• Start
  • Tier of Ill health retirement
  • Employee details
  • Employment details
  • Financial information
  • Additional information
  • Declaration
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You can use this service to prepare the leaver form needed for an employee leaving because of Ill health. 

Please do not complete this form without a supporting 'LGPS17A - Ill Health Certificate for a Current Employee' approved by a Independent Registered Medical Practitioner (IRMP).

What you need to know 

  • Tier of Ill health retirement awarded to the employee. 
  • Personal details of the employee.
  • Employment details including Pay reference and Post number.
  • Date of leaving employment. 
  • Full Time Equivalent Final pay (FTE). 
  • Final pay date (Best of the last three years).
  • Annual Assumed Pensionable Pay (AAPP). 
  • CARE Scheme - Cumulative Pensionable Pay from last 1 April to the date of leaving. 
  • Assumed Pensionable pay (APP) (if applicable) must be included for any reduced or no pay periods of sick leave and any periods of reduced pay for child related leave.
  • Any information needed to support the leaver submission can be added to the additional comments section.
  • The PDF output of this form will need to be uploaded to the employee record using i-Connect.