Police Ill-Health (Medical) Retirement:
Tiers, Process and Calculator
How police ill-health retirement works: the lower tier (often called Tier 1) and upper tier (Tier 2), the SMP's decision, the force's decision and the appeal, and how the 1987, 2006 and 2015 schemes compare. Covers England and Wales.
Want your own figures first? The free police ill-health retirement calculator shows the lower and upper tier pension before and after tax.
Trust Notice: Independent explanation of police pension regulations. Not regulated financial advice. Not affiliated with any police force or pension administrator.
Executive Summary
Ill-health retirement allows police officers to receive pension benefits before normal retirement age due to permanent medical incapacity.
In the 2015 scheme there are two tiers (often called Tier 1 and Tier 2):
- Lower tier: permanently unfit for ordinary police duties
- Upper tier: permanently unfit for any regular employment (work averaging at least 30 hours a week)
The 2006 scheme calls its tiers standard and enhanced. The 1987 scheme has a single ill-health pension.
Level of award depends on:
- Pension scheme (1987 / 2006 / 2015)
- Medical evidence
- Independent medical assessment
- Service length
Ill-health retirement is not automatic. It requires formal medical assessment and certification.
If a duty injury caused your condition, you may also be entitled to an injury award on top of the pension: the injury award calculator shows what each band pays, and injury award or ill-health retirement? explains how the two combine.
Optional, if you want your own figures written up: the reports below are preparation to take to your Federation rep or solicitor, not a substitute for them. Everything on this page stays free.
Facing medical retirement? Get all three reports
An injury award, an ill-health pension and leaving the service are often one decision. These three reports work out your own figures for each part, ready to take to your Federation representative or a solicitor.
- Injury Award Report£39.99 alone, 6 months
The paid tabs of the injury award calculator: earning capacity, SMP preparation, the medical appeal stages, inflation projections and unlimited AI questions.
- Ill-Health Retirement Report£49.99 alone, 12 months
Your ill-health pension estimate for your scheme, retiring on ill-health grounds against a deferred pension, SMP evidence, the appeal stages and AI questions.
- Pension Exit Report£29.99 alone, 12 months
Your pension if you resign, retire or are dismissed: what you keep, when it is paid, lump sums and what staying on would add. Printable.
No subscription. Secure checkout by Stripe. 14-day refund, no reason needed: refund policy. Estimates and general information, not legal, medical or financial advice. If you are a Federation member, speak to your rep first: the Federation can support members through medical retirement and appeals.
What Is
Ill-Health Retirement?
Ill-health retirement applies when an officer:
A Selected Medical Practitioner (SMP) decides the medical questions. The police pension authority then decides whether to retire you or require you to keep serving (Police Pensions Regulations 2015, regulation 82).
Regulatory Governance
Decisions are not made by HR or management alone. They rely on clinical evidence and an SMP's decision on whether the unfitness is permanent. In the 2015 scheme, permanent means likely to last until normal pension age (60) or earlier death.
The Two-Tier System Explained
Lower tier
Often called Tier 1You are permanently unfit for the ordinary duties of a police officer, but not for any regular employment. You may still be capable of other work.
No enhancement applies.
Upper tier
Often called Tier 2You are permanently unfit for any regular employment (work averaging at least 30 hours a week). This provides the highest level of protection.
Plus an enhancement: half of the pension you would have built from leaving to age 60, based on your final pay (regulation 104).
The enhancement can be stopped on review before state pension age (regulation 114).
Who qualifies: minimum service
- 2015 scheme: at least 2 years' qualifying service, unless your unfitness results from an injury received without your own default in the execution of duty (regulation 102(2)(b)).
- 2006 scheme: you must meet the scheme's qualifying service condition or be disabled by an injury on duty. If you are 55 or over when retired, you get your ordinary pension instead of an ill-health pension (regulation 29).
- 1987 scheme: 5 years' pensionable service or disablement from an injury on duty. Otherwise you get a gratuity, not a pension.
More detail: lower tier vs upper tier explained (including the 30-hour regular employment test and reviews) and what the ordinary duties test means.
Ill-health retirement checklist
Tick what is already in place to see the usual next steps. This does not tell you whether you will be retired or on which tier: the selected medical practitioner (SMP) answers the medical questions and the police pension authority makes the decision.
General information for England and Wales, not legal or medical advice.
Scheme Differences
1987 Scheme
- One ill-health pension: no lower or upper tier
- Needs 5 years' pensionable service or an injury on duty, otherwise a gratuity
- Sliding scale by service: at least 20/60ths after 10 years, at most 40/60ths, and no more than you would have had at compulsory retirement age
- Injury award is separate (Police (Injury Benefit) Regulations 2006)
2006 Scheme
Two tiers, called standard and enhanced. The standard ill-health pension is your ordinary pension (1/70th per year plus a lump sum of four times the pension) with no reduction for early payment. The enhanced top-up adds half of the service you could have built up to age 55 (regulations 29 to 31).
2015 Scheme
Lower and upper tier. Ill-health retirement is possible before normal pension age (60). The upper tier adds half of the pension for assumed service from leaving until age 60, based on final pay (2015 regulations, reg 104).
If you have service in more than one scheme
Since 1 April 2022 every serving officer builds pension in the 2015 scheme, so nobody yet has more than about 11.5 years of 2015-scheme service. If you also have 1987 or 2006 service, an ill-health award can include the 2015 tiers plus an ill-health element from your legacy scheme (2015 regulations, Schedule 4, Part 6). The McCloud remedy also moves service from 2015 to 2022 back to your legacy scheme, with a choice of benefits. These cases need figures from your pension administrator.
Ill-health exclusion for some 2015 joiners (regulation 36)
Under regulation 36 of the 2015 regulations, a new joiner could be examined before joining and found not eligible for ill-health benefits because of a pre-existing condition. In 2023 the Home Secretary accepted that this breached the non-discrimination rule in the Equality Act 2010. The Home Office consulted on removing it from 20 August to 17 September 2026. As at 7 October 2026 the outcome had not been published, and a remedy for past cases is expected to follow in a second consultation. If you were told you are not eligible for ill-health benefits, ask your Federation representative how this affects you.
Understanding how your schemes interact is essential, especially with the McCloud remedy.
The Medical Test
A doctor, the SMP, decides the medical questions. The police pension authority decides whether you retire.
Threshold Requirements:
- Evidence
Documented history of permanent disability.
- Permanence
The unfitness is likely to last until normal pension age (60 in the 2015 scheme) or earlier death.
- SMP report
A report from the SMP deciding the medical questions, given to you and the authority.
Temporary illness does not qualify.
The medical condition must be deemed permanent, meaning it is likely to last until normal pension age.
If you disagree with the medical decision, you have a statutory right to appeal it through an appeal board (often called the PMAB). Notice must be given within 28 days of receiving the selected medical practitioner's report, and your statement of grounds within a further 28 days of the authority receiving the notice (the authority can allow longer for either). The appeal deadline calculator works out the dates from the day you received the report.
Preparing for an SMP appointment? Use the printable SMP appointment checklist. For anxiety, depression or stress, see ill-health retirement and mental health.
Injury on Duty vs Ill-Health Retirement
These are not the same.
- Ill-Health Retirement Pension Based.
- Injury on Duty Award Separate Compensation.
Some officers may qualify for both awards if their medical incapacity resulted from an injury sustained in the execution of duty.
Tax differs. The ill-health pension is taxable. An injury pension can be paid tax-free (HMRC manual EIM75900). The injury pension is reduced by three-quarters of your police pension, so the two are not simply added together.
More: is a police injury pension tax-free? and the police injury pension guide.
Financial
Impact
Ill-health retirement may:
- Provide earlier pension access
- Reduce total lifetime accrual
- Affect lump sum options
- Interact with commutation
- Affect survivor benefits
- Trigger tax considerations
Every case is individual and requires personal calculation.
Impact Projection
Use the interactive model below to estimate potential accrual differences.
Ill-health pension estimator
An estimate of the lower and upper tier ill-health pension for police officers in England and Wales, including legacy (1987 or 2006) service for officers who joined before April 2015. Not financial advice, and not a decision on your case.
Your details
All in the 2015 scheme: at most about 11.5 years by October 2026.
Basic pay plus any pensionable allowances. Top of the constable scale is £52,015 from 1 September 2026.
More options
Leave at 0 to estimate it as pay x years / 55.3. Your annual benefit statement figure is more accurate, because the 2015 scheme builds pension on each year's pay.
2015 scheme only: 10 years' service, age 38, pay £52,015.
Permanently unfit for police duties
About £9,406 after income tax (£784 a month)
Also permanently unfit for any regular employment
About £18,316 after income tax (£1,526 a month)
The upper tier adds £10,347 a year before tax (pay / 55.3 x half of the 22 years to 60).
Subject to review: The upper tier enhancement can be reviewed at intervals of at least 5 years until State Pension age. If you are found able to do regular employment (30 hours a week on average) the enhancement stops; the lower tier continues for life (2015 regulation 114).
How this is worked out
- 2015 scheme: lower tier = accrued pension with no early payment reduction; upper tier adds final pay / 55.3 x half the years to 60, and with under 5 years' service the lesser of that and 3 x accrued pension (2015 regulations 102 to 104). Needs 2 years' qualifying service unless caused by a duty injury.
- Uses today's pay as final pay for every year. Your annual benefit statement and your scheme administrator's quote are the real figures.
- Income tax is England and Wales 2026/27, on the pension alone. Pension increases, part-time service, added pension and transfers are not included.
- The selected medical practitioner (SMP) answers the medical questions; the police pension authority decides whether to retire you and may instead keep you serving.
Value & Appeal Report
Lower and upper tier estimates, the deferred-vs-immediate gap, SMP evidence preparation, appeal preparation and a long-term value projection, to take to your Federation rep or solicitor.
Common Misunderstandings
Is Not Redundancy
It is a medical capacity process.
Not Purely Managerial
An SMP decides the medical questions. The authority then decides whether to retire you or keep you serving (regulation 82).
Not Automatic
Requires high thresholds of medical evidence.
No Upper Tier Guarantee
The SMP must find you permanently unfit for any regular employment, not just for police work.
It requires evidence and independent medical sign-off.
Psychological Health &
Ill-Health Retirement
Mental health conditions can qualify.
However, evidence requirements are substantial. SMPs typically look for a detailed history of treatment and specialist reports.
- Specialist consultant reports
- Comprehensive treatment history
- In-depth Occupational health review
Permanent incapacity remains the absolute threshold.
What Happens After Approval?
Immediate Payment
Your pension is paid straight away, with no reduction for early payment.
Lump Sum Options
You can usually commute part of your pension for a lump sum under scheme rules. Commuting does not raise an injury pension: the injury pension deduction is worked out as if the pension had not been commuted (Police (Injury Benefit) Regulations 2006, Schedule 3, paragraph 6(2)). HMRC tax rules also allow a serious ill-health lump sum where a doctor confirms life expectancy of less than a year (HMRC manual PTM063400), but only if your scheme's own rules provide one. Ask your pension administrator.
Survivor Benefits
Pensions for a spouse, partner or children follow your scheme's rules. Check that your partner and nomination details are up to date with your pension administrator.
Future Reviews
Reviews are possible. In the 2015 scheme a lower tier pension can be reviewed at any time until 60, and the upper tier at intervals of at least 5 years until state pension age. See below.
Illustrative Scenarios
Hypothetical examples to show how the tests work. These are not real cases.
Officer had severe treatment-resistant PTSD following a critical incident. Multiple treating clinicians confirmed the condition was chronic and likely permanent. The SMP found they were permanently unfit for any regular employment. Upper tier awarded.
Officer suffered a spinal injury on duty. Unable to perform operational police duties. However, the SMP found they were capable of sedentary civilian office work. Lower tier awarded: accrued pension only. Because the injury happened on duty, the officer may also be able to claim an injury award, which is a separate process.
Officer applied following a prolonged period of work-related stress. The SMP did not find the condition 'permanent': treatment options had not been fully exhausted, and prognosis suggested likely improvement within 12 to 18 months. Application refused.
Officer developed a heart condition precluding them from front-line duties. Unable to fulfil constabulary safety standards for operational deployment. Capable of civilian desk-based employment. Lower tier awarded.
Officer had a long documented history of severe, treatment-resistant depression. Psychiatric evidence confirmed the condition was unlikely to resolve before Normal Pension Age. The SMP concluded they were permanently unfit for any regular employment. Upper tier awarded.
Refusals, Appeals & Timeline
Selected Medical Practitioner (SMP)
The SMP is a doctor (or board of doctors) selected by the police pension authority (2015 regulations, Schedule 1, paragraph 1). The SMP decides the medical questions: whether you are permanently unfit for the ordinary duties of a police officer and, if so, whether you are also permanently unfit for any regular employment, which sets the tier (regulation 81). The SMP's decision can be challenged by appeal, or reconsidered if you and the authority agree.
Police Pension Authority (PPA)
Usually the Chief Constable. The authority must consider the SMP's report, and can only require you to retire if the SMP has found you permanently medically unfit. Even then, regulation 82 of the Police Pensions Regulations 2015 lets it require you to keep serving instead, for example in a role you can still do. A report finding you fit means no ill-health retirement.
Common Refusal Reasons
Not Permanent
The SMP considers your condition likely to improve before your Normal Pension Age.
Not Unfit for Ordinary Duties
The SMP finds you are not permanently unfit for the ordinary duties of a police officer. Separately, even where the SMP finds you permanently unfit, the authority can require you to keep serving instead, for example in a role you can still do (regulation 82(2)(b)).
Can Work Elsewhere
For the upper tier: the SMP finds you are not permanently unfit for any regular employment (work averaging at least 30 hours a week), so the lower tier applies instead.
How Long Does It Take?
The regulations set no overall time limit, and we have not found a reliable published average. Timelines vary by force and SMP availability, and delays at the assessment stage are common. See how long it takes for what we could verify.
Can You Appeal a Refusal?
Yes. If your application is refused, or you believe the tier awarded is wrong, you have a formal right of challenge.
1. Give notice within 28 days, then grounds within a further 28
Under Schedule 1, paragraph 2 of the Police Pensions Regulations 2015 you have 28 days from receiving a copy of the selected medical practitioner's report to give notice of appeal, then a further 28 days from when the authority receives your notice to send a statement of your grounds (the police pension authority can allow longer for either). Diarise both dates and speak to your Federation representative straight away. Do not let an informal conversation run the clock down.
2. Appeal board (often called the PMAB)
The appeal is heard by a board of at least three medical practitioners appointed by the police pension authority with the Secretary of State's approval, including at least one who specialises in a condition relevant to your appeal. It reconsiders the medical question.
Alternative: agreed reconsideration
You and the police pension authority can agree to refer a final decision back to whoever made it (the SMP or the appeal board) for reconsideration (Schedule 1, paragraph 3). They must reconsider it and, if necessary, issue a fresh report.
3. Legal Challenge
Some non-medical decisions, such as refusing a claim for a benefit or reducing a pension for your own default, can be appealed to the Crown Court (regulation 207). In rare cases, decisions may be challenged through judicial review or at an employment tribunal, particularly where disability discrimination under the Equality Act 2010 is relevant.
After You Retire: Reviews and Upgrades (2015 Scheme)
- Lower tier reviews. Until you reach normal pension age (60) the scheme manager can review a lower tier ill-health pension at any time it decides, and must review it if told your condition has worsened (regulation 110).
- If you are found fit for ordinary duties again. The scheme manager may give you notice that you can rejoin the force within 3 months, at a rank no lower than you held before. The lower tier pension stops at the end of those 3 months, or earlier if you rejoin (regulation 111).
- Upgrades are possible. If a review, or your own claim that you have got worse, finds you permanently unfit for any regular employment, you can move from the lower tier to the upper tier (regulations 112 and 113).
- There is a five-year limit. The upgrade right generally runs for five years from when your lower tier pension became payable for life. There is no limit where the condition is progressive and could have been expected to worsen when you retired.
- Upper tier reviews. If you get both tiers, the scheme manager can review you at intervals of no less than 5 years until your state pension age. If the SMP finds you are no longer unfit for any regular employment, only the upper tier enhancement stops, 3 months after the SMP's report (or earlier if you return to police service). The lower tier pension continues for life unless a separate review finds you fit for ordinary police duties (regulation 114).
- Treatment. If an SMP says your unfitness would have ended with normal appropriate treatment and the scheme manager decides you have wilfully or negligently not had it, the pension can be stopped, but only after written notices from both (regulation 115).
Source: Police Pensions Regulations 2015, regulations 110 to 117, read 7 October 2026. This summary is not advice on your case.
Older schemes
- 2006 scheme (regulation 51). A standard ill-health pension can be reviewed until you reach 55. An enhanced top-up can be reviewed at intervals of no less than five years until you reach 65. If you are under 55 and found no longer disabled for ordinary police duties, the authority can offer you the chance to rejoin within a period of at least three months.
- 1987 scheme (regulation K1). Reviews apply only if you would not yet have reached 25 years' service and could not have been compulsorily retired on age grounds. If your disablement has ceased you can be offered the chance to rejoin, and part of the ill-health pension, and any injury pension, can end. The online text of the 1987 regulations may not show every later amendment, so check with your pension administrator.
Ill-Health Retirement vs Resignation
Officers who cannot continue in service sometimes consider whether to apply for ill-health retirement or simply to resign. The financial difference is significant.
| Factor | Ill-Health Retirement | Resignation |
|---|---|---|
| Pension paid | Immediately | Deferred to your deferred pension age |
| Reduction for early payment | None | Yes, if drawn early |
| Service enhancement | Possible (upper tier) | None |
| Voluntary? | No: the authority decides, on the SMP's medical decision | Yes |
| Requires SMP assessment? | Yes | No |
| Can be refused? | Yes | N/A |
Also see: long-term sickness guidance and police pension schemes explained.
Common Questions
What is ill-health retirement in the police?
Ill-health retirement lets an officer leave with a pension paid straight away when they are permanently unfit for the ordinary duties of a police officer. A Selected Medical Practitioner (SMP) decides the medical questions. The police pension authority then decides whether to retire you or require you to keep serving (Police Pensions Regulations 2015, regulations 81 and 82).
What is Tier 1 vs Tier 2 police ill-health?
Tier 1 and Tier 2 are informal names. In the 2015 scheme they are the lower tier (permanently unfit for ordinary police duties but not for any regular employment) and the upper tier (permanently unfit for any regular employment, meaning work averaging at least 30 hours a week). The lower tier pays your accrued pension with no reduction for early payment. The upper tier adds an enhancement worked out as half of the pension you would have built from leaving to age 60, based on your final pay (regulation 104). The 2006 scheme calls its tiers standard and enhanced. The 1987 scheme has a single ill-health pension.
Can mental health qualify for police medical retirement?
Yes. The test is the same for any condition: you must be permanently unfit for the ordinary duties of a police officer. In the 2015 scheme permanent means likely to last until normal pension age (60) or earlier death. In practice SMPs usually look for a treatment history and specialist reports.
Does ill-health retirement reduce my pension?
You stop building pension when you leave, so your lifetime pension is usually lower than if you had served to full retirement. But an ill-health pension is paid straight away with no reduction for early payment. The upper tier adds an enhancement for lost future service, and that enhancement can be stopped on review before state pension age if you become able to do regular employment (regulation 114).
Who decides ill-health retirement?
Two decision-makers are involved. A Selected Medical Practitioner (SMP), a doctor selected by the police pension authority, decides the medical questions: whether you are unfit for the ordinary duties of a police officer, whether that is permanent, and whether you are also permanently unfit for any regular employment (regulation 81). The police pension authority, usually the chief constable, then decides whether to retire you or require you to keep serving (regulation 82).
Can I work after ill-health retirement from the police?
Yes. A lower tier pension is paid on the basis that you can still do other work. If you are on the upper tier, though, the scheme can review you at intervals of at least five years until state pension age. If an SMP then finds you are no longer unfit for any regular employment, the upper tier enhancement stops three months after the report (or earlier if you return to police service) and the lower tier pension continues (regulation 114). Get advice before taking regular work if you are on the upper tier.
Can you appeal a refused police ill-health retirement?
Yes. Give notice of appeal within 28 days of receiving the SMP's report (the police pension authority can allow longer), then send a statement of your grounds within a further 28 days of the authority receiving your notice (Schedule 1, paragraph 2). The appeal is heard by an appeal board of medical practitioners, often called the PMAB. You and the authority can instead agree to send the decision back for reconsideration (Schedule 1, paragraph 3). Some non-medical decisions, such as a refused claim or a reduction for default, can be appealed to the Crown Court (regulation 207). In rare cases decisions may be challenged by judicial review or at an employment tribunal.
What is the difference between police ill-health retirement and resignation?
Resignation means you leave voluntarily and your pension is deferred until your deferred pension age (State Pension age for 2015-scheme service, 65 for 2006, 60 for 1987), with early payment possible in some cases at a reduction. Ill-health retirement means your pension is paid straight away with no reduction for early payment, plus an enhancement if the upper tier applies. The financial difference can be substantial.
Retirement Command Centre
Unlock your full actuarial trajectory. Model McCloud windfalls, tax liabilities, and private-sector equivalents within our specialized strategy engine.
Final Position
Ill-health retirement exists to protect officers who can no longer safely perform their role. It is structured, regulated, and evidence-based.
Before making assumptions, understand: