52.—(1) A pension payable under this regulation shall be known as an ill-health pension and may be paid at two different tiers known as a tier 1 ill-health pension and a tier 2 ill-health pension.
(2) An active member [F2or a non-contributing member] who has not reached the age of 65 and who has ceased to be employed in HSC employment is entitled to immediate payment of a tier 1 ill-health pension that is payable for life if—
(a)in the opinion of the Department the member suffers from physical or mental infirmity as a result of which the member is permanently incapable of discharging the duties of the member's employment efficiently,
(b)the member's employment is terminated because of that physical or mental infirmity,
(c)the member has at least 2 years of qualifying service, and
(d)the member has claimed the pension.
(3) An active member who has not reached the age of 65 is entitled to immediate payment of a tier 2 ill-health pension if—
(a)in addition to meeting the condition in paragraph (2) (a), in the opinion of the Department the member suffers from physical or mental infirmity as a result of which the member is permanently incapable of engaging in regular employment of like duration,
(b)the member's employment is terminated because of that physical or mental infirmity,
(c)the member has at least 2 years of qualifying service, and
(d)the member has claimed the pension.
(4) The annual amount of a tier 1 ill-health pension (disregarding any additional pension) is calculated as specified in regulation 45(4).
(5) The annual amount of a tier 2 ill-health pension (disregarding any additional pension) is calculated as specified in regulation 45(4), but on the assumption that the member's pensionable service—
[F3(a)is increased by the enhancement period where the member—
(i)has not had a break in pensionable service of 12 months or more; or
(ii)has returned to pensionable employment 12 months or more after having a break in such service and it would be more favourable to the member to treat the member’s pensionable service before and after the break, and all such other breaks (if any), as continuous;]
[F4(b)is not increased by the enhancement period in the circumstances referred to in sub-paragraph (a) [F5(ii)] if—
(i)the member’s pensionable service before and after the break is treated separately under regulation 110, or
(ii)the member’s pensionable service in respect of an earlier service credit is treated separately under regulation 136G.]
(6) In this regulation, subject to paragraph (7), “the enhancement period” means two-thirds of the member's assumed pensionable service.
(7) If the member's pensionable service includes any period which, apart from this paragraph would be calculated in accordance with regulation 8 (meaning of “pensionable service”: part-time service), the enhancement period that would apply apart from this paragraph is reduced by multiplying it by the fraction—
where—
TPSa is the member's total pensionable service, applying that regulation in respect of any period in part-time employment, and
TPSn is the member's total pensionable service if that regulation were not applied.
(8) In this regulation “the member's assumed service” means, subject to paragraph (9), the further pensionable service that the member could have counted if the member had continued in service until reaching the age of 65.
(9) To the extent that any increase under paragraph (5) would cause a member's pensionable service to exceed the limit of 45 years provided for in regulation 7 (3), the amount of any excess will be reduced accordingly.
(10) This regulation is subject to—
(a)regulation 112 (effect of re-employment on tier 2 ill-health pensions), and
(b)regulation 113 (re-employed tier 1 ill-health pensioners).
(11) A member does not qualify for a pension under this regulation if the member's HSC employment has been terminated by the member—
(a)being dismissed from such employment (unless the Department is satisfied that the member was dismissed because of the member's infirmity); or
(b)retiring or resigning from such employment at a time when the member was the subject of disciplinary proceedings or had been notified that such proceedings were being contemplated; or
(c)otherwise retiring or resigning from such employment unless at the time of doing so the member's employing authority has notified the Department in writing that the member's physical or mental infirmity is the reason for the termination of that employment and the Department is satisfied that is the case.
(12) For the purposes of determining whether a member is permanently incapable of discharging the duties of the member's employment efficiently under paragraph (2)(a), the Department shall have regard to the factors in paragraph (14) (no one of which shall be decisive) and disregard the member's personal preference for or against engaging in that employment.
(13) For the purposes of determining whether a member is permanently incapable of engaging in regular employment of like duration under paragraph (3)(a), the Department shall have regard to the factors in paragraph (15) (no one of which shall be decisive) and disregard the factors in paragraph (16).
(14) The factors to be taken into account for paragraph (12) are—
(a)whether the member has received appropriate medical treatment in respect of the incapacity;
(b)the member's—
(i)mental capacity; and
(ii)physical capacity;
(c)such type and period of rehabilitation which it would be reasonable for the member to undergo in respect of his incapacity, irrespective of whether such rehabilitation is undergone; and
(d)any other matter which the Department considers appropriate.
(15) The factors to be taken into account for paragraph (13) are—
(a)whether the member has received appropriate medical treatment in respect of the incapacity; and
(b)such reasonable employment as the member would be capable of engaging in if due regard is given to the member's—
(i)mental capacity;
(ii)physical capacity;
(iii)previous training; and
(iv)previous practical, professional and vocational experience,
irrespective of whether or not such employment is actually available to the member;
(c)such type and period of rehabilitation which it would be reasonable for the member to undergo in respect of his incapacity (irrespective of whether such rehabilitation is undergone) having due regard to the member's—
(i)mental capacity; and
(ii)physical capacity;
(d)such type and period of training which it would be reasonable for the member to undergo in respect of his incapacity (irrespective of whether such training is undergone) having due regard to the member's—
(i)mental capacity;
(ii)physical capacity;
(iii)previous training; and
(iv)previous practical, professional and vocational experience; and
(e)any other matter which the Department considers appropriate.
(16) The factors to be disregarded for paragraph (13) are—
(a)the member's personal preference for or against engaging in any particular employment; and
(b)the geographical location of the member.
(17) For the purpose of this regulation—
“appropriate medical treatment” means such medical treatment as it would be normal to receive in respect of the incapacity, but does not include any treatment that the Department considers—
that it would be reasonable for the member to refuse,
would provide no benefit to restoring the member's capacity for—
discharging the duties of the member's employment efficiently under paragraph (2)(a), or
engaging in regular employment of like duration under paragraph (3)(a),
before the member reaches age 65, or
that, through no fault on the part of the member, it is not possible for the member to receive before the member reaches age 65;
[F6“permanently” means—
the period until age 65; and
in the case of a 2008 Section Optant who, before joining this Section of the Scheme, was assessed by a medical adviser as being—
permanently incapable of efficiently discharging their duties for the purposes of regulation 13A(2)(b)(i) of the 1995 Regulations (Ill health pension on early retirement), that Optant shall be deemed to be permanently incapable of discharging the duties of the Optant’s employment efficiently for the purposes of paragraph (2)(a),
permanently incapable of regular employment of like duration for the purposes of regulation 13A(2)(b)(ii) of the 1995 Regulations, that Optant shall be deemed to be permanently incapable of engaging in regular employment of like duration for the purposes of paragraph (3)(a);]
“regular employment of like duration” means—
in the case of a non-GP provider, such employment as the Department considers would involve a similar level of engagement to the member's current pensionable service as a non-GP provider; and
in all other cases, where prior to retiring from employment that is pensionable the member was employed—
on a whole-time basis, regular employment on a whole-time basis;
on a part-time basis, regular employment on a part-time basis,
regard being had to the number of hours, half-days and sessions the member worked in that employment.
[F7(18) In the case of a 2008 Section Optant, this regulation is subject to regulations 136L and 136N to 136R.]
[F8(19) In the case of a Waiting Period Joiner, this regulation is subject to regulation 136ZA.]
Textual Amendments
F1Words in reg. 52 heading inserted (with effect in accordance with reg. 1(2) of the amending Rule) by The Health and Personal Social Services (Superannuation Scheme and Injury Benefits) and Health and Social Care (Pension Scheme) (Amendment) Regulations (Northern Ireland) 2009 (S.R. 2009/188), regs. 1(2), 26(2)
F2Words in reg. 52(2) inserted (with effect in accordance with reg. 1(2) of the amending Rule) by The Health and Personal Social Services (Superannuation Scheme and Injury Benefits) and Health and Social Care (Pension Scheme) (Amendment) Regulations (Northern Ireland) 2009 (S.R. 2009/188), regs. 1(2), 26(3)
F3Reg. 52(5)(a) substituted (16.8.2022) by The Health and Social Care Pension Schemes, Additional Voluntary Contributions and Injury Benefits (Amendment) Regulations (Northern Ireland) 2022 (S.R. 2022/196), regs. 1(2), 37(a)
F4Reg. 52(5)(b) substituted (with effect in accordance with reg. 1(2) of the amending Rule) by The Health and Personal Social Services (Superannuation Scheme, Compensation for Premature Retirement and Additional Voluntary Contributions), and Health and Social Care (Pension Scheme) (Amendment) Regulations (Northern Ireland) 2010 (S.R. 2010/22), regs. 1(2), 32(2)
F5Word in reg. 52(5)(b) inserted (16.8.2022) by The Health and Social Care Pension Schemes, Additional Voluntary Contributions and Injury Benefits (Amendment) Regulations (Northern Ireland) 2022 (S.R. 2022/196), regs. 1(2), 37(b)
F6Words in reg. 52(17) substituted (with effect in accordance with reg. 1(2) of the amending Rule) by The Health and Personal Social Services (Superannuation Scheme, Compensation for Premature Retirement and Additional Voluntary Contributions), and Health and Social Care (Pension Scheme) (Amendment) Regulations (Northern Ireland) 2010 (S.R. 2010/22), regs. 1(2), 32(3)
F7Reg. 52(18) added (with effect in accordance with reg. 1(2) of the amending Rule) by The Health and Personal Social Services (Superannuation Scheme, Compensation for Premature Retirement and Additional Voluntary Contributions), and Health and Social Care (Pension Scheme) (Amendment) Regulations (Northern Ireland) 2010 (S.R. 2010/22), regs. 1(2), 32(4)
F8Reg. 52(19) inserted (with effect in accordance with reg. 1(2) of the amending Rule) by The Health and Personal Social Services (Superannuation Scheme, Injury Benefits and Additional Voluntary Contributions), Health and Social Care (Pension Scheme) (Amendment) Regulations (Northern Ireland) 2010 (S.R. 2010/286), Pt. 3 reg. 24, reg. 1(2)