What's the situation now?
Face to face medical assessments have resumed - but these are only being carried out if telephone or video assessments are not possible / appropriate.
The companies that carry out medical assessments must have Coronavirus safety measures in place for face to face assessments - see here.
Claimants could find that they have to wait longer than usual for their assessment - due to the backlog caused by the pandemic.
- Face to face medical assessments are normally used for Universal Credit (UC) (for those who wish to be assessed as having a limited capability for work), Employment and Support Allowance (ESA), Personal Independence Payment (PIP) and Industrial Injuries Disablement Benefit (IIDB). They can sometimes be used for assessing Disability Living Allowance too.
- Face to face medical assessments were suspended during the Coronavirus outbreak. They have resumed, although telephone / video assessments continue to be carried out instead where appropriate.
- Face-to-face assessments for Industrial Injuries Disablement benefit in England were resumed from 12 April 2021.
- Face-to-face assessments for PIP and work capability assessments for Universal Credit and ESA were resumed from May 2021.
- IMPORTANT: Anyone who wants to make a new claim for New Style 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 (due to the backlog) - any award / extra benefit would be 'backdated' - ie linked to the date the claim / request was first made.
What if someone misses their telephone appointment?
The DWP tightened up the rules from 2 November 2020. Touchbase magazine (dated 6th Nov - click here
"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 present during the telephone assessment, for moral support, or to help them with explaining their difficulties, then that is possible.
If that person is not able to be with the claimant in person at the time of the telephone call (eg if they do not live nearby), 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 so that they can be added to the call (a 3 way call).
Measures that were put in place due to the pandemic
Due to the pandemic, the DWP had to make some changes to the way claims and reviews were processed.
The DWP checked if there was sufficient information from the questionnaire and other written medical evidence to enable them to make a decision without the need for a telephone assessment.
Where the DWP did not feel they had enough paper based information / evidence they conducted telephone assessments where possible for UC, ESA, PIP & DLA.
Anyone who was already receiving PIP, ESA, Universal Credit or Industrial Injuries Disablement Benefit, continued to receive their payments as normal while alternative arrangements were 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.
The following information applies to those requesting a Work Capability Assessment through UC or making a new claim for New Style ESA.
As a temporary measure - from 17th December 2021 until 27th January 2022 - claimants do not need to submit medical evidence after seven days of sickness. The temporary suspension is to take pressure off GPs working on the covid booster push.
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.