Medical certificates while appealing

I would like to discuss two distinct but related issues over medical certificates while appealing.

1. This is a new issue I have not heard before: I have been told today by the contact centre that my client’s long-term sick note was made ‘invalid’ by his failing the WCA in April, and that he must now provide a new one from the date of the failure decision to be paid while appealing. It will not be hard to obtain another, but it will delay getting any money by a further unacceptable amount of time. I asked what the source of this ‘rule’ is and two call backs later, I was told it is new guidance not available to the public yet, although they are going to send this to me. I cannot find anything in the ESA or Medical Evidence regs to support this proposition.

2. This is a recurring issue: they also stated that if there is any gap in the period covered by medical evidence, payment will not be made at all. So even though my client has in fact submitted a new sick note from May, he cannot be paid any money, even for the weeks he is indisputably covered, until the gap (due to the allegedly invalid note) between his WCA and the new note is covered. There appears to be no basis for this ‘rule’ either and it is contrary to DMG 42453.

Although my client is going to get a note to cover the ‘gap’, I’m not happy with this culture of failing to cite the law relied on when something like this is challenged. Any thoughts on the correctness of these policies, and suggestions for challenge if not, would be welcome.

I had the “medical certificate back to the point of being found fit for work” issue a couple of weeks ago. The client as upset because his doctor would not give a backdated certificate.

I asked the person I spoke to at Jobcentre Plus to provide me with information as the relevant law or guidance. When he could not, he then said that it only needs to be from the date of the appeal.

I asked to register a complaint on the client’s behalf with a response to be sent to the client clarifying the requirements in writing with reference to the appropriate law/guidance and, what they were going to do to avoid this requirement being asked for again.

Who knows?

They might even respond.

I’ve had this problem since the inception of ESA; it’s not new round there parts.

I am sure we all find that there is - generally - a good deal of misunderstanding of the rules on ESA, in particular the appeal process. It’s not that straight forward. I haven’t come across the specific issue above, but I have found that somebody reclaiming ESA after an unsuccessful appeal is asked to provide a new med3, despite JCP holding one for the appeal period that contuinues beyond the tribunal date.

Other problems encountered include a lack of understanding of the appeals process, in particular set-asides and appeals to the upper tribunal.

We do the same as Tony….and also have to make sure the client doesn’t give it to JC+ when claiming JSA! :)

We will certainly be advising clients to work around this problem in the short term so they get paid.

But I’m still not satisfied that there is any basis to the rule, so why allow it to go unchallenged? Amongst other things, regulation 147A states that regulation 30 applies “as if that determination [the WCA] had not been made.”

Also, what if the GP will not backdate the certificate? The alleged ‘gap rule’ the DWP posit would then mean the client will be paid nothing.