down first time and you go to appeal you will need some further evidence (they will give you a reason why the initial application has failed so any further appeal evidence should address the reason why they have turned you down). So you may then have to arrange to see another specialist and get a report from them. But whatever happens and however hard it seems don’t give up, go through the whole process and all appeal stages if needed-a large proportion of cases are approved at the appeal or final independent panel stages.

Tracy

[ButtercupDaisy in reply to Tjba]

Thanks for that Tjba. Very useful info again.

Today I received notice that my paid sick absence is about to end and I will move to nil pay shortly. I should be eligible for SPPR.

Given your sick absence including appeals was over 12 months, did you apply and were you granted it? If so how is it calculated and how long can it be payable for?

My TL is clueless and it's impossible to speak to someone at HR!

Thanks

[Tjba in reply to ButtercupDaisy]

Hi, The sick pay at pension rate can be paid for as long as it takes to complete the ill health pension application (including any appeals). If you’re in alpha, it’s paid at the lower tier Ill health pension rate. If you’re in Classic there is just one tier of ill health pension. Civil Service Pensions do the calculation.

I didn’t formally apply for the SPPR, I just asked my line manager. In your situation, I’d email both your line manager and HR asking to be paid SPPR whilst your ill health pension application is ongoing,

Tracy

[Crimsonpoppy1 in reply to Tjba]

Hi. I hope you see this as I’mAnswering an old post. I paid for a private rheumatologist and the OH doctor assessing me for my employer rejected it because it was private and claimed it wasn’t detailed enough and because he’d only seen me once ! Any advice ?

[ButtercupDaisy in reply to Crimsonpoppy1]

Oh that’s not at all fair. The OH people don’t even see you when they assess you!

I’ve just paid for a private report to send off with my IHR application so hope I don’t get the same attitude.

Who is your OH provider and /or employer? Mine is HML and I am Civil Service.

[Sandymits]

Hi FARS

I do have experience of ill health retirement from the NHS. I was successful in getting my NHS pension at lower tier level because I suffer with fibromyalgia/CFS.

I was turned down initially with 3 reasons being cited. Firstly, my age on application being fairly young, I was in my mid 40’s. Secondly, I had not been under the care of a specialist centre. Thirdly, it was my first application.

I appealed on the grounds that I had attempted to access a specialist treatment centre through my GP but was denied NHS funding for the service. My GP has taken my case to funding panel twice.I had also had my contract terminated due to ill health caused by fibromyalgia on 2 separate occasions. I was a nurse sister on the district on both occasions. I had 22 years service as a nurse.

It took over a year to challenge the initial decision and it was very stressful but I was successful in getting My pension award at the lower level tier.

I can recommend TPAS, the Pensions Advisory Service for invaluable advice and support as I found the whole process fairly complicated especially whilst coping with a severe flare up which lasted years. It was an awful time for me as I felt a great loss on losing my nursing career.

Don’t give up and good luck.

[FARS4514 in reply to Sandymits]

Thank you, it’s for my wife she suffers with Fibromyalgia, FND and NEAD, my wife is 40 this year, we get the feeling they just want to get rid ASAP, it’s breaking both our hearts.

[Spaghetti123 in reply to FARS4514]

Hi Fars it’s not helping that covid is stopping any help. I feel this is being used against many of us who have been ill during the pandemic. I feel they will say with help, therapy and physio our fibro will go.

[Sandymits]

Oh bless you both. It is truly dreadful. Life does go on though. There is a new way of living that does not involve working for the NHS. We are more than just a job.All the best and keep well as can be. Things do work out in the end, not the same, just different xxx

[FARS4514]

Thank you, stay safe, xx

[Sugarhobbit]

Hi there.

I am a staff nurse in the NHS. I was first medically retired from the NHS when I was 25 with chronic fatigue syndrome and after 4 years I got my ill health retirement pension backdated after being denied it to start with. After 7 years of retirement I became well enough to return to work as a nurse part time in the NHS. Last year I had been back in work part-time for 20 years and I have been off long term sick for a year now with a very bad flare and the first time I have been off with my condition as I kept it under control. However I was not improving etc so I was referred to a rheumatology consultant where I work and last September I was diagnosed with fibromyalgia as well. My stage 3 meeting was yesterday and my contract will be terminated on the grounds of incapability of ill health and my 3 months notice period runs out 2nd April and I will be 52 then. My union rep is going to help fill the forms in for NHS retirement. My occupational health Dr says it's not up to him to say I will get it as it is far different from when I last got it. He has got all the evidence collected from the consultant and chronic fatigue clinic and physio to support the application. It will be sent to an independent medical company which takes a month to decide if I am eligible and if for tier one or tier 2. The drs are hoping for tier 2. They say it is on an individual basis and some people get it and some don't and have to appeal so I am crossing my fingers. I hope this helps your question. All reasonable adjustments in the job have to have been made etc there is a criteria. They do not give you any idea of what you might receive until you go through the process. Good luck, Sugarhobbit x

[FARS4514]

Hi Sugarhobbit, they have not mentioned anything about reasonable adjustment, my wife has asked if she could start working part time from home performing admin duties or as part of the triage team, but they have said that they are not prepared to do this under health and safety reasons because of the seizures. My wife's sick pay does not end until May, the occupational health doctor has recommended that my wife is allowed to continue receiving sick pay until May but they are not prepared to do this, they have given my wife the option of a 12 months career break to see if she is able to regain her health, or dismissal with 7 weeks pay its a total nightmare. x