It's Friday afternoon and Im seething at a PCA outcome.
I am not au fait with the training given to GP's to make them "Medical Assessors" but at the moment Im plumping for it to include a lobotomy.

Client writes on IB50 that he has depression but has difficulty talking about it..GP asks DWP to help assess patient who was at the time awaiting input from the Community Mental Health Team...Medical Assessor carries out a physical and mental assessment in 25 (TWENTY FIVE) minutes. Awards a "yes" for Is Scared or Anxious that work would bring back or worsen their illness...but qualifies it by saying "loss of confidence".
No other points awarded because client is "well presented, good historian and makes good eye contact".

Client is a "smiling depressive" who has just been diagnosed (provisionally) as suffering from querulant delusions and schizoaffective disorder and is on antipsychotic medication.
If I could see that the client had far more serious problems than he was admitting to - why couldn't the Medical Assessor? I have no formal training in mental health problems (other than experience). Why arent there specialist mental health MA's and for that matter decision makers?
Not to mention that the PCA is set up for only one kind of mental health problem (depression).

OK rant over....thanks for listening and if anyone does know about the training, please reply

Antipsychotic medication, scizoaffective disorder etc. That must be good grounds for Reg 10 or 27. Why a PCA in the first place.

You would think so, wouldnt u? Well the DWP won't change the decision (despite the updated diagnosis)without input from the Medical Services (which could take weeks she says) so I have to take the case to an Appeal hearing - a case of "When is a decision-maker not a decision-maker".

Wouldn't the updated diagnosis count as a new claim(new condition) while medical services are perambulating about?

This is interesting before the introduction of the computer assistes assesment I asked the DWP how a doctor had reached the conclusions. I told it was done by asking the claimant wat the did during an average day and by observing them. After the computer assisted model was introduced I accompanied a client and the doctor sort of apologised to the client saying that the department made him use the computer so he would be looking at the screen rather than client. Observation hence appeared less essential. I have sice asked if a copy of the lima programme is available and I have been advised that it is only for use by the Assessors and that the information it uses is available in public libraries.

Like many of these computer programmes they are designed for speed and clearly this is an issue. The doctor who does not agree with the suggested score is required to type in the justification. This no doubt takes more time and the more the Doctor insists on using their intelectual sovereignty ,in this way ,presumably the more chance they have of lossing the Secretary of States approval. This could be a reason for high staff tun over at the Glasgow centre

The Diasability Assessment Medicine is said to be contractually the intelectual property of the Secretary of State. So I think to get access to the training one has to buy into the franchise.

I've had a couple of ICB(Lima "assisted") recently and for want of a better word the medical assessments were crap. Most annoying is that standard phrases are popping up as evidence that the clt has failed PCA. "Cooks safely and eats well" - "They have no significant problems with shopping" and "Usually able to supervise a child".

Well whats wrong with that one might say. Well the above three were given as evidence under the descriptor "Can he or she answer the telephone and reliably take a message". I had a lot of fun with that one.

Then there's the response "Has not suffered any serious accidents recently" used in response to the descriptors "Do they overlook or forget the risks posed by domestic appliances or common hazards due to poor concentration" and Agitation, confusion or forgetfullness resulted in any potentially dangerous accidents in last 3 months" and thats before Howker arguments.

Then there are the "snapshot" favourites - "Not anxious on examination", "Not depressed on examination", "Looks well" and "Well kempt".

If the medical assessments are going to rely on this kind of multiple choice garbage then on the strength of my last appeals, arguing against some PCA just became a little easier. Roll on.

Went to Tribunal who refused to hear the case under Reg 10 or 27 without corroboration from the Psychiatrist of
a)client's lack of insight
and
b)client's diagnosis

I had BOTH plus his medication and care plan from his Community Psychiatric Nurse......you would think that would be enough!!

Should be a good arguement to the commissioners,look at the cmmentery for reg 10 in Bonner and Mesher Vol 1, 2003 pg691/2. Which outlines the evidence that is needed to support a request for exemption.
Though I notice you don't say if the appeal was successful or not due to passing points threshold for PCA. If he did it would be the first time a tribunal took the easy route.

They adjourned the appeal to await the report from the Psychiatrist - who will give them the same information as the cpn.

I had little chance of winning it based on the PCA as my client won't admit to any problems looking after himself, concentrating etc etc.....he relays somewhat convincingly stories of normal home life - and unless you know him he wont admit to being ill he refuses to accept the diagnosis of schizoaffective disorder.

I saw a 2 minute demo of LIMA at a fringe meeting at the CAB Annual Conference last week. It was the beginning of an introductory training piece for MS doctors which I understand was approx 30 minutes long altogether. Might be worthwhile asking if it's available to other organisations?

Riffling through my (possibly not very accurate) scribbles from the event ... the people presenting the meeting were Sarah Cookman and Brian Piper (I believe from the DWP) and Neil Kieper-Holmes from ATOS Origin.