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Need to claim ESA but can’t see a Doctor?
brief conversation with a new client today - she has an 18 yr old son with suspected autism - not sure if he is being supported by anyone - who is not in education/employment and really needs to claim ESA but part of his problems are engaging with others including the GP - she says she cannot get him to see the doctor and when she has phoned to ask for a home visit the helpful receptionist has claimed it is simply not possible.
i am meeting the client on friday and advised i would seek advice around the med cert issue - do i need to contact the GP surgery and not take no for an answer ??
has anyone else experienced something similar and managed to overcome it?
GP receptionists can be formidable individuals but it is always worth a try…...does the son never go out all? Is anyone else supporting the family from the Community Mental Health Team who could liaise with GP surgery?
The links below are helpful in giving more information about accessing a diagnosis of Autism for adults:
http://www.autism.org.uk/about/diagnosis/adults.aspx
http://www.autism.org.uk/about/diagnosis/adults/process.aspx
It can be challenging to navigate through the process but it is not essential that a GP provides medical evidence to support an ESA claim as DWP can accept a written statement from other health professionals confirming limited capability for work. A Med 3 from the GP is the usual route but a letter from the Mental Health team (if an option) can be accepted by DWP to support a claim.
. A Med 3 from the GP is the usual route but a letter from the Mental Health team (if an option) can be accepted by DWP to support a claim.
I’ve had a couple of similar issues where it’s been the Tribunal that accepted there was sufficient evidence. JCP have dug their heels in despite strong evidence of significant vulnerability from medics and social workers.
A GP must assess the patient before issuing a med 3 and I have seen situations where GPs have refused to issue certificates despite there being a known history of severe and enduring mental health problems. Even when I explain the reg 29/35 risk some have refused to issue.
The assessment a GP can conduct might be a paper based assessment, however if there’s no paper evidence it might be catch 22; certainly you need to provide some evidence for the claim to be considered.
[ Edited: 30 Jun 2016 at 01:56 pm by Dan_Manville ]
The law allows other evidence to be provided where it is unreasonable to provide the standard med cert/fit note:
Reg 2 (1A) The Social Security (Medical Evidence) Regulations 1976 as amended:
“Where it would be unreasonable to require a person to provide a statement in accordance with paragraph (1) above that person shall provide such other evidence as may be sufficient to show that they are incapable of work or have limited capability for work so that they should refrain (or should have refrained) from work by reason of some specific disease or bodily or mental disability.”
http://www.legislation.gov.uk/uksi/2010/137/pdfs/uksi_20100137_en.pdf Also on page 822 of Social Security Legislation 2015/16 volume 3.
Depending on the circs it may be possible to raise it as a safeguarding issue (hence Social Services should assess). It might at least get things moving to the point where GP will get involved (either via HV or the son being supported in accessing surgery).
Surely the Mum just books an appt. with the GP herself and then explains the situation? Receptionist issue should end there.
Surely the Mum just books an appt. with the GP herself and then explains the situation? Receptionist issue should end there.
yes, one would think - all i know is that she tried to request a home visit for the son because of his difficulties going outdoors and going to other places but receptionist point blank refused.
thanks for all your suggestions and recommendations though - i will be tackling the receptionist myself if necessary; at least i can advise both clients on the way forward.