Medical Report Form(s) Query

Hi all,

I am presently undergoing a protracted assessment for Employment and Support Allowance (ESA) and had hoped to receive some advice on where I should go from here, as regard to my supporting evidence.

This present assessment was initiated originally in March 2019, having been found to be unfit for work the year prior via a first-tier tribunal, and subsequently placed in the WRAG for 12 months. My ESA-50 questionnaire was submitted late (albeit by a couple of weeks only) having been advised by the DWP that there was no requirement for me to submit this by the deadline stipulated, owing to there being a marker on my claim, as I am classed as being a vulnerable adult. On the 8 April 2019, a medical report form (ESA85A) was completed by a nurse regarding my case, which claimed that she was 'unable to advise on the evidence held' and that the case would 'need to be adjourned to await further medical evidence from the GP'. This evidence, in the form of an ESA-113 form, was eventually submitted on the 18 April, and my ESA-50 was submitted shortly thereafter on the 23 April.

Following the receipt of this evidence, my claim was again assessed in June 2019 and another ESA85A was produced, this time by a different nurse who again stated that she was 'unable to advise on the evidence held' and that the case would 'need to be referred for an assessment'. Moreover, the nurse stated that the ESA113 did 'not clarify the current level of disability or mental health risk' and that an assessment would be 'needed to determine the level of function'. This same nurse looked again at the claim in July 2019 and reiterated these same comments, also stating that 'the level of disability is unclear from the available body of evidence'. I recently found out about these medical reports after submitting a 'Right of Access Request' to the DWP before Christmas, and I received this information earlier this week. Upon contacting the Centre for Health and Disability Assessments about these reports, the call handler I spoke with denied there being any sort of a report produced, and seemed to be under the impression that the information I had acquired had been produced by the DWP.

At this stage, I am unsure as to what additional evidence I can submit. My ESA-50 form contained several additional pages detailing my condition, and I have submitted supporting letters from my social worker, a former support worker, friends, ex-employers, educational establishments, as well as an NHS Foundation Trust who produced a detailed report, following my diagnosis of autism. All of this goes into some detail about how my condition affects me. I am also potentially minded to pay for some further evidence, from an independent psychologist/psychiatrist as a last resort, but before I do so I would appreciate any advice on where I should go from here.

Many thanks.

Hi Gordon,

Further to your question I have contacted both the DWP and Maximus regarding this point, who responded as follows:

Maximus: My file was returned back to the DWP on two occasions, the first being in August and then again in December. The CHDA could not provide me a reason as to why this was, but I understand that the evidence is still in the process of being reviewed.

DWP: The DWP cannot confirm either why my file was returned twice, but have claimed that my file is presently in "scrutiny" with the medical assessors.

Many thanks.

Gordon,

Do you have any ideas as to why it's taking so long?

Many thanks

Hi Alex

I believe the term of an assessment done on 'scrutiny' means a paper based assessment. This is what a decision maker told me. In my case a decision was made by a DWP Decision Maker without the assessment provider even returning the assessment report to DWP. I also had direct email contact with the DM and was placed in the Support Group under ESA reg 35. I was also told by the DWP DM that if I received a face to face assessment appointment letter, I must contact DWP immediately - as such an assessment would be a risk to my life. I did however have a supporting letter from the GP explaining this.

Natalie