NHS pensions: how do you get tier 1?

Posted on behalf of a new user
Jo, Facilitator

I want to go for ill health retirement but can only afford it if I get tier 1 so I can still do some easier work but earn more than the basic tax-free allowance which is all you can earn on tier 2. Did anyone ask for the tier you hoped to get when you went for ill-health retirement, or did you just wait and see? Has anyone done it and got tier 1? Has anyone been offered tier 2 and asked to have tier 1 instead? What was their response? I’ve been told the NHS uses ATOS for its medical assessments too - did anyone have a medical and talk about the tiers at it? Any tips very gratefully received.

As far as I know they give you whatever they decide, based on your medical reports from your oncologist and GP, supplied to the pension people via your occupational health dept.

I got Tier 2 which was OK as I didn’t plan to work in the NHS again anyway. I can work anywhere else if I want to and earn as much as i like.

Hello new-user and welcome. I’m presuming the amount you are allowed to earn is over and above, and in addition to, the pension they will give you? Don’t forget there will be a lump sum too. Good luck.

I think the criteria for getting tier 2(sic) is that, due to your illness, you are unable to continue in work of like-time, ie to carry on in a full-time role if you were full-time for the NHS, or to do a part-time job if you were part-time for them. So if you could show that you can do (maybe are doing?) a part-time or full-time job as appropriate, you would exclude yourself from being awarded at the higher tier rate? Tier 1 is for the case if you can no longer do your *own* job, but are considered fit for other work.

I have also heard they turn down a lot of bona-fide applicants first time round who then succeed at appeal. So persevere. Now that sounds like ATOS… But i’m guessing that with something clear-cut like cancer, the doctors’ reports will say it all for you, and you may not need an interview/face-to-face assessment.

Jeniffer congratulations, it’s good to hear the system does work sometimes!

Just another thought that might help the orignal poster: depending what kind of work you do in the NHS, your union may have a noticeboard on their website that would give a relevant answer not specific to BC sufferers but with more NHS expertise than here. So eg for nurses the RCN has a website with a members section, I’m sure doctors, physios, ambulance staff, lab techs, IT staff would all have something equivalent which would fit with your terms and conditions. You might get to network with other newly retired people near you too, even if their illnesses are different; remember common things like diabetes, epilepsy, arthritis, even depression can also develop and destroy careers, not just cancer. I heard once that less than 80% of NHS staff reach natural retirement, not sure if that’s still true, if it ever was. Wouldn’t surprise me, it’s a tough and very stressful sector to work in, even without health issues of your own. Hope that helps someone.

Hi new user
I applied for ill health retirement and expected to get tier 1, but got tier 2, plus a nice lump sum.I didnt have a medical, the decision was taken on the info provided by my Onc and OH consultant. You can contact the pension agency and get a forecast for both tiers.
I dont know what your diagnosis is, but you may be eligable for DLA and employment support allowance as well as your pension and that will boost your income.

Ladies I wish you well. As I was 58 going on 59 when Dx I did not have the opportunity to ask for early retirement. Meanwhile In the Pensions choices stuff which came when I was on chemo I now find this was 300% out when I phoned repeatedly to sort this out I was eventually told that my executors would be dealt with .).).)
I have now had 3 different estimates AND yesterday I got a 4th estimate and also in the same envelope another estimate for a lady living in Sheffield who I have never heard of. Incompetent or what??? What can a gal do ??? J xx

libby wrote: “I was eventually told that my executors would be dealt with” Well, If that is your best offer, I promise to come back and haunt you! Executors have absolutely no power whatsoever until you are dead and they have a certificate to prove it. In the meantime they can deal with you direct, or your solicitor/union-rep/Doberman-Rottweiler-cross…

I don’t want to retire, and have only been working for the NHS for four years, but I need advice.

When I was diagnosed with cancer in 2007 I was working as a temp having given up my job as a school librarian a few months previously.

After my breast reconstruction at the end of 2007 I applied for a job in my local trust working in medical records. Up till now I have managed to cope because I didn’t have to file but over the last few months many of the staff have left meaning we have had to do more physical work leaving me sore and tired.

Today I went into work to find I have been allocated even more physical work. I don’t know if they can do this without discussing it with me first. I just dissolved into tears, because I am always in pain as it was my dominant arm which was effected but have bitten my lip and got on with the work even playing badminton but I really don’t know how I am going to manage with filing heavy records.

Has anyone any advice as to what I do if my job has changed since being employed?

Dear all,

I have been reading your posts with interest and hope you are all OK.

I wonder if anyone could offer me some advice? I was dx with BC 2004, and am now also the proud owner of:
Sjogrens Disease
I took myself out of clinical work as really struggling with shifts. Now do desk job but find that is making lymphodema worse and am really struggling with fatigue,muscle,joint pains - really impinges on home life. My days off are spent resting and getting over fatigue for return to work.
I have thought about giving up but need money, so considering ill-health but it just sounds so daunting and i am scared of being turned down, but don’t think I can carry on for much longer.
Have worked for NHS 27 years. Can anyone offer me some advice? Do these conditions sound acceptable for ill health?
Thank you XXX

Do you have a reliable Occupational Health or a union rep you feel confident with? If so, I would suggest you discuss with them your thoughts and ask them for the best way to approach retiral, whether this be ill-health or otherwise. Any benefits advice agency should be able to offer independant advice to you also. I hope this helps. Take care. J.

The ‘Ill Health Retirement - ATOS Medical’ thread may be useful to you also. J.

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Norberte your lymphoedema would make it hard in many parts of the nhs, the sleeves because of hygiene issues if you are in a clinical role, or the fatigue, manual handling, coordination, chemobrain aspects and any other side effects of medication if you’re not, this would help your claim. To stay down at tier 1 seems to be your big financial issue so maybe try to identify any job you could do for the same number of hours that you used to work before diagnosis and show that you think that would still be possible (There doesn’t actually have to be such a vacancy and you don’t have to be doing or wanting to do that job) Good luck

Hi all,

Great to read all your posts and hope you are all getting on OK in your applications.

Can I ask, has anyone applied and got turned down? Does anyone know what happens in this situation? It’s just soooo daunting… very worried about applying and then not getting it, but then know I have reached the end of the road as far as continuing in current job.But then what would happen if turned down ?! Why do I worry so much…XX

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I asked occ health what would happen if I got turned down and I was told I could appeal. The worry is that you may at this point have had notice served on you under capability so it’s a bit nerve wracking if you have the prospect of no job and no pension. Norberte - funnily enough my occ health dr keeps saying he doesn’t make the decisions either!

Hi loupylou,

thanks for your advice. i have heard that you can appeal too. Does anyone know why / what criteria they can turn it down? XX

I think a lot hinges on the “permanently incapable” criteria. You have to be deemed permanently incapable (up to normal retirement age) of returning to your current post for Tier one. Unfortnately breast cancer seems to be deemed cured once treatment is finished. The oncologist isn’t always helpful as they make comments such as “it should settle down in time” or as mine likes to tell me “it’s probably the menopause and it will get better”. If the pensions people ask these specific questions to your oncologist then I don’t believe it will convince them that you can’t return to work even though occ health feel that you aren’t able. It’s a tough decision.

Hi Loupylou,

Thanks for that. I am considering ill health retirement on the basis of the other “ailments” i now possess, possibly courtesy of my breast cancer diagnosis and treatment since 2004. i am now the proud owner of;
osteoporosis - possibly as a result of 5 years (unmonitored) of Arimidex
Fibromyalgia and ? Sjogrens syndrome (autoimmune disease)which causes extreme faatigue,brain fog and muscle and joint pains)
Lymphodema - trunkal, but now possibly extending to dominent arm and hand

I have struggled to continue working with this little lot, changing from a clinical role to non-clinical. However, now sat at desk all day and computer work seems to be affecting lymphodema.
Although going to work, I am so tired and in pain much of the time from arthralgia/myalgia, I spend my 3 days off recovering, so that I can go back to work the following week - not good!

I have been thinking about ill health retirement for a while now but so scared of the process and especially of the “what if I don’t succeed” scenario.
I think of doing another job but really don’t think it would make a difference - fatigue etc still there whatever I do and that rules out any type of shift work.
Oh, what a situation, it’s getting me pretty stressed…XXXX