selected medical practitioner

Merseyside Police do not review Band 1 Injury Awards

iodpa 2016-05-132016-05-22 police injury award, Regulation 37, Review, selected medical practitioner

“The people heard it, and approved the doctrine, and immediately practiced the contrary.”
― Benjamin Franklin, The Way to Wealth

The most glaring source of scepticism towards Merseyside Police’s affection for the Police Injury Benefit Regulations can be summed up in five words: ‘they never review band ones’.

Merseyside Police recently set about conducting a mass review of the degree of disablement of former officers retired due to injury on duty, and who exist on an injury pension paid as compensation for those injuries. Merseyside conducted 502 such reviews last year.

We in IODPA have good reason to believe that these reviews were motivated by an intention to try to save money, and not by any concern to ensure that the pension Regulations were being properly applied. Merseyside was not looking to see if anyone was being paid their injury pension at too low band or too high a band, which would be appropriate if there had been some substantial alteration in their medical condition. No, they set out to see if they could reduce pension payments.

They accordingly started their review programme with those pensioners who are on the highest band of degree of disablement. The highest band pays the highest level of pension attainable, and, can’t be increased, but, Merseyside reasoned, might be reduced.

We revealed in an earlier blog how ‘only’ 25 individuals had their injury pension payments reduced. We don’t know by how much. We pointed out that it was beyond belief that not a single disabled former officer was found to be in a worse condition and given an increase in injury pension payment. Statistically, this lack of any increased pension payments is not possible.

The overall impression is that despite the fact that the Regulations impose on Merseyside’s Chief Constable (as the Police Pension Authority) a duty to ensure that police injury awards are administered fairly and lawfully, the Medical Retirement Officer (MRO) is happy to ignore the law when it suits him. It was the MRO who instigated and managed the reviews, and he has placed his Chief Constable in a very difficult position.

There are 880 individuals retired from Merseyside who receive an injury pension, 502 have been reviewed. The remaining 378 are all on band one pensions – the lowest payments – and this force has a policy not to review people who have no possibility of having their awards reduced.

Merseyside has ensured our cynical view of its motives by admitting they don’t review band ones. This admission is the clearest possible illustration that it is Merseyside’s view that if there are no pips to squeeze, why get the juicer out of the cupboard?

Here is the admission, obtained via a Freedom of Information Act request.

FREEDOM OF INFORMATION REQUEST

DJ 092/14 – RESPONSE

REQUEST

RESPONSE

The Medical Retirement Office of Merseyside Police recently sent out a number of letters, together with a questionnaire, to former officers who are retired and in receipt of an injury award pension.

The letters requested that the recipient complete the enclosed questionnaire with a view to considering whether his/her injury pension should be reviewed.

The questionnaire is entitled, ‘Review Of Injury Award Questionnaire’

I am requesting the following information in relation to these letters and questionnaires:

1) How many have been sent out?

2) How many is it intended to send out within the next two months?

3) What criteria were used to select the recipients? When answering please pay particular attention to whether recipients were selected by reason of their age, or by reason of them being at or around what would have been normal compulsory retirement age for the force, or for reason of the degree of disablement of the recipient.

1) The process commenced in 2014 and a total of 35 questionnaires have been sent out to date.

2) Within the next two months it is anticipated that a further thirty questionnaires will be sent out.

3) The criteria for selection of injury award review were based on Band 4, then Band 3, then Band 2. Band 1 will not be reviewed unless requested by the former officer and in that case they would be seen as a priority.

As the self-proclaimed architect of Merseyside Police’s retirement policy, it seems that the MRO enjoys the privilege of making up the rules to suit himself, and ignoring the Regulations whenever the fancy takes him. We understand that he, as a matter of common practice, acts completely outside the restrictions of the Regulations and makes decisions that he is not empowered to make.

We hear that he decides who will get an injury award and who will be refused. He does this without benefit of medical qualifications, or any meaningful input from the force’s tame SMP or FMA. We believe that the 502 reviews of degree of disablement were done similarly, with little to no consideration of medical matters, and were decided on the basis of a person’s income.

Some police forces have been quick to declare they have a duty to review degree of disablement, citing a positive power to do so, often quoting that a SMP has ‘recommended’ when an individual might be reviewed. However, these forces do not exhibit moral consistency when they ignore where a SMP may have advised, on a decades old retirement certificate, not to ever review the individual concerned. How many of the 502 who Merseyside reviewed had ‘no reviews’ or ‘no further reviews’ on their certificates? Where was the individual consideration whether a review was indeed appropriate?

The stench of of hypocrisy hangs heavily over Merseyside, but proves nothing about the topic – in reality there is no legal authority for Merseyside to say they won’t review band ones, en masse, just like there there is no legal requirement for a SMP to recommend when a review might take place, or to exempt someone from reviews.

Merseyside completely misses the point, which is that the PPA is required – legally required – to exercise discretion in each individual case. If the PPA (in reality the MRO with one eye on a bit of brown-nosing and career enhancement) decides to review all injury pensions, except for band ones, then there clearly has been not even an imperceptible nod in acknowledgement of the need to decide whether a review would be appropriate in each individual instance.

Below is the result of a recent Freedom of Information request which provides damning evidence that Merseyside will not rest until all injury awards have been reduced to the bare minimum.

FREEDOM OF INFORMATION REQUEST Ref. SM4011/16

REQUEST	RESPONSE	ADDITIONAL INFORMATION
In FOI request SM322/15 you state that the review was restricted to band 2 and above. Please provide me with the reasons that band 1’s were not reviewed.	We can confirm that historically Merseyside Police have not reviewed Band 1 Injury Awards unless the review has been requested by the ex officer themselves	The rationale for this approach is that the Force Medical Advisor, acting in the role of Selected Medical Practitioner, records on their certificate “No further review”. The pensioner is provided with a copy of this certificate confirming that this is the case. Therefore they have been formally advised that there will not be a review of their award.

The proposition that an administrative authority must act within the powers conferred upon it by the legislature may well be considered the foundation of Administrative Law. In Latin, ‘Ultra’ means beyond and ‘Vires’ means powers. Thus, the expression ultra vires means an act beyond the powers.

A Selected Medical Practitioner who writes ‘never to be reviewed’ on a former officers H1 certificate is acting beyond their statutory duty. They might have decided the person being assessed for an injury award will never work again, or their condition may likely never improve, but the Regulations do not bestow any authority to allow the SMP to declare that someone should never have their degree of disablement reviewed. Merseyside has seized on these ‘recommendations’ as reason to abandon the over-riding duty of the PPA to ensure that the correct level of injury pension continues to be paid.

What a SMP thought, some years ago, can never be more than a guess. Maybe an informed guess, but as nobody can predict the future, it is plain wrong to claim that a guess, made outside the Regulations, as a sort of extra-regulatory add-on to a certificate, should bind a PPA as to its future actions. If the PPA is claiming that these recommendations are binding, then the PPA is wrong. If the PPA fails to consider, from time to time, for each and every individual who is in receipt of an injury pension, whether their degree of disablement has altered, then the PPA is fettering the power of discretion which the Regulations require he exercise.

We also must question the reason behind any SMP recording on a certificate or in a report his opinion that an individual need not be reviewed. It is not beyond the realms of possibility, given the rampant corruption that we know is the norm in some forces, for the SMP to make that recommendation with the deliberate intent of ensuring that someone who should properly have been placed in a higher band of disablement is never seen by any future, more honest, SMP who would conduct a review and see that the original decision was flawed.

We pause here to speak directly to all the Merseyside pensioners who are on band one. We say, if you have reason to think that you should have been placed in a higher banding when granted your injury pension, or if you feel that your degree of disablement has substantially worsened since you retired, then you should seek professional advice – via IODPA – as any earlier decision on degree of disablement can be challenged by means of regulation 32-(2). That regulations allows the reconsideration of any earlier decision, without limit of time. So, even if you have been retired for many years, you can request that the PPA arrange for any earlier decision to be looked at again.

We recommend that you think carefully about the benefits of using regulation 32-(2) over simply asking the PPA to conduct a review. A review may increase your banding, but any increase in pension payment will commence from the date of the review. If you ask for and get a successful regulation 32-(2) reconsideration of an earlier decision, where the SMP decides you should have been placed on a higher band all those years ago, then you stand to be paid all monies lost by underpayment for all those years, with interest added.

When we look at what Merseyside are saying in the above FOIA response, we have to point out that it is scurrilous to claim that pensioners were advised they were never to be reviewed. Merseyside could not make that ‘promise’ (or was it a threat?) without breaking into pieces a fundamental part of the Regulations, which is the provision for the PPA to exercise discretion over whether or when to hold a review. Merseyside could not bind any future office-holder’s power of discretion, nor could Merseyside effectively say that the individuals concerned would never experience any alteration in their degree of disablement.

The point is that the Regulations definitely do not allow a band one to be treated any differently from a band four. Merseyside has deliberately set out to deny all the people who are on band one injury pensions any chance of having their pension increased. The recent mass review unfairly discriminated against all former officers who are on band one.

Some HR managers may ask, ‘Why can’t a former officer be labelled as ‘exempt from review’? The answer is that the Regulations do not confer the power of exemption upon the decision maker. The decision maker under the Police Injury Benefit Regulations is the Selected Medical Practitioner (SMP) but the decision itself belongs to the PPA.

The way that decisions are to be made has been clarified by cases which went to Judicial Review, but it is still surprisingly common for HR managers to still not understand the profound subtlety of what His Honour Judge Behrens declared in paragraphs 66 and 68 of Crudace, R (on the application of) v Northumbria Police Authority [2012] . HR managers seem to think that the decision is only for the PPA to make. It isn’t – the decision is owned by the PPA but it is delegated to the SMP.

He accepts, of course, that the actual decision is made, in the first instance, by the SMP or on appeal by the PMAB. He also accepts that both the SMP and the PMAB are independent. However he submits that the decision is still a decision of the Police Authority albeit a decision that has been delegated to the SMP/ PMAB by regulation 30(2) or 30(3). He referred me to paragraph 18 of the judgment of Laws LJ in Laws where he referred to the decision as being of the Police Authority (via the SMP/board). …

…68.It seems to me that the wording of regulation 37 makes it clear that the decision to revise the pension is the decision of the police authority. It follows, in my view that the decision of the SMP and/or the PMAB on appeal can only be as the delegate of the Police Authority. This is so even though they are independent and the Police Authority is bound to accept their decision as final (subject to reconsideration under regulation 32(2) and/or judicial review).

If the SMP records that it is his opinion that a person should not be reviewed for medical reasons then that is well within his medical judgement to say so and this shall carry weight in any future considerations but the SMP as the promise maker, nor the promise recipient, has any power to enforce it.

That being said there will have to be exceedingly strong and compelling evidence to allow a review if the previous SMP had declared that such a review would be harmful to the former officer’s health. Just being a band one is not a medical reason and is as opposite to compelling as can possibly be.

The decision maker can declare that a review should be avoided if at all possible: A SMP might well want to write,“In my medical opinion this former officer should never be reviewed as it will be to the detriment of his health” but such sentiment, or opinion, is worlds away from writing, “I have made a promise to this former officer that he shall never be reviewed”. Some people reading this will have documents stating exactly that this – that the last SMP they saw made such a promise to them – but unfortunately a substantive promise cannot be upheld if it is ultra vires.

A declaration made on a medical certificate recording “No further review” giving formal advice that there will not be a review of an individual’s degree of disbalement just because they are a band one is a travesty of not only the Regulations but also the foundations of administrative law.

The statute is clear that there are only two agents involved in the decision making process, the PPA and SMP – so how little weight shall be put on the decision of a civilian medical retirement officer who is telling the force medical officer to write on a certificate to never review someone purely because they can’t be reduced further?

Until Merseyside performs the necessary checks to make sure all the band ones retired from that force are receiving the correct award entitlement, that none of them have suffered deterioration in their degree of disablement in relation to their earning capacity, and as a result of these checks a relative proportion of the band ones are increased up a band, then scepticism of their true illegal intentions will forever remain.

Merseyside’s claim that band ones can self-refer themselves if they ever want to be reviewed is ridiculous, given many will not realise the option is open to them, and those that do know will not want to flagellate themselves by dealing with corrupt elements of an organisation which are determined to abuse the scope and purpose of the Regulations. Not a convincing argument by Merseyside Police to encourage a band one to volunteer to put themselves forward.

Remember, pensioners, and take note Chief Constable, that in 2015, in all the reviews of bands two, three and fours, not a single award was increased. Something is rotten in Merseyside, and the smell will only get worse unless someone takes a broom and a shovel and does some stable cleaning.

Nottinghamshire Injury on Duty Reassessment Program – Part 2

iodpa 2016-05-092018-08-10 National Attendance Management Forum, police injury award, selected medical practitioner

“People who know what they’re talking about don’t need PowerPoint.”
― Walter Isaacson, Steve Jobs

Welcome to part two. If you missed part one, here’s the recap: Dr Ralph Sampson and Stephen Mitchel of Nottinghamshire Police, in December 2015, gave a presentation to National Attendance Management Forum (NAMF) delegates about how they are attempting to save millions of pounds by ‘cunningly’ and nefariously reducing injury awards. The nightmare scenario of an active SMP such as Dr Sampson making an unintentional error of revealing his subconscious feelings that a review allows him to perform a ‘reassessment’, mixed with the total absence of referencing any case-law to the audience, leads to emboldened NAMF delegates going back to their forces thinking IODs are ‘ducks to be lined up’.

Notts-IOD-Presentation.pdf

*click image & use arrows to view all pages

Jumping straight in to where we left off in part one, slide 6 is a rather amateur and extremely poorly presented summary of some of the statistics generated by the Notts ‘reassessment’ program so far. There are few people on this planet that would admit to liking staring at text more than they like staring at pictures. Text takes time to read and it is boring to look at. But perhaps worst of all, when an audience is given text, they will, out of habit, attempt to read it. As they do so, you will be talking and they won’t be listening—because they’re reading. But they won’t be able to concentrate on what they’re reading because, well, you’re talking. It’s the vicious cycle of PowerPoint un-communication.

This is expounded further when the numbers don’t add up. And the audience aren’t going to argue otherwise as they’re all too busy trying to fathom out what the heck is going on in the jumble of words in front of them.

6.Numbers so far

381 former officers in receipt of lOD pension,

281 aged under 70 and included in programme

Concluded or currently in process = 235 (16 batches) (87%)

Number of paper reviews undertaken so far = 140

62 ‘no further action’ (44%)

78 ‘ possible substantial alteration” (56%)

Individuals where SMP review no longer required:- 26 (deceased; age
exempt; band 1 non-participants; terminal diagnosis)

78 SMP face to face assessments

2O reduced

1 increased

21 remained same

27 appointments scheduled

9 seen and Force awaiting outcome

In about five minutes we’ve cobbled together this graph.

It isn’t perfect but we weren’t the ones giving the presentation. What it does show is, out of the numbers given above, 69 out of the 381 are unaccounted for. They haven’t been reviewed, presumably they aren’t going to be reviewed and they are not in the exempted cohort.

What’s happened to them? These numbers represent people – disabled former officers and Notts have just erased them from their presentation. Perhaps they are selective in the data they want to portray. Notts definitely aren’t persistent in chasing a ‘non-engaging band one’ in comparison to when they attack, with shark-like ferocity, a ‘non-compliant’ band four.

The bottom line is that any way that you look at the figures, they are wrong, and they do not stand up to scrutiny. We have provided the proof of our assumptions at the bottom of this page for the benefit of the mathematically minded. *

This presentation is purportedly given by ‘professionals‘ to ‘professionals‘. They can’t even get their maths right. Dr Sampson supposedly makes sophisticated calculations of a former officers degree of disablement down to 2 decimal places but he is unable to subtract from 381.

7.Numbers so far

Of 42 ‘face to face’ SIVIP assessments where advised of outcome (28 days elapsed) – 21 changed bands (50%)
PMAB appeals = 3 potential
Numbers reduced to B1 due to non-compliance : O
Number of official complaints = 1

Slide 7 is aimed at promoting the perception that their ‘reassessment’ program is all about forcing a change to bands and spinning the lie to the NAMF delegates that there are few pitfalls. There is no neutrality and the agenda is always to change the status-quo. Why emphasis those changed when those kept the same outnumber the former and have just as much relevance? There has been 1 complaint and 3 appeals. This slide skirts over the reason for the appeals and fails to state the outcome of the complaint.

Just because there is no appeal, it doesn’t mean the decision was just or legitimate. Perhaps the ‘fight’ has left the former officer and they can’t cope with the dehumanising nexus of appeal forms and procedure. Despite the strength of their appeal, they make a conscious choice that appealing against the harmful side of bureaucracy is futile. In the Judicial Review case of Crudace, the presiding judge stated that twenty-one appellants withdrew their appeals after receiving a letter from the force Solicitor Nicholas Wirz, that in effect threatened the disabled former officers with a £6,200 adverse costs award if they persisted with their appeal.

Winston Churchill once said that the whole history of the world is summed up in the fact that when nations are strong they are not always just, and when they wish to be just they are no longer strong. And there is the clearest explanation possible of the case for justice where the former officers involved are not strong enough to do that themselves. Banking on the weak to not appeal is a pitiful and inexcusable show of strong-arm tactics.

Stating the number of appeals is meaningless. As far as Sampson & Mitchel are aware all twenty that were reduced could be submitting their complaints to the Pension Ombudsman.

The red highlighted bullet point shows the new invented weapon in the armoury of those SMPs trained by NAMF. The weapon of mutual destruction (WMD) is in the form of ‘if the former officer is non-compliant then we will reduce to band one.’ Of course, such a bullying course of action is not permitted anywhere in the Regulations. The presentation makes no reference to the actual Regulation 33 that only permits the police pension authority to make a determination on the available evidence if there is a failure to attend a medical examination. Pressing the ‘big red button’ on this WMD will be financial catastrophe for the victim but the response would be so massive that Notts would suffer “assured destruction” at Judicial Review.

8. £ to date

Funding for programme agreed
GP notes – approx £50 each
Impact to date -18 out of 21 that have changed band = £10ok net saving per year
With average life expectancy estimated at age 83…possible £20 million saving on the cases so far.

And the spin continues with slide 8. With a slide callously titled ‘£ to date‘ there is no doubting this is all about the money and this not about a genuine medical assessment, but rather, an opportunity for Notts to take away the injury award the former officer is entitled to.

The slide assumes the ‘savings’ are fixed. That Notts have got what they wanted, they can spend the £20 million they will save over the lifetime of those reduced and that’s the end of the matter. This could not be further from the truth.

This mindset is further evidence that Sampson cares not for the Regulations but only to please his bosses. Those reduced on his evidence of an improvement to their degree of disablement are surely, under the logic of Sampson’s suitable interval and positive power to review, absolute certainties to be reviewed again and their degree of disablement invariably likely to deteriorate accordingly.

Sampson & Mitchel surely can’t be insinuating that Regulation 37 vanishes once Notts have got their way, and once the goal of reduction is achieved then the former officer is gone clean out of their mind and consigned to oblivion?

The stench of hypocrisy oozes from slide 8. Later in the presentation (slide 15 to be exact) Sampson makes his brazenly duplicitous point that former officers were ‘reluctant to engage’ and there is a ‘misunderstanding from officers who claim previous SMP advised for life’. But in slide 8 Sampson is saying the reduction in banding is for life – with no balance check review ever again to see whether the reduction is perdurable.

9.

We have heard recently of an Australian qualified physiotherapist who is being used as an SMP. He has never practiced general medicine and although registered with the GMC is not on the GP register. How could someone like that be qualified to form an opinion on PTSD or complex trauma injuries? I wouldn’t let him lance a boil on my bum let alone make a decision about my degree of disablement.
I am sorry to say, but he is by no means untypical.
Forces are deliberately hiring the lowest level ofthe medical profession – those for whom payment was” ___is more important than professionalism

Slide 9 would be hilarious is the issue wasn’t so serious. A bias SMP, dancing to the tune of his paymasters and forgetting his Hippocratic oath, criticising other forces from using not only an physiotherapist – but an Australian physiotherapist! The nerve. These antipodeans coming over here and taking money from members of the faculty of occupational health – it’s obscene!

10. IOD REVIEW – Medical Assessment – REG 37.1

No pre-conditions for Reg 37.1 review suitable intervals
Degree of disability vs degree of disablement Need to clarify
Complete GP records/OHU records
Can’t revisit causation
Reviewing LOE calculation

Slide 10 incorrectly says there is no pre-conditions for a suitable interval. If this was the case the ‘suitable interval’ qualifier would not have been written into the Regulations. In fact the interval between reviews has a defined pre-condition – it has to be suitable, right or appropriate for a particular person, purpose, or situation. The pre-condition is implicit.

The presentation is also confused about their remit as they need to clarify whether a review concerns the Degree of disability vs degree of disablement. Surely it is rather too late to be asking such a question? The revisiting causation is a contradiction as that is exactly what they do in slide 14 but we will come to that later.

LOE is their acronym for level of earnings. Again this is contrary to the Laws judgement. We think that the 3 appeals now have the evidence they need to overturn Dr Sampson’s decisions.

11. IOD REVIEW – Medical Assessment – REG 37.1
Degree of Disablement – The degree to which their earning capacity is reduced by the injury condition, and expressed as a % of the appropriate comparator salary

(UEC-AECVCOMP SALARY
UEC – Uninjured earning capacity – same as Comp salary if no non-injury conditions affecting earnings
AEC – Actual Earning Capacity – takes into account injury and any non-injury conditions if present

Slide 11 defines degree of disablement. Sampson & Mitchel are totally incorrect to say it is expressed as a percentage of comparator salary. In fact it is minimum income guarantee expressed as % of the final average pensionable pay.

12.

Change in assessed LOE
Change in assessed LOE
Medical condition – improve/worsen
Non injury medical conditions affecting work capability/earnings
New Training/Qual Skills
New job/career opportunities – may be evidenced by salary

Slide 12 shows this ‘reassessment’ program is really an unlawful work capability test.

13. Outcomes so far
Paper Screen – 157
Assessments – 55
No change – 22
Change in perm disabling condition – 2
Non injury conditions – 14
Salary – 6
Change to comparator salary – 3

Slide 13 is another example of Sampson & Mitchel’s figures not standing up to scrutiny.

Remember slide 6 and the bullet point informing everyone that 140 had been papered reviewed? By slide 13 of the same presentation this number has increased to 157. In other words, whilst Sampson & Mitchel were talking to the NAMF delegates, at the same time and without a pause of breath, they magically managed to paper review another seventeen people.

Of the former officers who had a change of banding, only two had a change in their disabling condition – the prerequisite for substanstial change as dictated by the Laws judgement. But again the numbers do not add up. Earlier in the presentation it was stated there was twenty-one former officers who evidenced substantial alteration and had their bands changed. On this slide the count is twenty-five.

Fourteen former officers had their award reapportioned. Six reported a salary of whatever amount and had their awards changed. It is evident that Sampson has not been following the Laws determination at all.

14. Diagnoses l Causation
LBP – playing table tennis at lunchtime
No of sports injuries
Neck Pain – 80% – then commercial pilot for 12 years
Collapsing chairs
“Psychological defects of Low Self esteem and Low Confidence” Band 1

Slide 14 revisits causation. An avenue barred to any SMP upon a review and explicitly referred to as verboten in slide 10. This slide is one of those faux ‘humorous’ ones – put in so that everyone in the audience can have a good giggle. The commercial pilot anecdote is intended to spark outrage from the delegates. What it takes out of context is the pilot could have been earning £160K a year if his neck injury didn’t restrict his flying hours. Instead he is only earning, say £80K. This analogy is pure supposition, but technically this fictional example has lost 100% of his potential capacity to earn. Rather than point out a similar possibility, Sampson & Mitchel use a sensational tabloid headline, absent of any context, to get the delegates ‘clucking’.

Mentioning sports injuries is another example of sensationalism. The last final decision is a given and it is not up the the SMP to revisit the medical judgement of the previous doctor.

The ‘loss of confidence’ is a repulsive bullet point. If the index injury is, or leads to, an impact to self-esteem of the former officer by psychological detriment to the capacity to earn then the award is designed to reflect this. Such a detriment often means that there is no prospect of maintaining any employment.

A previously high-functioning individual who attained all the tests to become a police officer and is now unable to leave their home due to psychological affect of low self-esteem and poor confidence is, by definition, suffering from a personality disorder. People with avoidant personality disorder often consider themselves to be socially inept or personally unappealing and avoid social interaction for fear of being ridiculed, humiliated, rejected, or disliked. As the name suggests, the main coping mechanism of those with avoidant personality disorder is avoidance of feared stimuli.

Let’s emphasis again that these people used to be police officers – an occupation where avoiding stimuli is the antithesis of the necessary qualities required – and their index injury has forced them along the road to suffer from such a disability. To proclaim in such circumstances that it is an automatic band one fails on all measures to take the position of the individual into account.

15. Lessons Learnt / issues

lnitial letter despatched Christmas time – Fed / NARPO availability
Locate relevant IOD information
OHU and IOD files mixed
Addresses ~-~- stage 3 / those that live abroad
Former officers reluctant to engage in process
Misunderstanding from officers who claim previous SMP advised ‘for life’
Some former officers want reassurance medical records and questionnaire are not seen by non-clinical staff
Draft report – 28 days
Overpayment recovery
Traveling – Skype?

The ‘lessons learnt’ mention that a batch of review letters were sent just before Christmas time. Notts police is such a heartless and uncaring organisation that it never struck them at the time that this was a bad idea. They aren’t seemingly concerned of the impact to the individual by dumping such grief over the festive period – they just think its a lesson learnt because local Fed & NARPO couldn’t answer the worries of those affected as they were off enjoying their own Christmas break.

NAMF allowed Sampson & Mitchel to present their talk as so-called ‘experts’, to help delegates to fill in their gaps, to add to their shallow knowledge concerning reviews. Supposedly they had the hands on experience. Instead they’ve perpetuated all that is wrong with mass review programs.

These ‘experts’ are stuck in their own prejudicial thinking and are inflicting significant harm onto disabled former police officers. When SMPs such as Dr Sampson perform reviews just as a cost-saving mechanism they are renouncing the ethics, morals, culture, empathy, philosophy and understanding of their role as the medical authority required by the Regulations into much simpler factors based on numbers and calculations. They are manifestations of the phenomenon of doctors who know the price of everything and the value of nothing.

They are anachronisms who deny the changes, the evolution that’s happening since the case-law has defined how reviews should be carried out post HOC 46/2004. Their so-called experience is jaded (and diminished) by the ‘way they’ve always done it wrong’. They should not be allowed sustain the errors by briefing others.

So that’s it. There are bound to be glaring misdemeanours that you have found and we’ve missed. Feel free to post such findings in the comments.

*The proof:

Out of 381, 100 are age exempted – excluded because they are over 70 (why can’t those over 70 go up a band?). Of the remaining 281, 46 are yet to be contacted at all. This leaves 235. 62 are No-Further-Action. We are down to 173. 78 include those where they think there is evidence of substantial alteration.
Of the 78, 20 have been reduced. 21 Not altered. 1 Increased. 27 Future Appointment.9 Awaiting an outcome

Let us take the 78 from the 173:

Ninety-five remain. the 26 who are deceased, terminally ill or are band ones who have not ‘engaged’.

Sixty-nine are left over. The 69 forgotten few. All the colours match so you can check this for yourself. A missing sample of nearly 25% of the eligible 281 makes a mockery of the denominator used in their percentages throughout the presentation.

Nottinghamshire Injury On Duty Reassessment Program – Part 1

iodpa 2016-05-022016-05-22 NAMF, National Attendance Management Forum, police injury award, Regulation 37, Review, selected medical practitioner

A hypocrite is the kind of politician who would cut down a redwood tree, then mount the stump and make a speech for conservation.”

Adlai E. Stevenson II

Another definition of a hypocrite is someone who uses PowerPoint slides to say one thing to others although they value and believe something else entirely.

Recently Dr Ralph Sampson and Stephen Mitchel of Nottinghamshire Police (Notts) gave a presentation (perhaps using PowerPoint – other presentation software is available) at a National Attendance Management Forum conference (NAMF) to fellow NAMF delegates.

They were talking about how they do things in Notts. The bad news for them is the former officers reviewed by them inform us that, not only are they confused about their statutory duty, they are selective in their own rules and advice. Notwithstanding the rules used in Notts by Sampson and Mitchel, those that they wax lyrically to the NAMF audience, are predominantly worthless.

The presentation concerned how Notts are reviewing those former officers they have medically retired and awarded Injury Awards. We have obtained the slides for the presentation and have put it out into the public domain. The talk given by Sampson & Mitchel sets out their intention to conduct reviews because of concerns over their obligated cost of paying the awards until the former officer expires at an average of 83 years of age. It also says that reviews are intended to assess degree of disablement. Both premises are wrong.

Constant readers of these pages will not be surprised to hear the conflict of interest of having Dr Sampson as not only the reviewing SMP, but also as concerned with cost savings as his Notts paymasters. Notts-IOD-Presentation.pdf

*click image & use arrows to view all pages

There are 17 pages to the presentation so we intend to spread the talk about the slides over a couple of blog posts. But before will delve into the first few slides, let’s have a quick look at the words used by Sampson & Mitchel.

As expected with a NAMF presentation where the audience are eager to hear ways to reduce their financial commitments, ‘salary‘ is one of the most frequent words in the presentation. This table shows the 6 words most prevalent:

	programme	salary	medical	band	review	smp
Word frequency count	6	6	7	8	10	10

The frequent use of ‘salary’ just shows what their real agenda is.

We can’t find fault with slide one. It just contains the title of the presentation. [edit: A reader has found fault. The use of ‘reassessment’ (unlawful) in lieu of the correct term ‘review’ is indicative of a Freudian slip – thank you Whendie]

Slide two starts with the ‘background’ and mentions ‘earnings’.

2.Background

Reg 37(1) of Police (lnjury Benefit) Regulations 2006 Forces can undertake a review “at such intervals as may be suitable, to consider whether degree of …disablement has altered”

SMP to make a determination if/ how much earnings capacity has been affected
Band 1 (<25%)
Band 2 (25% – 50%)
Band 3 (50% to 75%)
Band 4 (>75%)

Minimum = Band 1

The red highlighted text shows that either Sampson is ignorant of the Laws case (unlikely) or he is intentionally willing to review former officers contrary to it’s judgements. They fail to explain how it is beyond all improbability that the interval is suitable to all the people they intend to review by pure chance alone.

‘Earnings’ is a word synonymous with salary and has no place in a review. Use of salary as the only measure is a failure to follow the judgement of Court of Appeal in Metropolitan Police Authority v Laws and can only amount to an unlawful reassessment where a former police officer could find his injury pension being reduced because of a difference of medical opinion on his capability for work rather than there being any real alteration in the officer’s degree of disablement. Sampson can not just ‘assess’ the degree of disablement.

The finding of Laws is that the SMP (or board) is not allowed to consider the pensioner’s current degree of disablement and then compare it with the previous assessment. The duty – the only duty – is to decide whether, since then, there has been a substantially altered change.

The right question for the SMP is not “what jobs can this person do today” but the comparative exercise of “has the impact of the index injury on the jobs she/he can do today substantially changed from the position at the last review date”.

The Laws judgement was reaffirmed in the case of Simpson. The conclusion in Simpson is clear. There can be no new consideration of notional earning capacity (i.e. what the officer would have been capable of earning but for his injury) unless and until there has been a substantial alteration in his physical condition or his present job opportunities, that is to say that something has actually changed since the last review, other than the mere passage of time.

But this isn’t what the NAMF delegates want to hear so Sampson & Mitchel play to the desires of their captivated audience.

3.Numbers / cost

380 + pensioners in receipt of an IOD award

£3.36 million per year

No programme of review for significant period of time, therefore no up to date medical information to ensure pension payments more accurately reflected up to date individual circumstances and ensure public money being spent wisely.

Notts Force Executive Board decision to commence programme of review – all Bands included; age under 70 for this programme of review

Slide three mentions the annual spend on injury awards (just to emphasis their mission to reduce this figure). The point of ‘not having a reviewing program for a significant amount of time‘ is a non-sequitur. A decision not to review is as much an exercise of a discretional power as a decision to review. Notts admit that they had consciously chosen not to review, and now they have changed their mind. Not knowing the individual circumstances of any given former officer is down to them and them alone. Never do these people think that once someone leaves the police service, they want to live their private life without the constant forensic examination and prying into their personal matters by their former force. Not having a review program is no reason to justify a new programme – quite the opposite.

Not performing any reviews gives a legitimate expectation that is based on the principles of natural justice and fairness, a maxim that seeks to prevent authorities from abusing power. A substantive legitimate expectation arises where an authority makes a lawful representation that an individual will receive or continue to receive some kind of expectation that they will be not have to undergo the trauma of a force reviewing them. Not reviewing is as much a lawful representation as reviewing itself.

The last bullet point on slide 3 is revealing. It was the force executive board that decided to start a review program, not the police pension authority. In other words finance officers, estate directors and HR directors all decided it was a good idea. The police pension authority is not a committee – it is the Chief Constable wearing a different hat.

4.Preliminaries

Letter sent to eligible pensioners Dec 2013 advising that a programme would commence

Tendering process for SMP (OJEU – with Derbyshire and Leicestershire) – SMP appointment Spring 2014

Process – Liaised with Federation; NARPO;
Regional Legal Services

Retained HR Admin support identified

No Regional OHU involvement

Slide four talks about who Notts have liaised with. It also mentions that there has been no regional occupation health unit involvement. Could this be because they have destroyed all the occupational information data they have and are reviewing people ‘blind’? They have apparently briefed local NARPO as well as the local Federation. This is mentioned in the slide as if such an action provides their review program with legitimacy. There is no mention of how the liaison progressed or whether any objections were raised.

5.Process

Sequence of review – eligible former officers who saw SMP furthest ago

Batches of 15 – approx six weekly intervals
Former officer sent (1) GP consent ; (2) OHU file consent; (3)questionnaire to complete

Letters – 3 stages – 28 days /14 days / 7 days
Following receipt of consent form, GP records requested

With completed paper/work, SMP undertakes ‘paper review” to make a determination if there has been potential ‘substantial alteration’ since assessment / last review

If no substantial alteration – end of process
lf substantial alteration indicated – former officer requested to attend meeting with SMP

Following assessment, SMP produces report and officer has 28 days to indicate whether they contest findings

Slide five exposes the process. The bullet points allude to substantial change but here is where the hypocrisy lies. There is no mention of change to the medical condition. It is about salary and nothing else.

Note that Notts expect the whole procedure for the 3 stages to be completed in 49 days! Notts also wants full medical records as well the notorious questionnaire to inaccurately condense decades of life into unrepresentative bite-sized chunks. The true agenda here is to examine the smallest details: a minute examination to enable apportionment and to revisit the original decision.

How can a questionnaire determine the existence of substantial change when there is no previous questionnaire, completed back-in-the-day, that can be used as a base line? The closed questioning leads to answers being interpreted in such a way that you can accomplish much more on the good days than on the bad days, the HR functionary will ignore any detail concerning your bad days and focus ONLY on what you can achieve on a good day.

Be in no doubt that the SMP will not be the one to perform this paper shift. An health professional is too expensive to contemplate and slide four stated that regional occupational health units will not be involved. Using a SMP at this stage will cost at least £500 per person if a competent preliminary valuation of the former officer’s condition is conducted. It is ludicrous to insinuate that for 380 former officers they will spend £190,000 just to consider whether there has been substantial change before they call the person to attend a face to face assessment with the SMP.

Mass reviews, blanket reviews, wholesale review programmes; they are all names for the same thing – always an attempt to reduce, never to increase an award. They are a conveyor belt with a predetermined agenda. For the former officer it is equivalent to entering a Mafia controlled casino where the dice man, pit boss and croupier all have complete control over the outcome. The review casino is selling an illusion that they are paying due regard to the medical condition correctly and that they are abiding by the Regulations.

That’s it for part one. Part two will follow in the next couple of weeks.

Merseyside’s Hatchet Man

iodpa 2016-04-272016-06-12 Chief Constable, police injury award, Regulation 37, Review, selected medical practitioner

Unlimited power is apt to corrupt the minds of those who possess it; and this I know, my lords, that where laws end, tyranny begins.

William Pitt – Case of Wilkes. Speech (January 9, 1770)

A hatchet man is a person employed to carry out controversial or disagreeable tasks, such as the dismissal of a number of people from employment. Merseyside Police employ a hatchet man with the grand title of Medical Retirement Officer (MRO) whose role is more sinister and which adversely affects vulnerable disabled officers and former officers.

His task is to prioritise maximum savings to the force budget, ‘through the robust investigation of injury award applications, appeals and reviews‘.

We quote above from his job description. This is what the man is hired to do. Not placed there to help injured and distressed people obtain their lawful rights, but to ‘investigate’ them with the objective of reducing the amount of money which would otherwise be paid them by way of recompense for injuries incurred in the line of duty.

There is only one way to read the intention behind the role of MRO. It is a perversion of what the Regulations governing injury on duty pensions were intended to achieve. We fully accept that no public money should be awarded without due diligence. All well and good if ‘robust’ was taken to mean that great care should be taken to comply with the Regulations, but we see that in Merseyside they believe that ‘robust’ means doing whatever they think they can get away with to deny injured officers and former officers their rights.

What Merseyside’s MRO is doing is unlawful. And it is shameful.

We in IODPA are not naïve. We understand all too well that there has to be some form of administrative procedure regarding Injury Awards which requires management by a functionary of some sort. That being said, the functionary needs to be neutral with no set agenda other than the lawful application of the statutory duties imposed upon the organisation by the Regulations.

We are, frankly, appalled to see that the job description of the Medical Retirement Officer ignores this principle and imposes an agenda upon the position which prioritises the needs of the organisation over the rights of the recipient. The job description includes sentences such as:

[. . . ] ensure that any changes to pension payments are implemented and financial savings made where appropriate.

There should be no thought given by the Medical Retirement Officer as to the financial consequences on the force of helping to ensure the Regulations are applied lawfully. His role is an abuse of the scope and purpose of the Regulations.

When we see that the Medical Retirement Officer’s main objective is to save money for the Chief Constable it becomes clear that he can not possibly be acting lawfully.

We know, for example, that he takes it upon himself to decide whether any applicant for an injury award application is seen by the selected medical practitioner (SMP) or not.

On behalf of the Police Pension Authority, who is in farcical fact, not an impartial body, but is none other than the Chief Constable wearing a different hat, the MRO blithely breaches the Data Protection Act by forensic examination of the confidential medical records and reports of individuals.

No wonder the Chief Constable of Merseyside finds it hard to arrange for the Regulations to be administered lawfully. He is under pressure to reduce spending, and police injury pensions consume a significant part of his budget. But, that is a pill he just has to swallow. He is under a legal obligation to administer the Regulations properly. He is not entitled to look upon them as an expense which can be trimmed.

I refer the Chief Constable to the case of The Police Federation of England and Wales v. The Secretary for the Home Department (Neutral Citation Number: [2009] EWHC 488 (Admin) Case No: CO/7612/2008). This case concerned the date when new commutation factors for police pensions were brought into law.

Justice Cox stated:

‘The Home Secretary’s undoubted interest in the expenditure of police authorities does not in my view enable her to alter those rights and liabilities which arise under the Regulations.’

And:

‘Affordability and public expenditure implications are therefore, in my judgment, irrelevant.’

It is not within the remit of any Chief Constable to direct an employee to save money by means of unlawful manipulation the Regulations. It is an abuse of his authority to specify in a job description that the MRO must approach his task with the objective of making financial savings. The over-riding intention of the Regulations is that people should be paid at the level which is appropriate to the individual circumstances. There is ample mechanism within the Regulations to ensure that this is achieved. Nobody should receive more that their due, and nobody should receive less than their due.

Merseyside has deliberately set out to ensure that the latter situation is the norm.

The MRO decides regulation 37 reviews without the benefit of any input from the SMP. He decides who has experienced a substantial alteration in degree of disablement, and who has not – and does this, not on the basis of medical evidence, but on whether the individual has increased earnings or not. He operates a rule of thumb, whereby if someone has seen an increase of over 10% in their earnings then, ipso facto, they must have had a substantial alteration in degree of disablement.

This is what he instructs former officers who are on an injury pension:

‘. . . if you commence work or if you are currently working and your gross salary increases by over 10% you are required to inform this department as soon as practicable.’

We have to comment that the MRO has no authority whatever to ‘require’ any private citizen to inform him of a salary increase. Moreover, we feel like shouting at the MRO that a pay increase does not in any way signify that there will have been a substantial alteration in degree of disablement.

What the MRO is doing is creating an iron link between wages and disablement, when, under the Regulations, no such link exists. Disabled former officers are free to earn whatever they can, and their employers are entitled to give them a pay rise if they wish. A pay rise can have no possible link with the level of an individual’s degree of disablement. The MRO is using this as a means of reviewing degree of disablement, as an excuse for holding a review with no good reason, and as justification for reducing the level of pension paid.

Merseyside have corrupted the purpose of the Regulations and turned its provisions on their head for the sole purpose of ensuring that disabled former officers are robbed of their correct level of injury pension payment. The medical basis of assessment of degree of disablement has been abandoned in favour of an actuarial exercise where the cost exposure to the force is the bottom line.

While any question under the Police Injury Benefit Regulations is medical by nature and always requires the opinion of a SMP, in Merseyside the SMP seemingly does not make the decisions. The SMP acts only as a rubber stamp for the pre-made determination of the Medical Retirement Officer. The Medical Retirement Officer is like an injury award hitman-by-proxy, getting paid to maximise cost savings for the Chief Constable, with no fear of any comeback.

Disabled former officers and serving officers seeking an injury award are kept in the dark. It seems very successfully, for few of them have the knowledge required to realise that they are being ripped off. Many of them are in no fit state to raise a query, and thus accept the decisions conveyed to them with no realisation that the decisions have been unlawfully arrived at. Put simply, they trust their force to do the right thing by them when injured on duty to the extent that they can no longer perform the ordinary duties of a police officer.

Clearly, that trust is sadly misplaced. There are some 880 former officers from Merseyside Police who are paid an injury pension. They need to wake up to the fact that they have, in all probability, been denied their proper pension rights.

Of course, a few individuals do raise queries with the MRO. They question his decisions. Some even manage to take matters to appeal via a Police Medical Appeal Board. Merseyside plays the numbers game. A deliberate calculation has been made, which concludes that those few individuals who do request an appeal to a Police Medical Appeal Board are far outnumbered by the majority who have no idea that they are being denied their rights.

The Medical Retirement Officer makes the decisions but never has to face the consequences. He never has to account for or justify his actions, as he is not the one who would have to be listed as the respondent at a PMAB, or at a judicial review.

The French have a term for such a position: éminence grise (French: “grey eminence”), a powerful advisor or decision-maker who operates secretly or otherwise unofficially. An apt English phrase is ‘the power behind the throne’, someone who does not have the ultimate official position in a government or organization but who secretly controls it.

The Medical Retirement Officer is not a qualified medical authority – but is deciding what are essentially medical matters. He is making decisions for the Police Pension Authority, and we question whether he has the delegated power to do so. The Chief Constable has already delegated the day-to-day operation of his role as PPA to the head or director of Human Resources. Delegata potestas non potest delegari is Latin for a constitutional and administrative law, translated as, ‘no delegated powers can be further delegated’ and may well apply here.

According to Merseyside, a Medical Retirement Officer as well as having the skills to save the force money should also have:

‘A good knowledge of investigative procedures [. . . ]. Knowledge and understanding of the Regulation of Investigatory Powers Act with regards to surveillance and investigation of officers and pensioners believed to be falsely claiming compensation.’

Not only shall the Medical Retirement Officer have the principle duty to reduce financial costs to the expense of those injured on duty, but he is also let loose with RIPA.

Judicial approval should be the norm, not the exception, for placing members of the public under surveillance and public authorities should be compelled to report how and why they are spying on disabled persons by abusing powers that were introduced to protect us from terrorism and serious crime.

There is no room for RIPA in the administration and lawful application of the Police Injury Benefit Regulations. Medical evidence is paramount. If the PPA has any cause to think that any individual is working the system, the regulation 37 allows for a formal review of the degree of disablement. The individual can be medically assessed by a duly qualified medical practitioner, selected by the PPA.

The SMP alone should make an assessment, and a decision, and once made that decision is final. Should there be any attempt to exaggerate one’s medical disability a qualified clinician should have little difficulty in spotting it. If fraud is suspected then this would be a matter for a serious criminal investigation and prosecution. It is not open to a Medical Retirement Officer to use RIPA as a means to maximise the financial savings to benefit the force budget.

An injury award is not a benefit that has to be reapplied for – it is an entitlement for life and is final once the high bar of the initial grant has been attained.

Is all the above too hard to believe? Can you bring yourself to realise that a police force, whose job it is to prevent crime, could allow disabled former officers to be put at the mercy of a MRO whose objective is to unlawfully reduce their pensions, and to do whatever it takes to prevent injured serving officers being granted an injury award?

Here is the job description of Merseyside Police’s Medical Retirement Officer as obtained in a recent Freedom of Information act request.

This job description shows all that is wrong with the way Merseyside, and some other forces, are administering injury awards. The glib references to following Home Office guidance is a poor attempt of virtue signalling – making a statement that blithely mentions the requirement to ‘follow guidance’ because it thinks it sounds right and it will garner approval, rather than because anyone will actually believe it. This job description was created in February 2015. The Home Office partially withdrew their central guidance for injury reviews in March 2012 and then completely in February 2014. There is no Home Office guidance to follow.

Instead, the Home Office now prefers to keep away from the misdeeds of Chief Constables and their hatchet men. The Home Office now says,

‘We would advise, in the event that such reviews are being conducted or considered, that police authorities should satisfy themselves that they are acting in accordance with the regulations and the relevant case law in the light of the decision in Simpson.’

IODPA suggest that the Chief Constable of Merseyside take a long hard look at what has been done, and continues to be done in his name by the Medical Retirement Officer. If the Chief Constable fails to act then our suspicion, that every breach of the Regulations committed by the MRO is done with his approval and encouragement, will be justified.

There are 880 individuals retired from Merseyside who receive an injury pension. There needs to be conducted and independent and scrupulously fair and impartial appraisal of how each and every one of their injury pensions have been administered.

Why Things Hurt

iodpa 2016-04-112016-05-22 morale, police injury award, selected medical practitioner, smp

“Of pain you could wish only one thing: that it should stop. Nothing in the world was so bad as physical pain. In the face of pain there are no heroes.”
― George Orwell, 1984

This post is about the complexity of pain and the observation that the doctors used by police pension authorities are not able to comprehend how the world of a previously fit and high-achieving police officer collapses once they are injured on duty. It shows that the consultants, GPs and clinicians of the former officer -who know of and have treated the individual – heavily out-guns the opinion of any given selected medical practitioner.

You haven’t had any contact with the police for years and now they want to reduce their financial commitment by reviewing your injury award . There has been no change, in fact you’re worse now than ever. You just want to be left alone to live your life. Or you are a serving officer struggling on long term sick leave and currently the victim of an UPP.

How can an occupation health doctor make a valid judgement on your health in a 60 minute ‘interrogation’ – don’t fool yourself into thinking it is anything but an inquisition: imagine Tomás de Torquemada assisted by the full incompetence of a HR department.

An injury on duty can involve both body and mind and quite likely both. A physical injury has psychological consequences. PTSD (Post Traumatic Stress Disorder), is caused when a person experiences an ordeal that causes physical harm or mental harm. The individual was either harmed, someone close to them was harmed, or they experienced events that was imprinted in their brains. In PTSD, there are two main parts of the brain that are affected and also where all the chemical imbalance in the disorder is located at. The two main parts are the Hippocampus and the amygdala.

http://www.chemistryislife.com/the-chemistry-of-post-traumatic-stress-disorder

The hippocampus is a part of the brain that is located inside one of the folds of the brain so it is not identifiable by the human eye but the way we can find it is that it is located at the temporal lobe which lies right under the temple of the human body. An important function that the hippocampus does is that it makes information into memory and stores it in the brain. So, for example, someone experiences a traumatic event in their life and they can’t forget about it even though they try really hard to. The hippocampus has taken this traumatic event that this person has and stored it in their brain as a memory which explains how PTSD works. This part of the brain can also send connections to the amygdala which then could explain the beginning of strong emotions triggered by specific memories or events. But it is not just for making memories. It also plays a huge roll in the making of creating new brain cells for the brain. The hippocampus may look intimidating but it can be affected very easily. Alzheimer’s Disease, Epilepsy, and little blood flow are just some of the injuries the hippocampus could have.

The other big part of PTSD is the amygdala. Like the hippocampus, it is also part of the limbic system and is also inside the brain just above the hippocampus and the lateral ventricle. This is the epicenter of emotional behavior, emotions, and also motivation. A lot of signals from the other brain parts go to the amygdala because it then makes those signals into emotion. The amygdala can produce components of emotion such as heart rate changes, blood pressure changes, and also respiration changes in the body. While the hippocampus makes memory, the amygdala takes those memories and combine them with emotion which could explain why certain memories produce certain emotions for us such as happiness and fear. This is where the “fight-or-flight” mechanism comes into play. Since so many alarm circuits of the human body are located in the amygdala, there is a lot of triggers that can activate the “fight-or-flight” response.

Sufferers of PTSD are prone to chronic pain and sufferers of the chronic pain of debilitating physical injuries are liable to suffer from PTSD-like chemical imbalances.

The author of this post has a physical injury that has also manifested itself psychologically. Chronic pain does that. A life not lived; a career cut short. Over time, to treat the condition, nociceptive prescription pain medication is supplemented with neuropathic medication. But we are still dragged in front of a SMP and demanded to explain ourselves. Questioned in a hour window on why we are no longer the high achievers we once were.

This video gives an interesting insight into pain but reveals a terrible dilemma. We are all individuals,and as IODs, all our circumstances are different. Herein lies one of the complexities that makes understanding and treating chronic pain so difficult.

Professor Lorimer has the advantage of being on the top of his game. He has a successful career in clinical Neurosciences. His lecture is factually correct. Experience doesn’t always match the explanation.

For the individual chronic pain is a reinforcing web of pain signals, personal history, seeking security in what you know (pain) and limited ability to envisage a future. It is life consuming and this is why the Regulations are there to compensate for work-related injuries.

SMPs are not equipped to understand how the brain creates and perpetuates pain. They will always fail to make a valid judgement on your health in an allotted 60 minutes. For this reason if you are ever unfortunate to go in front of a SMP, for whatever reason, go prepared. Make them understand the complexity of your illness.

Access to Medical Records

iodpa 2016-03-212018-03-21 caselaw, medical records, police injury award, Regulation 37, Review, selected medical practitioner

One of the most sacred principles of law is, that a written instrument must be construed upon the face of it, and that no parol evidence can be used for the purpose of inserting any words not therein contained.

– Sir R. Malins, V.-C, Inre Sayer’s Trusts (1868), L. R. 6 Eq. Ca. 321.

Let’s get one thing straight here, before we begin. For the benefit of any HR managers who do us the honour of reading our well-meant attempts to help steer them along lawful paths, and for the benefit of one Nicholas Wirz who appears to be attempting the opposite:

The Regulations are law, and it is not up to anyone to try to place upon them a meaning which is not there. OK, that said, let’s get back onto the main topic.

There is a lot of sensitive personal detail in everyone’s medical records. For example there will be references to third parties such as family members, or notes about relationship problems or the termination of a pregnancy. The sort of information which is meant to be seen only by one’s own doctor. It is confidential.

Disabled former officers may not appreciate the implications if they agree to the release of their full medical records to an Occupational Health Department or to a SMP. People do not tell things to a GP in confidence only for every little bit of information they give to end up being read by employees of a police force. Some doctors argue that if patients feel their entire records are routinely viewed by outsiders patients may decide not to reveal certain conditions to their GP.

We have a right to expect medical confidentiality so why should anyone be conned, coerced, bullied, or baffled into signing away that right? But this is what happens to disabled former officers who mistakenly give in to vapid threats and sign away their rights, consenting to full disclosure of all medical records since birth.

Not even the Department of Work and Pensions has the power to routinely demand full medical records. The DWP can only request reports as stated in this link DWP Medical (factual) Reports.

DWP and their assessment providers only request a report where it is needed and not in every case. The medical report you provide will then be considered when producing an assessment report.

NHS GPs are under a statutory obligation to provide certain information to a healthcare professional working on behalf of the DWP, in respect of patients that they have issued or refused to issue a statement, including a requirement to complete IB113/ESA113 reports. This is implicitly defined in a parliamentary instrument, also known as secondary legislation, namely The Employment and Support Allowance Regulations 2013. This Regulation refers to evidence provided in accordance with the Medical Evidence Regulations (which prescribe the form of doctor’s statement).

There is no legislation that permits the same disclosure to a police pension authority. An injury award is not a benefit that has to be reapplied for – it is an entitlement for life and is in effect compensation for work-related injuries.

But despite this, every time a force attempts to review an injury on duty award, without fail they will send out a consent form demanding access to all your medical history.

We believe that, in some forces, this is no more than a ploy to replace records which have been lost or destroyed.

We also believe that any demand for access to medical records so as to process a review of degree of disablement is unenforceable.

We know of instances where former officers have made a request under the terms of the Data Protection Act for copies of all information relating to them held by their former force. They have been told, shockingly, that their occupational health file and other medical records have been destroyed, in line with the force’s retention policy.

‘Destroyed’ is, we suspect with good reason, to be a euphemism for ‘lost’. All psychiatric/ surgical/ general-medicine consultant reports and other documents of some individuals have been lost by the force since their retirement. When they joined, full medical records were made available to the force medical officer and if they have since lost them, why would anyone trust them to be responsible with them a second time? Once bitten, twice shy.

More than this, why do they insist they have a right to any medical records?

You may be surprised to hear that there is nothing that permits them to have any; not partial, not full. None. Zero. Zip. Zilch. Nada.

Long ago and before the all-out corruption of the Regulations practiced by certain forces there was a time when, if a force medical officer had questions about a significant change in an IOD pensioner’s medical condition, they would order a bespoke report from individual’s own GP or specialist.

But Nicholas Wirz, Principal Solicitor of Northumbria Police wishes to change all this. Amazingly, he thinks GPs are biased and advises SMPs to ignore the opinion of the pensioner’s own doctor.

This is an excerpt from Wirz’s January 2014 SMP training indoctrination course:

This can often be the case with reports produced by a treating physician in support of their patient. The patient may have a very strong desire to achieve a particular outcome (eg medical retirement; an injury award – or larger award; being found not permanently disabled if young in service etc). Applying the facts to the correct legal test may not support a conclusion supportive of the officer/pensioner. This places the treating physician in an invidious position.

Explicitly reaching a conclusion their patient does not desire risks destroying that particular doctor/patient relationship. A common occurrence is for the treating physician to “fudge” the issue. SMPs need to be alert to this and be able to argue why a particular report has not been accepted. Usually this will require an analysis of the correct test and where the report fails to appreciate this.

Wirz proclaims in his guidance to SMPs that all doctors will only tell their patients things that they want to hear, and that physicians commonly fudge the issue. In other words, his view is that only the SMPs he ‘trains’ are the sole beacon of righteousness in a world full of misguided and fudge-prone doctors.

Hang on a moment. Back up a little and think about this goose and gander situation. What is sauce for one is sauce for the other. If it is OK for Wirz to say that all GPs and specialists can’t be trusted to be unbiased and impartial when writing a formal report on their patient’s condition, then surely it is OK for us to similarly point at all SMPs and say they can’t be trusted to be free of bias and partiality.

Who would you trust most to be truthful and impartial? Your hard working GP, trusted by parliament to issue medical reports to the DWP, embedded in the local community, with years of accumulated trust and confidence stored in their account, or a hired hand, a doctor who comes via his own private limited company with a contract through another private limited company to supply ‘medical services’ to a police force?

This post from February 2015 displays clearly how SMPs inplementing Wirz’s doctrine collude together to persuade themselves that GPs are not to be trusted and that any failure to disclose full medical records is an attempt to conceal from them facts that they can unlawfully use to reapportion or revisit causation – page 2 of the pdf is truly shocking: When SMPs Attack

Wirz continues with his claim that the SMP must demand full access to medical records, despite the fact (conceded in his own words) that the Regulations do not speak of medical records – only medical examination. It seems that in his delusional world a medical examination does not count if the SMP is not able to have prior sight of whatever medical records he demands.

So, if you are unfortunate enough to be knocked down by a number nine bus, does the doctor who arrives by helicopter to treat you at the scene first demand that your full medical records are made available? Why should a SMP need to see that you had measles when you were eight years old, or indeed any medical record which pre-dates the time of the last final decision on degree of disablement? In either scenario, a traffic accident or a review, what the doctor sees before them is what the doctor gets. Sure, they can ask for information, and the individual can chose whether to give it, but there is no way that any doctor can demand information.

Come off it Wirz. A SMP has no need of a full medical history to determine whether there has been any alteration in degree of disablement. If he needs an expert opinion, then he has only to ask the individual’s own GP or specialist for a report.

Wirz offers these words of wisdom to SMPs:

An officer/pensioner who elects not to take a step the SMP considers necessary risks the process being concluded by management: on the grounds that the election amounts to a failure:

“..to submit himself to such medical examination or to attend such interviews as the medical authority may consider necessary in order to enable him to make his decision.”

Where the PPA reaches this conclusion it,:

“.may make its determination on such evidence and medical advice as they in their discretion think necessary.”

Even though the Regulations refer to medical examination and interviews, the provisions have no meaning unless included in those terms are the necessary preparatory steps before those events can take place. A medical examination would be largely meaningless without, eg, prior sight of the relevant medical records. If the SMP considers a step “necessary” then the SMP should direct the officer/pensioner to take it.

This orthodoxy from the book of Wirz is fed SMPs, who foolishly emboldened with the utter tripe that is Wirz’s speciality dish of every day, are now routinely demanding full medical notes from birth.

The trouble for Wirz is that there is in fact no onus on the pensioner to prove that their medical condition has or has not changed. The last final decision is a given and is the starting point from which the SMP must make the assessment. When a police pension authority tasks a SMP to determine whether there has been any alteration in degree of disablement, the burden of proof rests solely on the police pension authority, via the SMP.

The SMP can’t begin the task by assuming there is substantial change and then asking the pensioner to prove, by submitting medical records, why there hasn’t been. That would be coming at the task from the wrong direction. It would be illogical.

Wirz has taken the words contained in the Police Injury benefit Regulations and has performed with them nothing less than reverse alchemy, turning gold into manure.

The literal rule of statutory interpretation should be the first rule applied by anyone referring to the Regulations. Under the literal rule, the words of the statute are given their natural or ordinary meaning and applied without seeking to put a gloss on the words or seek to make sense of the statute.

The Regulations state that the pensioner can face only a medical examination. They contain nothing about SMPs trawling through medical records. It is wrong for Wirz to try to insinuate that the provision has no meaning unless full medical records are released.

Medical records are no small thing. They are intrinsically confidential and a SMP has the same obligations under their regulator (the GMC) and by statute to act impartially and ethically as do the treating clinicians that so often are (according to Wirz) so eager to ‘fudge’ their reports.

The Regulations do not prescribe exactly how a police pension authority or a duly qualified medical practitioner acting on behalf of a police pension authority should set about any consideration but, using the literal rule, if the Regulations required the submission of ANY medical records it would explicitly state as such. Of course, there is no such mention.

Moreover, any actions taken by a police pension authority or anyone acting on its behalf must comply with the Data Protection Act, the Human Rights Act and all relevant parts of administrative law. This includes Data Protection Act 1998 – Schedule 1, Part 1, Principle 5. Wherein it is stated that,

‘Personal data processed for any purpose or purposes shall not be kept for longer than is necessary for that purpose or those purposes’.

We may well ask then, why do forces think they can hold on to sensitive personal information, including medical records, which has been processed at some point for some purpose, and has then remained unused for years?

And what is the situation should an individual refuse to accede to a demand that access is given to medical records held by their GP?

The Regulations say this:

Refusal to be medically examined

33.If a question is referred to a medical authority under regulation 30, 31 or 32 and the person concerned wilfully or negligently fails to submit himself to such medical examination or to attend such interviews as the medical authority may consider necessary in order to enable him to make his decision, then—

(a) if the question arises otherwise than on an appeal to a board of medical referees, the police authority may make their determination on such evidence and medical advice as they in their discretion think necessary;

(b) if the question arises on an appeal to a board of medical referees, the appeal shall be deemed to be withdrawn.

From this Regulation it is clear that a police pension authority, after a suitable interval and after consideration of the possibility of alteration to the medical condition, has the right to request an individual to subject himself to a medical examination or interview, but has no power to command it.

Note well – there is no penalty for wilful or negligent non-cooperation. If the police pension authority decides to continue in the face of willfull or negligent non-cooperation then it is permitted to make a decision on such evidence as is available.

Any such decision would need to be rational – that is based on facts, and not punitive. There is no power for a police pension authority to reduce or suspend any injury pension in such circumstances. Such action would be unlawful.

There is nothing that expressively permits a police pension authority or SMP the right to demand that an individual agrees to allowing access to any medical records.

Since the appeal case of Belinda Laws in 2010, those subjected to a review have generally allowed the release of partial notes since the last decision. Despite pressure from their HR department those in the know have refused consent for the SMP to access full medical records and only agree to release of those from the time of the last review.

But if you consider that the Regulations do not refer to any medical records at all, then arguably no medical records need be disclosed at all.

This is not wilful, nor is it negligent. Rather, this is a considered and advised decision based on compelling legal knowledge that the Regulations do not permit the SMP to have sight of such records.

It may not be ideal, but that’s the law. We don’t advocate non-cooperation as a tactic, but we do suggest that disabled former officers should be very selective about what medical information, or any other personal information, they chose to divulge to the police pension authority or the SMP. Just because someone asks you for information does not mean they are entitled to it, or that you are obliged to give it.

As former Police Officers there were many times we would have liked to have had access to additional personal information on individuals but the law prohibited it. This was to protect miscarriages of justice and to protect an individual’s rights to privacy.

When in doubt about why any information is requested, or what use will be made of it, the question to ask the SMP is for them to quote the Act and Section of any legislation which they think grants them permission to obtain sensitive personal information.

It is clear that Wirz, just like Grima ‘Wormtongue’ in the Lord of the Rings, uses words formed as his twisted corruption of the Regulations to manipulate people to nefarious ends. Fooling people by using devious and unscrupulous tactics to obtain irrelevant information is unethical and immoral, and it is certainly harmful to health.

The current Regulations do not serve the purposes suggested by Wirz and can only be interpreted literally and thus it would appear that individuals such as the SMPs who follow the book of Wirz are willing to operate outside the law to achieve their goals.

Unless you want to be reviewed or are currently applying for an award in the first instance you have the option to say no – tell them consent to any medical records is refused and revoked. Even if you are applying for an award or need to evidence substantial worsening of your medical condition at a review and wish to clearly evidence your index injury, think very, very carefully about disclosing information prior to your injury occurring. Any disclosure has to be relevant to the matter in hand. A recent, pertinent expert specialist clinical report carries more weight than you suffering from measles at 3 years of age.

No doubt there could be a backlash from the more idiotic of the pension authorities. You may receive threatening letters from SMPs, Directors of HR and staff officers or even the Chief Constable demanding that you do what they say. ‘Who are you go argue with us?’,you’ll hear them shout. But remember these people have never taken the time to read and understand the Regulations and the case-law built around them.

If you are in any doubt then ask the police pension authority the question:

As nothing can be more mischievous than the attempt to wrest words from their proper and legal meaning, will you please explain to me how can a medical examination be interpreted as giving you, yet again, authority to demand access to full or partial medical notes?

Bogeymen

iodpa 2016-03-082016-05-22 NAMF, National Attendance Management Forum, police injury award, selected medical practitioner, smp

“If there is anything more annoying in the world than having people talk about you, it is certainly having no one talk about you.”
― Oscar Wilde

A bogeyman (also spelled bogieman, boogeyman, or boogie man) is a monstrous imaginary figure. But it seems that some HR Departments believe he is real and even now stalks the land in human form.

The bogeyman of legend and fairy tale has no specific appearance. Children are told stories of shadowy shapes that flit into the corner of one’s eye and then disappear. The bogeyman might live under the bed, or in the wardrobe, or might be lurking in the dark overgrown bushes at the bottom of the garden. No matter where he hides, he is out to get you, so beware. Hurry home, children, dive into bed and pull up the covers so he can’t seize you by the toes and drag you off to his lair.

HR managers give the bogeyman more corporeal form and substance. They seem to think that the bogeyman appears in the borrowed shape of disabled former police officers. A guise quite at odds with the spirit of the legends and, as a modern take on a traditional myth, is really very inventive and clearly the product of a disturbed mind.

The etymology of the word “bogeyman” is uncertain, as is when it first appeared in the English language. Some sources date it to the 16th century, while others to around 1836, as a term for the Devil.

The Devil is now, according to the rumour mill being circulated by some police forces, stalking and abusing, not children, but stoical adult medical practitioners who work for police forces. By these accounts one force in particular is telling people, ‘that a doctor has been subject to stalking and that threats have been made against FMAs [Force Medical Advisors] by a campaign group’.

We at IODPA are extremely shocked and concerned at this revelation. Apparently there is a militant and anarchist campaign group out there that is actively seeking out and physically targeting force medical advisors (selected medical practitioners were not mentioned). The force spreading this malicious and unsubstantiated gossip mentions FMAs, plural – as in more than one single incidence. The source of this fairy tale we suspect to emanate from the National Attendance Management Forum, which is where HR managers and others gather together, safety in numbers, to exchange gossip and misinformation.

The unsubstantiated Chinese whispers we have heard are that the stalking typically involves a sped-up chase scene involving a crew of scantily-clad injured persons hobbling with their canes and struggling with their mental illness, with a doctor being the one chased, due to silly predicaments that he himself caused. A take-off on the stereotypical Keystone Kops chase scenes.

In all seriousness, we are in IODPA a cooperative made up solely of responsible, adult, medically retired police officers, who were all injured in the execution of their duty. It is generally known that it takes a high standard of character to be recruited into the police and that police work can be dangerous. Our members were all injured through no fault of their own and are now disabled members of the public with a strong core of moral code. We have been subjected to unlawful behaviour by police pension authorities but we will never reciprocate like with like. Injustice cannot be overcome with injustice.

The injuries of our members range from physical to psychological. Quite often the physical injuries have psychological repercussions. The psychological injuries are often extremely severe.

Perhaps IODPA is being too precious, but we hope that the Devil that these forces believe is stalking doctors is not meant to be a reference to us.

We therefore challenge any FMA, SMP or HR person to produce concrete proof of these allegations. If any person has been stalked, tell us who, when and where. If there was evidence of harassment, abuse and threats then any competent and independent person would expect there to be a criminal investigation and a prosecution. It speaks volumes that there has been no such thing. All police forces should be above the childish playground behaviour of spreading rumours.

In the meantime, we will take these bogeyman tales as no more than a foul ploy to divert attention away from the very real, and evidenced accounts of harassment and, yes, stalking, of disabled former police officers by police forces.

The fact is, members of our association have been stalked. There are instances where people with IOD awards have been put unlawfully under surveillance. We can never forget the case of the West Midlands consultant psychiatrist, Dr Nicholas Cooling, who personally hired a team of private detectives to stake out and video an injured police officer. The GMC suspended him over that little lapse of ethics.

Another tale of harassment concerns a former South Wales officer whose police career ended after he was severely traumatised following the 2002 clash between Cardiff City and Leeds United fans, and who won a victory in 2009 against South Wales Police, which had kept him under surveillance for months. The Police Medical Appeal Board (PMAB) was highly critical of South Wales Police, which had claimed he was not entitled to an injury award. The Appeal Board adjudication said video evidence of him was irrelevant. Material disclosed subsequently showed that 11 officers from South Wales Police and the neighbouring Dyfed-Powys force were used to spy on him for months in an operation estimated to have cost more than £100,000.

There have been too may instances to list here where a person with an IOD award has been abused and harassed over a course of years not just by a SMP but also by the bullying machinations of a zealous and uncaring HR department.

We will mention one incident, which concerns a very ill retired former officer who was summoned to be reviewed. Two friends drove him to the appointment at the force’s occupational health offices, and waited for him in the car-park. When the review was under way a uniformed police officer with their epaulettes removed came out of the building and blatantly took photographs of the waiting vehicle and the occupants. Here was no RIPA authority, nothing that allowed this intrusion into civil liberty. Not prepared to be taken at a disadvantage, the occupants themselves took a picture or two of the uniformed officer taking pictures. Then a doctor came out of the building, walked up to the car and spoke to those within saying, ‘Do you want a close up?’

We know of another incident where a person with complex psychological issues was forced to undergo a review just because he was a band four. Despite his condition down-turning and his clinicians warning the force and evidencing his severe deterioration during the months of delay cause by the police pension authority, the force in question kept up their sanctimonious fishing trip. This sorry episode was reported in this blog post.

Driven to the realms beyond madness he told his crisis clinician during a mental health crisis team counselling session that he wanted to kill those who he saw were harming him. This clinician took the threats seriously and was duty bound to escalate his concerns to the relevant authorities. There are always two sides to every story.

The shameful outcome of this shameful event is the force ‘deferred‘ the review (a made up thing that does not exist in the Regulations), saying the former officer is too ill and that he should be reviewed again in 3 months, ‘when he is better’.

A review isn’t a benign thing. It damages people. And if they are damaged already they become more and more unstable. IODPA does not condone unlawful behaviour. That said, we can understand why someone with complex PTSD isn’t always in control of their own responses.

When a force proclaims that a campaign group is physically threatening Doctors, and it uses this as an excuse to withhold information, it tarnishes everyone. This circus show encourages guilt by association, and seeks to demonise all disabled former officers. We say, you hypocrites, first take the plank out of your own eye, and then you will see clearly there is no speck in our brother’s eye.

IODPA only asks for fairness, respect and the fundamental and lawful following of the Regulations.

Those injured former officers who contribute to this association are all law abiding citizens.

If only those that administer the police injury award scheme were as conscientious as we are.

Bad Medicine

iodpa 2016-01-102016-01-10 selected medical practitioner

“Men will always be mad, and those who think they can cure them are the maddest of all.”

“Doctors put drugs of which they know little into bodies of which they know less for diseases of which they know nothing at all.”
― Voltaire

The College of Policing released a report in 2015 concerning an inquiry it arranged into the Injury on Duty process. This post will discuss how that report revealed issues concerning the Occupational Health clinicians who are used by forces in the role of ‘duly qualified medical practitioners‘ as required by the Regulations which govern police injury pensions.

Each of the quotes used below are excerpts from the College’s report.

Before I begin, I need to mention the structure of the College.

It is perhaps not quite the independent seat of learning and academic rigour which one might naturally expect of anything calling itself a ‘college’. It is currently a private limited company, with but one shareholder, who is the Home Secretary. It’s own web site tells us that,

‘As the College is currently a company limited by guarantee, as well as an Arm’s Length Body of the Home Office, all members of the Board are Company Directors. ‘

In plain language, the College is the Home Office pretending to be an academic institution.

Being arm’s length is a bit like the Mafia setting up apparently legitimate shell companies to launder its money and to give the appearance of respectability. With the Home Office it is not dirty money which needs to be laundered, but dirty, disrespectful ideas which seek to undermine the law of the land.

Just as the College is not quite what it would like us to think it is, much the same sort of misdirection applies to the odd little off-shoot of the medical profession known as Occupational Health.

By some self-publicising accounts Occupation Health is a, ‘multi-disciplinary approach to developing and ensuring compliance with safe working practices, and maintaining the health and well-being of those employed in a particular occupation or workplace’.

Phew. Quite a mouthful. One has to wonder quite what that has to do with regards to administration of the Police Injury Benefit Regulations. Yet the situation is that forces have been persuaded to accept that any SMP must hold a minimum qualification in occupational health.

Occupational Health clinicians like to get people back to work, or help prevent them getting injured or ill in the first place. That is their raison d’etre. Notwithstanding that a police officer is not an employee (they are holders of office), once medically retired a former officer injured on duty is no longer employed in any sense of the word – they are retired via incapacity – so it is hard to see quite what value an occupational health clinician can bring to the area of police injury pensions.

Injury on Duty awards are governed by Regulations, which mention not a single word about duly qualified medical practitioners needing to have a qualification in occupational health. All that the Regulations require is the selected medic is actually qualified to practice – which means they must be registered with the GMC.

So, how is it that IOD pensioners are now faced with having to be assessed by medics whose chosen ‘specialisation’ has effectively removed most of them from the actual day-to-day practice of ‘real’ doctoring? The answer is that some few years ago, the now-defunct Police Negotiating Board, whose remit was to negotiate the details of pay and conditions for serving police officers, strangely decided to issue a joint circular, with the Home Office, in which it agreed that all ‘duly qualified medical practitioners’ who were to make decisions under the Regulations should hold a minimum qualification in occupational health.

The effect of this has been to narrow the pool of duly qualified medical practitioners who might work as ‘selected medical practitioners’ (SMPs) down from the approximately 236,000 doctors who are licensed to practice medicine in the UK, to a measly handful of doctors who have bothered to qualify for what most mainstream doctors regard as the utterly irrelevant specialisation of occupational health.

The small number of potential doctors who can be selected by a police pension authority has been further diminished by the interference of the National Attendance Management Forum which has seen fit to produce a list of doctors it claims ‘have shown an interest in’ working as SMPs. This is, of course, typical new-speak meaning that these doctors are the sort who are either gullible enough or corrupt enough to see the Regulations as no more than a general guide which can be ignored.

Disabled former officers have been powerless to prevent the erosion of the role of what was intended by the Regulations to be performed by independent, experienced medical professionals. Instead, they now face the prospect of the level of their pension income being in the dubious hands of doctors who are on the very bottom tier of the medical profession, and who have shown themselves to be variously incompetent, corrupt or ignorant of what the Regulations require of them.

IODPA has seen examples of SMPs knowing full well that a former officer is a 100% band 4 but still, with perverse logic, and directly contrary to the Regulations, give the retiree a figure of 85% in order to provide some forlorn future ‘hope’ of a recovery to the disabled person. Similarly, SMPs have looked to the future and speculated about what jobs a retiree may be able to do – thus completely missing the point that an assessment of degree of disablement is supposed to be based the extent the disabling effects of duty injury have – past tense – had on the individual’s capacity to work. In other perversions, SMPs ‘decide’ that an individual is, say, 50% disabled, only for some HR pen-pusher with no medical qualifications take a short list of wages which might be earned, compare them to either the former police salary earned, or some nominal figure plucked from the data on national earnings produced by the Office of National Statistics, and then – wait for it – take one from the other to determine a ‘degree of disablement’ then take the 50% off the resultant figure.

This sort of manipulation is without a doubt completely unlawful. IODPA gives fair warning to HR managers, SMPs and Chief Constables that this issue will be dealt with in the High Court in due course.

Given that considerable doubt has been cast on the professional competence of SMPs, on their independence, and on the unwarranted and illegal interference with their decisions by HR personnel, any reasonable police pension authority would cease the practice of wage comparison at once. Of course, we at IODPA know full well that police pension authorities will do what they always do and deny there is anything wrong.

Just as occupational health qualifications have no part to play in the role of SMP so is reason, common sense and decency absent from the small number of Chief Constables who continue to allow their wayward HR managers to abuse disabled former officers and stick two fingers up to the Regulations.

We need now to return to the inquiry which the College of Policing completed, to get a glimpse of the full, disturbing picture of the shambles that is the administration of police injury pensions.

Shockingly, the College admits that that some forces take delight in the subversion of the Regulatory process by influencing the SMP. Moreover some SMPs take delight in being influenced to do the subversion – what better way to keep the paymaster happy!

In the event of incidents of force subversion of the regulatory process, considering SMPs are on the whole employees of occupational health providers working under contract with the force, there is a clear conflict of interest for the companies in question in the event that a SMP raised concerns. – paragraph 19.10

That is no surprise to us. Add together a force willing to subvert a lawful process with a SMP whose occupational health mindset is such that they only sees their role as being to get someone back to work and you have a rather a monstrous double-sided conflict of interest.

The College reveals there is little attraction in working as a SMP.

In addition to this there is a general perception articulated by a number of clinicians who engage with this review that the police service is not a desirable employer. At the heart of this issue appears to be concerns over vulnerability to baseless complaints, or threats of complaints, by officers or former officers, to the GMC in order to obtain more favourable pension settlements. Other SMPs report perceived pressure from management to obstruct the process and influence decisions – paragraph 19.7

It is the involvement of and bastardisation of ‘guidance’ by the National Attendance Management Forum, and the fact that it has produced a list of doctors, and companies providing doctors who are willing to act as SMPs that has meant a small pool of lowly occupational health clinicians now have a monopoly. The NAMF has its set list of preferred SMPs – a list that, we repeat, has had the consequence of further stifling the available pool of competent clinicians. SMPs are now given work just because they have been working as SMPs and not because their judgements are sound.

Otherwise excellent doctors are either barred from becoming SMPs or see the role as beneath them, and dangerous to their professional reputation to boot.

Many forces are experiencing increasing difficulty in identifying suitable doctors to perform this role. The role of the SMP is a specialist one and at the time of writing the available resource is limited. Historically, when the relevant regulations were written, many SMPs worked as Force Medical Advisors (FMA) in other forces. However ongoing changes to occupational health delivery has resulted in the vast majority of forces now obtaining clinicians from private companies with no prior background of the police service.- paragraph 19.3

One of the problems relating to the difficulties in obtaining suitable doctors as SMPs is cost. Whilst SMPs can represent a significant cost resource to Forces, SMP work is relatively poorly paid compared to other roles clinicians can obtain both in the field of occupational medicine and in the private sector. In addition to this, the General Medical Council (GMC), in their 2014 edition of our annual ‘state of medical education and practice’ report, recognises the decline in the number of doctors choosing to go into occupational medicine and reports that occupational health has more doctors aged over 50 than any other speciality. – paragraph 19.5

On one hand the College is saying there is a shortage of SMPs and on another they say they are underpaid. Market forces do not work this way. A rare resource can charge an inflated amount; what the College fails to report is that a cabal of SMPs have a monopoly and all the available work is taken by a small number of well-paid ‘guns for hire’. We know, for example, of one SMP who was paid over £45,000 for conducting fewer than a dozen reviews. These ‘established’ names suffocate competition and prevent new blood from entering the profession.

We have to also comment that it seems the College is saying that becoming a SMP is really the last chance saloon for occupational health clinicians who have failed to make a living elsewhere.

The situation, according to the College, is that these rather pathetic failures are thrown in the deep end when they take on the role of SMP.

There is at present no recognised training or qualification for Force Medical Advisors (FMA) attempting to manage these complex issues, or for SMPs, who must make statutory, quasi-judicial decisions.- paragraph 15.3

It is not the Regulations which are complex. In fact, as statutory instruments go, they are concise and clear. The esoteric fog only exists because the police pension authorities have, in the words of the College, repeatedly attempted to subvert the process. It has fallen to the judiciary to undo the damage the Home Office and individual forces inflict on the Regulation’s interpretation.

Perhaps the raw truth is more like the College has heard forces moan to them that they are finding it difficult to undermine the Regulations. That, having dreamed up a cunning plan to control the supply of doctors who can act in the role of SMP, some forces now find they have contracted people who are so useless as to not even be capable of perverting the Regulations convincingly.

The PNB guidance states that in order to perform the role of a SMP a doctor must be competently trained to effectively assess a police officer’s medical condition and disability. However the role of the SMP also requires them to understanding the complex regulations and case law and make arbitrations on evidence. These requirements lie outside the normal skill set of a professional clinician and are more associated with the role of a legal professional. – paragraph 15.4

Again the College is seeking to excuse the poor administration of Injury Awards by repeatedly proclaiming that the Regulations are complex – conveniently forgetting that it is those who administer the Regulations who have forced the wealth of case law into existence as a result of their inability to do things right.

Any competent holder of a medical degree will take huge offence at the College’s assertion that making decisions based on arbitrations of evidence is beyond their skill-set. Given the regulatory demands of any aspect of the medical profession such understanding is surely a core skill.

To date there are limited training opportunities available and no centrally accredited SMP qualification. Individual SMPs are therefore reliant on their experience of the work, personal endeavour and any ad hoc training they have been given by their employers. – paragraph 15.5

The Regulations in their current form have been in existence since 1987. Almost 30 years have passed and the College brazenly declares that there is still no gold-standard to measure the competency of a SMP.

Again the College conveniently forgets that the current chaos of poor and shady SMPs had its birth in Home Office circular 46/2004 which contained guidance from the Home Office which was an unlawful carte blanche attack on the Regulations. It took a courageous IOD pensioner to drag the Home Office to the very door of the High Court before the Home Office caved in and accepted the guidance was unlawful and agreed to withdraw it.

The guidance has been erased but the perversions of the Regulations continue, with some forces inventing ever more complex ways of manipulation so as to produce decisions which reduce the amount of pension paid.

It is no wonder that even decent SMPs are hopelessly confused or find their genuine efforts to apply the Regulations properly are frustrated.

The review has found little to no evidence of the private companies who are contracted by forces to provide both occupational health provisions and SMPs providing formal training for SMPs. Furthermore it is questionable whether consideration of training was included in tendering when obtaining SMPs through occupational health companies. – paragraph 15.9

Even the business school mantra of, ‘If in doubt outsource it’ is called into question by the College. By hiring a company to provide a SMP a police pension authority will lose any in-house experience but at least they can blame a private company when it all goes wrong. Or not. The private companies become bigger and bigger and as they do so they become less fit for purpose. The College fails to address why all this public money is given to occupational health companies who fail to evidence competency in the tendering process.

So, where is all this going? What actually lays behind the Home Office encouraging the College to make its enquiry? Why is the Home Office apparently content so see exposed so many failures by forces, their HR departments and SMPs?

Bear in mind when pondering this apparent own goal that the College is an arm’s length body of the Home Office. The College is the Home Office.

The report contains a blatant clue as to what the Home Office hopes to achieve. It raises the spectre of complaints against SMPs and it puts forward the suggestion that, when performing their roles under the Regulations, SMPs should have immunity from GMC standards.

It is noted that in separate correspondence to the Home Office representations have been made to suggest judicial exclusion for the role of the SMP. Furthermore legal opinion obtained as part of this review suggests that a medical authority appointed under the Regulations may be covered by the doctrine of
judicial privilege.- paragraph 19.2

Who made these ‘representations’ and what motivated them being made? It is an astounding suggestion – that doctors which the Regulations require do nothing more complicated or demanding than make independent medical assessments and decisions should need to be elevated to the status of a Crown Court Judge.

This immunity is contrary to the guidance of the GMC who state …

The first duty of a doctor registered with the GMC is to
make the care of their patient their first concern. The
term ‘patient’ in this guidance also refers to employees,
clients, athletes and anyone else whose personal
information you hold or have access to, whether or not
you care for them in a traditional therapeutic
relationship. – Section 2

A SMP is always a medical doctor first and therefore is answerable to the GMC. Under the Regulations their role is primarily medical in nature and purpose. A SMP must comply with the Regulations. Yes, decisions a SMP makes form part of a quasi-judicial process, but the College is in error when it suggests the SMP should become a judicial figure, for that element and responsibility is already present and rests with the office of police pension authority.

The report is nothing more that a sham. It is not the independent, impartial, academically rigorous enquiry it purports to be. As a dissertation it would be torn apart, for its entire purpose is to provide support for an idea. It is an exercise in propaganda.

Appendix D of the report contains the ugly truth of the Home Office’s purpose. The Home Office likes appendices. It was appendix C to Home Office circular 46/2004 which tried to encourage forces to act unlawfully. Here we have yet another appendix intent on much the same objective.

Appendix D offers a vision of a future arrangement when Regional Centres manage all aspects of the administration of injury awards. Forces, and SMPs, will completely lose the independence of thought and action which the Regulations are intended to ensure. The Home Office will have recreated the infamous Volksgerichtshof, the ‘people’s courts’ of the Third Reich, which were intended to provide that regime with an apparently lawful way of side-stepping the inconvenience of an independent judiciary.

Various benefits to such an arrangement are touted, but the plain truth is that if regional centres are created then they will be controlled entirely by the Home Office, no doubt through another shell company – sorry, an arm’s length body – which will ensure that all doctors hired as SMPs are compliant, corrupt and whose purpose will be to subvert the Regulations to the very great detriment of the brave men and women who were disabled in the line of duty.

For the Love of Money

iodpa 2015-11-252015-11-25 HR, selected medical practitioner, smp

For the love of money
People will steal from their mother
For the love of money
People will rob their own brother
For the love of money
People can’t even walk the street
Because they never know who in the world they’re gonna beat
For that lean, mean, mean green
Almighty dollar, money
– The O’Jays

Every now and again a search on Google turns up dynamite.

£45,701.50 … read this figure again out loud.

It transpires that Dr Philip Johnson has been paid £45,701.50 by Avon & Somerset constabulary since the 1st of August 2014 for his role to conduct reviews of Injury on Duty awards. And this is just for an ‘evaluation’ to see how unlawful their unlawful review program really is. Heaven knows how much he’ll cost them when he does this for ‘real’.

We know that the minions of the A&S HR department have 3 lists:

1. Those they have ignored for years and want to reduce but have no legally valid idea how to squeeze their pips;

2. The 16 band fours it trampled on in 2014 (most of which still have had no result);

3. Those retired recently (more likely by Johnson) who are due (according to them) a review.

Johnson has barely ‘reviewed’ a double figure number of IODs and, for this part-time work on top of his salaried job as force medical officer of Dorset, he has been paid a king’s ransom of almost £46,000 in just over 12 months.

That works out at around four and half thousand pounds per person reviewed. If the farce wants to review all 490 IODs the constabulary will end up paying Johnson a handsome £2,450,000.

Don’t forget that this £2.5 million is not a one off. Bulpitt (A&S force medical officer) and Johnson are under the delusion that every IOD shall be reviewed every 2 years if they can’t be dropped a band and every 5 years if they are dropped a band.

Do you like their logic here? Review them more often if they can’t prove substantial change – more bites of the cherry you see; but review them less often if the ‘good’ doctors get their devious way and they are reduced.

It’s like playing snakes and ladders with the board full of grease-covered snakes, with only one ladder … and this ladder is decrepit, riddled with wood-worm and with a suspiciously sawed through rail.

Back to Johnson and his £46K. As mentioned this is a recurring payment as the constabulary is deluded into thinking they have a positive power to review ‘as and when’ their coffers are running low. As soon as they are brassic, up steps Johnson, ready to invoice the constabulary more money per IOD than he can ever attempt to unlawfully reduce them by.

Of course, this money per IOD does not include the expense of a Police Medical Appeals Board, the Judicial Review and the Regulation 32 reconsiderations that follows.

Johnson has already cocked up massively. He has recklessly and unlawfully given some IODs new certificates with changes to their percentage even though he has written on the same certificate and accompanying report that there is no change (let alone no substantial change) to the IOD’s medical condition or capacity to earn.

IODPA wonders whether Johnson will now invoice A&S for all the time he takes to put together his defence when he is dragged in front of appeal boards.

contemporaneous

iodpa 2015-06-272015-09-21 Regulation 37, selected medical practitioner

“It is better to tell the truth and face the punishment, than to lie and face the consequences.”

― Anthony Liccione

Hard to spell, difficult to pronounce for some but still pleasing to the ear even though it is full of vowels , the word contemporaneous is drilled into you as a probationer. The time during or immediately after an event has to be captured otherwise the memory is undermined. Court cases have been lost to due the absence of strictly contemporaneous note taking.

Important advice to a police officer, and indispensable to a doctor. The health industry is rich in unstructured data which exists to record the well being, progress and medical interventions of patients. Unstructured data which consists largely of notes made by the clinician contemporaneously.

One of our well-placed sources in Avon and Somerset constabulary has informed us that there are murmurings that Johnson is not a happy bunny. (I don’t like to dignify him with the title of ‘doctor’ as I don’t think he deserves it.) Most of those injury pensioners reviewed by him back in November and December 2014, (and who still have not had a decision over 8 months later), have submitted subject access requests under the Data Protection Act for the handwritten notes they saw Johnson make during his face-to-face assessments with them during the course of a review. He was seen to make notes throughout each session, including when he was pouring over former officers’ medical records, familiarising himself with the contents of the file provided by HR and Occupational Health, and during the face to face interrogation and his summary closing the session.

During the review the Johnson invariably held a pen and had an A4 pad in front of him. This jotting pad wasn’t for him to doodle or add up his fees whilst the person being reviewed was wilting under his less than desirable bedside manner. The jotting pad was there to record in writing what was being said together with the SMP’s thoughts, reactions, observations, etc.

After the review it seems to be common sense to say that the SMP is duty bound to summarise what was said, so that he can refer back to his notes when he writes the formal report.

But, according to Johnson he made no notes. He seems to have no record of the sessions other than his memory, which must be remarkable, given that some sessions lasted an hour and a half. If he wrote up the sessions later, then when did he do this? The longer after the session, the less they could be relied upon to be accurate.

He’s answered some of the subject access requests with a curt reply along the lines of, “I did not take any notes”.

This poorly conceived and ill-thought out response by Johnson shows either that he is lying or he is admitting to not making any contemporaneous records. The former is bad enough – the data is not his to withhold – but it is terrifying to contemplate the lack of professional integrity required to be deliberately deceptive so as to conceal what appears to be the fact that notes were written months after the event, only when it was not possible to maintain the lie that no notes were made.

Why would a doctor not make notes? Let’s run with the face value that no notes were actually taken. According to this version of reality, Johnson read through the individuals’ occupational health files, and did not take notes. He then read through the letters and specialist reports sent by the former officers’ medical specialists, and did not take notes. He then sat for an hour or more and conducted a face to face review with the former officers, and did not take notes. He then collated his thoughts immediately after the review finished, and did not take notes. Then in all the months from the review up to the present day, not once did Johnson put pen to paper and jot down anything concerning the individual?

Perhaps the organisations which oversee the fitness for doctors to practise medicine would like to hear about this lackadaisical approach to record keeping.

Our secret source, whose insider guidance is continuing the exposure of incompetence that was first revealed with Freedom of Information Act requests, has also shone a light on the content of the those few handwritten notes that Johnson has released. Yes, that’s right! Johnson, when backed into a corner and under pressure of contemplation of the very large fines the Information Commissioner’s Office can hand out, has suddenly discovered that he has written notes on some, and not others. His consistency is rather lapse. Could it be due to the fact he has written some things he does not want to disclose so he says no notes were taken?

Nah, can’t be that, can it?

Does Johnson not know that each and every review he conducted was recorded in high definition audio sampled at 256 Kbps? Our very own ‘Deep Throat‘ has confirmed to us that the force knows this. But given what Johnson has been writing it seems that this information has by-passed him.

For the benefit of the Police Pension Authority who has to defend the decision of Johnson – A SMP can not revisit the original diagnosis. So, if that is what he is doing – writing up notes some time after the sessions, in such a way as to try to justify his part in what were all unlawfully held reviews, then he is essentially and effectively revisiting his decision. He can’t be recorded as stating that he, ‘sees no change’ in an individual’s degree of disablement then make notes some time later which contradict that decision. If this goes to a PMAB or to judicial review, then he will look very silly indeed.

Also, the merits or otherwise of a previous diagnosis are out of bounds. The earlier decision on the duty injury and its causation is a final decision and cannot be revisited. There is no point in a SMP doing anything other than accept the earlier decision and he should not be going anywhere near thinking that the original decision was not one he would have come to. This legal impediment doesn’t stop our flexible unfriendly medic. He was quite willing to put in undated handwritten notes of one session that in his view the original diagnosis of duty injury was wrong. You could not make this stuff up. Just how limp is Johnson’s grasp of the Regulations and associated case law?

A police officer’s pocket book entry kept in the same manner would be ridiculed in a court of law. Johnson will similarly be demolished should this go to a police medical appeals board. The Board does not suffer fools gladly.

Perhaps, instead of spending time making up notes months after the event, Johnson ought to read the appeal court case of LAWS:

Metropolitan Police Authority
Appellant
– and –

Belinda Laws
Respondent
– and –

Police Medical Appeals Board

Regulation 37(1) then provides for periodic reviews at which the authority is to consider “whether the degree of the pensioner’s disablement has altered”. On the judge’s approach this does not allow the SMP or the Board to redetermine the merits of any earlier decision of either

repeated by Simpson:

THE QUEEN on the application of SIMPSON

Claimant
– and –

(1) POLICE MEDICAL APPEAL BOARD

(2) SECRETARY OF STATE FOR THE
HOME DEPARTMENT

(3) NORTHUMBRIAN POLICE AUTHORITY

It is not open to the SMP/PMAB to reach a different decision in relation to the fact of disablement, whether the disablement is likely to be permanent or whether the disablement resulted from a duty injury

It’s your choice, Johnson. Salvage what is left of your professional reputation by telling the truth now, about how you have been taken for a ride and how, once you jumped on the gravy train that was promised to you – namely several hundred cut and dried reviews of compliant sheep-like former officers at several hundred pounds a pop – you could not jump off the train without breaking your reputation.

Or you can continue to lie and make things up as you go along, in which case circumstances will rapidly spiral beyond your control and the consequences will be very severe indeed.

john yardley on PSNI/RUC Injury Awards and Appeals"Dr VIVIAN" strikes again with his home grown guidance and rules to follow exactly the same as when he and...
John on PSNI/RUC Injury Awards and AppealsContacted the federation in the early days of my retirement asking for advice and help. I got neither ! I...
Chopper on PSNI/RUC Injury Awards and AppealsSimply corrupt, in every sense of the word.

IODPA

Merseyside Police do not review Band 1 Injury Awards

Nottinghamshire Injury on Duty Reassessment Program – Part 2

Nottinghamshire Injury On Duty Reassessment Program – Part 1

Merseyside’s Hatchet Man

Why Things Hurt

Access to Medical Records

Bogeymen

Bad Medicine

For the Love of Money

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