Completely bemused?

I am completely bemused…if anyone has any thoughts I’d be very grateful!? Bare with me this is a wee bit long winded!

I see a client today who has numerous musculo skeletal symptoms, degenerative lumbar spine disease, rheumatoid arthritis, the list goes on.

She worked for the NHS, however following a report from her occupational therapist (ATOS) it was recommended that she should be medically retired. 

Client made a claim for DLA in May 2012, she was awarded HR mobility & HR care from 02/05/2012, decision letter dated 30/07/2012.  Money was backdated etc.

On 25th August 2012 (which was a Saturday) the client received a letter from the Medical Services (undated) informing her that the DWP have arranged a medical examination to assist them in deciding her entitlement to DLA.

The letter provided information about why a medical examination was required but did not give a date of when a medical examination would take place.  The same day (approx 2 hours after receiving the letter) a HCP visited the clients home to carry out a medical examination.  The HCP was there 30 minutes and did not ask the client to do anything, simply asked some questions. 

Following the examination client received a further letter from the DWP informing her that they have looked at the claim again to make sure she is receiving the correct amount and that they have decided that she is not entitled to any rate from 02/05/2012.

When looking through the medical report (which client requested) I noticed that pages 12 to 21 were missing. Client called to ask for a copy of the missing pages earlier today and she was informed that she could not have a copy as the information may be harmful!?

She tells me that she has not told anyone that she was awarded (so that rules out my suspicions that someone has reported her to the DWP).

I know we can challenge the decision is the usual way, but is there case law with regards to the time limit in the DWP superseding the decision. 

Client is really unwell and from what I can see would fulfil the test for high rate mobility & high to middle rate care.  Plus it was ATOS that did the report, which pushed for medical retirement.

Anyone have any thoughts?

Sounds like you need to phone her GP/Consultant and have a chat about her condition. In terms of Atos they will do what ever they get paid to do-helping employers get rid of sick employees or getting sick people off benefit!

I should certainly use the ATOS OT report as evidence for the appeal (along with whatever you can get from her GP/consultant, etc). I think I would lodge an appeal in the usual way, but include in it a request for an explanation of what triggered the decision to commission a HCP report, and what evidence was used to superseed the decision of 30/7/12. Ask for a further copy of the HCP report and see what comes back. I can think of only two explanations of why the report has been considered to contain harmful evidence- either the HCP thinks she is making the whole thing up (and they don’t want to copy her on that section in case she kicks off) or the HCP identified some other, potentially life-threatening, condition (in which case it makes the decision to revoke the award even odder).

Thanks Guy’s,

I just think the whole thing is very strange indeed! I shall definitely be asking for an explanation and a copy of the report.

An allegation that the claimant is exaggerating/lying/swinging the lead does not count as harmful information and there are no good grounds to exclude it. I’m virtually certain there is case law on this but as I am sitting here with a large cat on my lap I am literally not in a position to get the book out!

The relevant para in the DMG is 01591 which only states that evidence should be witheld ‘if disclosure would be harmful to the health of that person’ (which could cover a multitude of circumstances) but I’m sure Ariadne is right.

Canterbury Assessment Centre - ATOS -  Canterbury BDC

A very similar case passed over my desk a while back.

Following an ESA assessment and then an appeal due to the client failing to obtain any points, I was handed the ‘appeal bundle’ to have a look at.

Page 47 of the Medical Report Form was missing - Harmful Information.
I obtained on behalf of my client a copy of his full file from the DWP.

Within the package was page 47!!

The report completed by the ATOS assessor read: 

“Claimant very obnoxious, sarcastic and complained about the assessment format and the typical day. He stated that they are not relevant and told me to contact his many consultants. Claimant very unco-operative and makes the assessment difficult. He kept taking his medication throughout the assessment. I am of the opinion that this person is attempting to deceive the DWP into making a award by any devious means possible.”

Added by the DWP at a later date was the following note:

“When bundle of evidence is back from photocopying, please add this sheet to the submission for TAS - DO NOT send it to customer.”

If it hadn’t come to light via the SAR this document would have been placed before the TS, yet the client nor his advisor would have been made aware of its existence.

Suffice it to say I complained and was assured that it was a ‘mistake’ and that it would be retrieved from the TS.

Subsequently, following a letter to the client’s MP, he was immediately awarded at least 15 points and placed in the Support Group for three years!!!

Was this an isolated case? Was it a genuine mistake? Or is it the tip of a large iceberg that many know nothing about?

I have retained a copy of that page and it now features on my wall contained within a photo frame (minus the client’s name of course)

It serves to remind me that where the DWP are involved, they will stoop as low as possible to ensure that genuine benefit claimants lose their entitlement - I see it now as a war!!!