CHAPTER 6E+WIll-health retirement
SECTION 1E+WGeneral
InterpretationE+W
106. In this Chapter—
“ill-health application” means an application under regulation 162 for payment of—
(a)
an ill-health pension; and
(b)
if applicable, a total incapacity pension; and
“stepped down employment” has the meaning given in regulation 117.
Incapacity definitionsE+W
107. In this Chapter, a person (P)—
(a)is incapacitated if, as a result of illness or injury, P is unfit to be in eligible employment despite appropriate medical treatment;
(b)meets the incapacity condition if—
(i)P is incapacitated; and
(ii)P is likely to be incapacitated permanently; and
(c)meets the total incapacity condition if—
(i)P is incapacitated; and
(ii)P's ability to carry out any work is impaired by more than 90% and is likely to be impaired by more than 90% permanently.
Ill-health applicationsE+W
108.—(1) An ill-health application made by a person (P)—
(a)must be accompanied by all the medical evidence necessary for the scheme manager to determine whether P is entitled to the payment of an ill-health pension and, if applicable, a total incapacity pension; and
(b)must be signed by P's employer unless—
(i)P left all eligible employment for a reason other than because P was incapacitated; or
(ii)P made the ill-health application more than 2 years after the last day of pensionable service.
(2) The medical evidence must include a medical report containing evidence that P meets—
(a)the incapacity condition; and
(b)if applicable, the total incapacity condition.
SECTION 2E+WIll-health pension
Entitlement day for ill-health pensionE+W
109.— [(1)] The entitlement day for an ill-health pension is the latest of the following—
(a)the day that falls 6 months before the date of a medical report following consideration of which the scheme manager is satisfied that a person (P) meets the incapacity condition or, if applicable, the total incapacity condition;
(b)the day specified in that medical report as the day on which P first met the incapacity condition or, if applicable, the total incapacity condition;
(c)the day after P leaves all eligible employment;
(d)the date of any previous medical report following consideration of which the scheme manager is not satisfied that P meets the incapacity condition or, if applicable, the total incapacity condition.
[(2) The scheme manager may only make the determination mentioned in paragraph (1)(a) after consideration of a medical report produced no more than 18 months before the date on which P made the ill-health application.]
Entitlement to ill-health pensionE+W
110.—(1) A member (P) is entitled to payment of an ill-health pension from the entitlement day if—
(a)P is qualified or re-qualified for retirement benefits;
(b)P has not reached normal pension age;
(c)P has left all eligible employment;
(d)P has applied under regulation 162 for payment of an ill-health pension;
(e)P has not applied under that regulation for payment of any other retirement pension; and
(f)the scheme manager is satisfied after consideration of a medical report—
(i)if paragraph (2) applies, that P meets the incapacity condition and the total incapacity condition; or
(ii)if paragraph (3) applies, that P meets the incapacity condition.
(2) This paragraph applies if—
(a)P left all eligible employment for a reason other than because P was incapacitated; or
(b)P made the ill-health application more than 2 years after the last day of pensionable service.
(3) This paragraph applies if—
(a)P left all [pensionable service] because P was incapacitated; and
(b)P made the ill-health application—
(i)before leaving all eligible employment; or
(ii)within 2 years after the last day of pensionable service.
[(3A) Where paragraph (3) applies, the illness or injury which P relies upon in P’s ill-health application to meet the incapacity condition must be—
(a)the same illness or injury which was the reason, or as the case may be, one of the reasons for P leaving pensionable employment; or
(b)connected to or consequent upon that injury or illness.]
(4) Except as provided in regulation 114, an ill-health pension is payable for life.
No entitlement to ill-health pensionE+W
111.—(1) A member (P) is not entitled to payment of an ill-health pension—
(a)in respect of any pensionable service after P reaches normal pension age; or
(b)if paragraph (2) applies.
(2) This paragraph applies if—
(a)a direction under section 142 of EA 2002 given on a ground mentioned in subsection (4)(a), (b) or (c) of that section has effect in respect of P,
(b)the Secretary of State is considering giving such a direction in respect of P,
(c)P is included, or is being considered for inclusion, in any of the lists mentioned in paragraph (4), or
(d)the General Teaching Council for Wales or the Secretary of State has made, or the General Teaching Council for Wales or the Secretary of State makes, or is considering making, a prohibition order in relation to P on the grounds of unacceptable professional conduct or that P has been convicted of a relevant offence.
(3) But paragraph (2) does not apply if the Secretary of State determines that the only reason for the direction or the direction being considered, for including, or considering including, P in any of the lists; or for making, or considering making, a prohibition order is unrelated to P's culpable behaviour.
(4) The lists are—
(a)the children's barred list (established under section 2(1)(a) of SVGA 2006);
(b)a list maintained under the law of Scotland or Northern Ireland which the Secretary of State specifies by order under section 3(2)(b) of SVGA 2006 as corresponding to the children's barred list;
(c)the adults' barred list (established under section 2(1)(b) of SVGA 2006);
(d)a list maintained under the law of Scotland or Northern Ireland which the Secretary of State specifies by order under section 3(3)(b) of SVGA 2006 as corresponding to the adults' barred list.
(5) In this regulation—
“prohibition order”, “relevant offence” and “unacceptable professional conduct” have the same meanings as in Schedule 2 to the Teaching and Higher Education Act 1998 ; and
“SVGA 2006” means the Safeguarding Vulnerable Groups Act 2006 .
When ill-health pension does not become payableE+W
112.—(1) If an ill-health pension does not become payable before the death of a member (D), a death grant is payable in respect of the member.
(2) For the purpose of paragraph (1)—
(a)an ill-health pension does not become payable before D's death unless the initial payment of the pension is made before D's death; and
(b)an ill-health pension that becomes payable before D's death but ceases to be payable under regulation 114 or 118 is taken not to become payable before D's death.
[When ill-health pension is taken to become payable before death of member: commutation of whole pension (serious ill-health)E+W
112A. An ill-health pension is taken to become payable before the death of a member (D) if—
(a)before D’s death D made an ill-health application;
(b)at the same time as D made the ill-health application, D made an application under regulation 171 (commutation of whole pension (serious ill-health)) for commutation of the ill-health pension and, if applicable, a total incapacity pension; and
(c)following consideration of the applications mentioned in sub-paragraphs (a) and (b), the Secretary of State determines that the ill-health pension and, if applicable, any total incapacity pension payable with it, should be commuted.]
Annual rate of ill-health pensionE+W
113. The annual rate of ill-health pension payable to a person (P) is found by—
(a)taking the amount of full retirement earned pension specified in P's pensioner member's account;
(b)adding the amount of full retirement additional pension (if any) specified in that account; and
(c)subtracting the conversion amount (if any) specified in that account in relation to the sum of those amounts.
When ill-health pension ceases to be payableE+W
114. An ill-health pension ceases to be payable to a person (P), unless P has reached normal pension age, on the earlier of the following dates—
(a)the date on which P re-enters eligible employment;
(b)the date on which P engages in any work as a teacher which is not an eligible employment.
SECTION 3E+WTotal incapacity pension
Meaning of “entitlement day” (total incapacity pension)E+W
115. The entitlement day for a total incapacity pension payable with an ill-health pension is the same as the entitlement day for the ill-health pension.
Entitlement to total incapacity pensionE+W
116.—(1) A total incapacity pension is payable to a person (P) from the entitlement day if—
(a)P is entitled to an ill-health pension because the scheme manager is satisfied that P meets the incapacity condition;
P has applied under regulation 162 for payment of an ill-health pension and a total incapacity pension; and
(b)
the scheme manager is satisfied after consideration of a medical report that P meets the total incapacity condition.
(2) For a person in stepped down employment, the scheme manager must be satisfied that P's total incapacity is wholly or partly related to the ill-health which led to the change in the terms of employment.
(3) A total incapacity pension is not payable to P if—
(a)P left an eligible employment for a reason other than because P was incapacitated; or
(b)P made the ill-health application—
(i)after leaving all eligible employment; and
(ii)more than 2 years after the last day of pensionable service.
(4) Except as provided in regulation 118, the total incapacity pension is payable for life.
Annual rate of total incapacity pensionE+W
117.—(1) The annual rate of total incapacity pension payable to a person (P) is—
where—
AR means P's annual rate of pensionable earnings—
(i)
as at the last day of pensionable service; or
(ii)
if P applies for a total incapacity pension while P is in stepped down employment, as at the day before P's annual rate of pensionable earnings was first reduced under paragraph (2);
PS means P's prospective service (in years and fractions of a year);
“P's prospective service” means the period beginning with the day after the entitlement day and ending on the day on which P would have reached prospective normal pension age.
(2) P is in stepped down employment if—
(a)P is in an eligible employment;
(b)the terms of that employment are changed wholly or partly because of P's ill-health; and
(c)as a result of the changed terms of employment, P's annual rate of pensionable earnings is reduced.
(3) For the purpose of [sub-paragraph (ii)] of the definition of AR, P's annual rate of pensionable earnings is increased by the amount (if any) by which it would have been increased if it had been an official pension within the meaning of section 5(1) of PIA 1971—
(a)beginning, and first qualifying for increases under that Act, on the day after the day on which P's annual rate of pensionable earnings is reduced; and
(b)ending on the day on which the scheme manager receives P's application for the total incapacity pension.
Cessation of total incapacity pensionE+W
118.—(1) A total incapacity pension ceases to be payable to a person (P) on the date on which P's ability to carry out any work ceases to be impaired by more than 90%, unless P has reached normal pension age before that date.
(2) For the purpose of paragraph (1), P's ability to carry out any work ceases to be impaired by more than 90% on the earliest of the following dates—
(a)the date of a medical report requested by the scheme manager under regulation 175 which shows that P no longer meets the incapacity condition or, if applicable, the total incapacity condition;
(b)the date on which P re-enters eligible employment;
(c)the date on which P engages in any work as a teacher which is not an eligible employment;
(d)the date on which P engages in any other form of work unless—
(i)P provides the scheme manager with a certificate from a registered medical practitioner stating that, in the opinion of the practitioner, P continues to meet the total incapacity condition despite engaging in such work, and
(ii)the scheme manager is satisfied that P continues to meet that condition despite engaging in such work.