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Quality of Medical Evidence

 

SocialJustice
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Benefits Caseworker, Citizens Advice Bromley

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I am a new Caseworker Trainee and am struggling to get responses to my evidence requests to GPs.
Most of my clients do have some form of medical evidence, such as letters from GPs and consultants confirming diagnoses and prescriptions, as well as briefly outlining how the condition affects the client.

However, from the various information I have been given, it is unclear to me whether this is considered sufficient by the Tribunal, or whether they expect a full descriptor-based report such as recommended by Leicester Welfare Rights Service guides and templates.

Furthermore, even if I were able to obtain full descriptor-based reports from all the GP’s, I am a little concerned that they will tick 0 for a lot of the less obvious descriptors due to time constraints and the fact they are often not familiar with the relevant law or indeed the points system?

I am aware of options to request medical records based on data protection legislation as well as the option to ask the Tribunal to give directions.

     
ClairemHodgson
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in any event, have you the money to pay the gp for said report?

and bear in mind that the fact that someone has a diagnosis of whatever is not relevant to whether or not they can or cannot do the relevant tasks reliably repeatedly etc. 

and also, unless it’s something obvious, will a gp in fact know whether or not the particular patient can do the particular thing?  probably not.

     
benefitsadviser
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Tribunals do not require descriptor based reports from a GP, and nor should they. GPs role is to diagnose a condition, not to second guess what activities they may or may not be able to do. Reg 4 comes in to play. Can the person complete the descriptor safely, reliably, as often as required, to an acceptable standard??? I doubt a GP can add any weight here. Clients oral testimony is key to support diagnosis V ability to complete said descriptor(s)

     
Mike Hughes
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Senior Welfare Rights Officer (Take-Up), Salford WRS.

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Bless you for a chance to bang on about my favourite subject smile

DLA, PIP and AA do not require a diagnosis. If diagnosis, symptoms and treatment are not in dispute then the need for medical evidence is much reduced and the focus should be on anecdotal examples which support particular activities, descriptors or care needs. 52% of disability benefit claims succeed with no medical evidence and there’s been no research done on whether the 48% who which succeed with medical evidence do so specifically because of said medical evidence or even as to what constitutes “medical” evidence. There’s some evidence the 48% includes people who sent in their script or their appointment letters for example. Exceptions where such evidence almost certainly will prove useful are mental health professionals with explicit evidence to offer re: symptoms, medications etc. and perhaps learning disability. GP reports are by and large irrelevant as what your GP knows about, for example, your walking beyond “waiting room to surgery chair” or your night time needs is either what you’ve told them or extrapolated in the manner we would object to if done by a HCP.

There is some merit in a report which repeats what a claimant has said and there’s a couple of bits of useful case law on that but by and large I tend to focus on ensuring the claim form contains lots of anecdotal examples of what happened when a claimant attempted specific points scoring activities.

Asking any medical professional for a functional assessment which matches PIP or ESA is the definition of optimistic too.

     
SocialJustice
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Benefits Caseworker, Citizens Advice Bromley

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Thank you for all the input, it was very helpful!

     
stevenmcavoy
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WRO, campaigns and policy, Enable Scotland

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in my opinion….and it is only opinion..

in the vast, vast majority of cases the outcome of a tribunal where the appeal isn’t a technical one will come down to what your client tells them on the day mixed in with who you happen to get sitting and what mood they are in.

I would get too caught up in thinking you need evidence for all of the reasons already stated.  most of the time your client turns up, says whats already been written down in the forms etc but the tribunal just come to a different opinion.

now the importance of evidence can of course change depending on the specifics of the case but for many not having it wont do any harm what so ever.

my clients primarily have learning disabilities, autism or aspergers.

for some of my clients evidence is useful (they might struggle to explain themselves on the day or underestimate their abilities) but for many it wont be (they might have a particularly articulate family member etc that can give good evidence).

I am in a particularly lucky position tribunal wise in that most of my referrals come from other professionals who work with my client so can provide me with evidence based on their actual experience of working with the client either via supported employment or a college course etc.

I next to never have “medical” evidence as there is no treatment for a learning disability.

suppose this is all a long winded way to say that dont assume you need evidence and if you think you do ask yourself why you need it and what it might show.

     
Mike Hughes
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Wholly agree Steve.