Ill health retirement application

dennisim

Hello. I was hoping I could get some advice. I've seen similar discussions with very good advice and help given.

This will be a long post. Sorry.

I am currently applying for ill health retirement due to fibromyalgia. My application was denied and my 1st appeal rejected.

I believe the process is not being carried out in good faith by the pension provider. The medical physician they used misinterpreted my medical notes to draw an incorrect conclusion that is a stark contradiction to the information I'm being told by the specialist. 

For the appeal I asked the specialist to write what my condition is and how it affects me in plain English. In my appeal I used these notes that contradicted the pension physicians original assessment. The pension determiner simply ignored the new information and found any ambiguity to uphold the original assessment.

I have a 2nd appeal but I'm unsure of how to approach it.  Do I use the same tactics again "getting my specialist to write in plain English the details of my condition" only to be ignored again. Or do I ask for a different physician to look at my medical notes or get a different determinor. I'm at a loss knowing I'm up against people who do this day in day out. 

I have the ombudsman as a last resort. Can I build a case strong enough to prove I have been unfairly assessed.

Any advice or help would be greatly appreciated.

janer1967

Hi there 

I cant specifically advise nit knowing your pension providers criteria for eligibility however ill health retirement is very hard to get approved as they are basically saying you are unfit to work again in any capacity 

Have you sought any expert advice acas maybe a place that could assist or sign post you to somewhere that can help 

Is your fibro advanced and affect you all the time or do you have times when it flares up 

I would say providing the same evidence will give most likely the same result 

Good luck 

dennisim

I'm really not sure where to get advice hence why I've posted here. I will look into Acas thank you. 

My fibromyalgia affects me significantly in all aspects of my life. It's very debilitating. As such I'm unable to work.

janer1967

Have you had a occupational health assessment ? Have they recommended you are not fit to work 

Pension wise also deals with pension queries and there is also cab and welfare rights but pensions are a complex beast so you may need more specialist advice 

See if there is anything in the employment section on here as well 

dennisim

Yes. To be honest the employers did everything they could for me. I attended a hearing where I was let go after 12 months off sick. 

I met the criteria to apply for ill health retirement. It seems the pension fund can obtain their own medical assessment. Which they have done. By someone who's never seen me and coming to a different conclusion to my specialist. I don't know how to argue my side against this. It seems they are allowed to pay for a medical assessment and pick the one that best suits their objective.  

janer1967

True they are allowed to appoint an independent medical professional to assess your case . 

Logically this has to happen as your own specialist could be bias on your favour there is a lot at stake for them to payout 

As advised contact some local advice centres to help you my knowledge is limited to the human resource side of the process rather than pension provider 

Sorry I can't help more 

dennisim

How is me accessing my pension money a risk to them?

janer1967

I presume you are under retirement age so they will be paying you for longer than expected 

It's not a risk it is a cost 

I'm sorry I don't seem to be helping you so I will leave it there 

poppy123456

I'd advise you to get some expert advice as Janer advised because you've already had 1 appeal rejected.

dennisim

I accept I need expert advice but I don't know where to get it. 

I looked at acas and I can't seem to find any information there regarding ill health retirement applications appeals.

It just seems so unjust that they can pay someone to pick holes in my medical notes and disregard my specialist who has physically seen me numerous times and go with the medical  professional who has never seen me. 

For that medical professional to conclude the complete opposite to what my specialist tells me can't be achieved unless that is their intention. 

Thanks for helping.

Cher_Alumni

Hi @dennisim

How are you getting on? Did you manage to seek expert advice? If not, I'd recommend calling the ACAS helpline via the following contact details:

Helpline 0300 123 1100
Open Monday to Friday, 8am to 6pm.
The advice you receive is free but you may be charged for the call depending on your phone provider and whether you use a mobile or a landline.

Please let us know how you get on and all the best with it. Take care.

dennisim

Thank you cher. I have 5 months left to make the 2nd appeal. 

I'm just so very very angry about how the determinor simply chooses to ignore evidence in favour of incorrect assumptions made by the medical professional they have paid for. The curse of fibromyalgia is it's ambiguous in nature. No 2 people with it are affected the same. The medical professional has exploited this ambiguity to undermine a legitimately disabled persons claim. And that to me is simply disgusting behaviour. 

The fact the determinor wouldn't change the decision means this is intentional and not done by accident. 

So yeah I need help. I don't know how to fight my corner if the opponent can deny reality.

L_Volunteer

I completely hear how you are feeling angry @dennisim. Not least as I also have fibromyalgia and hear the ambiguity. 

There may be similarities in how we experience it but it will always be slightly different between people too. 

Is there anything, in particular, that might help you move forwards with the appeal? Please don't hesitate to let us know if there's anything at all we can do to support you 

durhamjaide2001

Good luck and happy retirement 

katwater51

Hi @dennism some disputes about pensions are covered by the financial ombudsman service. Possibly may be worth lodging a complaint with them. 

dennisim

katwater51 said:

Hi @dennism some disputes about pensions are covered by the financial ombudsman service. Possibly may be worth lodging a complaint with them. 

Thank you. I get a 2nd appeal with lgps who are the pension provider. If there is still no movement from them I will appeal via the ombudsman. I'm not sure how that process works but will cross that bridge when I need too.

dennisim

A quick update. My anger is starting to subside. I have until August 3rd to appeal this latest decision. I have appointments with the various Doctors who are dealing with my condition I will get as many as I can to put as much detail as possible in my medical notes to assist the appeal.

I have recently had an ESA face to face review that found I was incapable of carrying out any type of work. Could I add this to the evidence I use to appeal?

Alex_Alumni

I don't think it would hurt to use it as evidence @dennisim, and I'm glad to hear you're feeling less angry now that some time has passed. 

Let us know how things go, and if we can help any further

katwater51

Hi @dennisim not meaning to reiterate points already made, but I was also wondering if anything ACAS said was of help to you? 

dennisim

Hi. Sorry for the long wait between updates. I've been caught in a spiral of seizure - recovery, seizure - recovery. Acas we're not particularly helpful. They just reiterated the process the pension has to follow and we're unable to advise me personally as to how to proceed..

My appeal needs to but done by August and I've as much information as I'm going to get. Ive been discharged by the chronic pain specialist but he gave a very thorough assessment of my condition most of which contradicts their medical professionals assessment. Hopefully it's enough to make them see reality.

If not on to the ombudsman I go.

Hannah_Alumni

@dennisim I'm so sorry to hear you've been so unwell. I hope it is enough to make them see reality! Please keep us updated and I hope you are getting as much rest as possible!