Many faking ill-health to win retirement

Many people who retire on the grounds of "ill-health" are not really ill, a study of 800,000 retirements in six major organisations, including the fire brigade and police, has revealed.

Some generous bosses (or lax employers, depending on your point of view) will accept back- ache, stress and anxiety as reasons for retirement and do not even require that the condition is permanent, while others are much tougher, the author says.

Rates of ill-health retirement varied dramatically between organisations, and in two cases, geographically within the same organisation. "Wide variations in the proportion retiring on the grounds of ill-health, within the same organisation, suggest that the process is out of control," says Dr Jon Poole, a consultant occupational physician from Dudley, who carried out the survey.

He studied the details of everyone who retired between 1990 and 1995 in six organisations: Rover, the fire, police, and ambulance services, the Post Office and the Teachers' Pensions Agency and found huge discrepancies between employers. To preserve confidentiality, the results were kept anonymous.

The contrast between different employers can be seen by looking at two of the groups. Organisation A rarely allowed retirement on the grounds of ill- health. Anyone wanting to opt for it had to be examined by three doctors, namely his or her GP, a company occupational doctor and an independent occupational doctor. Ill-health had to be permanent and back and joint problems and mental ill-health were rarely accepted. Only 20 out of 10,000 employees retired for illness in this group.

In organisation B, by contrast, retirement on the grounds of ill-health could be granted with the evidence of only one doctor, either the applicant's GP or the organisation's doctor, and back- ache and mental problems were frequently accepted. In this company, the rate of retirement on ill-health grounds was 250 per 10,000 employees, more than 10 times the rate for group A.

The study, published in today's British Medical Journal, is important because one in two employees now retire early, and a third of them do so at enhanced rates, on the grounds of ill-health.

Heart disease clearly prompts some retirement, but here again, the severity of it does not seem to be the deciding factor. In people who had had heart surgery, for example, the rate of abnormal electrocardiograms was no different between those who went back to work and those who retired.

But Dr Poole's most compelling evidence for the notion that not everyone who retires for ill-health is ill is the way that retirements peak in certain organisations at the precise moment when benefits increase. In organisation C, for example, where benefits were enhanced for people who had worked 10 years and then 27 years, retirements peaked at those points.

Dr Poole concedes that if you have some chronic illness you might hang on until you hit the right moment financially before you present your symptoms to a doctor, but does not feel that that could account for the marked differences.

The study also points out that in two of the organisations (the only ones which provided information by sex) women retired at up to five times the rate of men before the age of 40 and after the age of 50.

Dr Poole believes that employers who always take the ill- health retirement route to get rid of people give themselves problems.

"This has the effect of medicalising dissatisfaction, generating consultations with doctors and expensive investigations for what are comparatively minor illnesses," he says.

Dr Poole recommends that companies should insist that employees wishing to retire for ill-health should be seen by an independent doctor, rather than the company doctor, because a company doctor might feel a conflict of interest between his loyalty to the patient and his duty to the company.