SDA - sending in medical evidence

Hi all,

Have just had enquiry from somebody whose SDA ceased earlier this year due to a failure to send in medical evidence in support of his claim. Unfortunately SDA was way before my time and non of our reference books go back that far.

From what I can work out it appears that because he has been receiving SDA since early 90s he was protected from PCA and where this is the case there is a need to continue to provide medical evidence demonstrating their incapacity for work.

My question is, what sort of medical evidence was one required to send in support of such a claim?

For SDA (depending on the date of the original claim) a person was ‘incapable of work’ if they ‘passed’ the ‘own occupation’ or ‘all work/PCA’ (now called the WCA) test. Some claimants were exempt from the AWT/PCA if they were receiving SDA before 12/4/95. There was also an age or ‘80% disablement’ test.

There was no ongoing requirment to provide ‘medical evidence’ ie medical cretificates / sick notes.

Could it be that your client has been ‘migrated’ from SDA to ESA, failed the WCA and not provided a ‘fit note’ in support of his appeal in order to get the assessment rate of ESA? Or, failed to return the ESA50 as part of the migration process?

The 2000/1 ed of CPAG (p70) says that if you were receiving SDA when the all-work test came in, i.e. since before 13/4/95, then you are exempt from the PCA, and “You can continue to receive SDA for as long as you submit medical certificates to the Benefits Agency and satisfy the pre-13 April 1995 test of incapacity for work (see the 17th ed of CPAG for details of this test).”

I know someone on SDA who each year is asked to provide an “annual” medical certificate, I guess on the above basis. Their GP doesn’t understand why, but duly obliges.