title: Changing medical criteria and medical severance payments may reduce the rate and costs of ill-health retirement.
abstract: OBJECTIVE
  To identify the core best practice standards in ill-health retirement (IHR) procedures. To investigate whether changing medical criteria and introducing medical severance payments affect the rate and cost of IHR.
  
  
  METHODS
  The core standards for best practice in IHR procedures were distilled from the published literature. On 1st April 2000 the study pension scheme altered the IHR medical criteria to define permanent incapacity and introduced medical severance payments for employees with temporary incapacity. Rates and costs of IHR were measured before and after these changes.
  
  
  RESULTS
  Following the changes, the annual rate of IHR fell from 8.89 to 2.90 per 1000 members (P < 0.001), the median age at IHR rose from 50 to 55 years (P = 0.01) and pension scheme costs fell by 25 million pounds sterlings per year.
  
  
  CONCLUSIONS
  Changing medical criteria and introducing medical severance payments may reduce the rate and costs of ill-health retirement. Target rates of four cases of IHR per 1000 active members per year, and 15% of total retirements, are proposed for schemes serving industries with average health risks.
authors.affiliation: Atos Origin-Medical Services, Lancashire, UK. nigel.wilson@atosorigin.com
authors.forename: Nigel
authors.initials: N
authors.lastname: Wilson
mesh_terms: D016009:Chi-Square Distribution; D003365:Costs and Cost Analysis; D004185:Disability Evaluation; D004608:Eligibility Determination / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009787:Occupational Medicine / Q000592:standards; D010415:Pensions; D017410:Practice Guidelines as Topic; D012179:Retirement / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data