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What counts as 'good cause' to miss a medical?

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10 years 4 months ago #81592 by MammaT
I got a letter yesterday asking for my reasons why I'd missed an ESA medical on 6th Dec. I've had no medical questionnaire form (ESA50?) and no appointment letter. I've filled the form in and returned it but it strikes me that they could refuse to accept this as 'good cause'.
I had no way of knowing a medical was due as nobody knows they want you until they send a questionnaire for you do they? They've suspended my benefit and I fear the worst.
I can't believe it took 9 wks for them to send me this letter asking for my reasons. It doesn't add up to me but how can I prove that???
Has anyone else missed a medical and,if so, how long was it before they sent you a letter asking why?
Thank you all.

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10 years 4 months ago #81595 by Gordon
Mamma

There's not much time before the forum closes for the day so I'll try and cover off as much as I can.

There are very limited circumstances where a Decision can be made on your claim without the issuing of an ESA50 and these all remove the need for a medical, so this has not happened.

So an ESA50 should have been issued if a re-assessment was required.

There are circumstances where a medical can still go ahead, even if an ESA50 has not been returned. It is standard practice, although not specifically required, that in these circumstances the DWP should contact your GP with an ESA113 to request details of your condition, so it would be worth speaking to your doctor to see whether this has happened.

The DWP have a policy of assuming that post is always delivered, so it would be worth checking with the Royal Mail to see if there have been any local postal problems that could have affected the delivery of both the ESA50 and any request to attend a medical.

I am assuming that you have confirmed that the address information that the DWP have for you is correct, if not you should do so.

It is not unusual for ATOS to contact you by phone in order to arrange the medical, do you know if you have missed any such calls?

Beyond the above, there is not much more you can do until a Decision has been made on whether you had Good Cause to miss the medical.

Let us know how you get on and good luck.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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10 years 4 months ago #81597 by Derek4
Hi MammaT

The most bizarre aspect of your situation, as well as the 9 weeks it's taken them to realise that you didn't attend the medical, is that no ESA50 has been received but they are not suspending your benefit for failing to send the questionnaire on time. In most circumstances benefit would stop when the claimant fails to meet the ESA50 deadline and a face-to-face assessment would not be arranged.

I trust you explained why you had good cause for not attending and hopefully it will be accepted, but if it's not the decision is appealable.

Good luck

Derek

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10 years 4 months ago #81600 by MammaT
Hello and thank you Gordon and Derek for your very useful replies.

I do not answer the phone at all and this has been explained on both the previous ESA50's I've completed and I've had letters arranging medicals before.

My doctor has been contacted on my behalf and there was a form sent to her in November.

The sorting office has been contacted previously as there is another similarly named road in our area and we often get post for the corresponding number there, as do our neighbours. They said it could happen, especially with Christmas temp workers in. Not satisfactory and they need to be chased up on that but it's hard to know you've had post go missing if you don't know a letter is on the way.

I've explained all the above to DWP so it's a waiting game now. My worry is they won't accept the reasons and, although I know I can appeal, I can't claim payment at assessment rate whilst waiting as that's only if you've had the medical and are appealing that decision.

That will leave me in a complete hole with no money coming in, waiting for an appeal and for 6 months to pass before I can claim again.

Believe it or not I'm trying to remain upbeat as I can't actually do anything right now.

Thank you both again.

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10 years 4 months ago #81601 by MammaT
Actually, can I also just ask what the circumstances are where they send the doctor a form but not you?

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10 years 4 months ago #81604 by Gordon
MammaT wrote:

Actually, can I also just ask what the circumstances are where they send the doctor a form but not you?

Where a claimant has declared either in their ESA application that they have mental health issues, ATOS have instructions to consider proceeding to a medical even if an ESA50 is not returned.

In these circumstances they should contact the GP, to confirm the diagnosis and to find out whether there is a risk to their own staff or the claimant were they to attend a medical.

Hope this explains it.

Gordon

Nothing on this board constitutes legal advice - always consult a professional about specific problems

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