Date: 18 th October 2013

1. Railways pension schemeDr CRAIG WEDDELLLEAD OH PHYSICIAN, BUPA IMASARIOPS annual conferenceYork Date: 18th October 2013

2. Railways Pension Scheme Bupa Private and Confidential “Railway pensions and ill health retirement; getting the evidence right – which applications are likely to succeed and why” What makes an application successful and how to avoid the pitfalls

3. Agenda Bupa Private and Confidential • Bupa IMAS services • Railways Pension Scheme – Eligibility criteria, definition of incapacity • Documentation • Gathering the medical evidence • RME report content • Avoiding the pitfalls • Reaching the final destination • Steering clear of the Pensions Ombudsman • Questions

4. Bupa IMAS services Medical adviser to RPS Assessing applications for ill-health retirement benefits (incapacity benefits) Review of ill-health retirement benefits award (incapacity benefits) Attendance at Trustees meetings Bupa Private and Confidential

5. RPS – eligibility criteria Bupa Private and Confidential Eligibility criteria Rule 5D 5 years qualifying service Application must be submitted within 1 year of leaving service Taking early retirement benefits,>age 50. Rule 11A Definition of ‘incapacity’ NRA (age 60)

6. RPS – ‘incapacity’ Bupa Private and Confidential Incapacity means : ‘bodily or mental incapacity or physical infirmity which, in the opinion of the Trustee on such evidence as it may require, shall prevent, otherwise than temporarily, the Member carrying out his duties, or any other duties which in the opinion of the Trustee are suitable for him’

7. Documentation Forms –PM30/PM31 Section A – applicant Section B – employer Section C – Railways Medical Examiner Supplementary medical report

8. Gathering the medical evidence Bupa Private and Confidential OH consultations Review of OH record Railways medical standards GP medical reports Specialist reports

9. RME report content • Use of standardised medical report template • Medical diagnosis • Medical summary • Symptoms, functional capabilities, treatment to date • Consideration of Incapacity • “bodily or mental incapacity or infirmity”. • “must not be temporary”. • “prevent the member from performing his duties”. • “prevent the member from performing any other (suitable)duties • Treatment options • Rehabilitative measures • Reasonable adjustments, including redeployment • Likely timescales • Prognosis for medical condition Bupa Private and Confidential

10. Steering clear of the Pensions Ombudsman Bupa Private and Confidential Understanding of scheme rules and requirements Clear and consistent medical opinion Assessing the medical evidence Weighting of medical evidence Dealing with conflicting medical opinion

11. Reaching the final destination Understanding your role • RME, employer, Trustee Stick to your timetable • Give yourself enough time to collect the medical information/reports and advise the employer accordingly • Manage expectations Have a clear route map Mind the gaps Bupa Private and Confidential