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The National Health Service Pension Scheme Regulations 2015
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Whole provisions yet to be inserted into this Instrument (including any effects on those provisions):
- reg. 21(2)(f) and word inserted by S.I. 2024/281 reg. 19(3)
- reg. 28(2)(f) and word inserted by S.I. 2024/281 reg. 20(3)
- reg. 30(7)(8) inserted by S.I. 2024/281 reg. 21(4)
- reg. 31(9)(c) inserted by S.I. 2024/281 reg. 22(2)(a)
- reg. 31(11)(12) inserted by S.I. 2024/281 reg. 22(3)
- reg. 68(1)(ea) inserted by S.I. 2024/281 reg. 24(3)
PART 6 E+WDeterminations
Determination of questionsE+W
14.—(1) Except as otherwise provided by these Regulations, any question arising under this scheme is to be determined by the scheme manager.
(2) Any such disagreement as is referred to in section 50 of the 1995 Act M1 (resolution of disputes) must be resolved by the scheme manager in accordance with any arrangements applicable under that section.
Marginal Citations
M1Section 50 was substituted by section 273 of the Pensions Act 2004 (c.35) and amended by sections 16(1) to (6) of the Pensions Act 2007 (c.22).
Determinations by medical practitionersE+W
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 53(5)(b) (procedure for allocation election under regulation 51);
(b)regulation 76(9) (pension credit member);
(c)regulation 90(2)(c) or (3)(b) (early retirement on ill health: active members);
(d)regulation 93(1) or (5) (re-assessment of ill health pension);
(e)regulation 94(1)(c) or (2)(c) (early retirement on ill health: deferred members);
(f)regulation 109(1) (option to exchange pension for lump sum: serious ill health);
(g)regulation 122(3)(b)(i) (dependency because of physical or mental impairment);
(h)paragraph 7(1) of this Schedule (beneficiary incapable of looking after own affairs);
(i)section 229(3)(a) of the 2004 Act M2 (determining whether an individual satisfies the severe ill health condition).
(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).
Marginal Citations
M2Section 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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