Clause 1 - Pension and compensation schemes: armed and reserve forces
Armed Forces(Pensions and Compensation) Bill
2:30 pm
Death-in-service lump sum of four times pensionable pay
Children's pension
Benefits payalbe to substantial registered unmarried partners
Death-in-service lump sum of approx. 1 1/2 times pensionable pay
Children's pension
Children's GIS
Benefits payable to registered unmarried partners
Children's pension
5 year pension guarantee
Benefits payable to registered unmarried partners
Children's pension
Children's GIS
Benefits payable to registered unmarried partners
Home to Duty and Physical Development Injuries/Deaths
Home to Duty
32 Compensation will be provided for limited home-to-duty travel to cover emergency callout (to duty only), travel to/from operations/exercises overseas (in accordance with Joint Service Publications guidelines) and other detached duty travel.
33 Exceptionally, if Service Families Accommodation (SFA) is unavailable within 50 miles radius of the workplace then compensation will be provided in the event of an injury or death whilst travelling between home and work. Individuals who choose to live more than 50 miles from work in SFA will not be covered under the scheme.
Physical Development Activities
34 Compensation will be provided for injury arising from all publicly funded fitness, sports and adventurous training activities that would qualify as ''on duty'' as laid down in Service Regulations.
35 Defined fitness activities (regulations as laid down in the Armed Forces Physical Development Policy document) are also eligible for compensation in the event of injury. These must be part of a formal training or fitness programme agreed by the Service authority as necessary to meet Service fitness requirements.
36 Injuries incurred in the above activities will generally be admissible for compensation only if they are reported, recorded and subject to medical examination when incurred. This should generally take place within 24 hours of the event. However, the scheme will have discretion to accept attributability where under the specific circumstances the reporting timescale is not practicable or where the injury cannot be attributed to a single incident. This will be subject to the existence of reasonable evidence, including within service medical records, to support the case for attributability.
37 Injuries incurred during or in support of sporting commitments undertaken in a professional capacity or for a national team will not qualify for compensation under the new scheme. It is considered reasonable that these will be covered by separate provisions.
38 Travel to sports competitions and other activities as classed as ''on-duty'' within the Service regulations will be covered under the Compensation Scheme provided that this travel is publicly funded.
39 Injuries incurred in leisure or social activities will not be eligible for compensation under the new arrangements. It will be for individuals themselves to consider whether they need to make arrangements for appropriate cover for such activities.
Reservists
40 All members of the Reserves as defined under the 1996 Reserves Forces Act will be covered under the AFCS. This replaces the benefits they currently receive under the Attributable Benefits for Reservists Scheme (ABRS). As with the current ABRS, this scheme is designed to give Reservists the same attributable benefits as regular Service personnel. However, where a Reservist is in receipt of benefits from elsewhere, such as a personal pension or an occupational pension, benefits under the new Compensation Scheme would be abated.
Time limits
41 This will be the same as for regular Armed Forces personnel. Eligibility for compensation for disorders that develop after service termination will be subject to a time limit of five years, apart from certain listed late-onset conditions, such as some cancers.
Guaranteed Income Stream
42 In many cases, assessing lost earnings for Reservists will not be straightforward, however, as military service will not be their only occupation. The assessment of lost earnings will not be based on a Reservist's pay in his/her civilian occupation as this is not the financial basis on which he/she is employed, would be complex to administer, and would raise issues of equity between reservists.
43 Lost earnings will therefore be assessed on the basics of the Reservist's military salary, which is in most cases the salary of a regular counterpart of equal rank. This will ensure consistency of approach with the regular Armed Forces. So that those in a high-
earning civilian occupation will not be disadvantaged, full account will be taken of pay supplements that some Reservists earn (to compensate for those whose gross civilian earnings are higher than their gross service pay).
Physical Development Activities
44 Reservists will be covered under broadly the same criteria, but when the detailed scheme rules are being developed due account will be taken of their particular circumstances and specific guidelines will be provided.
Disputes and Appeals Process
Internal Appeals Process
45 Precise details of the appeal procedures are not yet finalised. However, a claimant will have the opportunity to challenge decisions taken by the scheme administrators. This will start with a single or twin stage Internal Dispute Resolution Process (IDRP) which will be followed by the right of appeal to the Pensions Appeal Tribunal (PAT), and at second stage to the Social Security Commissioners. Both are ECHR compliant, independent appeals bodies.
46 Claimants will be notified of decisions in the Scheme and provided with reasons for decisions. The points on which a claimant can challenge decisions include:
(1) decision to award/not to award;
(2) level of award;
(3) decision not to waive time limits;
(4) decisions on application of exceptional review on grounds of deterioration.
47 Individuals will have a period of, say [90 days] following the date of the initial decision notification, when they can dispute the decision and apply for review. They will need to provide grounds and present such additional information as they judge appropriate to support their case. There will be some discretion to waive the time limit for internal review where there is good cause, such as claimant being overseas, illness etc.
Independent Appeals Process
48 If the grounds for the appeal are accepted as legitimate, the case will be reviewed and again the outcome notified with reasons. The claimant can then further challenge the review decision within a defined period [30 days], to the independent appeals authority, the Pensions Appeal Tribunal (PAT).
Pensions Appeal Tribunal
49 The PAT is the existing point of appeal from decisions of the current scheme. It is intended the PAT will concurrently hear appeals under both the old and new schemes, until claims under the old scheme have phased out over time.
50 The PAT rehears cases in full, considering issues of fact and law. The Tribunal is headed by a legally qualified President, supported by a panel of part-time Legal Chairmen, Medical Members and Service Members.
Further Appeals: Social Security Commissioners and Court of Appeal/Court of Session
51 Under the new scheme decisions of the PAT may be appealed on a point of law to the Social Security Commissioners. This is a change to the present situation, where the High Court is currently the first point of appeal from PAT. Changing the path of appeal will bring the appeal route into line with modern tribunals policy and provide better customer service for appellants.
52 The Commissioners currently hear appeals from a wide range of tribunals. They are experienced judges, well qualified to judge on difficult points of law, and provide a low-cost, user-friendly forum that is far more accessible than the High Court.
53 It is intended Commissioners with appropriate experience in armed force pension matters be assigned to these appeals. It is also intended they be named ''Pensions Appeal Commissioners'' during the hearing, to signify the special status given to veterans' issues.
54 Decisions of the Social Security Commissioners may in turn be appealed to the Court of Appeal (or the Court of Session in Scotland) on a point of law. In some cases it may be appropriate for particularly difficult points of law to have final resolution in a Court.
General Administration
Administration of the Scheme
55 Administrative arrangements are not yet developed in detail, however some key points have been established as follows:
(1) A claim will be considered automatically where there is a medical discharge from service or a death in service.
(2) Decisions in the scheme will be evidence-based, dependent on case-specific facts, the standard of proof and in line with contemporary medical understanding of causes of the disorders.
(3) Guidance and instructions for decison-makers, and policy underpinning the Scheme will be published and regularly reviewed.
(4) There will be a statutory internal dispute resolution procedure followed by a right of appeal to the PAT which provides an independent ECHR-compliant appeals procedure.
56 The details will be developed by a working group, with tri-Service representation and input from agencies such as the Veterans' Agency and the Armed Forces Pay and Administration Agency. Interested veterans organisations will also be consulted.
57 The administrative process will be subject to the usual government financial controls and arrangements will need to ensure the integrity of the scheme and make it fraud resistant. Comprehensive management information will be required and the administrators and medical advisers will be provided with adequate training, published guidance and supervision. Suitable quality assurance processes will be included. The details of these processes are still to be developed.
Adjudication of Claims and the Role of the Doctor
58 Decisions will not be medically certified but made by administrators with access to medical advice. Designed on the tariff system and with the time limits for claiming, it has been the aim to make the new scheme's decisions relatively simple and to reduce to a minimum the scope for discretion.
59 To ensure high quality decsions medical input is needed in the new scheme. Three main areas are as follows:
(1) scheme design (including review and updating of tariff and exceptions list);
(2) provision of medical evidence;
(3) provision of medical advice to the decision-maker where required.
60 Service medical evidence is key to the new arrangements and emphasis will be on the importance of detailed, accurate service records fully documenting incidents, events and health information. This will be supported by the work done since the 1991 Gulf crisis to improve the medical records of Service personnel including the introduction of the Operation Medical Record (FMed 965). In the longer term it is proposed to link electronic and paper records for both peace-time and operations. The system will be compatible with NHS systems and in line with the Government information strategy on electronic medical records. The Compensation Scheme will be introduced at a time when there have been significant improvements in the management of medical records. The resultant Service medical records will allow administrative staff broadly to establish the presence and nature of disablement and eligibility. Analysis of in service data and war pensions claims confirms that the majority of claims will be for musculoskeletal injuries and conditions which are well suited to a tariff approach.
61 More complex claims will benefit from easily accessible medical advice for administrative decision-makers. Particular issues may be:
(1) Where the claimed disablement does not quite fit the tariff;
(2) There is no clearly appropriate tariff level;
(3) Whether cases falling outside the 5 year time limit for submitting claims should be accepted for consideration on the basis that they should fall within the ''excepted'' list;
(4) Medical disorders where there is no consensus understanding, eg psychological injury.
62 Where necessary and, as now, with permission, post-service evidence from the claimant's clinicians or by examination will be obtained. Advice to adjudicators will be provided by trained dedicated doctors who have knowledge of the Scheme, law and
policy as well as a background in disability analysis or occupational health.
Welfare
63 The War Pensioners Welfare Service (WPWS) will remain for those who are already in receipt of a War Pension. With a different client base and setting, we will consider the particular nature of the support required for the new compensation scheme, avoiding duplication of existing related services. Support around service termination will be paramount. Long term follow-up is likely to be appropriate only for the most seriously disabled. The Veterans Agency will play an important role in advising on the development of proposals for a support mechanism and we will consult as appropriate with ex-Service organisations.
Provision of Medical Treatment for Disablement Leading to Medical Discharge
64 As with the present provisions, the assumption is that in-service care will be provided by the Defence Medical Service, while post-service responsibility for service-related disablements will fall to the NHS. We will be consulting with the Department of Health about the continuance of current arrangements for priority NHS medical treatment for compensated conditions.
Transition
65 Although claims for injuries through the new Compensation Scheme will be made for injuries and illnesses whose cause occurs after the date of implementation, we recognise there may be less clear cut cases and will be developing mechanisms to ensure that no claims will fall between the gaps of the new and old schemes.'.