Frequency of WCA

Am interested to know if advisers have identified incidences of repeating WCAs disproportinate to clients’ conditions, or is it just in the westcountry?

Have several clients going into WRAG at tribunals who then get a new WCA within months.  The CEO of JCP (in a letter to a client) states that “We are obliged to follow the recommendations of our medical service provider regarding the frequency of WCAs” (Note to IDS: no point in having decision makers).  The legislation provides a power to re-assess up to every three months, but not a duty.  The WCA reports always provide a prognosis, but they all seem to say “should improve in 3 months”, inspite/despite the type of condition. Has anyone seen anything different? 

Aside from the cost of repeated examinations (we’d all love to see the details of the ATOS contract), people also fall out of pathways to work which is clearly counter productive to the whole policy.

3 months wouldn’t seem out of the ordinary in my experience.

The regs allow for a change of circs within the 3 months = Re-Assessment or 3months = Reassessment.

Supposing Atos are paid for each referral then why would they say see again in 12months?

Well I think your last point may be source of the problem!

Just had one repeat WCA with a review date of 2 years being given-yippee!

Tribunals can and do make rulings about the length of DLA awards. Might it be worth NAWRA et al campaigning to extend that power to ESA as well and give some appeal rights against over-frequent WCAs. Logically speaking if a tribunal does not uphold the decision following on from the WCA medical could it not reasonably challenge the doctor/nurse’s opinion about return to work as well.

I think Pete C’s point is a good one. JCP (in letters) are saying that just because a tribunal awards 15+ points, it does not mean there was anything wrong with the medical assessment (a contradiction in terms if ever there was one). If tribunals do not currently have the power to stipulate the duration of an ESA award then we are going to be going round in circles with some people.

A colleague and I were just talking about this last week - we both have clients who are being asked to attend another WCA within a few months of being placed into the WRAC group after an appeal.

In actual fact I posted here last year following my clients appeal; she has a well documented history of severe mental health problems and experiences manic phases where she is a danger to herself and aggressive to others. I couldn’t believe she had failed the ESA in the first place, then to add insult to injury, once she succeeded at appeal the DWP applied for a statement of reasons and my client had to wait to see if the DWP were going to take any further action.

Her appeal was heard last October and here we are 9 months later and she has been called to another WCA, has been given no points and is having to appeal again. I tend to think I’m fairly sanguine about things but this makes me really angry, as I can’t see any basis for the DWP/ATOS thinking that her condition should/would have improved in such a short time, and certainly not based on the medical evidence we presented at the appeal. Client feels as if she is being deliberately targeted and I’m having a hard time disagreeing. Obviously none of this is great for her mental health either! My colleagues clients’ have stated that they feel as if they are being punished for having the termerity to appeal the first time round and it’s as if the DWP wants to keep failing them till they just take the hint and stop trying to claim ESA.

I happili accept that I used to see clients who had been on IB for years without any kind of follow-up, and given that DLA awards are time limited, it would seem reasonable to give some kind of limit on awards of ESA. If we did have a recognised time limit in place at least our clients would know where they stood and what to expect.

Client has Lib-Dem MP. MP has questions re. Atos contract. Danny Alexander is also Lib-Dem and First Sec. to the Treasury/critic of ESA. Wider issues in play about waste of public funds. Watch this space. Waiting for result from clients 2nd examination. before looking at the appeal angle - if any.

The ESA85s (unlike the IB85) we see do not seem to contain the ATOS opinion on when the claimant should be referred for their next WCA. Assume the recommendation is now contained in a part that is not routinely disclossed in DWPs appeal submission.

However 12 months appears routine - we are now seeing ESA claimants who have failed their 2nd WCA and around the appeal process we go again! Many of course having (again) undergone the DWP miracle cure for their severe mental health condition etc etc at the medical examination centre.

We now have a letter from a DWP minister that infers that tribunals do indeed have the power to suggest a period before the next WCA should take place.

Is there anything in the current legislation that specfically prevents a tribunal setting a timescale before the next medical, as per PeteC’s point above?

off the top of my head (which means i’m probably wrong) the suggestion would have no teeth as it wouldn’t be binding on the DWP.

The tribunal are considering the decision of the DWP and nothing more.

If legislation came up with a decision that the DWP must make on reassessment i.e. 3months, 6months, 12months etc. then that would be a decision that could be considered.

As above the current legislation is ‘an assessment may be carried out every three months or sooner if there’s a change of circs.’

Tribunals can and do make findings of fact that significant improvement (because of the nature of the claimant’s condition, length of illness etc) is improbable in the foreseeable future - there is a doctor on the Tribunal after all, who may know more about the client’s condition than the original medical examiner.

Tribunals are also under a duty to report to the RTJ any medical report which gives rise to serious concern - they don’t do it often, but may do so if there is a thundering blunder indicating medical ignorance, rather than poor recording of facts due to over-reliance on the LIMA drop-down options (a major cause of inappropriate statements).

Client has now had a reply from the minister. Apparently the £100 million pa includes everything, so cannot draw the conclusion that ATOS is paid per medical. It’s all down to the prognosis the healthcare professional puts in the report. All down to IDS now to come up with his single benefit system…

With regard to this- has anyone got any tips or suggestions as to whether a claimant can request that they don’t have to go to another WCA so soon after their appeal?

We’ve had a query from a family member of someone with severe mental illness. The fact they were awarded no points then had to appeal seriously affected their mental health and the family member is extrememely concerned that going through it all again so soon is going to be of great detriment to their health.

Or is it simply a case of having to go or risk being sanctioned/losing benefit entirely?

Thanks

My personal view is that some of these cases should go to judicial review.  Not only are the medicals (in some cases) pointless, it is also a waste of money and time, let alone the anxiety generated for the clients.  At some point common sense needs to be injected into the system and perhaps that role now falls to the judiciary

rethink - 03 November 2010 01:26 PM

With regard to this- has anyone got any tips or suggestions as to whether a claimant can request that they don’t have to go to another WCA so soon after their appeal?

We’ve had a query from a family member of someone with severe mental illness. The fact they were awarded no points then had to appeal seriously affected their mental health and the family member is extrememely concerned that going through it all again so soon is going to be of great detriment to their health.

Or is it simply a case of having to go or risk being sanctioned/losing benefit entirely?

Thanks

Might this particular case come under Reg 29 of the ESA regs. If the claimant has some specific illness that means that there would be a risk to his or someone else’s health if he was not found to have LCW then he doesn’t need to score any points and, by extension, there is no purpose to the medical either. The medical does not appear to be compulsory, Reg 23 of the ESA regs says ‘MAY be to called attend a medical’ not ‘MUST be called to attend a medical’