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SR1 (terminal illness) not being accepted by DWP

disgustedofbridport
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Dorchester CAB

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My colleagues who work for the Citizens Advice Macmillan service have heard from a specialist cancer nurse who says that she’s had several rejections of SR1s, on the grounds that the claimants’ conditions are “stable”.

The latest example is a client who hasn’t got worse for 4 months, but a specialist Cancer nurse who knows her has written (and stands by her claim) that her death can be reasonably expected within 12 months.

There are two criteria in essence for qualifying as terminally ill, as I understand: 1. the person has a disease which is progressive , and 2. death as a result of this disease can reasonably be expected within 12 months.

A progressive disease that gives a sufferer a period in which they don’t get worse is still progressive if that disease is going to lead to the person’s death, surely?

A specialist Cancer nurse who knows a patient vs. one of the not-always-expert people who work for Atos/Capita/Serco? Whose opinion should carry more weight?

Has anyone else encountered this?

BCD
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Kirklees council

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Yes we have come across it from time to time, also doing Macmillan work. Often, as you say, the word ‘stable’ seems to be the issue. At other times it is impossible to know why it has been refused. I saw one rejected recently (not my case) for metastatic lung cancer, which surprised me.  I have been told (but have no way of confirming) that a random sample of SR1s are checked by the APs and the rest just go through on the nod. Just before Christmas I had a Consultant refusing to issue one for someone they believed to meet the criteria because the last SR1 they had done had been rejected. Which is silly as well as irritating, but gives an idea of how refusals can have a ripple effect even on highly experienced medical professionals.

In the cases it has happened to my clients I have usually got a CNS to reissue the form with different wording and it has subsequently been accepted.

I would be interested to know whether refusal of a SR1 is an appealable decision?

As I understand it, the criteria is as stated here https://www.gov.uk/government/publications/dwp-factual-medical-reports-guidance-for-healthcare-professionals/e5b3b502-9067-4b20-93c0-1006d9cb0edb :

“A clinician should complete an SR1 form promptly if they believe that their patient:

has a progressive disease, and
as a consequence of that disease, it would not be a surprise if their patient were to die within 12 months”

disgustedofbridport
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Dorchester CAB

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That’s a helpful hint about re-wording a new SR1. Thank you.

I’m going to find out about whether the decision can be appealed or not, and I’ll post a reply.

Daphne
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BCD - 07 January 2025 02:39 PM

I would be interested to know whether refusal of a SR1 is an appealable decision?

The decision of how much PIP to award or whether to apply the waiting period is definitely appealable, so I think in effect it is.

If it’s a WCA then again could appeal if not awarded LCWRA without a waiting period.

However, if it’s about not making the decision within 2 weeks then that is more about delay and might be more a letter before action and threat of judicial review

Be interested in other’s views though

Laura R
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Casework central and East Northamptonshire Citizens Advice

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I have appealed a case where a SR1 was not accepted and I am just waiting for a hearing date now.  I hope the client is still alive when we get a date.

LibraryNerd
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Bassetlaw Citizens Advice

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Laura R - 09 January 2025 10:06 AM

I have appealed a case where a SR1 was not accepted and I am just waiting for a hearing date now.  I hope the client is still alive when we get a date.

Surely, if there’s any reason for an expedited hearing then it’s that!

SanC
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Heart of Kent Hospice

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working in a hospice with many SR1’s completed on a daily basis - it is possibly the wording that the cancer nurse is using that is causing several SR1’s to be rejected.
Very rarely do we have SR1’s rejected, and if DWP are unclear on anything, they will call to speak to one of our specialist nurses/ consultant to check through the circumstances.
It is usually anything other than ‘palliative’ or ‘non-curative’ in the treatment box that alerts DWP to question the SR1.
My suggestion would be to issue another SR1 with slightly different wording or from a consultant / GP.
This would be quicker than an appeal or MR

[ Edited: 9 Jan 2025 at 10:54 am by SanC ]