6.3.7 You can grant members of any age Ill Health Retirement if the Scheme Medical Adviser believes their breakdown in health is likely to be permanent and prevent them from carrying out their work. The document ‘Ill Health Retirement - procedural Guidance for Employers’ (which is in Annex 6J), provides further information. Under alphanuvos, premium and classic plus there are two tiers of benefits payable depending upon whether the member cannot do their own job or cannot work again in any capacity.

Please note: if a member is due to be moved into alpha while they are in the process of an IHR application (or an appeal against a decision to turn down their application) you must not move the member until you are aware of the final decision. They must have exhausted all their options to appeal.

Where it is clear that an employee has health problems that are affecting their capability for work, employers should always consider IHR. You should not try to influence an employee’s decision or give any kind of assurances about their eligibility for IHR.

Where the member does not meet the IHR criteria, or IHR is not appropriate, you may consider dismissing them on the grounds of efficiency (see ‘Dismissal on grounds of efficiency’ (6.2.18 to 6.2.25) for further information).

The following paragraphs tell you the steps to take to guard against the possibility of overpaying CSCS benefits to a member who has appealed against your decision not to give them IHR.

Retrospective Ill Health Retirement (RIHR)

RIHR can apply when a former employee asks their former employer to consider them for Ill Health Retirement after they have left employment. RIHR is not a provision in the Civil Service Pension scheme rules. This means that former employees have no statutory right to RIHR. 

All RIHR applications need agreement from the Scheme Manager (Cabinet Office) before processing. The Scheme Medical Adviser (SMA) will not accept applications for RIHR without evidence of Scheme Manager agreement. For more information see the ‘Applying for RIHR’ section.

This guidance is for further clarification and does not replace EPN 340.

Criteria for RIHR applications

The Scheme Manager will only agree to RIHR applications in exceptional circumstances. For example, where there has been a mistake or omission in handling the former employee’s exit. That is usually where an employer has dismissed an employee, or they resigned for reasons connected with health, but:

  • the employer failed to consider IHR for an individual when it is clear that they should have; and/or
  • the employee was not made aware of their right to apply for IHR.

Other types of exit alongside IHR and RIHR

Voluntary Exits

Where someone is leaving voluntarily, for example:

  • Resigning
  • Retiring, or;
  • leaving under voluntary exit/redundancy terms

It is important that employers make it absolutely clear to employees that if they choose to leave on one of these voluntary exit terms instead of IHR if they are eligible, any on-going IHR application, including those already at the appeal stage, will cease when the individual exits. If an employer suggests to an employee before they exit that RIHR would be an option for them later, they would be mishandling their exit.

Dismissal or compulsory redundancy

If an application for IHR was made before an employee’s last day of service, that application should continue to its conclusion. This includes those already at the appeal stage. Under these circumstances, IHR applications that are completed after the last day of service should not be treated as RIHR.

Employers should explain to employees that if the IHR application is successful, any leaving package they have already been quoted would be replaced by the IHR benefits and any exit compensation that has already been paid, would need to be paid back by the employee.

More information, including suggested wording employers can use to record employees acknowledgement and agreement to return the compensation owed, can be found in the ‘Paying CSCS benefits while an appeal against refusal to grant Ill Health Retirement is in progress’ section of Employer’s Pension Guide section 6.

Applying for RIHR

Employers must apply to the Scheme Manager on behalf of a former employee. Former employees must not contact the scheme manager or the SMA directly.

Employers should put the application in writing to:

cspsemployerenquiries@cabinetoffice.gov.uk

You must set out the reason the former employee believes they are eligible for RIHR and provide the following details on their exit:

  • sequence of events (with dates) leading up to their exit
  • details of sick absence(s);
  • copies of any relevant Occupational Health Adviser (OHA) reports;
  • records of any capability hearings or discussions;
  • copy of the dismissal letter, if applicable; and
  • any other relevant correspondence or emails records of conversations between the employer and former employee advising them of their options on leaving. 

If you have questions about whether RIHR might apply, email cspsemployerenquiries@cabinetoffice.gov.uk

The Scheme Manager will assess the evidence to decide whether an employer has managed the former employee’s exit correctly.

If the Scheme Manager agrees, the employer should apply to the SMA in the normal way.

Details to include:

  • in the application to the SMA, clearly state that it is an RIHR application
  • in the referral for the Scheme Administrator (MyCSP) and the SMA, include evidence of the Scheme Manager’s approval (usually the email reply to the employer’s request). The application cannot proceed without it.

At this stage, employers should explain to the former employee that the SMA’s assessment will determine whether they met the IHR criteria at the time they left service, not the time of application for RIHR - even if their health has since deteriorated.

Published:
4 January 2022
Last updated:
27 January 2022