Second ATOS Assessment Required before PIP Decision

Wondered if anyone else has come across this situation. New claim for PIP attended ATOS on 8/4/2016, then on 14/6/2016 gets a call from ATOS, he has to attended a new assessment. No information from PIP just call from ATOS. So called PIP as customer has learning disability and very distressed and angry. So rang PIP received very woolly answer that more information needed, so ordered copy of the report already compiled on the 8/4/2016) and will look to see what the problems is.

Anyone had similar experience of this ?, and I would welcome any tips on how to handle this? very frustrating given the very poor quality of reports used to refuse a PIP claim, and again used to refuse at MR stage.

Can always hope that the report is poor and the PIP DM’s are rejecting them, but experience wouldn’t support this but won’t know until report received.

Don’t forget that ATOS/Maximus/Crapita etc get paid according to the number of assessments they carry out!

There seem to be a few ways for the DM or AP to trigger further action from a HCP.

As far as I can tell, the APs run quality checks on some proportion of cases and make revisions to their advice if they think the initial advice was deficient. DMs seem to be able to refer back to HCPs if they need “further advice” either because of new evidence or because something was not addressed in the initial advice.

I guess either procedure could trigger a second medical if the reviewer thought “the only way we can sort this out is to bring the claimant back in”.

I have only known it happen once though and that was in a case where the HCP conducting the first assessment happened to have been the line manager for the claimant for five years in a previous job but somehow failed to mention that in the report. In that case the AP arranged a home visit without needing to be asked - which made things slightly easier.

Thanks for that I will await the HCP report and re think it then, as I am contemplating refusing the second appointment if the report seems sound and covers the right points and let a tribunal decide. As my concern is claimant has learning disabilities and may contradict himself. Hopefully the report arrives before the medical.

One of ours complained to the MP after a second assessment resulted in the need to appeal.
Here’s the reply they got. It could be that there is no report, as here.

“I have been investigating her claim that an assessment took place in September 2015 with a view to providing a copy of whatever report we hold to help her appeal.

I can confirm that there are notes on the system to show that a Mr G B was allocated to attend a Home Consultation in September 2015 but this report has never been completed. The Scheduling team cannot locate a report and nowhere on Atos or DWP systems is a copy held. The report seems to have never been uploaded to our systems and this is one reason why an assessment was done later in the year.

I wish to make it clear that I fully believe that M   had an assessment but I cannot find out what happened. I even tried to call Mr G B, however there was no answer and given that so much time has passed it may not be possible for him to recall.

The report that was completed in November would have superseded the September report. I am sorry that I am not able to get a definitive answer as to why the report is not showing. I would be speculating.

If I can be of any further assistance please do not hesitate to contact me.”

The good news is he attended a second medical and was awarded Enhanced Daily Living & standard Rate Mobility. Which will not be reviewed before 2026.

Are DM’s themselves medically qualified to make decisions from the outset eg using the contents of a PIP1 application or shouldn’t the DM have a HCP present when making a PIP decision with or without a medical assessment having taken place.

No requirement for DMs to be medically qualified as it isn’t a medical decision unless a diagnosis is at issue. It’s a decision based on the practical consequences of a medical condition. Not the same at all. The DM can refer for an in house medical opinion if they think needed but those are generalised and easily challenged. “I would ordinarily expect that…”. “A claimant with this condition ought…”. All irrelevant unless looking at the specifics of that particular claimant. Becomes more interesting when their view is that a further opinion should be sought.