The National Health Service Pension Scheme Regulations 2015

Re-assessment of entitlement

93.—(1) This regulation applies if—

(a) in respect of a member (M) the scheme manager is satisfied as mentioned in regulation 90(2)(c); and

(b) at the time M is awarded a pension the scheme manager gives M notice in writing as mentioned in paragraph (2).

(2) The notice is that M’s case may be considered once within a period of three years beginning with the date of the award to determine whether, at the date of the consideration, M meets the condition in regulation 90(3)(b).

(3) M may apply to the scheme manager for a review of whether M subsequently meets the condition in regulation 90(3)(b) if—

(a) M makes the application in writing no later than the relevant date;

(b) the application is accompanied by further written medical evidence—

(i) relating to whether, at the date of the scheme manager’s review, M has the physical or mental infirmity mentioned in regulation 90(3)(b); and

(ii) that relates to the same physical or mental infirmity as a result of which M met the condition in regulation 90(2)(c);

(c) no previous application for a review has been made under this paragraph; and

(d) M has not become entitled to a Tier 2 IHP in respect of any later service under regulation 97.

(4) The relevant date in paragraph (3)(a) is—

(a) the last day of the period of three years after the giving of notice under paragraph (1)(b); or

(b) if M engages in further NHS employment during that period, the first anniversary of the day on which the employment commences or, if sooner, the last day of that period.

(5) If, after considering the further medical evidence the scheme manager determines that M has the physical or mental infirmity for the purposes of regulation 90(3)(b), with effect from the date the determination is made, M—

(a) ceases to be entitled to a Tier 1 IHP; and

(b) becomes entitled to a Tier 2 IHP.

(6) If a determination is made under paragraph (5), in calculating the Tier 2 addition pursuant to regulation 92(3), in the explanation of factor E for “period starting on L+1” substitute “period starting on day of the determination under regulation 93(5)”.