NHS pension and 3 year review to change to tier 2

[Tommytimmles]

Hello

I am in receipt of a tier 1 NHS ill health pension. I was given a 3 year option for a review. Part of the reason for not granting tier 2 ( unable to permanently work in any capacity ) was that l should attend pain management, migraine clinics and that l could do admin work under a flexible working pattern. I have tried various drugs, has CBT and physio to no avail. Has anyone gone through this process of a 3 yearly appeal and could guide me. I have not been referred to pain management nor migraine services as my GP has been managing me. Many thanks

[Dinkie]

Haven't gone through this myself, however I would imagine that reports would be required. Could your GP not refer you to one of the fibro clinics. I went to the Guys & St Thomas's one. It is only one appointment where you would see several specialists and they then prepare a report for your GP to action. This would, I assume, count as documentary evidence of where you are fibro wise. If the pension company think you should have attended pain management etc I could see this being a sticking point.

I know from experience with the legal side of employment etc that pension companies will want every i dotted and t crossed before they will consider any changes.

Hopefully someone with the relevant experience will be along to add their thoughts.

[Tommytimmles in reply to Dinkie]

Many thanks for replying. I will ask again but l think referrals are limited and they expect the GP to manage. I have had fibro 15 years now.

[Dinkie in reply to Tommytimmles]

Getting a referral to the clinic took me 2 years. I have learned now that any request for a referral must be done in writing to your GP it then forms part of your notes. Verbal requests are often not noted down. Follow up any written referral with a telephone consultation. When I followed this method I managed to get the referral. After all it is only one appointment no follow ups required, so not exactly a great drain on the services. I got the referral many years after my diagnosis. My GP was very anti referrals - her comment- they can't do anything more than I can do for you - she was so very wrong. GPs cannot be experts in all fields nor should we expect them to be but equally they should also be willing to refer when necessary.

[Tommytimmles in reply to Dinkie]

Thank you l will ask the GP for a referral but l am time limited now till l can get a review.

[releasethemagic]

For private sector pension schemes, reviews to decide if an ill-health pension should continue to be paid are common and they use any excuse to stop the money. From my reading of the NHS pension scheme rules, you are fortunate that a Tier 1 pension cannot be taken away unless you take-up NHS employment again, but you could get Tier 2 with a service addition, (so more pension) if they think you can't do any job at all, as opposed to your old job.

Reports will definitely be needed so you need to get on to that straightaway. If you have claimed any benefits like ESA or the Universal Credit equivalent, or PIP, you need to get hold of the disability assessor's report (not the letter from DWP about the report). Write to DWP using signed for post to request a copy. You may need proof that you asked for it, if they fail to post it to you. If you have a Blue Badge, that is further evidence as is a disabled Council Tax reduction from your Local Authority and a disabled bus pass. Copies of letters from any hospital doctors who have treated you will also help. You are entitled to request a copy of all medical records held by each NHS organisation and from any private facilities you may have used.

You will need to get a much information together as possible and if you can get a medical professional to say that you will never work again in any capacity, that may well clinch it.

[Tommytimmles in reply to releasethemagic]

Thank you for taking the time to reply and the good advice. I am lucky that l have a tier 1 but they did not at the time deem it permanent. I have vestibular conditions and lt was ridiculous of them to suggest l could do PT admin role flexible at home. I can’t look at screens for more than 5 min. I agree l need a report and may have to get this privately. It’s very frustrating as my fibro is treated by the GP and l tried to see rheumatology but they got the hump thinking the neurology had diagnosed me. I have had this condition for 15 years and with long covid, rheumatology referrals are not being done.