The Health and Social Care Pension Scheme Regulations (Northern Ireland) 2015

PART 6 N.I. Determinations

Determination of questions N.I.

14.—(1) Except as otherwise provided by these Regulations, any question arising under the scheme is to be determined by the scheme manager.

(2) Any such disagreement as is referred to in Article 50 of the 1995 Order (resolution of disputes) M1 must be resolved by the scheme manager in accordance with any arrangements applicable under that section.

Marginal Citations

M1 Article 50 was substituted by Article 250(1) of the Pensions (Northern Ireland) Order 2005 (S.I. 2005/255 (N.I. 1)) and amended by Article 14 of the Pensions Act (Northern Ireland) 2008 (c.1 (N.I.))

Determinations by medical practitioners N.I.

15.—(1) The scheme manager may make arrangements for functions under this scheme in relation to decisions to which sub-paragraph (2) applies that are exercisable by the scheme manager to be discharged by—

(a) a medical practitioner (whether practicing alone or as part of a group) whom the scheme manager has approved to act on the scheme manager's behalf, or

(b) a body (incorporated or unincorporated) which—

(i) employs medical practitioners (whether under a contract of service or for services), and

(ii) is so approved.

(2) This paragraph applies to a decision as to a person's health or degree of physical or mental infirmity that is required for the purposes of this scheme and, in particular, a decision required for the purposes of—

(a) regulation 52(6)(b) (procedure for allocation election under regulation 50);

(b) regulation 75(9) (pension credit members);

(c) regulation 89(2)(c) or (3)(b) (early retirement on ill health: active members);

(d) regulation 92(1) or (5) (re-assessment of ill health pension);

(e) regulation 93(1)(b) or (2)(c) (early retirement on ill health: deferred members);

(f) regulation 108(1) (option to exchange pension for lump sum: serious ill health);

(g) regulation 121(3)(b)(i) (dependency because of physical or mental impairment);

(h) paragraph 7(1) of this Schedule (beneficiary incapable of looking after their own affairs);

(i) section 229(3)(a) of the 2004 Act (determining whether an individual satisfies the severe ill health condition) M2 .

(3) In relation to such a decision, the scheme manager may require a person entitled or claiming to be entitled to benefit under this scheme to submit to a medical examination by a medical practitioner selected by the scheme manager.

(4) The scheme manager must also offer the person an opportunity to submit a report from the person's own medical adviser following an examination of the person by the medical adviser.

(5) In taking a decision mentioned in sub-paragraph (1), the scheme manager must take into consideration both—

(a) the report mentioned in sub-paragraph (4); and

(b) the report of the medical practitioner who carries out the medical examination mentioned in sub-paragraph (3).

Marginal Citations

M2 Section 229(3)(a) was substituted by section 660 of, and paragraphs 1 and 6(1) and (3) of Schedule 17 to, the Finance Act 2011 (c.11)