Anxiety, Depression, Stress &
Ill-Health Retirement
Mental health conditions are assessed under the same police regulations as physical ones. This guide covers anxiety, depression, adjustment disorders and work-related stress: what the ill-health retirement test really asks, when a condition counts as an injury on duty, how the process runs, and what support is there. PTSD has its own guide.
Independent information, not advice · Sources checked 7 October 2026 · England and Wales unless stated
Yes, both are possible. Ill-health retirement needs a Selected Medical Practitioner to find you unable to do the ordinary duties of a police officer, likely until you are 60, assuming normal treatment. The cause does not matter for that. An injury award also needs the condition to have been caused or substantially contributed to by an injury received in the execution of duty, which for stress means a substantial causal link to your service, not just being on duty. Help is available now.
This page explains the rules. It does not tell you how to describe your health, and it cannot predict a decision: that turns on the medical evidence in your case. Be accurate with every doctor you see; that is what the process is designed around. For PTSD in particular, including disputes about whether the diagnosis is PTSD at all, see our PTSD guide.
Two separate questions
People often run these together. The regulations do not.
| Ill-health retirement | Injury award | |
|---|---|---|
| The question | Can you do the ordinary duties of a police officer, now and likely until 60? | Were you permanently disabled by an injury received in the execution of duty? |
| Does the cause matter? | No. Any cause, at work or outside it | Yes. A duty injury must have caused or substantially contributed to the disablement |
| Who answers the medical questions | A Selected Medical Practitioner (SMP) | An SMP (often the same one, at the same time) |
| What it pays | Your accrued pension, unreduced; plus an enhancement on the upper tier. Taxable | A one-off gratuity, plus an injury pension topping your income up to a guaranteed minimum |
| The rules | Police Pensions Regulations 2015, Part 6 and Chapter 3 of Part 7 | Police (Injury Benefit) Regulations 2006 |
You can be ill-health retired without an injury award, and you can claim an injury award after leaving another way. Our which route guide explains how the two fit together.
Anxiety, depression and stress count
Both sets of regulations say so expressly:
- Regulation 74 of the 2015 pension regulations: "infirmity" means a disease, injury or medical condition, "and includes a mental disorder, injury or condition"; "injury" includes any injury or disease, "whether of body or of mind".
- Schedule 1 to the injury benefit regulations defines injury the same way, and regulation 7(8) gives infirmity the same meaning.
There is no list of qualifying diagnoses and no higher bar for mental health. Anxiety disorders, depressive disorders, mixed anxiety and depression, adjustment disorders and other recognised conditions are all assessed on the same questions. The 2019 Avon and Somerset case, for example, concerned a chronic adjustment disorder.
"Stress" on its own is not a diagnosis. What the SMP assesses is the medical condition, how it affects what you can do, and how long that is likely to last. Ordinary pressure, however unpleasant, is not the same thing as a disabling condition.
What 'permanent' actually means
This is the question most mental health cases turn on, and it is precise. Under the 2015 scheme the SMP must decide you are permanently medically unfit for ordinary duties if, in their opinion (regulation 76):
- you are unable to perform the ordinary duties of a member of the police force; and
- that inability is caused by infirmity of mind or body and is likely to continue until you reach normal pension age, or until you die if the SMP thinks that is likely first.
Normal pension age for police officers is 60, set by section 10 of the Public Service Pensions Act 2013. Regulation 75 adds that the question is decided at the time the SMP decides it, and that you are taken to receive normal appropriate medical treatment.
So "permanent" means something different depending on your age when the SMP decides:
| Age at decision | Period the unfitness must be likely to last | What that means in practice |
|---|---|---|
| 30 | 30 years | A long horizon: the SMP must think the unfitness is likely to last for decades, with treatment |
| 40 | 20 years | A long horizon: the SMP must think the unfitness is likely to last for decades, with treatment |
| 50 | 10 years | A long horizon: the SMP must think the unfitness is likely to last for decades, with treatment |
| 55 | 5 years | A shorter horizon: the question is whether you are likely to recover enough to return to ordinary duties before 60 |
| 58 | 2 years | A shorter horizon: the question is whether you are likely to recover enough to return to ordinary duties before 60 |
For a younger officer with a condition that often responds to treatment, this is a high bar. It does not mean a condition must be incurable; it means the SMP must think it more likely than not that you will not be able to return to ordinary police duties before 60.
The injury benefit regulations use a similar idea for 2015 members (regulation 7A links the test to the 2015 medical unfitness test). For members of the 1987 and 2006 schemes, those regulations, as published, say only "likely to be permanent" without naming an age. If legacy rules matter in your case, ask your Federation representative or the pension administrator how "permanent" is being applied.
Treatment first: what that does and does not mean
Because permanence is judged assuming normal appropriate medical treatment (regulation 75(2)), treatment is often central in mental health cases. What the rules actually say:
- It is an assumption, not a checklist. The SMP asks what is likely with normal appropriate treatment. If a recommended treatment has not been tried, the SMP may not be able to say the condition is likely to last until 60.
- Refusing some treatment can be reasonable. "Appropriate medical treatment" does not include treatment the police pension authority decides it is reasonable for you to refuse (regulation 75(3)). If you disagree with its decision, you can appeal under regulation 207 or 208 (regulation 75(4)).
- Waiting lists are a practical problem. The regulations do not say what happens when recommended treatment is not available for months. Ask your clinicians to say in writing what the outlook is with and without it.
- It carries on after retirement. If you are ill-health retired and later wilfully or negligently fail to receive appropriate treatment, the pension can stop, but only after written notices from the SMP and the authority and a decision that the failure is wilful or negligent (regulation 115).
None of this asks you to accept treatment you and your clinicians think is wrong for you. It does mean that the reasons for any treatment decision should be clear, and recorded by the people treating you.
Before retirement: staying in work
Ill-health retirement is the end of a process that usually starts with trying to keep you in work. Knowing the rules on that part helps you take part in it.
- Disability and reasonable adjustments. Under section 6 of the Equality Act 2010 you have a disability if you have a physical or mental impairment with a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities. "Long-term" means it has lasted, or is likely to last, at least 12 months, and an effect that is likely to recur counts (Schedule 1, paragraph 2). Section 42 treats holding the office of constable as employment by the chief officer for these purposes, so the duty to make reasonable adjustments (section 20) applies to police officers.
- Adjusted duties and pay. If you are on adjusted duties for a long time, Annex EE allows a review after 12 months and, in some cases, a reduction equal to the deployment part of the X-factor (8% of pay for constables, as issued in 2015), with written notice after 9 months and 1 month's notice of any deduction. See restricted duties.
- Retention after an SMP finding. Even after an SMP decides you are permanently unfit for ordinary duties, the authority can keep you serving (regulation 82). If you want to stay, say so and say what you could do; if you do not think a role would work for your health, say that too, with your clinicians' view.
None of these steps is a precondition the regulations impose before an SMP referral. Forces set their own procedures, so ask where you are in yours and what happens next.
Lower tier or upper tier
Regulation 101 sets two thresholds:
- Lower tier: permanently unfit for the ordinary duties of a police officer, but not for any regular employment. You get your accrued pension with no early payment reduction.
- Upper tier: also permanently unfit for any regular employment, meaning employment for an annual average of at least 30 hours a week (regulation 2), until 60. An enhancement is added based on the years to 60.
For mental health conditions the upper tier question is often harder than the lower tier one. Someone who cannot safely carry a warrant, make arrest decisions or work in public-facing, high-pressure roles may still be able to do other work for 30 hours a week. The SMP looks at what work you could do, not just the job you had. Fluctuating conditions are assessed over time, so evidence of how the condition has behaved over months is more useful than a snapshot.
- Two years' service. You need at least 2 years' qualifying service, unless the unfitness results from an injury received without your own default in the execution of duty (regulation 102(2)(b)).
- Retire or retain. An SMP finding does not automatically end your career: the authority may require you to retire, or to continue to serve (regulation 82). Forces may look at alternative roles first.
- Pre-existing conditions. If you joined under the 2015 scheme with a health condition and were excluded from ill-health benefits under regulation 36, take advice. In a 2023 legal challenge the then Home Secretary conceded that, in that case, regulation 36(5) breached the Equality Act 2010 (Home Office consultation paper); a consultation on removing it ran from 20 August to 17 September 2026 and the outcome had not been published when we checked.
Work-related stress and the injury award
This is where most disputes about mental health injury awards sit. The High Court summarised the core principles in Avon and Somerset (2019), drawing on the Court of Appeal in Stunt (2001):
- The test is whether the injury is "directly and causally connected" with your service as a police officer. It is not applied in an overly legalistic way, but there must be "a substantial causal connection".
- The connection must be with your service, "not simply with his being a police officer".
- Duty "is not to be given a narrow meaning". It covers all aspects of the work and your work circumstances, including events at work and "things said or done to him by colleagues at work".
- Work need not be the sole cause, provided there is a substantial causal connection.
- It is "not sufficient that the officer is 'on duty'". The injury must arise out of the duties you were doing, or the conditions or circumstances in which you were doing them.
The judge described how earlier cases fell on either side of that line:
| Case | What caused the condition | Result |
|---|---|---|
| Kellam (2000) | Anxiety and depression after harassment and victimisation by colleagues at work | Decision that this was an injury in the execution of duty upheld: the correct test had been applied |
| Stunt (2001, Court of Appeal) | Stress illness from a disciplinary investigation | Not received in the execution of duty: it resulted from being a police officer, not from carrying out duties |
| Clinch (2003) | Psychiatric condition from disappointment at repeatedly failing to get promotion | Not an injury in the execution of duty |
| MacDonald (2004, Court of Session) | Stress from feeling his skills were not recognised and from the duties allocated to him | Not enough: something external impacting on the officer while carrying out duties was needed |
| Edwards (2005) | Psychiatric injury caused by notice of a return to uniform after 12 years in CID | Not an injury in the execution of duty: the effect would have been the same if the news came by post |
| Hudson (2009) | 21 matters over years, including work restrictions, treatment by senior officers, grievance and disciplinary matters | Board's finding upheld: the 'drip drip' effect of the pattern was capable of causing injury in the execution of duty |
| Avon and Somerset (2019) | Chronic adjustment disorder after many short-term redeployments | Board's decision quashed for applying the wrong test and relying on management failings; not decided either way by the court |
Two points from Avon and Somerset are worth knowing. First, the judge said there are not two competing lines of authority, one generous and one strict: the same test is applied to different facts. Second, the board in that case was wrong to rely on admitted management failings to support a "benevolent view" of what counts. Whether managers handled things well or badly is not the test; the causal link to your service is.
Landmark Chambers' guide (written by barristers at that chambers; a secondary source) argues that an officer who develops a permanent condition in response to stress at work is entitled regardless of whether the stress was the standard level police officers face, and regardless of fault, apart from own default and disciplinary cases. It also criticises the reasoning in MacDonald. Treat this as one informed view, not settled law.
Remember regulation 8: the duty injury only has to have "caused or substantially contributed to" the disablement. Where work and non-work factors combine, the question is whether the duty-related part was substantial. Archived Home Office guidance described cumulative causes as the "straw that broke the camel's back" and said the question then is how far the duty-related incidents contributed.
Misconduct investigations, grievances and performance processes
Many officers become unwell while under investigation, in a grievance, or in a performance process. The law here is uncomfortable but clear in its starting point:
- Disciplinary proceedings. In Stunt the Court of Appeal said that "however elastic the notion of execution of duty may be, it cannot be stretched wide enough to encompass stress related illness through exposure to disciplinary proceedings".
- Career and posting decisions. Clinch, MacDonald and Edwards show that conditions caused by disappointment about promotion, recognition or a move of role have been held not to qualify.
- Mixed histories. In Hudson, grievance and disciplinary matters were among 21 matters over several years, and the board's finding that the overall pattern caused an injury in the execution of duty was upheld. Where an investigation is one strand among duty-related ones, the decision is a medical one on the whole evidence.
None of this affects ill-health retirement, which does not depend on the cause. Being under investigation can affect timing and other decisions, so take advice from your Federation representative or a solicitor before anything is decided. See your rights under investigation and suspension and restricted duties.
When the cause is not work
Bereavement, relationship breakdown, money worries, a physical illness or a long-standing condition can all lead to anxiety or depression. If that is your situation:
- Ill-health retirement is still open to you on exactly the same test, provided you have 2 years' qualifying service.
- An injury award is not, unless a duty injury also caused or substantially contributed to the disablement.
- Where both work and non-work causes contributed, an injury award is possible if the duty part was substantial, but the degree of disablement may reflect only the part caused by duty.
- Sick pay rules (Annex K) are the same whatever the cause, though duty-related incapacity is one of the situations where extending pay is generally appropriate under national guidance.
If your condition is linked to a personal-injury claim against someone else, or you were a victim of crime, other routes may exist. See police compensation routes.
How the process runs
Forces have their own procedures, but the legal steps are the same everywhere in England and Wales.
- Treatment and occupational health. Your GP and treating clinicians, and your force's occupational health service, usually come first. Adjusted or recuperative duties may be tried. See the occupational health process and restricted duties.
- Referral to an SMP. Before considering compulsory ill-health retirement, the police pension authority must refer four questions to an SMP: are you unfit for ordinary duties, is that likely to be permanent, are you unfit for any regular employment, and is that likely to be permanent (regulation 81).
- Records and the appointment. The SMP examines or interviews you as they think appropriate. If you wilfully or negligently fail to attend an examination or interview the SMP considers necessary, the authority can decide on the evidence it has (regulation 77). Ask what records are wanted and why.
- The report. The SMP gives the authority and you a report with the decision. It is final unless appealed or reconsidered.
- The decision. The authority, after considering all the circumstances and your input, decides whether to retire you or keep you serving (regulation 82).
- Injury award questions. If an injury award is being considered, the SMP also decides whether the disablement results from an injury in the execution of duty and the degree of disablement, usually with an earnings assessment. See earnings assessments.
- Appeal. 28 days from receiving the report to give notice, then 28 days for grounds, to a board of medical referees. Reconsideration by agreement is another route if you have new evidence. See appeals.
For what the SMP appointment involves and how to prepare factual information, see the SMP guide. For how long each stage can take, see how long it takes.
- Letters or reports from the people treating you: the diagnosis, the treatment tried and how it went, what is recommended next, and the likely course.
- GP records showing when problems started and how they developed.
- Occupational health records, and what adjustments or alternative duties were tried.
- For an injury award: a dated, factual record of the work events you believe caused or contributed to your condition, with any references.
Clinicians should only say what they genuinely think. An SMP and any appeal board test the evidence, and consistency matters more than emphasis.
Questions worth asking at each stage
These are questions, not tactics. They help you understand where you are in the process and what is being decided, so that nothing comes as a surprise.
| Stage | Ask | Why it matters |
|---|---|---|
| Occupational health | What do you think my options are: adjustments, a different role, or a referral to an SMP? What will you tell my force? | The authority can keep you serving instead of retiring you (regulation 82), and you are entitled to understand what is shared |
| Your clinicians | What is the diagnosis, what treatment is recommended next, and what is the likely course with it? | Permanence is judged assuming normal appropriate treatment |
| The force or HR | Which questions are being referred to the SMP? Is an injury award being considered at the same time? | Ill-health retirement and the injury award can be decided together or separately |
| The SMP stage | Which records will the SMP see, and can I send my own clinicians' reports? | The SMP decides on the evidence in front of them |
| After the report | When did I receive it? Do I agree with each answer? Is there new evidence for reconsideration? | 28 days to give notice of appeal, from receipt |
| Before a decision | What roles have been considered for me, and can I comment before the authority decides? | The authority must consider your input before retiring or retaining you (regulation 82) |
| Your Federation rep | Can you check the referral, the report and any earnings assessment, and represent me at appeal? | A representative can check the documents with you and represent you at an appeal |
Pay while you are off
Annex K treats mental health absence like any other: full pay for 6 months, then half pay for 6 months in any one year period, reduced by paid sick absence in the previous 12 months. After that there is no pay unless the chief officer extends it.
- National guidance quoted in the Weed judgment lists incapacity directly attributable to an injury or illness in the execution of duty, and cases referred to an SMP for permanence, among the circumstances in which extending pay would generally be appropriate. It is still a discretion, not an entitlement.
- If you think your condition is work-caused, ask in writing for an extension before half pay starts, and ask for your force's policy.
Use the sick pay calculator to see when half pay would start, and see police stress leave and long-term sickness for the wider process.
What it can pay: illustrative figures
Hypothetical officer, not a real case: pay of £44,544 (our calculator's default), 9 years' service all in the 2015 scheme, retiring at 35. Simplified pensions (today's pay, no revaluation). After-tax figures use 2026/27 England and Wales rates, assume no other income, and treat the injury pension as tax-free. Benefit deductions are not included.
| Outcome | Route | Ill-health pension | Injury pension | Total before tax | Total after tax | Gratuity |
|---|---|---|---|---|---|---|
| A: depression not caused by duty; can do other regular work | Lower tier | £7,249 | - | £7,249 | £7,249 | - |
| B: depression not caused by duty; cannot do any regular work | Upper tier | £17,318 | - | £17,318 | £16,369 | - |
| C: anxiety caused by duty; slight loss of earning capacity | Lower tier + band 1 | £7,249 | £7,926 | £15,176 | £15,176 | £5,568 |
| D: anxiety caused by duty; minor loss of earning capacity | Lower tier + band 2 | £7,249 | £16,835 | £24,084 | £24,084 | £11,136 |
| E: as D, but also unfit for any regular work | Upper tier + band 2 | £17,318 | £9,283 | £26,602 | £25,652 | £11,136 |
- The injury award matters more than the tier. Compare A with D: the injury pension tops income up to a guaranteed minimum based on pay, band and service.
- The upper tier adds less than it seems once an injury pension is paid. Moving from D to E raises the ill-health pension by £10,069 a year, but the injury pension falls by 75% of that. The total rises by £2,517 before tax and only £1,568 after tax, because the extra pension is taxable and the injury pension it replaces is not.
- Without an injury award, the tier matters a lot. Compare A with B.
There is no standard figure for a mental health retirement: it depends on the tier, the band, your pay and your service. Run your own figures in the injury award calculator, and see the worked examples by band for the arithmetic.
After retirement: reviews and recovery
Mental health conditions can improve or worsen, and the regulations allow for both.
- Lower tier reviews. The scheme manager may review at any time until 60 whether your unfitness has ceased or significantly worsened, and must review if told it has worsened (regulation 110).
- If you recover. If the SMP decides you are no longer unfit for ordinary duties, you can be offered your job back within 3 months, and the pension stops at the end of that period or when you rejoin (regulation 111).
- If you get worse. You can move to the upper tier only if the worsening is notified, or picked up on a review, within 5 years of the lower tier pension starting, unless the condition is a progressive one (regulations 112 and 113). The progressive conditions listed in Schedule 2 (such as cancer, multiple sclerosis and Alzheimer's disease) do not include anxiety, depression or stress-related conditions, and we found no other published list. Do not wait if things are getting worse.
- Upper tier reviews. At intervals of not less than 5 years until state pension age; if you become able to do regular employment, the enhancement stops 3 months after the report but the lower tier continues (regulation 114).
- Injury pension reviews. The degree of disablement can be reviewed under injury regulation 37 if it has substantially altered. A review cannot reopen whether the injury happened on duty. See injury award reviews.
Support that exists
Nothing in the regulations treats getting support as counting against you, and it can make treatment, evidence and decisions easier. Services that exist for police officers specifically:
- Oscar Kilo Mental Health Crisis Line: 0300 131 2789, 24 hours a day. Oscar Kilo says it is independent and confidential, for anyone working or who used to work in policing who is in a mental health crisis or having suicidal thoughts.
- Police Care UK: free and confidential support, including psychological support, for serving and former officers, staff, volunteers and their families harmed through policing. It is independent of the police service.
- Your Federation or staff association: welfare support and advice on the process, and representation. Ask your branch what it offers, including for retired members.
- Your GP and the NHS: your GP can advise on treatment and help you reach mental health services, and the NHS says you may be able to refer yourself to some services.
- Your force: occupational health, any employee assistance programme, and post-incident support such as TRiM. See post-incident support.
Worried about what occupational health will tell your force? Read telling occupational health about your mental health. The full list of services is in our support directory.
If you are off work now, the useful things are the simple ones: keep going with treatment, keep copies of letters, speak to your Federation representative, and ask in writing about sick pay before half pay starts. If you have an SMP report, note the date you received it, because the 28-day appeal clock runs from then. The money questions can be looked at calmly when you are ready; the calculator is there when you want it.
If you are a partner, family member or colleague
Many people reading this page are doing so for someone else. The process belongs to the officer, but you can help with the practical side and with support.
- If you think someone's life is at risk, or they cannot keep themselves safe, the NHS says call 999 or go to A&E.
- Samaritans (116 123) is free and open to anyone, at any time.
- Police Care UK supports the families of serving and former officers harmed through policing, as well as officers themselves.
- Practical help that tends to matter: keeping copies of letters in one place, noting the date each report arrives (the 28-day appeal clock), and going to appointments if the officer wants company. Leave decisions about treatment and the process to them and their advisers.
Colleagues and supervisors can find information on the process for their force from occupational health or HR. If you are a line manager, your force's attendance and ill-health procedures set out your part.
What people get wrong
- "Mental health doesn't count." Both sets of regulations include mental disorders and injury of mind expressly.
- "Permanent means for life." For 2015 scheme ill-health retirement it means likely to last until normal pension age, 60, assuming normal treatment.
- "Stress at work means an injury award." There must be a substantial causal connection with your service. Being on duty when it developed is not enough, and some causes (disciplinary proceedings, career disappointment) have been held not to qualify.
- "If it wasn't caused by work, I can't be medically retired." Ill-health retirement does not depend on the cause.
- "The upper tier is always worth fighting for." With an injury award, three-quarters of the extra pension comes off the injury pension, and the extra is taxable.
- "Once retired, I'm safe from reviews." Lower tier pensions can be reviewed until 60, and upper tier enhancements until state pension age.
- "Asking for help will end my career." A diagnosis does not lead to retirement on its own, and the independent services listed on this page say they are confidential.
Not verified / needs checking
- How often mental health claims succeed. We found no national figures for England and Wales, and give none.
- Cases described second-hand. Kellam, Stunt, Clinch, MacDonald, Edwards and Hudson are described from the 2019 High Court judgment, which we read in full; we did not read each judgment separately.
- "Permanent" for 1987 and 2006 scheme decisions. The published legacy regulations say "likely to be permanent" without an age; we did not verify how authorities apply that today.
- A published list of progressive conditions. Regulation 112 allows the Secretary of State to publish one; we found none adding mental health conditions.
- The regulation 36 outcome. The consultation closed on 17 September 2026; no outcome was published when we checked.
- NHS 111 option numbers. The national NHS page says "select the mental health option"; option 2 is what NHS 111 Wales and the English trusts we checked say. Menus can change.
- Tax on the injury gratuity. HMRC's guidance we read does not settle the one-off gratuity; check with your administrator.
- Scotland and Northern Ireland. This page follows England and Wales. See our Police Scotland and PSNI guides.
Get told when injury award rules change
Leave your email and we will write by hand when something changes that affects injury awards or ill-health retirement: the regulations, Home Office guidance or the yearly pension increase. Nothing automatic, and no spam.
No automatic emails and no spam. Unsubscribe any time. Privacy policy.
- Free now, with or without signing up:
- Open the free SMP appointment checklist
- Work out your appeal deadlines
Frequently Asked Questions
Can a police officer be ill-health retired for anxiety or depression?
Yes, if a Selected Medical Practitioner decides you are permanently unable to perform the ordinary duties of a police officer. The 2015 regulations define infirmity to include a mental disorder, injury or condition, so anxiety and depressive disorders are assessed under the same test as any physical condition. The police pension authority then decides whether to retire you or keep you in a role you can do.
What does 'permanent' mean for police ill-health retirement?
Under the 2015 scheme, the SMP must think your inability to do the ordinary duties of a police officer is likely to continue until you reach normal pension age, which is 60 for police officers, or until death if that is likely to come first (regulation 76). It is judged assuming you receive normal appropriate medical treatment.
Do I have to try all treatment before I can be medically retired?
Not every treatment. Permanence is judged assuming you receive normal appropriate medical treatment, which excludes treatment the police pension authority decides it is reasonable for you to refuse (regulation 75). In practice, if recommended treatment has not been tried, the SMP may find it too early to say the condition is permanent. You can appeal a decision that a refusal was unreasonable.
Can work-related stress lead to a police injury award?
It can. Injury includes injury of mind, and the courts have accepted psychiatric injury caused by work circumstances, including things said or done by colleagues. But there must be a substantial causal connection between the injury and your service as a police officer: being on duty when it developed is not enough, and stress from your feelings about your career or posting has been held not to qualify.
Does stress from a misconduct investigation count as an injury on duty?
The Court of Appeal held in Stunt (2001) that stress-related illness through exposure to disciplinary proceedings is not an injury received in the execution of duty. Where an investigation is one of several causes alongside duty-related events, the medical authority decides on the evidence whether the duty-related events caused or substantially contributed to the disablement.
What if my depression was caused by things outside work?
You can still be ill-health retired, because the ill-health test does not depend on the cause. You would not get an injury award, which needs a duty injury. If you have less than 2 years' qualifying service, the ill-health pension needs the unfitness to result from a duty injury (regulation 102).
Will a mental health condition be lower tier or upper tier?
It depends on what you can do, not on the diagnosis. Lower tier means permanently unfit for police duties but not for regular employment elsewhere. Upper tier means permanently unfit for any regular employment, defined as an annual average of at least 30 hours a week, until 60. Many people with anxiety or depression can do some other work, which points to the lower tier, but it is a medical decision on the evidence.
Can the force keep me on in a different role instead of retiring me?
Yes. Even when the SMP finds you permanently unfit for ordinary duties, the police pension authority may require you to continue to serve, after considering all the circumstances and your input (regulation 82). Ask what roles are being considered and say what you think you could manage.
How long do I have to appeal an SMP decision?
Give notice of appeal within 28 days of receiving the SMP's report (the authority can allow longer), then a statement of grounds within a further 28 days. The appeal goes to a board of medical referees. You can also ask the authority to agree to send the decision back to the SMP for reconsideration if you have new evidence.
Can my ill-health pension be stopped if I get better?
A lower tier pension can be reviewed at any time until 60. If you are found no longer unfit for ordinary duties, you can be offered your job back and the pension stops after 3 months or when you rejoin. An upper tier enhancement can be reviewed at intervals of at least 5 years until state pension age. The pension can also stop if you wilfully or negligently fail to get appropriate treatment after two written notices (regulation 115).
Will I pay tax on an ill-health pension and an injury pension?
The ill-health pension is taxable like any pension. HMRC's manual says payments from police injury benefit schemes can be paid tax-free. That is why moving from the lower to the upper tier can add less than it seems: the extra pension is taxable and three-quarters of it comes off a tax-free injury pension.
Where can I get help if I am struggling right now?
If you or someone else is in immediate danger, call 999 or go to A&E. For urgent help that is not an emergency, call NHS 111 and choose the mental health option (option 2 in the areas we checked). Samaritans are available on 116 123, free, any time. People working in or who have left policing can call the Oscar Kilo crisis line, which is open 24 hours.
Sources and how we checked them
Every factual claim on this page was written from the sources below, read on 7 October 2026. Rules and figures change, so check the source for the date you are reading this. Where we could not confirm something from an official or independent source, the page says so rather than guessing. Spotted something out of date? See our corrections policy.
- Police Pensions Regulations 2015, regulations 74 to 77 and 81 to 82 (legislation.gov.uk, revised) — infirmity includes a mental disorder; permanent medical unfitness; normal appropriate medical treatment; likely to continue until normal pension age; refusal to attend; retire or retain (accessed 7 October 2026)
- Police Pensions Regulations 2015, regulations 101, 102 and 104 — lower and upper tier thresholds; 2 years' qualifying service or a duty injury; amounts (accessed 7 October 2026)
- Police Pensions Regulations 2015, regulations 110 to 115 and Schedule 2 (as made) — reviews; rejoining; upgrade within 5 years; progressive conditions list; failure to receive treatment; 'regular employment' (reg 2) (accessed 7 October 2026)
- Public Service Pensions Act 2013, section 10 — normal pension age for members of a police force is 60 (accessed 7 October 2026)
- Police (Injury Benefit) Regulations 2006, Schedule 1 and regulations 6 to 8, 30 to 33, 37 — injury includes injury of mind; execution of duty; caused or substantially contributed; SMP questions; appeals; reviews (accessed 7 October 2026)
- SI 2018/997, regulation 10 (regulation 7A) — injury award disablement test for 2015 scheme members linked to the 2015 medical unfitness test (accessed 7 October 2026)
- R (Chief Constable of Avon and Somerset) v Police Medical Appeal Board [2019] EWHC 557 (Admin) — the Stunt principles; substantial causal connection; not sufficient to be on duty; summaries of Kellam, Stunt, Clinch, MacDonald, Edwards and Hudson; management failings (accessed 7 October 2026)
- Home Office: Guidance on medical appeals, section 4 (archived 2022) — duty not given a narrow meaning; disciplinary proceedings; cumulative causes. Withdrawn (accessed 7 October 2026)
- Landmark Chambers, Police Injury Pensions, chapter 4 (2020) — counsel's view on 'work circumstances' and on fault. Secondary source (accessed 7 October 2026)
- Home Office: Police Pension Scheme 2015, regulation 36 consultation — ill-health exclusion for pre-existing conditions; consultation 20 August to 17 September 2026 (accessed 7 October 2026)
- Annex K determination text (copy hosted by Police Federation, West Midlands) — sick pay: full pay then half pay; chief officer discretion (accessed 7 October 2026)
- Home Office, Annex EE (limited duties and the deployment component of X-factor), effective 1 May 2015 (Circular 010/2015) — adjusted duties: 12-month review, notice periods, X-factor deployment component (as issued in 2015) (accessed 7 October 2026)
- Equality Act 2010, sections 6, 20 and 42 and Schedule 1 paragraph 2 — disability includes mental impairment; long-term means 12 months or likely to recur; reasonable adjustments; constables treated as employed by the chief officer (accessed 7 October 2026)
- HMRC Employment Income Manual EIM75900 (injury benefit schemes, including police and firefighters) — injury benefit 'can be paid tax-free'; the ill-health pension is taxable (accessed 7 October 2026)
- NHS: Where to get urgent help for mental health — call 111 and select the mental health option; 999 or A&E if life is at risk; Samaritans 116 123 (accessed 7 October 2026)
- NHS 111 Wales: mental health — call NHS 111 and press option 2 for urgent mental health support (accessed 7 October 2026)
- NELFT NHS Foundation Trust: call NHS 111, option 2 — an English trust describing the 111 mental health option as option 2 (accessed 7 October 2026)
- Samaritans: contact us — 116 123, free, any time, from any phone (accessed 7 October 2026)
- Oscar Kilo: Mental Health Crisis Line — 24/7 confidential crisis line for people working in, or who used to work in, policing (accessed 7 October 2026)
- Police Care UK (charity, formerly the Police Dependants' Trust) — free, confidential support for serving and former officers, staff, volunteers and families harmed through policing (accessed 7 October 2026)
On this topic elsewhere
More in this guide series
Tools, pensions and support
Disclaimer
PolicePay.co.uk is an independent reference site. This page is general information, not legal, medical or financial advice, and the outcome of any injury award or ill-health retirement decision turns on the medical evidence and the facts of the individual case. Decisions are made by the police pension authority, selected medical practitioners and appeal boards, and the regulations are amended from time to time. Speak to your Police Federation representative or a solicitor about your own case, and your pension administrator about your figures. If you are struggling, speak to your GP or one of the services listed on our support directory; if you or someone else is in immediate danger, call 999. Details apply to England and Wales unless stated. Details are as checked on 7 October 2026.