Ill health retirement declined by Medigold. Any advice on appeal ?

[kingrollo]

I worked for the NHS and after my heart attack last year I enquired about I'll health retirement. I had to have an interview with the trusts occupational health doctor - who agreed to support my case for IHR.
This was based on 3 areas of my health:-

Spinal issues - ongoing on and off for 30 years - but significantly worse in the last 3.

Mental Health - pretty much as above.

My cardiac health.

Despite the trust doctors report - NHS pensions contract out the health assessment to an external company Medigold.

These have sent back a very long winded report saying that on the balance of probability and with ongoing medical care my conditions are likely to improve before my normal pensionable age . They have reports from my GP and specialist doctors which in my opinion describe the opposite.

In my opinion I have exhausted all possible options - in particular my spine issues which the most recent nerve ablation provided only a couple of weeks of relief. The next huge step would be spinal fusion.

I have wrote directly to Medigold asking them what treatment options they consider available - but Medigold gave declined to enter into any sort of dialogue. Instead saying I must appeal through NHS pensions. However if they can say "you will get better" without being required to present any evidence to support this - what's the point of an appeal .

Anybody any experience of dealing with Medigold?

 

[midlife]

Are you in a union, they often have legal support. Having dealt with NHS pensions they are something out of the Dark Side at times

 

[kingrollo]

Are you in a union, they often have legal support. Having dealt with NHS pensions they are something out of the Dark Side at times

No not in a union.

 

[midlife]

Ah. As far as I am aware there is no back door and you have to appeal through NHSBSA official channels

You need updated medical reports from your employer that refute the claims of medigold. You can access the Medigold report as it forms part of your medical records.

NHSBSA put time limits on everything so I’d check when the clock for this started ticking.

Do you have something like. Collaborative chair / Director that sits above your line manager ?

 

[kingrollo]

Ah. As far as I am aware there is no back door and you have to appeal through NHSBSA official channels

You need updated medical reports from your employer that refute the claims of medigold. You can access the Medigold report as it forms part of your medical records.

NHSBSA put time limits on everything so I’d check when the clock for this started ticking.

Do you have something like. Collaborative chair / Director that sits above your line manager ?

I'm not employed anymore. I retired on ill health grounds !

 

[Webbo2]

I'm not employed anymore. I retired on ill health grounds !

I take it what you are after is to get your pension early?

 

[kingrollo]

I take it what you are after is to get your pension early?

You get a higher rate of pension if it is agreed on ill health grounds.
They paid me a reduced pension as I am not yet pensionable age.

 

[Bonefish Blues]

I'm not employed anymore. I retired on ill health grounds !

You did that unilaterally, I guess? Took early retirement, as it currently stands.

 

[kingrollo]

You did that unilaterally, I guess? Took early retirement, as it currently stands.

Well when the hospital doctor agreed to support my case for ill health retirement and I had supporting documents from my GP and other medical professionals - I thought I would get the same decisions from NHS pensions.

I'm not well enough to work anyway - I would have eventually been dismissed.

It's just frustrating that they can say you will get better with correct treatment - when I have exhausted all the treatment options. They won't even tell me what they believe the correct treatment is.

 

[Webbo2]

Well when the hospital doctor agreed to support my case for ill health retirement and I had supporting documents from my GP and other medical professionals - I thought I would get the same decisions from NHS pensions.

I'm not well enough to work anyway - I would have eventually been dismissed.

It's just frustrating that they can say you will get better with correct treatment - when I have exhausted all the treatment options. They won't even tell me what they believe the correct treatment is.

I don’t know whether this is an option but getting an opinion from an Orthopaedic surgeon on your back plus reports from a Psychiatrist/ Psychologist and a cardiac consultant.
If you could get these and they are in your favour then it will be hard for the pensions board to turn you down.
It might be worth paying out for these in order to further your cause.
when I was working ( in mental health) I had patient who a degenerative spine condition which prevented him from working. He was called in to see if he was entitled his current benefits and when the doctor questioned his diagnosis, he produced x rays he’d had done in France with a report confirming his condition.
He continued to receive his benefits.

 

[N0bodyOfTheGoat]

I was "invited" to have an IHR phone interview after being signed off sick with my long covid for ~11 months while a postie, with access to my GP records and the interview it was agreed, but I didn't qualify for drawing my pension early (not that I knew much about that at the time and so wasn't expecting it).

 

[Drago]

It was different for me with my medical retirement - there were very clear police regulations that had to be followed one by one.

Isn't here anythjng similar for you, or ismit at the whim of them pension provider? There is a pensions regulator you could try appealing to.

Best of luck.

 

[kingrollo]

I don’t know whether this is an option but getting an opinion from an Orthopaedic surgeon on your back plus reports from a Psychiatrist/ Psychologist and a cardiac consultant.
If you could get these and they are in your favour then it will be hard for the pensions board to turn you down.
It might be worth paying out for these in order to further your cause.
when I was working ( in mental health) I had patient who a degenerative spine condition which prevented him from working. He was called in to see if he was entitled his current benefits and when the doctor questioned his diagnosis, he produced x rays he’d had done in France with a report confirming his condition.
He continued to receive his benefits.

They have already have such evidence.

 

[Webbo2]

They have already have such evidence.

Then you need to get appealing possibly with a legal representative. If funds are a problem age concern or citizens advice might be able to help.

 

[Drago]

Before you do anythjng else, submit an SAR to medigold. What they say to you, and what they say among themselves may be two very different things and may aid your case. At worst it costs the price of a stamp and gets you no further.