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Ill health – The case study of Ms H

Complaint Topic: Ill health
Outcome: Resolved by Early Resolution
Type: Pension complaint or dispute

Ms H was refused an ill health retirement pension and approached us for help. We explained our own view on her eligibility was irrelevant, but we could check if the decision was taken correctly, in accordance with the scheme’s rules.

Ms H was refused an ill health pension because the medical adviser had noted not all treatment options had yet been completed. The medical adviser subsequently opined it was too early to decide on Ms H’s eligibility.

The decision on Ms H’s eligibility rested with her employer. We contacted them and asked, given they did not have medical advice on the likely effect of the proposed treatment, whether they had sufficient medical information to refuse Ms H’s application.

The employer agreed to refer Ms H’s application to another medical adviser and seek further input on the likely effect treatment would have on Ms H’s future work capability.

After reviewing the medical advice they subsequently received, it was agreed Ms H was eligible for an ill health pension and it was agreed it should be backdated to May 2019.  

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