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The Health and Social Care Pension Scheme Regulations (Northern Ireland) 2015

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Determinations by medical practitioners

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15.—(1) The scheme manager may make arrangements for functions under this scheme in relation to decisions to which sub-paragraph (2) applies that are exercisable by the scheme manager to be discharged by—

(a)a medical practitioner (whether practicing alone or as part of a group) whom the scheme manager has approved to act on the scheme manager’s behalf, or

(b)a body (incorporated or unincorporated) which—

(i)employs medical practitioners (whether under a contract of service or for services), and

(ii)is so approved.

(2) This paragraph applies to a decision as to a person’s health or degree of physical or mental infirmity that is required for the purposes of this scheme and, in particular, a decision required for the purposes of—

(a)regulation 52(6)(b) (procedure for allocation election under regulation 50);

(b)regulation 75(9) (pension credit members);

(c)regulation 89(2)(c) or (3)(b) (early retirement on ill health: active members);

(d)regulation 92(1) or (5) (re-assessment of ill health pension);

(e)regulation 93(1)(b) or (2)(c) (early retirement on ill health: deferred members);

(f)regulation 108(1) (option to exchange pension for lump sum: serious ill health);

(g)regulation 121(3)(b)(i) (dependency because of physical or mental impairment);

(h)paragraph 7(1) of this Schedule (beneficiary incapable of looking after their own affairs);

(i)section 229(3)(a) of the 2004 Act (determining whether an individual satisfies the severe ill health condition)(1).

(3) In relation to such a decision, the scheme manager may require a person entitled or claiming to be entitled to benefit under this scheme to submit to a medical examination by a medical practitioner selected by the scheme manager.

(4) The scheme manager must also offer the person an opportunity to submit a report from the person’s own medical adviser following an examination of the person by the medical adviser.

(5) In taking a decision mentioned in sub-paragraph (1), the scheme manager must take into consideration both—

(a)the report mentioned in sub-paragraph (4); and

(b)the report of the medical practitioner who carries out the medical examination mentioned in sub-paragraph (3).

(1)

Section 229(3)(a) was substituted by section 660 of, and paragraphs 1 and 6(1) and (3) of Schedule 17 to, the Finance Act 2011 (c.11)

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