TPO upholds ill health complaint

The Pensions Ombudsman (TPO) has upheld an ill health benefits complaint against the Central Networks Group of the Electricity Supply Pension Scheme.

‘Mr R’ complained that the trustee had paid his deferred benefits with effect from April 2017, rather than the point at which he applied for the early payment of his deferred benefits on the grounds of ill health (September 2015).

TPO has ordered the trustee to review the case after obtaining further clarification from the medical adviser of the scheme.

In 2015, the scheme administrator, Western Power Distribution (WPD), referred the case to occupational health physician, Dr Williams, who advised that the permanence of Mr R’s ill health could not be established.

Dr Williams stated that with treatment, it was likely that Mr R would recover sufficiently “to return to meaningful employment”.

Mr R subsequently appealed to the schemes two-stage internal dispute resolution (IDR) procedure and was informed on 4 April 2017 that the trustee was not able to consider medical evidence from a practitioner who had not been appointed by the employer.

When Mr R reapplied for the early payments of his benefits on 26 April 2017, the case was once again referred back to Dr Williams who at this time found that Mr R was suffering “significant ill health”.

WPD confirmed to Mr R on 14 September 2017 that his pension would now be paid, however Mr R queried the effective date of payment, and appealed again under the IDR procedure in order have this reflect the initial application for early payment in 2015.

Mr R argued that he had provided medical certificates that were accepted by the Department for Work and Pensions as proof of incapacity from September 2015, and had not been examined by the company doctor.

The scheme confirmed its decision not to backdate the benefits in both the stage one and stage two decisions.

However, TPO, Anthony Arter, has now directed the trustee to obtain clarification from Dr Williams concerning his 2015 opinion before reviewing the case.

Arter stated: “Dr Williams’ 2015 report did not provide the trustee with sufficient information for it to be able to understand his reasoning. I accept that the trustee can only review cases from a lay perspective. I am in the same position.

“However, it should have asked Dr Williams to explain what treatment he had in mind and what he meant by 'meaningful employment'."

If the scheme trustee subsequently finds it appropriate to backdate the benefits, TPO has directed it to pay Mr R arrears of pension, together with simple interest at the base rate quoted by the Bank of England.

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