Civil Service - iLL Health Retirement
Hi I wonder if anyone has any advice for me please. I have worked in the civil service for 15 years. I was diagnosed with Chronic Daily Migraine by a neurologist 11 years ago. Since then I have tried every available treatment without success. Sadly my health has deteriorated and I was off work for 6 months last year due to this condition. I returned for a few weeks over Christmas, however Im now on sick leave again. I had a meeting with Occupational Health last week who have agreed that I'm a suitable candidate to apply for ill heallth retirement. I have tried all available reasonable adjustments which proved unsuccessful. I have completed the IHR form and given permission for them to contct my GP and specialist. The biggest problem i can foresee is proving this condition will "likely" be permanent and prevent me from working until my retirement age. I'm currently 54. From all i've read online, it appears to be very difficult to be granted ill health retirement. It's my opinion that its impossible to predict if there will be a suitable treatment for any illness and that I should be granted this with possibly a review after 3 or 5 years. Just wondering if anyone has any thoughts or advice? Thanks
Comments
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Hi, I was awarded upper tier civil service IHR in 2024, also aged 54 so I have a good working knowledge of the processes.
The pension portal has advice on it and a search for civil service IHR will bring up a comprehensive members guide. This is useful as it lays out the criteria you would need to meet and the specific definitions used by the pension provider. I would highly advise that you familiarise yourself with the specific wording used in their criteria.
The below would be my take on it, and you are correct, proving permanency of both condition and symptoms is paramount. This would likely be a little difficult for you to evidence to the degree required by the pensions provider. The same would go for someone suffering from say fibromyalgia. Whilst we can agree that this condition can have a huge impact on a persons life it is likely that from the pension providers perspective it is unlikely to prevent them from working.
My gut feeling is that you might be eligible for the lower tier award as this is tied to ‘prevents you from carrying out your current job or role’, whereas upper tier is basically incapable of working in any capacity.
The pension provider can only make decisions based on current medical advice, available treatments, therapies etc, they will not take into consideration possible future advances. I understand where you are coming from but they will only endorse an award based on the here and now.
if I remember correctly you would only get a review if awarded the higher tier award, the lower tier is a permanent award. Once an IHR pension is in place and active it cannot be changed…so, if you received the lower tier but your condition worsened 5 years down the line, you cannot reapply for a higher award, you would still only receive the lower tier.
I understand what you are suggesting but, and this sounds horrible, but you’re opinion doesn’t count when it comes to an IHR application, the pension provider sets its criteria against the latest medical advice and treatments.
It depends on the severity of your Chronic Daily Migraines (CDM) and the type of work you do. Some people with CDM can manage their symptoms with medication, lifestyle adjustments, and accommodations, while others may find it impossible to maintain a regular work schedule.
Here are some factors to consider:Your success in obtaining Civil Service Ill Health Retirement (IHR) for Chronic Daily Migraine (CDM) would depend on several factors, including:
1. Severity & Impact on Work
• You would need to demonstrate that your migraines are severe, frequent, and disabling enough to prevent you from performing your job duties.
• If migraines cause cognitive impairment, light/sound sensitivity, or prolonged absences, this strengthens your case.
2. Medical Evidence• A strong application requires detailed medical reports from specialists (neurologists, pain management, occupational health).
• Evidence of unsuccessful treatments (e.g., medications, lifestyle changes, therapy) shows that your condition is unlikely to improve.
3. Occupational Health Assessment• The Civil Service Pensions Scheme (or your specific employer) will likely require an occupational health review.
• They assess whether reasonable adjustments (e.g., remote work, flexible hours, assistive tech) could allow you to continue working.
• If no adjustments help, your case is stronger.
4. Eligibility Criteria
• Most Civil Service Ill Health Retirement schemes (such as the Alpha Pension Scheme in the UK) have two tiers:
• Lower Tier – If you cannot continue in your current role but could do another job.
• Upper Tier – If you are unlikely to work again before retirement age.
• Chronic Daily Migraine might qualify for Lower Tier if it stops you from doing your job but not all work. Upper Tier is harder to get unless your migraines are completely disabling long-term.
5. Past Cases & Precedents
• Some people with CDM have successfully claimed IHR if they could prove their condition made sustained work impossible.
• Cases where migraines cause severe neurological impairment, require frequent hospital visits, or cause chronic medication side effects tend to be stronger.
How to Improve Your Chances
✔ Keep a symptom diary – Log frequency, triggers, impact on work.
✔ Obtain strong medical reports – Ensure your neurologist and occupational health document how CDM affects your function and why no treatment has worked.
✔ Highlight failed reasonable adjustments – If work accommodations didn’t help, this shows that continued work is not viable.
You likely know all of this anyway but this would be my take on it.Feel free to reach out with questions
S
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The below follows on from my previous response and would be along the lines of the things you might want to highlight.
So, Suffering from Chronic Daily Migraines (CDM) can significantly impact your ability to work, depending on the severity, frequency, and how well treatments manage your symptoms. Here’s how it might affect different aspects of work:
1. Physical & Cognitive Functioning• Chronic pain & fatigue – Persistent head pain can lead to exhaustion, making it hard to focus or complete tasks.
• Brain fog & cognitive issues – Difficulty concentrating, memory problems, and slower processing can make even simple tasks challenging.
• Light & noise sensitivity – Bright office lighting, computer screens, or noisy work environments can worsen symptoms.
2. Productivity & Performance
• Frequent absences – If migraines are unpredictable or severe, you may struggle to maintain regular attendance.
• Reduced efficiency – Even when at work, pain and discomfort might slow your pace and lower output quality.
• Difficulty meeting deadlines – Brain fog and fatigue may make it harder to stay on top of workload expectations.
3. Work Environment Challenges
• Office settings – Fluorescent lights, prolonged screen use, and noise can be major triggers.
• Physically demanding jobs – Stress, exertion, or irregular shifts may worsen symptoms.
• Customer-facing roles – Dealing with people while experiencing pain can be overwhelming.
4. Emotional & Mental Health Impact
• Increased stress & anxiety – Worrying about job performance or job security can add to stress, which may trigger more migraines.
• Isolation from colleagues – Needing to take frequent breaks or work in a dark, quiet space might make social interaction harder.
• Depression & frustration – Long-term pain and work difficulties can lead to emotional distress.
5. Workplace Adjustments That Might Help
• Flexible working hours – Starting later or adjusting hours to work around migraine patterns.
• Remote work – Avoiding commuting and working in a controlled environment.
• Regular breaks – Time away from screens or resting in a quiet, dark space.
• Assistive technology – Anti-glare screens, ergonomic chairs, or voice-to-text software.
If your migraines are severe and frequent despite treatment, holding down a job may become unsustainable, especially in rigid or high-pressure roles.
S
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Hi Bydand, thanks very much for your very detailed reply. It is very much appreciated. I was diagnosed wth CDM 11 years ago by a neurologist. Since then I've exhausted every treatment available to the NHS. The latter treatments are very expensive to the NHS and are seen as a breakthrough treatment. Sadly, for me none have worked. My migraines are severe. I have supplied 3 months of headache diaries with my application which I also give to my neurologist. Over the last few years I have tried all reasonable adjustments. I work in a court. I have worked in the courts with adapted darker lights, ive had flexible adjustments, and went part time for a period. Last year I was off work for almost 6 months. I returned for a few weeks, however my migraines are so severe I'm again on long term sick leave. I suffer from severe pain behind my right eye, throbbing headache (pain is 8 or 9 with 10 being most severe) i have nausea/sickness, dizziness, brain fog, sensitivity to light and fatigue. I live alone and spend the majority of my days in a dark room with black out blinds and an ice pack on my head. I have notified my neurologist and GP that they may be asked to complete a report for me. I struggle to get out of bed my pain is so severe. If i'm granted lower tier my thoughts are I would appeal this decision. My positions is I'm not fit for any job. The pain and symptoms are too severe. A change of job would not help me. I'm literally unable to do it. The OH adviser said she believes i'm unable to continue working for the foreseeable future and that I may be eligible for ill health retirement and said in her report to my HR that she believes my application should proceed to the next stage.
Thanks for your very helpful advice and all the points you made. I have emailed the completed application form to my HR over the weekend. However, im just wondering…. there wasn't much space in the box provided on the application form for me to go into much detail about how my condition affects me. It might be an idea if I send a seperate page with more information, to go along side my application. I was unsure whether to do this as I didnt see any where on the form where they say I could add more details on a seperate page. I suppose the worst that can happen is they say they wont take this into consideration. Thanks again for your help, very much appreciated.
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Hi again,
Your condition sounds extremely debilitating and not much fun at all so I can only sympathise with the position you find yourself in and hopefully you will get the outcome you want.
Ref the space on the form in which to write comments, I decided that it wasn’t sufficient to allow me to answer the questions each box asked in enough depth so I wrote in the boxes…see attached sheet… then proceeded to write an in depth answer separately…..i did this for all three question boxes and each of my attached sheets were at least two pages long.
My thinking being that I only get one chance at this and I needed them to be aware of my illness and associated struggles. Yes you need to back up your claims with medical evidence but It is so important that you highlight your struggles too and not just the medical facts and average. The chief medical pension Officer will have an understanding of your condition from a medical standpoint, but you need to make your application and answers have that personal viewpoint.
Not sure if you can add anything after form has been sent of, but I don’t see why not. My advice would be to be quick in doing this, don’t wait as you need all info to go in front of the scheme medical Officer at the same time. Be proactive and tell HR that you want the extra details added…..do this by email with any attachments so you have a record of your request should you need to appeal…….see below for extract from civil service portal ref appeal……you can’t just appeal because you disagree!!!
What if I disagree with the Scheme Medical Adviser’s assessment?If you disagree with the content of the report and your disagreement relates to medical opinion (rather than factual errors), or you have additional evidence you would like to be taken into account, the only way to challenge this is to follow the formal appeals procedure.
- The Medical Reviews and Appeals Guide provides details of the appeals procedure. Your employer should give you a copy of this guidance.
- You cannot appeal against the scheme medical adviser’s assessment if you withdraw consent for the report and certificate confirming whether or not you have qualifying medical reason for ill health retirement to be issued to your employer (see ‘Withdrawing consent for the Scheme Medical Adviser to send their report to your employer’).
The appeal period does not start until your employer has formally told you whether or not your ill health retirement assessment has been successful.
On the back of my application the pension provider arranged a verbal meeting by phone with the pension medical Officer to discuss my application and ask questions. It took about 45 mins…..a lot of what was discussed was about what I had written specifically.Other than the above, there’s not really an awful lot I can add. It’s just a waiting game once application is in.
Reach out though if you have anything else to ask, and do let us all know how you get on as it can help others in a similar position.
Kindest
S
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again thanks so much for taking the time for this well thought out and very sensible advice. Overnight I have managed to type up a 2 page answer to the 3 questions and quickly sent on to my HR business advisor dealing with my case. I only sent her my ihr1 form over the weekend so I’m hopeful she is able to merge both together and send off all to the scheme medical advisor. I feel better now that at least any decision they come to will at least have had the benefit of reading the difficulties I have due to this debilitating condition. I await a reply from HR confirming she has received all. Thanks again, very much appreciated.
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No worries, let’s hope the right decision is made and you get the outcome you hope for
S
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My HR Buisness advisor has confirmed she received all the documentation and has forwarded my application to MYSCP. I will let you know how I get on and thanks again for all your help. It really has been very much appreciated.
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That’s great. I didn’t think there would be a problem as you had just put application away to Hr over weekend, but best to have that confirmation anyway for piece of mind and at least this way they have a better overview of not only your illness but how it affects you in your own words and not just verbatim text from a medical book.
My feeling is that you will likely be asked to consent to the pensions medical doctor contacting you. This will likely be by phone. My advice is to keep a copy or notes of what you said in application as they will likely ask you to either expand on what you’ve said or clarify points they are maybe not too sure about. Your responses to these questions will be used as part of the process for decision making purposes, so be aware of what you’ve are saying, even on really innocent questions they might ask, ie, do you drive, how do you get to work , do you have hobbies etc. Your focus must be on how your condition affects you daily and how the condition and symptoms as it stands today with medical intervention has not in your case been successful.
It is also a good idea to have a timeline of when your condition started to affect you, periods of sick, reasonable adjustments tried and why they failed, dates of hospital appointments, medications ( including side effects), treatments and Dr’s you have been under to hand during any call. I would try and get onto this now and prepare so you are ahead of the game and you aren’t blindsided and left wallowing by being asked questions on the day.
Always keep in mind that they have permanency in mind when assessing you.
Feel free to reach out nearer the time if you want advice, help or just moral support.
S
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thank you so much, again absolutely wonderful, sensible thought out advice. I will let you know how things progress and start doing my preparation for a phone call. I’ve also been looking into future universal credit new style employment and support allowance claim as I’m on half pay and will be on nil pay in a couple of months. I’ve never claimed benefits in my life, looks like my timing is a bit off with the rumoured announcement from the government Tomorrow 🤣
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quick update. The scheme medical advisor has written to me telling me they’ve written to my specialist for a report. I’ve been in touch with my specialists secretary. She said he won’t write a report until he receives payment. The scheme medical advisor have told him they will pay his fee however unfortunately he just provided his bank details. They require a proper invoice from the specialist. As yet the specialist hasn’t provided an invoice. He only works every Wednesday at the hospital. What a carry on.
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What a palaver, how can something so simple in the process be so difficult to arrange. Unfortunately it will be a waiting game. You could opt to pay for the report yourself to perhaps speed the process up.
I don’t know if things have changed now but it used to be the case that the scheme medical adviser would not pay for a medical report in advance as they had no guarantee of the quality of the report or when they would receive it, or even if it would be received at all. That’s why they used to insist on an invoice so the other side could at least be accountable.
I was in discussion with my specialist about my IHR application right from the start and sent her info on the scheme and the criteria I had to meet in relation to my stated illness and symptoms……she did not charge me anything for her time or report writing.
With the limited days your specialist works I hope this doesn’t drag on. I have highlighted a particular part of the civil service IHR guide for members below.
You obviously do not want the medical adviser to proceed to decision without them having received a report as part of the consultation process.
- If a medical report is needed from your doctor, or specialist, or both, (referred to as a third party report), the Scheme Medical Adviser will send the request for a report from your doctor and/or specialist (or both, if needed) within 5 working days of receipt of the case. They will send two chase letters if a report has not been received after 20 days and then 25 days and will continue to process your case when the report has been received, or after 30 working days, if the report has not been received.
- Where the Scheme Medical Adviser has requested a medical report they will complete their assessment and produce an outcome report and certificate within 45 working days of receipt of the case. See ‘The Scheme Medical Adviser’s assessment report’ for information.
Scott
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Hi Scott Thanks for your reply. Yeah, i've tried something similar. I've been in touch with my specialists secretary for many weeks now. She's been forwarding on many letters to the specialist for me. I'd made him aware many weeks ago a request for a report was forthcoming. I'd asked if I could pay for this myself however his response was he would wait until he he receives the letter from my employer. I'd actually contacted my HR, they said in any event they would not reimburse me if i'd paid the fee myself. I'd also emailed the specialist's secretary details of the IHR scheme criteria and updated him on my symptoms. I've been trying not to leave anything to chance. Sadly, one the many triggers of Chronic Daily Migraine is stress, and all this palarva exacerbates my symptoms. I also did worry that the interactions i'm having with the Scheme medical advisor and the Specialist would give the impression that rather than being unfit for work I am in fact on the ball. I've had to inform them that these emails are being sent while im in bed in a dark room with an ice pack on my head after waiting for pain relief kicking in.
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Well, it seems like everything that could be done has been done, so really just a waiting game. I’m glad you have been so proactive in your discussions. If only for peace of mind ( even on an unsuccessful application ) you will at least know that you have done all you can.
I think for anyone applying for IHR it is especially important to have the conversation with doctor or specialist and keep them in the loop.
For me it was just about highlighting to them the fact that how they write a report and the words they use specifically can make or break an application. Their actual content and medical opinion would be the same but how they worded it with regards to the pension criteria was important. Any decent medical professional supportive of your application shouldn’t have any problems with this.Fingers crossed things will start to move forward soon.
Take it easy
Scott
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the plot thickens… I received an email from the specialists secretary saying the report has been sent to the scheme medical advisor this morning. I replied saying I’d asked for it to be sent to me first as I’m allowed to do.
I contacted the OH company dealing with my case. They said they have received the invoice and the report. They said the specialist should’ve sent the report to me first as per my request. The OH advisor has agreed to email me a copy of my report shortly.
I asked what happens next, will the SMA have a phone consultation with me or ask to see me. She said No, a decision in my case will be made without having to speak with me. I’m unsure why?0 -
I have now received the report. It details my symptoms, the treatments I have tried. Also with the comment
On the basis that Mr x has been suffering from chronic migraine with frequent disabling
symptoms for over 10 years, which have not responded well to any of the standard migraine
treatments, I think it is unlikely there will be a significant improvement in his symptoms in the future.
Not sure if this will be sufficient for the SMA. Fingers crossed
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Well, at least things are moving in the right direction at least. Hopefully you are happy enough with the specialists report and are happy it contains everything you think should be included…Yes they should have sent it to you first if they requested for that to happen. In most cases this is a good idea so you can challenge anything you think is wrong or not factual.
It is sometimes the case that the medical Officer does not need to phone you or have a face to face interview. I would still maybe prepare to have one though.
Just a waiting game now then.
Be aware that should the award be unsuccessful or you want to challenge the award you receive there are very short time limits that apply in appealing.
Anyway, keep us all up to date.
Scott
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