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Regulations 77, 81, 106, 117, 209

SCHEDULE 1Medical decisions: appeals and reconsideration

Interpretation

1.  In this Schedule—

“appeal board” means a board appointed under paragraph 6 of this Schedule;

“final decision” has the meaning given in paragraph 3;

“medical decision” means a decision contained in—

(a)

a report by the selected medical practitioner under regulation 81 (referral of medical questions to a selected medical practitioner for purpose of regulation 82);

(b)

a report by the selected medical practitioner under regulation 83 (compulsory retirement of member who was required to continue to serve);

(c)

a report by the selected medical practitioner under regulation 86 (referral of medical questions for purpose of early payment of a full retirement pension on grounds of permanent medical unfitness);

(d)

a report by the selected medical practitioner under regulation 107 (referral of medical questions for purpose of reduction of benefits);

(e)

a report by the selected medical practitioner under regulation 117 (referral of medical questions for purpose of a review);

(f)

a report by the appeal board under paragraph 2(5) (appeal against decision of a selected medical practitioner); or

(g)

a fresh report by a medical authority under paragraph 3 (referral of final decision for reconsideration).

“medical authority” means a selected medical practitioner or an appeal board;

“police pension authority” means the police pension authority acting in exercise of its functions as employer or scheme manager;

“selected medical practitioner” means—

(a)

a single duly qualified medical practitioner selected by the police pension authority; or

(b)

a board of duly qualified medical practitioners selected by the police pension authority.

Appeal against decision of a selected medical practitioner

2.—(1) Within 28 days after a member of a police force receives a copy of a report by the selected medical practitioner containing a medical decision (or such longer period as the police pension authority may allow), the member may give notice of appeal to the police pension authority against the decision in accordance with paragraph 7 (procedure and costs on appeals to appeal board).

(2) An appeal under this paragraph is to be held in accordance with paragraph 7.

(3) Sub-paragraph (4) applies if, within a further 28 days after the police pension authority receives the notice of appeal (or such longer period as the police pension authority may allow), the member gives the police pension authority a statement of the grounds of appeal.

(4) The police pension authority must, unless the member and the police pension authority agree to a further reference to a selected medical practitioner under paragraph 3—

(a)notify the Secretary of State that a statement of the grounds of appeal has been received; and

(b)refer the appeal to an appeal board for decision.

(5) The decision of the appeal board, if it disagrees with any part of the report of the selected medical practitioner—

(a)must be expressed in the form of a report; and

(b)subject to paragraph 3, that report is final.

(6) A copy of the report must be given to the scheme manager and to the member.

Referral of final decision for reconsideration

3.—(1) This paragraph applies if a medical authority has given a final decision in relation to a member of a police force (“the member”).

(2) For the purpose of this Schedule, a medical authority has given a final decision if—

(a)the selected medical practitioner has given a medical decision and the time for giving notice of appeal against the decision under paragraph 2(1) has expired without an appeal being made;

(b)the selected medical practitioner has given a medical decision and, following the giving of notice of appeal under paragraph 2(1), the police pension authority has not yet notified the Secretary of State of the appeal; or

(c)an appeal has been made to an appeal board and the appeal board has given a decision.

(3) The police pension authority and the member may, by agreement, refer the final decision to the medical authority for reconsideration.

(4) The medical authority must reconsider the final decision and, if necessary, issue a fresh report.

(5) A copy of the fresh report must be given to the scheme manager and to the member.

(6) The fresh report is final, subject to—

(a)any further reconsideration of the final decision under this paragraph; or

(b)an appeal under paragraph 2 against the medical decision.

(7) In sub-paragraph (6), “appeal” means an appeal in respect of which a notice of appeal was given before the medical decision was referred under this paragraph.

(8) In this paragraph, “medical decision” does not include a decision contained in a fresh report issued under this paragraph.

Referral of final decision by court or tribunal

4.—(1) If a court hearing an appeal under regulation 207 (appeals to Crown Court) or a tribunal hearing an appeal under regulation 208 (appeals to Secretary of State) considers that the evidence before the medical authority which gave a final decision was inaccurate or inadequate—

(a)the court or tribunal may refer the final decision to the medical authority for reconsideration in the light of such facts as the court or tribunal may direct; and

(b)the medical authority must reconsider the final decision and, if necessary, issue a fresh report.

(2) A copy of the fresh report must be given to the scheme manager and to the member.

(3) Subject to any further reconsideration under paragraph 3, the fresh report is final.

Referral to appointed medical practitioner

5.—(1) If a final decision is referred to a medical authority for reconsideration under paragraph 3 or 4 and the medical authority is unable or unwilling to act, the final decision may be referred to an appointed medical practitioner.

(2) The decision of an appointed medical practitioner has effect as if it were that of the medical authority who gave the final decision.

(3) In this paragraph, “appointed medical practitioner” means a duly qualified medical practitioner or a board of duly qualified medical practitioners—

(a)agreed by the member of the police force and the police pension authority; or

(b)appointed by the court or tribunal.

Appointment of appeal board

6.—(1) An appeal board must consist of not less than 3 medical practitioners—

(a)who are appointed by the police pension authority in accordance with arrangements approved by the Secretary of State; and

(b)of whom one must be appointed chair.

(2) At least one member of the appeal board must be a specialist in a medical condition relevant to the appeal.

(3) Where there is an equality of voting among members of the appeal board, the chair has a casting vote.

(4) There must be paid to the members of the appeal board—

(a)such fees as are determined in accordance with arrangements made by the Secretary of State; or

(b)where no such arrangements have been made, such fees and allowances as the Secretary of State may from time to time determine.

(5) Any fees or allowances so payable must, subject to paragraph 10 (costs payable if hearing is cancelled, adjourned or postponed)—

(a)be paid by the police pension authority; and

(b)be treated as part of the expenses of the police pension authority for the purposes of this paragraph.

Procedure and costs on appeals to appeal board

7.—(1) The notice of appeal and the statement of grounds of appeal must be in writing.

(2) The police pension authority must send copies of the following documents to the Secretary of State and to the appeal board—

(a)the notice of appeal;

(b)the statement of grounds of appeal; and

(c)any other documents the Secretary of State considers necessary.

Hearing the appeal

8.—(1) The appeal board must—

(a)appoint a time and place for hearing the appeal and for any further hearings it may consider necessary; and

(b)give notice of the hearing to the appellant and the police pension authority (“the parties to the appeal”).

(2) Notice of a hearing must be given at least 2 months before the hearing (or any shorter period the parties to the appeal agree).

(3) The parties to the appeal must, not less than 35 days (including weekends and public holidays) before the date appointed for a hearing, inform the appeal board whether they intend to be represented at the hearing.

(4) The appeal board may interview or examine the appellant at any hearing.

(5) Any hearing (including any medical examination of the appellant) may be attended by—

(a)the selected medical practitioner or, if the selected medical practitioner is unavailable, a duly qualified medical practitioner appointed for the purpose by the police pension authority, and

(b)a duly qualified medical practitioner appointed for the purpose by the appellant.

(6) A medical practitioner mentioned in sub-paragraph (5) who attends a hearing may only observe a medical examination.

(7) If any hearing includes a medical examination, only medical practitioners may be present for that part of the hearing.

(8) The appeal board must supply the Secretary of State and the parties to the appeal with a written statement of its decision.

(9) If the appeal board disagrees with any part of the selected medical practitioner’s report, the appeal board must supply a revised report.

(10) A copy of the revised report must be given to the scheme manager and to the member.

Written evidence or a written statement

9.—(1) A party to an appeal who intends to submit written evidence or a written statement at a hearing must, subject to sub-paragraph (2), submit it to the appeal board and the other party not less than 35 days before the date appointed for the hearing.

(2) If a party submits written evidence or a written statement under sub-paragraph (1), the other party may, not less than 7 days before the date appointed for the hearing, submit written evidence or a written statement in response.

(3) Any evidence or statement submitted under sub-paragraph (2) must be submitted to the appeal board and the party who submitted the evidence or statement under sub-paragraph (1).

(4) The appeal board may postpone or adjourn the date appointed for the hearing if—

(a)written evidence or a written statement is submitted in contravention of this paragraph; or

(b)it appears necessary to do so for the proper determination of the appeal.

(5) References in this paragraph to periods of days include weekends and public holidays.

Costs payable if hearing is cancelled, adjourned or postponed

10.—(1) Subject to the following provisions, the expenses of each party to the appeal must be borne by that party.

(2) This sub-paragraph applies if a hearing is cancelled, adjourned or postponed at the request of, or due to the actions or omissions of, the police pension authority less than 22 days (including weekends and public holidays) before the date appointed for the hearing.

(3) If sub-paragraph (2) applies, the appeal board must require the police pension authority to pay to the appellant any expenses actually and reasonably incurred by the appellant in respect of attending or arranging to attend the cancelled, adjourned or postponed hearing.

(4) This sub-paragraph applies if the appeal board determines that a hearing has been cancelled, adjourned or postponed at the request of, or due to the actions or omissions of, the appellant less than 22 days (including weekends and public holidays) before the date appointed for the hearing.

(5) If sub-paragraph (4) applies, the appeal board may require the appellant to pay towards the cost of the cancellation, adjournment or postponement such sum not exceeding the total costs of the cancellation, adjournment or postponement as the appeal board decides, taking account of representations from either party.

Costs payable on decision

11.—(1) Costs are payable in accordance with this paragraph on determination of the appeal.

(2) If the appeal board decides in favour of the appellant, the police pension authority must refund to the appellant any expenses actually and reasonably incurred by the appellant in respect of attending any hearing of the appeal.

(3) This sub-paragraph applies if the appeal board—

(a)decides in favour of the police pension authority; and

(b)reports that in its opinion the appeal was frivolous or vexatious.

(4) If sub-paragraph (3) applies, the police pension authority may, subject to sub-paragraph (5), require the appellant to pay towards the cost of the appeal such sum not exceeding the total fees and allowances of the members of the appeal board as the police pension authority thinks fit.

(5) If the appeal board, after taking account of any representations from either party, decides there are exceptional reasons why the appellant should not pay towards the cost of the appeal—

(a)the appeal board must give the parties written notice of its decision; and

(b)the police pension authority must not require the appellant to pay towards those costs.