Hello all

Got a client who is doing a DLA appeal who has a somewhat unsympathetic GP. DLA form ordered on 29/04/09. DLA turned down on basis of GP report that basically says client has no mobilty problems or care needs. However I note that the GP report is dated 19/11/08, sometime prior to the claim. I suspect this GP report was done for a previous claim, which is in no way connected with the current claim. I would like to challenge the GP report on grounds that clients condition has deteriorated since this report, although her claim form does not state that her condition has deteriorated. Would it be possible to challenge this GP report, and would it be best to wait until the Tribunal to do this, as I suspect if I challenge it now, the DLA will just ask the GP for another report, which will probably be just as negative. Any thoughts on tatics.

Do you have any other source of evidence to corroborate the client's view that her condition has deteriorated - has her medication changed, specialist or other health professional involvement? Has your client confirmed to you that she did previously apply and told you what happened as a result (eg appeal)?
In many cases GPs have no way of knowing the practical aspects of a medical condition. They do not visit the patient at home, don't see them walking more than a few feet from the waiting room, and only have the client's word for it.
GPs often provide three sorts of useless medical reports.
The first sort says "no difficulty".
The second says "Not known".
The third says "She tells me that she can't..."
The third sort is useless because it adds nothing whatsoever to the evidence that the client can give to the Tribunal. It does not represent the doctor's own opinion.
My view for what it is worth is to check with the client what the doctor has actually seen her do and if s/he has never visited the client at home try to persuade the Tribunal that the doctor is simply not in a position to give information on disability. And use any other means of corroboration you can find.
You yourself can give evidence of facts directly observed. What about doing a timed and measured walking test? If your client has claimed to walk 15 yards in 35 minutes it's not surprising that no-one believes a word of it. 35 seconds would be different (and still quite slow!)

I have had problems with GP evidence - on one memorable occasion I wrote for medical evidence and the GP telephoned me and told me not to work with my client as he was a liar! If there is no other medical opinion available I write to TS and ask them to direct an EMP report. This worked with my 'liar', who was found to have substantial impairment in his lower limbs.

The decision makers guidance on Medical reports is quite clear on their value:-

"51.3 Sources of Further Evidence
51.3.1 General Practitioner Factual Reports (GPFRs)
(i) A special fee payable to individual GPs has been agreed whereby factual information based on a patient's clinical records will be provided. The fee does not extend to the provision of an opinion and so, unless the information is already contained within the clinical records, the GP will not be in a position to provide it. It has to be understood that individual entries in a patient's clinical record are relatively brief and will usually concentrate on diagnosis, clinical findings and treatment plan. The records will not really contain any meaningful information relating to care and mobility needs.
In general therefore GPFRs can provide useful information on the diagnosis and overall severity of a person's disabling conditions. It will not usually be appropriate to ask specific questions about the help a person requires unless there appears to be gross under-or over-representation of those in the claim pack.
(ii) Where a person has a number of different conditions which are being
investigated and treated by a variety of hospital departments, the GP's records will be the place where all this information is co-ordinated. In these circumstances the GP may well be able to indicate the relative importance of the various conditions in terms of their effect on the patient's day to day life".

......and whilst I think about it, what reaction would you get if you submitted a medical report which was some six months or more out of date.....? The patient may well have been less disabled at that point in time, depending on what the medical conditions are ..

Getting an EMP is all very well, but...
they are giving you evidence of NOW, not date of decision; and
some EMPs appear to be congenitally incapable of recognising any form of disability when they see it.
But you might strike lucky.

The problem I've noticed over the years is that very often the DM will take a negative or non-informative GP report as a simple indicator of non-entitlemnt without bothering to check with other sources.

Around here the regular visiting EMP is actually pretty fair (shock/horror) and his reports are generally balanced - if you can manage to interpret the handwriting.

I would be in favour of more EMP reports and scrapping the GP reports or at least removing Q6 (getting around/self care, etc.) but I'd like Medical Services to bribe their EMPs to use laptops. A bit more time and trouble spent on properly deciding claims would cut down the number of tribunals. The tribunal is actually the first time a claimant meets human beings in the decision making chain: a bizzare system when you think about it.

Generally, I've found the best documentary evidence comes from copies of letters sent by consultants to the GP, although many people don't have these, of course.

I wonder how long it will take the DWP to get around to introducing lie detection systems on the phones? "You say you can only manage 20 yards - is that correct?" Yes...buzzzzzzzzzz. Sorry. computer says no!"