ESA Medical Reports for an application/appeal - no longer free!!

[ANDYANDFLO]

Another bit of bad news. GP's & Consultants have decided in my area that they will no longer offer medical reports to be used in ESA applications and appeals free of charge.

 

The decision has been made citing lack of free time and cost. GP's cite too many free reports for patients is causing time loss which is directly leading to quality of care for other patients.

 

They are working to the rules set down by the DWP:

 

A patient has asked for a report to support his appeal after having his Incapacity Benefit withdrawn. Do their GP have to provide a report?

 

No. GPs, as certifying medical practitioners, have a statutory obligation to provide statements of incapacity to patients on their list and certain information to a healthcare professional working for Atos Healthcare on behalf of DWP when requested. However, under their NHS contract there is no requirement for GPs to provide reports or offer an opinion on incapacity for work to anyone else unless requested to do so by Jobcentre Plus.

Claimants should contact Jobcentre Plus or the Appeals Service, where appropriate, if they think that further medical evidence is necessary to support their claim or appeal. They should state clearly their reasons for believing that further evidence is necessary.

If Jobcentre Plus or the Appeals Service consider that further medical evidence is necessary, they will seek it. They will be responsible for paying any fee to the doctor providing the report.

So NHS GPs are under no obligation to provide such evidence to their patients nor to provide it free of charge. If a GP does not agree to provide additional evidence for their patient then it is a private matter to be resolved between the GP and their patient.

 

I am left with two choices, pay for the reports privately or apply to DWP/Tribunal Services for them to obtain them if THEY think they would help me get ESA. They would of course be responsible for the costs.

 

Anybody with any useful ideas where I go to from here? I obviously cannot afford the fees they are charging. And how do I persuade the DWP/Tribunal Services to agree to them if it means over turning their own decisions.

 

I hope this does not become a national situation.

[RaeUK]

Hi ANDYANDFLO,

mmm. I'm going to go on semantics here.

You say you have to pay for medical reports. I think thats standard. That said I've never asked my GP for a medical report. In my interpretation thats a physical examination followed up by a written report of some depth.

I've always asked my GP if she would be kind enough to write a letter of support. Three or four so far I think. Never been a problem.

She is succinct I'll give her that. The letters may only be a couple of paragraphs in length but she pulls no punches.

Whilst - bizarrely - I failed at my tribunal the 'medical expert' made special mention of her supporting letter.

Not sure if that adds anything to your dilemma!

Best wishes

Rae

[ANDYANDFLO]

Hi ANDYANDFLO,

mmm. I'm going to go on semantics here.

You say you have to pay for medical reports. I think thats standard. That said I've never asked my GP for a medical report. In my interpretation thats a physical examination followed up by a written report of some depth.

I've always asked my GP if she would be kind enough to write a letter of support. Three or four so far I think. Never been a problem.

She is succinct I'll give her that. The letters may only be a couple of paragraphs in length but she pulls no punches.

Whilst - bizarrely - I failed at my tribunal the 'medical expert' made special mention of her supporting letter.

Not sure if that adds anything to your dilemma!

Best wishes

Rae

 

Hi thanks

Sorry to have confused the problem. What has happened, well here at least is two fold. The GP will not now give a letter of support/opinion of how illness affects my working life/GP history of visits etc without payment.

Secondly, the Consultants will not give a letter of support/history of illness/how it affects me/prognosis without payment.

 

Yes you are right both used to send these reports free of charge.

Both the GP and the Consultants are saying that this work is not covered by their NHS contract. As such anything other than what they are paid to do will now have to be paid privately

[ANDYANDFLO]

Sorry a bit more. All of this info has been obtained by the doctors and is already on their files. It's like going to your GP and talking to him/her as a matter of course during an appointment and getting advice/info about your health problem. Now if you want that confirming in writing I will have to pay for it as giving me a letter confirming what is wrong with me is not covered under the GP's contract with the NHS. Likewise the consultants.

I should have made sure that the reports sent to GP from my Consultants were copied to me as well for which I am entitled to receive at the time BUT not at a later date. Confusing yes!!!!

[RaeUK]

Yeesh! That sounds like the hypocritic oath!

The only thing I can think of is patience. Until the election dust has settled down then complain loudly and clearly to your MP. It's wrong.

Best wishes

Rae

[honeybee13]

That's awful. In civil law, wouldn't the person or organisation be liable for costs like that if they lost? Although it doesn't help the cash flow of the people needing the letters or reports and I don't know if it will be addressed. I feel we should bombard someone - the DWP? - with emails about this, not sure if it would help, but I would feel better!

 

I can sort of see the doctors' point. They're paid by insurance companies for these letters and given how many people are being let down by the DWP, the work is falling to the doctors to do it for nothing. Which takes us neatly back to Atos and the DWP.....

 

Grrrrrrrrrr. HB

[ErikaPNP]

It's not DWP rules; it is what is set down within the NHS, although DWP feature it in their website in their FAQ's. A medical practitioner working for the NHS has never been under obligation to write a report for a patient for incapacity for work at the patient's request, this is private practice and has been the case for as long as I can remember.

 

Some people have been lucky in that their medical practioners will write a report at their request without charge but they are within their rights to refuse as this.

 

You can ask for a copy of your medical records which they do have to provide if you submit an official request for them - these may or may not feature an overview of how your condition affects you though if you have therapy such as OT or physio or the like then your records are more likely to contain this information. The downside is that they can charge you for your medical records.

 

The Appeals Service exists as a justice system. They are not affiliated with DWP and if they feel that you are entitled to the benefit then yes they will revise the decision. It may lift your spirits to know that over half of incapacity and disability decisions are overturned at appeal. This is something that has caused DWP to be heavily criticised in recent years, particularly after the introduction of ESA in 2008. These criticisms led to a review of the ESA descriptors. Some of the descriptors are set to be changed, some for the better but some for the worse. I am not confident in the new descriptors as a whole but there are an improvement to some of them. A tribunal also take a very dim view where a decision has been made in ignorance of a material fact, or where the evidence has not been balanced proportionately. Every Appeal costs the DWP thousands, whether a decision is altered or not so it is not in their interests to allow a case to go to appeal where they can revise the decision in the claimant's favour before it gets to that stage, providing of course that the claimant is entitled.

 

DWP are obligated to revise a decision if there is information which is sufficient in changing the reasoning for the decision. That revision may or may not be to the claimant's benefit though.

 

I would strongly suggest a written letter to DWP and the Appeals Service expressing that you feel your own medical practitioners will be able to provide information which is contradictory to their assessment. Give reasons for this to support your case. The more information you provide, the more likely it is that a report will be requested. Have a look in the sticky's at a thread honeybee set up and use it as a template for your reasonings, inserting your own medical issues into it.

 

Best wishes

Erika

[commiekips]

GPs charge for supplying copies of medical records. The charge differs from area to area. The charge is down to the claimant and cannot be recovered, even after a successful appeal. CAB advises it may be beneficial to have copy of medical records from the beginning of your claim to the present when applying for and taking part in an appeal.

[cloch]

why doesn't everyone bog the system down by using the freedom of information and apply using the data protection act for a copy of all data whether written or computer based etc that atos or the dwp have.

 

Do the requests separately and compare the information between the two organisations.

 

they can't claim client confidentiality and once you've got all the data , next time you contact them and they come out with some more crap , ask them where they got the new info from as it doesn't seem to be in the file information received from them.

 

jUST KEEP ASKING FOR UPDATED INFORMATION

 

iT IS YOUR LEGAL RIGHT.

 

The dwp is so inefficient that if they go on strike you'd not even notice.

[davina2]

I've got my medical report today and I paid 50 pounds for the 60 pages of the report.

I expect I'd be asked to pay about the same amount for my doctors letter and a consultant's letter.

 

I wonder if there is a way to have a refund for this? From the tribunal to order ATOS to pay for this as they were the ones who have made the mistake :D? Yeah, lets charge ATOS they are the rich ones :D

 

On another note I am so angry with my doctors when I had a look at the report, there are SO MANY blood test results which were quite bad but I was never informed of them ! Some of them constant alerts for 5 years !! If my doctors have monitored this and followed the dots I might not be so ill today ! But the doctors are overworked and stressed out too and have little time to compare the results with the history.

 

I am so glad for the homeopathic hospital, they were the ones to open my eyes and show me the larger picture.

 

It seems that almost the doctors do not want to let you know how serious your condition is. When I was at my ATOS medical the nurse who examined me got angry that I was TOLD about my results, she said the blood test results should not be explained to me as it ( I quote her) "increases my anxiety"

 

Well, I have been trying to fight with my doctors for years to prove my condition is not mental but physical, now I got the proof but what is good in it when my condition is 90% worse?

 

The point I want to make is that IMO 50% of us would not be in this situation if the doctors were more alert and more interested to treat our conditions long ago.

[ANDYANDFLO]

I've got my medical report today and I paid 50 pounds for the 60 pages of the report.

I expect I'd be asked to pay about the same amount for my doctors letter and a consultant's letter.

 

I wonder if there is a way to have a refund for this? From the tribunal to order ATOS to pay for this as they were the ones who have made the mistake :D? Yeah, lets charge ATOS they are the rich ones :D

 

On another note I am so angry with my doctors when I had a look at the report, there are SO MANY blood test results which were quite bad but I was never informed of them ! Some of them constant alerts for 5 years !! If my doctors have monitored this and followed the dots I might not be so ill today ! But the doctors are overworked and stressed out too and have little time to compare the results with the history.

 

I am so glad for the homeopathic hospital, they were the ones to open my eyes and show me the larger picture.

 

It seems that almost the doctors do not want to let you know how serious your condition is. When I was at my ATOS medical the nurse who examined me got angry that I was TOLD about my results, she said the blood test results should not be explained to me as it ( I quote her) "increases my anxiety"

 

Well, I have been trying to fight with my doctors for years to prove my condition is not mental but physical, now I got the proof but what is good in it when my condition is 90% worse?

 

The point I want to make is that IMO 50% of us would not be in this situation if the doctors were more alert and more interested to treat our conditions long ago.

 

Hi, I too have now received copies of my medical files. They cost me £100 as I am treated at two different hospitals - 330 miles apart!! There is only one way that these could be obtained free of charge and that is by the Tribunal/ATOS/DWP applying for them on your behalf - something that they are obliged to do if you can convince them that evidence exists that can disprove the ATOS report & DWP decision!!! See how far you get with that one I ask??

One of my files goes back to 1994 when one of my illnesses started. I agree it does make sobering reading - there were many instances that my tests were not compared. One of the worse ones was a report from my Psychiatrist in 1996 when he stated that sectioning me under the Mental Health Act would be unnecessary - hey he was ignored and I spent a month locked up in a secure unit!!!

Right I must move on - I have now requested copies of my file from DWP & ATOS. As regards costs, yes, my GP is charging me £125 for a report and copies of their files, and £250 for each of my two Consultants to give an opinion on all of my various illnesses.

All of this to prove ATOS wrong!!! AND the whole ball will start rolling again when I put my claim in for DLA and no doubt a further medical re my ESA claim in time to come!!! Where does it end???