Hi all

I have a Client who has been on disability benefits for 21 yrs he has a serious mental health problem resulting in 3 8 month sections in the last 10 years - he is supported in the community by CPN, sees psychiatrist every month, district nurse etc etc he has recently attended a medical and GUESS WHAT he scored 5 points and he is now fit for work -we are appealing are in the process of sending the latest mental health assessment which has been done by his psychiatrist and hoping it will be overturned before appeal - reg 27b - am slightly concerned that EMP has ignored all the history and comment made by EMP in 1996 stating " I doubt that this person will ever work". Nothing has changed since then at all.

His medication is controlled by his psychiatrist not his GP due to the very high dosage he has to take to control his illness - oh and he has no recollection of what happens to him when he is put on a section and the events that lead up to this>>>

Question - how is this client fit for work??? and has anyone else experienced a similar case??

Ps. indef award of DLA MRC and LRM

I dont understand why he isnt on HRC.

Yep had similar cases. Had one case where the CPN accompanied the cl and spoke at length to the MA about cl's mental health and inability to cope with day to day living and guess what.... MA stated "no overt sign of depression".
It's a bit of a hobby horse of mine that dm's and MA's are clueless when it comes to mental health and how a retired or semi retired GP can come to a different conclusion from an expert in the field is beyond comprehension and how a dm can give more weight to the MA than a Consultant Psychiatrist is amazing. I know the decisions get overturned either before or at appeal, but in the mean time the cl's health deteriorates due to the stress. If it wasn't so serious it would be laughable

Thanks for that Margie - its also a real bug bear of mine too & like u said if it wasnt so serious it would be laughable - just wondering what type of work he could do - (he has to sleep after his lunchtime medication as it knocks him out!) & that along with the constant visions he sees is going to make work very difficult..........

Maybe he could be a DM?

Wouldn't reg 10(2)(e)(viii) be more appropriate given the support of the CPN and psychiatrist?

yes it would be.........but we only became involved after the decision was made.

But there isn't any reason why you can't argue for it to be applied now is there? Except of course that the chances of getting a DM to disagree with the medical advisors report are slim.

Thanks Ian 4 that I will look into it and yep Margie a DM would be a starter for 10!!!!!!!!

Are DM's and MA's joined at the wrong thinking brain? Why is it that anomalies against the cl are never questioned but the ones in favour are? Alcohol again??? Just kidding

This is a growing problem' if the client is able with your help I feel there is aclear case to complain about this Doctor to the General Medical Council (GMC) it is a often overlooked route of complaint. The EMPs negligence will have caused un told stress for your client I am sure.

Ian's point about Reg 10 etc is a very good starting point, from your description it sounds like your client is on an enhanced CPA - might be worth exploring the following - obtaining copy of CPA, a and report from the CPN (we've got a med evidence proforma that covers the mental health questionnaire stuff - , your welcome to a copy), having a look at his medication as well, is he on eg antipsychotics or mood stabilisers - how effective is the medication eg is it a guarantee of no more relapses, does he have insight into his condition, does he comply with his medication. Does the medication even work - a lot of people are known as treatment resistant ie the drugs don't work.
what areas are the 5 points awarded for because they might lend credence to the idea he should be exempt.

excuse the chaotic nature of this posting, i'm in a public library and my times up.

Lastly i once had a client who after a medical wotsit was awarded nil points and the Tribunal awarded him 36 points (because it appeared they were disgusted his case had got to that stage) he had been a client of the local mental health services for years and had been admitted under the MHA 1983 numerous times, so your case has struck a raw nerve with me.

i can feel a rant coming on, so i'm off see ya andy

I think it sounds from what you have said that he should be exempt from the personal capabity assessment
On the Benefit training courses I run that include dealing with this problem I have a standard letter I suggest people use.

Here is the part that I think is relevant to this guy.

Re: Exemption from the Personal Capability assessment process


I should be considered for exemption from the Personal Capability assessment process.

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.

Example - I suggest using these words ... *They live in Supported housing and have regular medical supervision. They take long term medication ................. This medication has anti- psychotic preparations including depot neuroleptics or mood modifying drugs
Please could you confirm in writing that you have decided to exempt this person.

This definition of SMI is arguably wrong. Following Howker it should be argued that it is the unamended form which applies i.e. you have a severe mental illness.

Thanks you to all who replied - decsion was overturned yesterday and Client is now exempt - hurahhhhh!! (till the next time)!