Client disallowed IB after failing to attend a medical on Sunday 23 December 2007. Client has suffered with bipolar affective disorder, having several relapses and hospitalizations, over 30 years. Psychiatric report from 2 years ago indicated cognitive impairment as a result of her mental illness, and complete dependance on her husband. She receives middle rate care DLA and low mobility. Dizziness and unsteadiness on her feet caused by strong medication, also generalized pain in limbs. Sees psychiatrist every 3 months. In addition has diabetes, requiring insulin injections twice daily, high blood pressure, and 18 months ago suffered a stroke, leaving her with slurred speech and increased weakness and pain in limbs.

Her husband rang Medical Services on receipt of the notification (which included a suggested journey plan by bus, but did not include the 'important information' referred to in the letter about the examination, what she should take, and about travel expenses). He told them that she would not be able to attend by public transport because she was suffering from swollen ankles at the time, and couldn't get about. She would need a taxi. They REFUSED this request, and he somehow managed to get into a dispute about it with 4 people at Medical Services - he is extremely offended and angry about the treatment he received.

They told me they had not completed an IB50 prior to the examination date, but have been sent one since, and returned it. Client was sent request for reasons for non-attendance, which client took to the neighbourhood office for completion.

She received a disallowance of IB from 24/13/07 on the grounds that they (DWP) had not received a reply to their request for reasons for non-attendance. (Client's husband has phoned up, and they have confirmed that the reply had in fact received the reply, but it was in another part of the department at the time of the decision - which i suppose, is slightly better than being on a traffic island in exeter - but no change in the decision...?)

Now, none of this should have happened, but it did, so i guess one question is, how long will it take to sort it out? i would like it to be put right immediately, and would welcome any comments or suggestions. Thanks in advance.

Bung in an immediate WRITTEN appeal with as much medical evidence as you can find. Don't rely on telephones as you will be very lucky to get through to anyone who can help. With reasonable luck they will revise the decision on the spot, but you will need some sort of external, "expert" evidence to show they aren't just making this up.

Hi, I wish you good luck with this. I deal with IB being stopped all the time for non attendance at PCA's due to MH issues & suggest an appeal with support letter from psychiatrist and CPN if she has one (or any other MH professional).The bad news is that generally they make my clients go down the whole formal appeal route which obviously takes months. The good news is I occasionally get the IB reinstated due to the support letters within a couple of weeks.

Who knows, maybe your local office has more sensible/clued up staff than ours does?!

This used to happen fairly frequently when i worked in a psychiatric hospital. Even though the WRU i was a part of had developed a good working relationship with the local DWP staff, they would never countenance overturning a decision to disallow without an appeal being lodged, which was both time-consuming and expensive. Daft practice that I wish they would change, especially when the fact of non-attendance is often a key indicator of the severity of someone's MH condition.

Hi Jan,

We had vaguely similar situation (our client didn't have the severity of your clients mental health issues), and persuaded medical services to phone the DWP IB section to explain it was miscommunication/misinformation between dept's within the medical services that cocked up the situation not the client (we rang IB section too) i.e. client responded. By some act of a higher wotsit (Exeter BDC sounds better than the in Brum), the DM reinstated IS, and a new appointment for the Incap for work/PCA, obviously exemption sounds more appropriate for your client.

hope this makes sense - gotta dash out of the building

thanks everybody - i've put in an appeal and a complaint - we'll see what happens. prior to CMS, i found the local IB sections pretty reasonable to deal with, and more reliably knowledgeable than the other sections, but it's all gone to pot now, and i can't even speak to them. i feel kinda sorry for them, but even more sorry for their 'customers'.
i was wondering if anyone knows Medical Services policy on travel expenses? client's husband was under pressure to bring wife to examination centre - but he doesn't drive, and she was physically incapable of travelling by bus.

the 'suggested journey plan' was a new one on me. there's a table, with the strange headings "Transport Type" "Legs" "Leave" "Arrive" "Duration". Transport type is completed "Walk, bus" and "Legs" has the entry "5" which is a bit worrying...The table below breaks down the journey into 3 walks, of 7 mins, 10 mins and 5 mins, and 2 bus journeys...

i rather suspect that medical services were getting so much flak from people they called for an interview on the Sunday before xmas that they didn't listen to him. guess maybe they were having a big clearout for pathways to work...but who knows..?

client's husband says he is not an educated man, but he treats people with respect and expects to be treated the same way.

Couldn't you argue that she is exempt from the personal capabity assesment because she has a severe mental ilness?

this is part of my basic standard letter that I adapt and send to incapacity benefit

I feel that ... may fit into the rules for exemption from the Personal Capability assessment process because they have a Severe mental illness
I understand that Severe mental illness is defined as
mental illness so adversely affecting a person's mood, behaviour or social or environmental awareness, including interpersonal relationships, that continued psychiatric care is essential.
The medication taken has anti- psychotic preparations. Please could you confirm in writing that you have decided to exempt this person.

Was the appointment really on a Sunday - Were they offering sunday dinner or doing overtime to get rid of the back log before christmas?

it really was on the Sunday before Xmas - no dinner - but it's just dawned on me that the 5 legs refers to the 5 stages of the journey. duh! : ) i suppose a 5 legged turkey cuts down on arguments, but all there was on offer was an hour's travelling and a half hour wait to see the doctor.
i rather think the clear-out was for the start of pathways to work at beginning of January, but i do think it's a bit much sending people for compulsory medicals at any time, without regard to their right to respect for family life...i don't think client was impressed with this, but was not complaining, nor refusing to attend, nor asking for another date...simply that she couldn't travel by public transport and needed a taxi because at the time she could not walk more than a few steps...
i have argued that referral was inappropriate because exemption should have applied, and reg 6 requires IB50 information to be obtained (the reg 6(2) exception clearly not applying in this case) but in any event, authorisation of taxi travel was unreasonably refused. this client's IB entitlement has been removed because the Department refused to authorize a taxi. the gummint wonders why its so unpopular...client's husband wonders if he was expected to carry his wife on his back...

Just worth checking - she did get the appopriate period of written notice of the hearing???

yep. they notified on 13/12 for 23/12. looks like they took account of funky xmas post...

Maybe a pointless idea, but how feasible was the suggested journey on a Sunday? Did it reflect Sunday bus times or weekdays? Coz I'm not sure it's a good idea on a cold winter's day to be hanging round waiting for bus connections when you're a bi-polar diabetic.

me neither! : ) but the journey was theoretically feasible. it appears the whole exercise was planned on the theoretically feasible - the logistics of bussing people to medical examinations however is not the same as hauling biscuits, even if the exams are compulsory...real peoples' lives are involved...

Just to update - DWP have had some difficulty getting all the docs from remote storage, and i've been advised today that if they are not back by wednesday (after the strike) they will revise. couldn't tell me whether medical services had advised DWP that client had let them know about the refusal of taxi fare stuff without the papers, but apparently medical services have the final say on taxi fares - they have a policy, and possibly contract arrangements re taxis. to be continued...

I'm just seething about this, surely it there must good cause for refusing to attend an examination on a Sunday, whatever your mental or physical health condition, or whether you have to travel by bus or live next door to the Medical Examination Centre?

I feel like clubbing together to pay for a taxi to deliver your client to James Purnell's (or David Freud's) doorstep on a Sunday and see how they like having their weekend interrupted in this way.

I note your first posting says her benefit was disallowed from 24/13/07, normally I'd discount the addition of an extra month to the calendar as a typo on your part, but in this case it would seem entirely consistent with the rest of the administration and decision making!

: ) yes.

my theory is that medical services had so many people trying to rearrange these appointments, that having made such an unreasonable decision, they entrenched their position, and rendered themselves incapable of hearing what client was actually saying. i was very careful to check with client whether it was the date of the appointment which was the problem, but husband was clear that it was wife's swollen ankles and inability to walk, and he was saying she couldn't attend unless a taxi was arranged.

i would have understood if they _had_ had a problem with with the appointment date. sunday is not a normal working day, and a reasonable policy would be receptive to a person's reasons for wishing to change the date. the fact that a person is subject to compulsory medical examinations does not render them sub normal human rights as a citizen, and er... some mutuality in AGREEING the appointment arrangements is not an outlandish suggestion for a supposedly expert body in a non-feudal advanced society...

the decision to send sick and disabled people into the birmingham city centre on the sunday before christmas, when the town is heaving with shoppers, traffic and celebrators, also a time of the year when some claimants may well be receiving visits from relatives who have travelled from far afield, is in a class of its own, and i daresay, someone was paid a lot of money to make it.

that someone should have their right to IB removed because Atos Origin wouldn't authorize taxi fares has well and truly got me spitting feathers.

the DWP spokesperson was sympathetic, as well they might be, and i feel i detected some frustration and feelings of powerlessness with regard to medical services, though she was of course, diplomatic and discreet, and i could be wrong about this...

but i am concerned that the policy on what is a basic administration function is in the hands of the contractor... i was surprised to hear a while back that the decisions to refer for medical exams were being made by medical services, when it is an administration function, and the medical services company has a financial interest...the existing demarcation lines already appear suspect, so the new wave of privatisation which you point to... let's just say, i don't think those who are concerned (and whose voices are IGNORED) are making a fuss about nothing. it's my belief that the Freud/Purnell policy will cost lives.

Surely, Jan, the contractors who are gonna get £60k a pop for getting claimants into jobs long enough to earn less than a third of that (at NMW) will use some of their profits to pay for taxis to medical exams for those who need them...?

Hang on. Gotta answer the door. There're some people in white coats ringing the bell...

Don't worry Gerry, they've just come to give you a 'fitness certificate'.