Ill Health/Injury Benefits

Ill-Health Retirement

If you are a current Scheme member, have at least two years membership and are too ill to work in your present job you may be able to retire early and take your pension benefits. If you think ill-health retirement applies to you, please read the Guide to Ill-Health Retirement and complete form AW33 available from the Scheme Forms section of this website but you must be leaving work solely because of permanent ill-health. If dismissed for any other reason you cannot qualify for an ill-health pension.

There are two tiers of Ill health retirement and the benefits you get will depend on whether or not you are capable of undertaking employment elsewhere. The minimum pension age does not apply in the case of ill health retirement. Ill health pensions are increased each April in line with increases in the Consumer Price Index(CPI).

It may be possible to move between the tiers after retirement where our medical advisers indicate your condition may meet Tier 2 requirements within 3 years of retiring. It may also be possible if your condition is such that it is not possible to determine at the outset whether you will recover sufficiently to undertake any regular work.

If you are terminally ill you may take your benefits immediately as a lump sum. In this case they will be calculated based on Tier 2. Please see the Terminal Ill-Health Factsheet for more information.

Your benefits may be reduced or withdrawn if you take up further HSC employment after retiring early due to ill health.

If you are a deferred member and you become too ill to undertake regular employment before your normal pension age, you may able to take your pension early without reduction or any enhancement. If this happens you can download the application form AW240 available to download form our Scheme Forms section. This gives more information about what you need to do.

Injury benefits

A separate scheme covers HSC Staff and Practitioners (whether they are in the HSC Pension Scheme or not) for injuries or diseases contracted in the course of work. The Injury Benefit Scheme can provide temporary or permanent payments to you or your dependants if you are absent from work, unable to earn as much or die as a result of the injury or disease.

The HSC Injury Benefits Scheme is not part of the HSC Pension Scheme. It is governed by different regulations and it covers almost all HSC employees and most general practitioners, whether or not they are members of the HSC Pension Scheme.
Those covered by the Scheme include:

• Employees of a HSC Trust, HSC Board, Business Service Organisation, Public Health Agency, Patient Client Council;
• General Medical Practitioners, non-GP providers, Ophthalmic Practitioners and General Dental Practitioners working for the HSC;
• Holders of honorary appointments with an ‘Employing Authority’;
• Employers of certain Out of Hours Providers or other HSC organisations that have been approved by the Department to be covered by the scheme.

Freelance GP and Dental Locums, GP practice staff, GP co-operative staff, dental practice staff, ‘Direction’ employees, reservists and staff working for companies that provide a service to the HSC, e.g. agency staff, are not covered by the scheme.

There is no qualifying period, everyone is covered from the day they join the HSC.

The information contained in this section is a general guide. It is not a full statement of the law which governs the Injury Benefits Scheme.

More information can be found on the HSC Injury Benefit Guide.

Following the review of the HSC Injury Benefit Scheme, a new Injury Allowance scheme will be introduced on 31 May 2013.

Significant amendments have been made to the HSC Injury Benefit Scheme regulations.

A range of support materials have been produced to assist in the implementation of the new provisions. These include the following:

Part A – Injury Benefit – A Guide For Employers

Part B – Injury Benefit – A Guide For Staff

Part C – Injury Benefit – Transitional Arrangements

• Qualifying Conditions

  Current members who have at least 2 years membership, and become permanently incapable of doing their present job because of ill-health may
  be able to receive a pension.

  Termination of the employment contract because of unsatisfactory attendance due to sickness, will not automatically lead to early payment of a pension.

  If our medical advisers accept the application they will qualify for early
  payment of Scheme benefits if:

  • they are working in the HSC and have at least 2 years’ membership; or
  • they have chosen to leave the Scheme and are still working in the HSC and have at least 2 years’ Scheme membership.

  If a current member thinks ill-health retirement applies to them, they
  should complete form AW33. But they must be leaving work because of permanent ill-health. If dismissed for any other reason they cannot qualify for an ill-health pension.

  Benefits may also be paid early if they no longer work in the HSC provided:

  • they have at least 2 years’ deferred membership and are no longer able to earn an income through regular work.

  They should complete form AW240 available on the scheme forms section of the website.

  Our medical advisers, in every case, will assess the medical evidence and advise whether the applicant is permanently incapable of either carrying out their present HSC duties or doing any regular work. If this is confirmed and we are satisfied they meet the rules for ill-health retirement, we will pay a pension.

• Benefits

  There are two tiers of ill-health benefits.
  Tier 1 is entitlement to the retirement benefits they have earned to date, paid without any actuarial reduction for early payment. This level of benefit is payable if they are:

  • a Scheme member accepted by our medical advisers as permanently
    incapable of doing their current HSC job; or
  • a former Scheme member accepted by our medical advisers as permanently incapable of earning an income by doing regular work.

  Tier 2 is entitlement to the retirement benefits they have earned to date enhanced by two thirds of their prospective membership (for 1995 and 2008 scheme members) up to reaching their normal retirement age and 50% of prospective membership for 2015 scheme members up to their NRA.

  This level of benefit is payable only if they are a Scheme member accepted by our medical advisers as permanently incapable of both doing their current HSC job AND permanently incapable of regular employment of like duration to their HSC job, taking account of their:

  • mental capacity;
  • physical capacity;
  • previous training; and
  • previous practical, professional and vocational experience

  Irrespective of whether or not such employment is actually available to them.

  1995 Section

  Members of the 1995 Section of the HSC Pension Scheme, who retired due to ill- health up to 31 March 2016, would only have got a minimum increase of 4 years, subject to the maximum membership that could have been achieved by their normal retirement age.

  Example Tier 2 calculations for members of the 1995 Section

  1. A member of the above Scheme, who has a normal retirement age of 60, is accepted as qualifying for Tier 2 ill-health benefits at age 48, after 28 years’ full time Scheme membership. Their ill-health pension would be calculated using total Scheme membership of 36 years, 28
  years actual plus 8 years enhancement (2/3rds of the 12 years’ prospective membership to normal retirement age of 60).

  Example Tier 2 calculations for members of the 1995 Section

  2. A member of the above Scheme, who has a normal retirement age of 60, is accepted as qualifying for Tier 2 ill-health benefits at age 55, after 30 years’ full time Scheme membership. Their ill-health pension would be calculated using total Scheme membership of 34 years, 30 years actual plus the minimum guaranteed enhancement of 4 years. This is because 2/3rds of the prospective membership to normal retirement age of 60 is less than the guaranteed enhancement.

  2008 Section

  Example Tier 2 calculations for members of the 2008 Section.

  A member of the above Scheme, who has a normal retirement age of 65, is accepted as qualifying for Tier 2 ill-health pension at age 56, after 10 years’ full time Scheme membership. Their ill-health pension would be calculated using Scheme membership of 16 years, 10 years actual plus 6 years enhancement (2/3rds of the 9 years’ prospective membership to normal retirement age of 65).

  2015 Scheme

  A member of the above Scheme, who has a normal retirement age of 65, is accepted as qualifying for Tier 2 ill-health pension at age 53, after 15 years’ full time Scheme membership. Their ill-health pension would be calculated using Scheme membership of 21 years, 15 years actual plus 6 years enhancement (50% of the 12 years’ prospective membership to normal
  retirement age of 65).

• Index linking

  HSC ill-health pensions are fully index-linked to protect them against inflation. This means they are increased each year in line with the cost of living, for as long as they are paid. The increases are paid from April each
  year. In the first year the amount of increase will depend on the date they retire.

• Re-employment

  If the member receives Tier 1 ill-health benefits, and returns to work in the HSC before their normal retirement age and their earnings exceed a certain level, some of their pension will be subject to Abatement as explained below.

  If the member received Tier 2 benefits and is re-employed anywhere, as well as being subject to Abatement they will not be able to earn more than the equivalent of the lower earnings level (LEL) set by HM Revenue & Customs (HMRC) for the payment of national insurance contributions before their Tier 2 pension is replaced by a Tier 1 pension.

  If the member is re-employed in the NHS/HSC, the maximum period of re-employment before their Tier 2 pension is replaced with a Tier 1 pension is 12 months, even if their NHS/HSC earnings remain below the LEL. Please notify us immediately if they earn more than the LEL in any tax year or if they are re-employed in the HSC for more than 12 months.

  If they earn more than the LEL or are re-employed for more than 12 months in the HSC, their pension will be replaced by a Tier 1 pension from the next pension payable date following:

  • the point when their earnings exceeded the LEL; or
  • after 12 months re-employment in the HSC,

  whichever is the earliest.

  If the pension has been replaced by a Tier 1 pension because of this, they can re-qualify for a Tier 2 pension if:

  • they are under normal retirement age; and
  • their employment ends within 12 months of the substitute Tier 1
    pension; and
  • our medical advisers accept that they once again satisfy the Tier 2
    condition.

  1995 Section
  If they are members of the 1995 Section the period of re-employment in the HSC will be pensionable only if:

  • in the case of a Tier 1 pension, they are under age 50 on the date they
    return to HSC employment;
  • in the case of a Tier 2 pension, they are under age 49 on the date they
    return to HSC employment.

  2008 Section
  If they are members of the 2008 Section, their period of re-employment in the
  HSC will be pensionable provided:

  • they are under age 75; and
  • they have not retired on the grounds of serious ill-health and exchanged their pension for a one-off lump sum payment.

  2015 Scheme
  Members of the 2015 scheme can rejoin the scheme provided they have less than 45 years’ service and are under 75 years of age, however –

  Tier 1 – can rejoin on re-appointment
  Tier 2 – can only rejoin after 1 year of being re-appointed.

  Further information can be found here.

• Abatement

  If they return to HSC employment before their normal retirement age and their earnings are above a certain level, some of their ill-health pension may be reduced. We call this abatement.

  Abatement applies where earnings from re-employment plus the “unearned” portion of the ill-health pension exceeds earnings before retirement.

  Abatement is applied up to a maximum of the value of the “unearned” portion of the pre-commuted pension.

  In the case of Tier 1 benefits the “unearned” portion of the ill-health pension is:

  • the difference between the amount of pre-commutation pension in
    payment and the amount of pre-commutation pension that would have been payable after actuarial reduction for early retirement, prior to your normal retirement age.

  In the case of Tier 2 benefits, the “unearned” portion of the ill-health
  pension is:

  • the extra pension arising from the membership enhancement they
    have received; plus
  • the difference between the amount of pre-commutation pension in
    payment for actual membership and the amount of pre-commutation pension that would have been payable for that membership after actuarial reduction for early retirement, prior to their normal retirement age.

  You should explain how ‘Abatement’ applies to them, if they intend to return to HSC employment. Abatement no longer applies when they reach their normal retirement age or their earnings fall below the required level, whichever is the earlier.

• If a member is seriously ill

  If a member is terminally ill and does not expect to live longer than a year, they can apply to exchange all of their ill-health benefits for a one-off, usually tax-free, lump sum payment. They must have some HMRC personal lifetime allowance (LTA) remaining to make the exchange.

  The one-off lump sum payment will be calculated using exchange factors as follows:
  1. Pension up to level that gives the maximum permitted lump sum amount (see Guide to the Scheme) will be converted at the rate of £12 lump sum for every £1 of pension given up.
  2. The remaining pension will be converted to a lump sum at the rate of £5 lump sum for every £1 of pension. Their dependants will still get any pension they are entitled to in full.

  1995 Section

  If they are paying additional contributions
  If they are buying ‘Added Years’ or a bigger lump sum for Scheme membership before 25 March 1972 by deductions from pay and they apply to retire:

  • they must have been paying the additional contributions for more than 12 months; and
  • when they retire they are under normal retirement age, to be credited with the full purchase without having to make any further payments

  If they are buying or have already bought ‘Additional Pension’ and when they apply to retire:

  • they have been paying the additional contributions for more than 12
    months; or
  • in the case of purchase by lump sum contribution, it is more than 12
    months since payment was made, they will be credited with the full purchase.

  If they apply to retire within 12 months of starting to pay for any of the above benefits the purchase will be void. Any payments made will be returned.

• Requesting ill-health retirement

  If the member if still employed in the HSC please give them form AW33-09.

  If the member is no longer employed in the HSC and they approach you, ask them to write to HSC Pension Service for form AW33PB

  NB: In the event that insufficient evidence/information is provided with an
  application for ill health retirement, HSC Pension Service will determine that the application does not meet the requirements for ill health retirement.

  If HSC Pension Service approve the request, please give them form AW6 to claim ill-health benefits.

  If seriously ill and would like to exchange benefits for a one-off lump sum payment, please tell HSC Pension Service.

• Lifetime allowance (LTA)

  In testing benefits against the LTA the following values will be used, either

  • benefits including any enhanced membership granted; or
  • seriously ill and have exchanged benefits for a one-off lump sum, the total lump sum.
• Terminally Ill Members

  A member who is terminally ill and does not expect to live longer than a year, can apply at retirement to exchange all of their ill-health benefits for a one-off, usually tax-free, lump sum payment. To make this exchange, they must have some of their HM Revenue & Customs (HMRC) personal lifetime allowance (LTA) remaining. If the member takes up this option, their dependants will still get any benefits they are entitled to in full.

  A member who is under their NPA at retirement, 60 in the 1995 section, 65 in the 2008 Section and State Pension Age (SPA) or age 65 if this is later in the 2015 Scheme, and has at least two years’ membership must complete form AW34 if they wish to exchange their ill health retirement benefits for a one off lump sum payment. The benefits will be enhanced under the Tier 2 ill health regulation.

  A member who is over NPA or SPA for the 2015 scheme is ineligible to apply for ill-health retirement benefits. However, they do have the option to exchange their retirement benefits for a one-off lump sum payment where life expectancy is less than 12 months. The benefits will not be enhanced under the ill-health retirement arrangements.

  The one-off lump sum payment is calculated using the exchange factors as follows:
  1. Pension up to the level that gives the maximum permitted lump sum will be converted at the rate of £12 lump sum for every £1 of pension given up. The remaining pension will be converted to a lump sum at the rate of £5 lump sum for every £1 per pension.

  If a member exchanges retirement benefits for a one-off lump sum payment their dependents will still get any benefits they are entitled to in full.

  An application to exchange retirement benefits for a one-off lump sum must be made before the pension is paid and cannot be changed once the lump sum payment has been made. The application Form AW34 is available from the Scheme Forms section for those members who have met or exceeded their Normal Retirement Age.

• Injury Benefits

  General information

  The Injury Benefits Scheme provides benefits for HSC employees who as a result of an injury or disease wholly or mainly attributable to their HSC duties:
  are on certificated sick leave with reduced pay or no pay, or have their earning ability permanently reduced by more than 10%, or die, leaving a spouse, civil partner and/or dependants.

  In the rest of this booklet the word ‘injury’ means injury or disease wholly or mainly
  attributable to the duties of the HSC employment.

  More information about the Scheme can be found below:
  http://www.dhsspsni.gov.uk/hsc-pensions.htm/

  Temporary injury allowance

  If you are on authorised sick absence with reduced pay or no pay because of the injury(or if you are a general practitioner temporarily absent from your practice because of the injury), you may be eligible for a temporary injury allowance (TIA).

  This allowance is paid by your employer. It tops up your income (i.e. pay, HSC pension and certain Social Security benefits) to 85% of the average pay you were getting immediately before your pay was reduced because of the injury.

  TIA is not payable if your total income is more than 85% of your average pay. When you return to work or leave employment the TIA stops.

  TIA is subject to income tax deductions but not National Insurance or pension contribution deductions.

  More information about ‘average pay’ and calculating TIA can be found here.

  Permanent injury benefit

  Permanent injury benefit (PIB) may be payable if the  injury causes a permanent reduction in your earning ability of more than 10% in the general field of employment. It can be paid if:

  • the number of hours you are able to work is permanently reduced; or
  • you have to change to a lower paid job; or
  • you have to leave your HSC employment.

  If the permanent reduction of your earning ability caused by the injury is 10% or less, you will not receive any benefits.

  The PIB allowance can be adjusted when certain Social Security benefits start or stop but not when they fluctuate.

  The PIB annual allowance is a percentage of your average pay and is based on:

  • your length of HSC employment; and
  • the amount of permanent reduction in your earning ability.

  If your employment ends because of the injury, you may also qualify for a lump sum payment. This is also a percentage of your average pay.

  No annual allowance is payable if your total income (i.e. HSC pension and certain Social Security benefits) is more than the annual allowance.

  If you think your earning ability has reduced because your injury has worsened, you can ask us to review your annual allowance. We cannot review your lump sum.

  The table on the next page shows how the annual allowance and lump sum are worked out.

  The benefits are calculated using the following table:

  Permanent reduction of earning ability caused by the injury	Annual Allowance (including HSC Pension and Social Security Benefits) shown as a % of average pay				Lump Sum: Shown as a % of average pay
  	Years of HSC Employment
  	Less than 5 years	5 years and over but less than 15 years	15 years and over but less than 25 years	2 years or more
  0-10%	No entitlement to an annual allowance or lump sum
  More than 10% up to 25%	15%	30%	45%	60%	12.5%
  More than 25% up to 50%	40%	50%	60%	70%	25%
  More than 50% up to 75%	65%	70%	75%	80%	37.5%
  75% or More	85%	85%	85%	85%	50%

  Example:

  If the permanent reduction in your earning ability is 30% and you have 23 years’ employment, your annual allowance would be 60% of your average pay.

  Remember: The percentages in the first column show the permanent reduction in earning ability.

  Death Benefits

  Incapacity Benefit
  If you die as a result of the injury, we may be able to pay allowances to your spouse or civil partner and certain dependants. These allowances are intended to top up payments such as HSC survivor benefits. The annual allowance is a percentage of your average pay. The percentages are shown in the tables below.

  Dependants	Percentage of average payable following death
  Widow/Widower or Civil Partner only	45%
  Each of the first 4 children	10% if there is a widow / widower or civil partner or 20% if there is no widow / widower or civil partner
  Each dependent incapacitated adult child*	20% if there is a surviving parent, or 45% if there is no surviving parent
  One dependent	20% if there is a widow/widower or civil partner, or 45% if there is no widow/widower or civil partner

  The total amount of allowances cannot be more than 100% of  your average pay. A lump sum of 50% of your average pay may also be paid, provided you had not already had a lump sum as described above.

  *A dependent incapacitated adult child is someone who, regardless of age, is permanently unable to earn a living due to ill health or disability.

  Damages and Compensation

  You cannot receive all of a damages or compensation claim settlement and all of your injury benefits as well, where they are paid for the same injury.

  If you get damages or compensation for your injury it is very likely to affect how much injury benefit we can pay you.

  If you have already received damages or compensation when you make your claim for injury benefits you must tell us so we can take it into account when we work out your injury benefits.

  If you obtain damages or compensation after you have been awarded the injury benefits you must tell us within 14 days of the settlement being reached.

  You will have to repay some or all of the injury benefit we have paid you and failure to repay monies owed may lead to legal action.

  Index linking

  All allowances from the HSC Injury Benefits Scheme are index linked to protect them against increases in the cost of living.

  More information:

  If you have any

  questions about the Injury Benefits Scheme, or need more information please see our website
  http://www.dhsspsni.gov.uk/hsc-pensions.htm/

  Alternatively your employer may be able to help you.

  You can also write to us at:
  HSC Injury Benefit Scheme
  Waterside House
  75 Duke Street
  Londonderry
  BT47 6FP
  E-mail us at: hscpensions@hscni.net
  Ring us on 028 71 319 111
  The office is open from 9.00am to 5.00pm Monday to Thursday and
  9.00am to 12.00pm on Fridays (Public Holidays excepted).
  Or fax us on 028 71 319 144

  Please tell us your National Insurance number when you call or write to us.