The Local Government Pension Scheme Regulations 1997 introduced the internal dispute resolution procedure (IDRP) and subsequent changes to the LGPS regulations have not removed the various provisions which are now contained in:
The Local Government Pension Scheme Regulations 2013:
- Regulation 74 ‐ Application for adjudication of disagreements
- Regulation 75 ‐ Decisions of the adjudicator
- Regulation 76 ‐ Reference of adjudications to Administering Authority
- Regulation 77 ‐ Decisions of the Administering Authority on reconsideration
- Regulation 78 ‐ Rights of representation
- Regulation 79 ‐ Appeals by Administering Authorities
As administrators of the Devon and Somerset Pension Funds, Peninsula Pensions is legally required to have a formal complaints procedure. Ours is the IDRP which places strict obligations on both scheme employers and Peninsula Pensions.
The IDRP is a formal procedure put in place to resolve disagreements about decisions taken regarding LGPS pension matters. The process is in two stages:
- Stage 1 is looked at by your nominated IDRP Stage 1 Appeals Officer (the ‘adjudicator’)
- Stage 2 is looked at by Peninsula Pensions
What you need to do:
- You must appoint a person to consider appeal cases at Stage 1 of the IDRP
- Ensure that applications are dealt with properly and timely
Avoiding appeals via an informal process
Where a member is unhappy with a decision, it may be better to deal with the matter informally. The member could have a meeting with the body that took the decision, where further details and reasons for the decision could be provided.
To make sure the decision is fair and understandable to the member, it’s important to show that it was made in a way that is consistent with how other decisions are made. This means following and complying with a clear policy statement. When the member understands that the decisions were reached by following these established guidelines, they are more likely to see that it is not a personal attack on the complainant, Keeping records of the decision is crucial.
Sometimes, when informal efforts to resolve disagreements don’t work, the member has the legal right to start the formal IDRP. Detailed investigations will take place into the decisions that were made and the methods used to reach those decisions.
The importance of record keeping
Once investigations reach the formal appeal process, evidence of how and why first instance decisions were reached will be required. It is therefore important that you keep detailed records of the decisions taken.
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The Internal Process (IDRP)
Who can appeal (the applicant)?
- a member or a prospective member
- a widow or widower of the member
- a surviving civil partner of the deceased
- a cohabiting partner
- the deceased member’s dependants, or
- the member’s representative
When and why can the applicant appeal?
- The member must appeal within six months of the date they are notified of that decision, or from the date of the act or omission – the Stage 1 Appeals Officer has the discretion to extend this time limit
- The member has a further right of appeal to the Administering Authority if dissatisfied with the decision made by the Stage 1 Appeals Officer
- The applicant may appeal against any decision made by you or the administering that affects their rights or benefits under the scheme or against any other act or omission by either party.
Rights of representation
The applicant can nominate a representative to make the application on their behalf at either stage of the procedure and the representative can continue the appeal.
The appeal may be made or continued by a family member or another suitable representative under the following circumstances:
- If a person dies and had a right to make an appeal
- If the applicant is a minor or is incapable of acting for themselves
- If the applicant becomes otherwise incapable of acting for themselves
Where a representative is nominated before an appeal is made, the appeal must specify their full name and address and the representative must be sent a copy of all correspondence.
A fair and impartial decision
The decision must be fair‐minded and impartial having regard to the following principles:
- not representing any party or interest, and
- no previous personal involvement with the case
Even where the appeal is against a decision made by Peninsula Pensions as the administering authority, there will always be senior officers who were not previously involved and who can make an unbiased decision while also taking into account and respecting Peninsula Pension’s previous position.
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IDRP - Stage 1
The applicant should contact you, in writing, with a copy of the decision they wish to appeal against if possible.
The appeal is then submitted to your nominated IDRP Stage 1 Appeals Officer – the ‘adjudicator’.
You must appoint a person to consider appeal cases at Stage 1 of the procedure. Scheme regulations do not specify who the adjudicator should be, but in practice, it is recommended to be someone with relevant expertise as the person will need to understand the details of the dispute.
The purpose of the first stage is to carry out a formal review of the initial decision. This can be used as an opportunity to reconsider the question, and where appropriate, to alter the decision if it was not a reasonable one to reach based on the relevant procedures, legislation and evidence. For example, where certain relevant facts or evidence were not considered, or where there has clearly been a mistake or oversight.
Your nominated Stage 1 Appeals Officer must:
- Check that the application has been submitted within six months of the relevant date and send an acknowledgement
- Consider all facts, reports, background information before reaching a determination
- Request further evidence if necessary
- Provide a determination within two months of receiving the appeal and issue a copy of the determination to the applicant or representative, the employer (if the adjudicator is independent) and Peninsula Pensions
- If this is not possible, the adjudicator must write to the member immediately explaining the reason for the delay and when a determination will be made. The member may then refer the dispute direct to us because of the failure to adhere to the time limits.
Although in most cases the Stage 1 decision will be a final one, there may be circumstances where the adjudicator may wish to issue a provisional decision so that the views of all interested parties, in particular, that of Peninsula Pensions, can be obtained before a final decision is taken.
Because the two-month time limit relates to the final decision, a letter of explanation should be sent if the issue of a provisional decision delays the final decision beyond the time limit.
Important points to note
- The adjudicator cannot make a determination outside the provisions of the regulations
- The specified person cannot consider cases of alleged maladministration
- A right of appeal against a decision on entitlement to a benefit only arises after the earlier of the date employment ends or the date specified in a notice to opt out
- A successful appeal only applies to that particular case
- Unless the applicant refers the decision to Peninsula Pensions for determination under regulation 60, the decision reached by the adjudicator is final and binding on the scheme employer
Notice of stage 1 decision
The adjudicator must provide a written notice of their decision within two months of receiving the appeal and must be sent to:
- the applicant (and/or their personal representative)
- the scheme employer
- the Peninsula Pensions
The decision notice must include the following:
- the question for determination
- evidence received and considered
- the decision
- a reference to any legislation or scheme provisions that it relies upon
- where relevant, a reference to the scheme provisions conferring the discretion whose exercise has caused the disagreement
- a reference to the applicant’s right to have the disagreement reconsidered by Peninsula Pensions and the time limit for doing this
- a statement that The Pensions Ombudsman (TPO) is available to assist the member with any difficulty with the scheme which remains unresolved, and the address for The Pensions Advisory Service (TPAS)
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IDRP - Stage 2
If the member is not happy with the decision of the adjudicator, they may refer the matter to Peninsula Pensions as the Administering Authority. A disagreement may also be referred in cases where:
- the adjudicator has failed to issue either a decision, or a letter of explanation, within two months from the date of appeal, or
- an interim letter of explanation was sent, but the adjudicator has failed to subsequently issue a decision.
The person determining appeals at Stage 2 will, in many respects, undertake that function in the same way that the adjudicator did under Stage 1.
The applicant’s complaint must be considered in depth and in a formal way. Peninsula Pensions need to be satisfied that the Stage 1 decision was reasonable, considered all relevant facts and regulations, was consistent with other decisions reached and that it would stand up to external scrutiny.
Peninsula Pensions will:
- reconsider the decision, taking full account of the facts of the case and any evidence submitted, or relied on, by either party during Stage 1
- check that the regulations were applied correctly
- check that sound, impartial procedures were used to reach the decision. This is particularly important where the dispute concerns the exercise of a discretion by either you or Peninsula Pensions
Important points to note
Peninsula Pensions
- cannot replace your first instance decision, it can only instruct you to reconsider where a discretion has been exercised
- cannot make any awards for maladministration even where found
- has no power to act outside of the regulations, nor to instruct any party to do so
- has no power to award compensation for any reason, including where an appeal is upheld against the amount of a benefit due; limited to placing the affected party in the position they would have been in
- The decision of Peninsula Pensions is binding and can only be overturned by the Pensions Ombudsman or the High Court. We will not enter into further correspondence relating to the appeal
Notice of a stage 2 decision
We must respond to a Stage 2 appeal within two months of receipt so within the same time limits that apply to Stage 1.
A notice of the decision must be in writing and contain:
- the question for determination
- evidence received and considered
- the decision
- a reference to any legislation or scheme provisions that it relies on
- where relevant, a reference to the scheme provisions conferring the discretion whose exercise has caused the disagreement
- a statement that The Pensions Ombudsman (TPO) is available to assist the member with any difficulty with the scheme which remains unresolved, and that TPO may investigate and determine any complaint or dispute of fact or law and the TPO’s address
If the member is not happy with the decision of the adjudicator, they may refer the matter to Peninsula Pensions as the Administering Authority. A disagreement may also be referred in cases where:
- the adjudicator has failed to issue either a decision, or a letter of explanation, within two months from the date of appeal, or
- an interim letter of explanation was sent, but the adjudicator has failed to subsequently issue a decision.
The person determining appeals at Stage 2 will, in many respects, undertake that function in the same way that the adjudicator did under Stage 1.
The applicant’s complaint must be considered in depth and in a formal way. Peninsula Pensions need to be satisfied that the Stage 1 decision was reasonable, considered all relevant facts and regulations, was consistent with other decisions reached and that it would stand up to external scrutiny.
Peninsula Pensions will:
- reconsider the decision, taking full account of the facts of the case and any evidence submitted, or relied on, by either party during Stage 1
- check that the regulations were applied correctly
- check that sound, impartial procedures were used to reach the decision. This is particularly important where the dispute concerns the exercise of a discretion by either you or Peninsula Pensions
Important points to note
Peninsula Pensions
- cannot replace your first instance decision, it can only instruct you to reconsider where a discretion has been exercised
- cannot make any awards for maladministration even where found
- has no power to act outside of the regulations, nor to instruct any party to do so
- has no power to award compensation for any reason, including where an appeal is upheld against the amount of a benefit due; limited to placing the affected party in the position they would have been in
- The decision of Peninsula Pensions is binding and can only be overturned by the Pensions Ombudsman or the High Court. We will not enter into further correspondence relating to the appeal
Notice of a stage 2 decision
We must respond to a Stage 2 appeal within two months of receipt so within the same time limits that apply to Stage 1.
A notice of the decision must be in writing and contain:
- the question for determination
- evidence received and considered
- the decision
- a reference to any legislation or scheme provisions that it relies on
- where relevant, a reference to the scheme provisions conferring the discretion whose exercise has caused the disagreement
- a statement that The Pensions Ombudsman (TPO) is available to assist the member with any difficulty with the scheme which remains unresolved, and that TPO may investigate and determine any complaint or dispute of fact or law and the TPO’s address
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Beyond IDRP - the external appeal
Where a member remains dissatisfied after the appeals process IDRP has been exhausted, they can seek an independent review of their appeal. The Pensions Ombudsman (TPO) can review appeal decisions beyond the IDRP.
The Pensions Ombudsman
The Pensions Ombudsman:
- will consider cases after the member’s case has been through the scheme’s two stage IDRP
- may investigate and determine any complaint or dispute of fact or law in relation to the scheme, made or referred in accordance with the Pension Schemes Act 1993
- make awards of compensation for loss and for distress and inconvenience
The determination of the Ombudsman is final and binding on all parties, subject only to an appeal on a point of law to the Chancery Division of the High Court.
Cases sent to the Ombudsman’s office are initially assessed by his staff to determine whether the appeal or dispute can, or should, be referred for consideration by the Ombudsman. Further information may be sought at this stage from you, Peninsula Pensions and the individual.
Where the Ombudsman does make a determination about a case that they feel can and should be before them, the possible outcomes are the same as set out at Stage 2 of the IDRP. The appeal may be wholly or partially upheld or they may determine that the appeal should not be upheld at all.
The Ombudsman will consider previous cases, but they are not legally binding precedents. Therefore, during an Ombudsman investigation, the involved parties should focus on the specific facts and applicable laws in their situation instead of relying on the outcomes of past cases that may appear similar. For a record of previous decisions made by the Pensions Ombudsman, please refer to their website.
The Ombudsman’s decision can only be challenged on a point of law and needs to be made to the High Court within 28 days.
Early Resolution Service (ERS)
The Ombudsman now operates an Early Resolution Service (ERS) in addition to its normal Adjudication Service.
The aim of this service is to provide a quick, informal and streamlined process. Complainants wanting to use the ERS will not be expected to have first gone through our IDRP. If a complaint is still not resolved, the case can then be referred to the Ombudsman’s Adjudication Service but only after the scheme’s IDRP process has been completed.
Further points on appeals
As you can imagine, determining appeals is anything but straightforward so we are available to help you with this task and will provide information on the process and regulations that may be involved. However, we cannot draft responses, advise upon decisions or become otherwise directly involved with your function.
It is important that you keep comprehensive records in the event of an appeal from members.
Members must not be discouraged from submitting an appeal.
Considerations of medical appeals
If a dispute over ill health has emerged, it would be sensible for you to first check that all the regulatory requirements have been complied with. If not, a fresh decision needs to be made and there are some suggestions of the points you need to consider:
- Has a qualified, approved independent registered medical practitioner (IRMP) been used to assess the member’s eligibility?
- Has the IRMP clearly stated that the member is not assessed as permanently incapable?
- Has the IRMP paid due consideration to the duties of the post?
- Has the IRMP considered reports from the member’s GP and consultants before arriving at that decision?
- Has the IRMP made a recommendation in accordance with the LGPS regulations?
- Have you made your decision having considered all relevant evidence?
- Have you asked all the necessary questions before reaching any decision?
Exercise of discretionary powers
The adjudicator may be asked to consider a disagreement about the way in which you have exercised one of your discretions under both the main scheme regulations and the Local Government (Discretionary Compensation) Regulations 2006.
In such cases, the role of the person deciding the disagreement is not to overturn the initial decision but to ensure that the discretion has been exercised reasonably and if not, to determine that the m
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Further points on appeals
As you can imagine, determining appeals is anything but straightforward so we are available to help you with this task and will provide information on the process and regulations that may be involved. However, we cannot draft responses, advise upon decisions or become otherwise directly involved with your function.
It is important that you keep comprehensive records in the event of an appeal from members.
Members must not be discouraged from submitting an appeal.
Considerations of medical appeals
If a dispute over ill health has emerged, it would be sensible for you to first check that all the regulatory requirements have been complied with. If not, a fresh decision needs to be made and there are some suggestions of the points you need to consider:
- Has a qualified, approved independent registered medical practitioner (IRMP) been used to assess the member’s eligibility?
- Has the IRMP clearly stated that the member is not assessed as permanently incapable?
- Has the IRMP paid due consideration to the duties of the post?
- Has the IRMP considered reports from the member’s GP and consultants before arriving at that decision?
- Has the IRMP made a recommendation in accordance with the LGPS regulations?
- Have you made your decision having considered all relevant evidence?
- Have you asked all the necessary questions before reaching any decision?
Exercise of discretionary powers
The adjudicator may be asked to consider a disagreement about the way in which you have exercised one of your discretions under both the main scheme regulations and the Local Government (Discretionary Compensation) Regulations 2006.
In such cases, the role of the person deciding the disagreement is not to overturn the initial decision but to ensure that the discretion has been exercised reasonably and if not, to determine that the matter should be reconsidered in a proper manner.
IDRP – A simple flowchart of the process
