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Coronavirus: What's Changed - Medical Assessments
Coronavirus - Medical Assessments

KEY FACTS:

  • Face to face medical assessments for Universal Credit (UC), Employment and Support Allowance (ESA), Personal Independence Payment (PIP), Disability Living Allowance (DLA) and Industrial Injuries Disablement Benefit (IIDB) had been suspended during the Coronavirus outbreak. But some are resuming: see below*.

  • Assessments based on the questionnaire (and other written medical evidence) have been completed where possible for UC, ESA, PIP & DLA. So some claimants may receive an award without having to attend a face to face medical if the DWP have enough paper based information / evidence.

  • Where the DWP do not feel they have enough paper based information / evidence they are conducting telephone assessments where possible for UC, ESA, PIP & DLA. This is where the claimant receives a phone call and further information about their disabilities and how they affect them are gathered.

  • *Where the DWP feel they cannot gather sufficient information for the assessment by phone or paper,  face-to-face assessments for Industrial Injuries Disablement benefit in England resume from 12 April 2021, 26 April Scotland and Wales; face-to-face assessments for PIP and work capability assessments for Universal Credit and ESA resume from May 2021 in England Scotland and Wales in line with when indoor socialising is allowed in each country. 

  • For PIP assessments only (currently) the claimant can ask for paper or phone assessments where a face to face assessment would be inappropriate or unfair to them in the light of their condition. This is not an appealable decision but anyone refused should seek advice as the DWP could be contravening Equality Act rules.

New Claims

IMPORTANT: Anyone who wants to make a new claim for ESA, PIP, DLA, IIDB - or request a Work Capability Assessment if the claimant is on Universal Credit - should not delay in making their claim / request. Even if the medical assessment is delayed - any award / extra benefit would be 'backdated' - ie based on the date the claim / request was first made.

The DWP will try to conduct the medical assessment either as a paper based assessment or may arrange to contact the claimant by telephone, although if they are unable to do the assessment  in this way, from April/May some assessments will be carried out face to face.. 


Reviews and reassessments

Anyone already receiving PIP, ESA, Universal Credit or Industrial Injuries Disablement Benefit, will continue to receive their current payments as normal while alternative arrangements are put in place to review or reassess their claim. 


On 6 July 2020 a DWP press release said:

'Anyone who makes a new claim or is due an assessment will be contacted, if necessary, to discuss next steps, which could involve either telephone or paper-based assessments.
We will shortly be writing out to some PIP and DLA claimants asking them to complete paperwork to resume their reviews, reassessments and renewals. For PIP cases where paperwork has already been returned, claimants may be contacted by one of our Assessment Providers.' 

On 23 September 2020, the Minister for Disabled People, Health and Work, Justin Tomlinson said
'We have used paper-based reviews where possible, and we are bringing telephone assessments into the WCA in the same way that we have done with personal independence payments'


More details on the gov.uk website - click here


What if someone misses their telephone appointment?

The DWP has tightened up the rules from 2 November 2020. Touchbase magazine (dated 6th Nov - click here) says:

"From Monday 2 November, ESA and UC telephone assessment appointment letters will make it clear that claimants must attend their telephone appointment. FTA (failure to attend) and FTP (failure to participate) action will apply, e.g. benefit may be stopped (ESA) or entitlement change (UC), for those who have been issued with this letter and fail to attend or participate in their appointments without good reason.

 No one will have their support stopped without being contacted first. People will be contacted to ask them to explain why they did not, or could not attend or participate in the assessment and where good cause is provided and accepted, support will continue."


Can another person be added to the phone call to support the claimant?

Yes. If the claimant would like to have a family member or friend (who does not live with them) present during the telephone assessment, for moral support, or to help them with explaining their difficulties, then that is possible. They will need to let the company which is planning to carry out the telephone assessment (Health Assessment Advisory Service, Independent Assessment Services or Capita) in advance of the telephone appointment. Then they can be added to the call.


Recent question

A client has been waiting 6 months for a UC Work Capability Assessment. Last week, they tried to do the assessment with him over the phone, but they were not able to complete the assessment because they needed more information that they were unable to get over the phone. As the DWP haven’t made a decision, there is nothing to challenge. Is there anything we can do to request a telephone decision, as it could be a considerable time before they are able to do a face to face interview?

If it was not possible for the assessor to gather enough evidence over the phone, it would not be appropriate for the DWP to make a decision based on the evidence so far. 

If you or the claimant are able to gather any additional evidence to demonstrate which descriptors / criteria are satisfied, then you could let the UC dept know about that and ask how it can be shared with the Health Assessment Advisory Service (who carry out the assessments).

If the extra paper evidence is not sufficient to enable a decision to be made, the claimant will have to wait until a face-to-face assessment can be done. 

They could be waiting for some time, so it could be worth the claimant keeping a diary / record of symptoms and how they are affected in terms of what activities they cannot do at the current time. The assessment will be about how they were around the time when they were referred for the WCA. So, if their health condition changes between now and when the assessment is done, this would be useful to refer to.

If the claimant is currently expected to do any work search / work preparation activities as part of their Claimant Commitment, they should explain their health problems to the work coach to ensure that their Claimant Commitment is realistic.


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