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Medical evidence requests
Hi
I am hoping that the experts online will be able to give me some assistance with my new task.
As it stands, I am doing some research on medical evidence requests as our team is looking towards having a more uniformed approach in terms of the way we collate the information. In addition to this, we are currently in the process of contacting solicitors in the hope we can work in partnership with them, via the legal aid system, to obtain medical evidence. This being a result of evidence becoming more increasingly difficult to obtain as a consequence of the charges being the main barrier; our service is a free service and a large percentage of our clients do not have the money to pay for it. Consequently, we are hoping that we can negotiate with GPs and consultants whereby they will receive payments for persons qualifying via the legal aid system and they may perhaps waive the charge for others, which I must say is a very small percentage. We aim to do this by facilitating talks in surgeries and explaining the importance of medical evidence.
In terms of medical evidence for DLA, we mainly send a letter to the consultant/GP detailing that the client is appealing a decision. We then confirm their health and the mobility and care needs that they state stem from their condition and then ask the GP to provide their professional opinion on their statements and provide a brief indication of their opinion where possible. We are always very careful ensuring we are objective rather than subjective and that we are not leading (given previous case law etc). Every case is pertinent to the clients needs, ensuring that we get the best possible medical evidence for the client. We endeavour to be as thorough as possible given supportive medical evidence normally leads to appeals being overturned. For example, if a claimant’s DLA ceased on renewal, we would perhaps ask the GP to confirm if the client’s condition has improved since the previous decision. If they confirm that it has not, then we can use this to our advantage at appeal, along with previous reports and a decision such as CDLA/4032/2006 to back this up. Bingo….. We’ll it normally works for me!!!!!!
For IB, we tend to work differently; some of our advisers send a letter to a GP/consultant stating the client has failed the PCA and detail their health conditions. We then ask the health professional to complete an attached questionnaire detailing the points that the client feels they should have attained. We mention about the test of reasonable regularity etc and ask the GP/consultant to provide his professional comments on the client’s statements, providing a brief indication of their opinion where possible. In all, we aim to obtain an independent judgement of the claimant’s problems rather than a letter, simply relaying information. We then normally expand on the descriptors by stating why the client feels they satisfy the criteria, for example; -
15(b) cannot concentrate to read a magazine or follow a radio programme (2 points) Mr…… has poor concentration levels and is constantly tired. Consequently, he is unable to read a magazine or follow a T.V programme in one continuous session.
However some of our advisers tend to send a standard questionnaire to the medical professionals asking them to input the client’s health condition, medication and then tick the descriptors that apply.
In essence, each case is different. For example if regulation 27(b) was appropriate, a letter may be issued detailing the legislation and why the client believes they satisfy the criteria. (List not exhaustive)
In all, I believe a good representative should be able to ascertain what evidence is required in order to help win a case and obtain the evidence where possible. Therefore I am looking for feedback and would welcome any ideas and templates that you may use.
I have considered trying to set up more standard templates for different situations, however I have not out much thought into it, so sorry if it sounds duuuuu!!, : -
• DLA- Children – care needs in excess of child same age without a disability
• DLA Children – Supervision in excess of child same age without a disability
• DLA- Physical
• DLA – Mental Health
• DLA- SMI Route
• AA –
• DLA- Renewal- has there been an improvement in clients condition
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Incapacity Benefit: -
• IB – Reg 27/27b
• IB- letter and questionnaire or letter detailing relevant descriptors
• IB_ letter asking whether condition has improved, E.g. if client states it has not, then can ask tribunal to take into account previous reports.
I thought that we would then use these templates (adapt them to each individual case) and then send these to solicitors etc or use them ourselves where appropriate.
On this note, I would most welcome your thoughts and experience on this matter and look forward to your replies.
Cheers
Nicola
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