I have a client who failed to attend medical, didn't do anything about it for ages

we have put in a late appeal which is slowly progressing

I advised her to reclaim in the meantime, and ask for the claim to go from the date after the last claim stopped, this she has done.

two probs have arisen , one concerning payment of IB which I will deal with in this posting,
the other concerns med certifcates - I have done a separte posting about that


problem -

IB office tell me she cannot recieve any money until after a decision has been made on her incapacity, which will probably be after her next medical - several weeks from now.

they cannot treat her as unfit for work on the basis that she supplys med.cert's, as they would if it were an entirely new claim, and pay her for the period before she is examined.


I can see the logic of this - i.e. the last claim was stopped because she failed to attend a medical, so why should they resume paying her until she is examined. I am also assured by learned ex-collegues that this is correct.

However, I cannot see in the regs any bit that says they havn't got to pay her, can anyone help?

Jim Cook

Under the SS (IFW) Regs Reg 28 they can't treat her as incapable of work under the PCA if it was determined that she was capable within the last 6 months, unless specific circumstances apply eg she has become significantly worse. Is this what you meant?

Sue

no, thats not what I meant,
I dont think there has been a determination under the PCA that she is capable of work
- because she didn't attend the examination

I believe that this is a different situation, and the 6 month rule you mention wouldn't preclude her from reclaiming for the same condition

?

no, thats not what I meant,

I thought not - it's a rare question when *I* come up with the answer first!

Have you read R(IB)2/01 (final paragraph)

"The period to which a determination under regulation 8(2), and, indeed, most other determinations, relates ends immediately before the date from which a new claim or application is effective. For any period within 26 weeks of the decision under regulation 8(2), the claimant would not have had the benefit of regulation 28(1) of the 1995 Regulations (under which a person is usually treated as capable of working pending assessment under the all work test) unless either of the conditions of regulation 28(2)(b)(i) or (ii) was satisfied (i.e. if the claimant suffered from a new disease or disability or could show a worsening of the former disease or disablement) but, if the claimant had been found to satisfy the all work test, there is no reason why effect should not have been given to that decision from the beginning of the period in respect of which the new claim, or application for a review could properly have been made. "

Sue

Thanks Sue, that is really helpful
do you have any suggestions on the other question I posted regarding this client, (since you're on a winning streak!)
Thanks
Jim

There is always Mr Blairs new radical approach she could find a job .
Joking aside if your appeal decision to stop ICB she can still claim IS at reduced rate.