Ill health resources
All members
- Ill health process flow chart (PDF 17KB)
- IRMP approval form (Word 190KB)
- IHRE1 – Referral to an independent doctor (Word 45KB) – for employers
- IHRC – Consent form to release medical records (Word 79KB) – for members when the doctor doesn’t have a consent form
- Guidance note 2 – processing an ill health retirement case (Word 107KB)
- RETIRE 1, 2, 3, 5 – member retirement forms
Active members
- Ill health notification form (Word 48KB)
- Ill health guide (Word 98KB)
- Guidance note 1: Making the decision for an active member (Word 144KB)
- IHCERTA1: The main ill-health certificate (Word 86KB) – completed by the employer and the independent doctor
Ill health toolkit for active members:
- Contents (Word 79KB)
- Letters (Word 168KB)
- Checklist for practitioners (Word 91KB)
- Leaflet for active members (Word 169KB)
- IHRE1 option flowchart (PDF 56KB)
- IHCERTA1 decision making flowchart (PDF 50KB)
Deferred members
Ill health Guidance Note 4: Ill-health deferred benefits into payment (Word 96KB)
The main ill-health certificate completed by the employer and the independent doctor for leavers/optant outs:
- Before 1 April 1998 –IHCERTD1 (Word 81KB)
- Between 1 April 1998 – 31 March 2008 –IHCERTD2 (Word 48KB)
- Between 1 April 2008 – 31 March 2014 –IHCERTD3 (Word 57KB)
- After 1 April 2014 –IHCERTD4 (Word 50KB)
Ill health toolkit for deferred members:
- Contents (Word 72KB)
- Checklist deferred benefits into payment for practitioners (Word 76KB)
- Leaflet for members with deferred benefits (Word 98KB)
- Letters deferred benefits into payment (Word 71KB)
Tier 3 reviews
Guidance for retirements
- Before 1 April 2014 – IH guidance note 3A (Word 78KB)
- After 31 March 2014 – IH guidance note 3B (Word 121KB)
Key forms
Leavers 1 April 2008 – 31 March 2014
- TR3REV08C Tier 3 certificate (Word 84KB) – for pensions discontinued 3 or more years ago – member request that early payment on health grounds be considered (must be before normal retirement age).
Leavers 1 April 2014 Onwards
- TR3REV14A Tier-3 certificate 18 month review (Word 87KB) for pensions still being paid.
- TR3REV14B Tier 3 certificate (Word 91KB) for pensions still being paid – member requests that:
- uplift to Tier 2 be considered (outside of 18 month review process) or
- early payment on health grounds (i.e. move to permanent pension) and;
- or pensions that ceased within last 3 years – member requests that:
- uplift to Tier 2 be considered or early payment on health grounds (must be before normal pension age)
- TR3REV14C Tier-3 certificate (Word 84KB) for pension ceased 3 or more years ago – member requests that early payment on health grounds be considered (must be before normal pension age).
Other forms
- TR3NOT Tier-3 review notification (Word 51KB) form to inform the Pensions Service of outcome of review where there is no TR3REV08A/B/C or TR3REV14A/B/C e.g. when a decision is taken that you consider the individual to be in gainful employment
- TR3REF Tier-3 review to IRMP (Word 45KB) form to refer a Tier 3 review case to an Independent Registered Medical Practitioner (IRMP)
- IHRC3 (Word 47KB)where your chosen IRMP has no specific consent form, to be completed by the member to allow the release of medical records to the independent doctor
- BENDEC3 Declaration of other benefits (Word 54KB) for use when uprating from Tier 3 to Tier 2.
