Personal Independence Payment sample medical report formYou may never have seen one. Or you may only have ever seen your own.{jcomments on}

Which is why we’ve now published a sample PIP PA4 medical report form.

If you’ve never had a PIP medical it gives you the chance to learn in advance what kind of evidence the health professional is going to be collecting about you. Which means you can prepare more effectively to try to ensure that they get all the evidence they need to compile an accurate report.

If you already have your own PIP medical report, it gives you the opportunity to compare it with ours. Our sample is by no means a good report. It’s intended to be about average and there are certainly lots of grounds on which we would challenge it.

But if yours is even less detailed than our sample one, then you have got something you can definitely challenge at a hearing.

We haven’t yet finished updating our guide to challenging a PIP medical report. Though most of it will remain the same there are some issues we want to address in more detail and there have been some changes to the layout of the medical report. The new guide will be out before the next newsletter.

But two there are a number of issues which stood out for us.

Ignoring further medical evidence
Use of further medical evidence was very poor. In the majority of cases, reports from other health professionals, such as GPs or consultants, are listed in the ‘evidence considered’ section and then simply never referred to again. Therefore any contradictions between the evidence of the HP and other health professionals are never brought to the attention of the decision maker or dealt with.

Failure to address contradictions in the evidence would be sufficient for a report to be found unacceptable using the DWP’s own PIP audit criteria and would certainly not impress a tribunal.

Not saying where evidence came from

Some HPs were careful to explain where each item of evidence came from. In particular, was it the claimant questionnaire or something allegedly said during the face-to-face interview?

But many simply used phrases like: ‘ He reports that . . ‘ or ‘Reported difficulties are consistent with . . .’

It’s vital that the decision maker knows this. Because, once again, if there is a contradiction between what the claimant said in their questionnaire and what they allegedly said at the assessment then this should be considered both by the health professional and by the decision maker.

The fact that the PIP medical report does not have a section for setting out which options the claimant selected in their questionnaire makes it even easier for contradictions to be ignored.

But it also makes it easier for the report to be challenged at a tribunal

For more on this, see the link below to the full article, including the best ways to prepare for a medical, and ‘Who’s better: Atos or Capita?’.

Lack of detail
Evidence gathering seemed to be generally haphazard. Most reports were woefully short on detail, with just a sentence or two dealing with each activity in the Functional history, for example.

If there is detailed evidence in your PIP questionnaire but the health professional selects a lower scoring descriptor based on much flimsier evidence, you have strong grounds for a challenge. Soi, make sure you do the best job you possibly can of your PIP1 questionnaire and a poor face-to-face assessment will be less of a threat to your benefits – at tribunal at least.

Who’s better: atos or capita?
Is there an advantage in having your medical with one company rather than the other? We’d say not.

Both rely to some extent, though in different places, on standard responses. This is particularly noticeable where Atos are employing former ESA assessors. Many ESA veterans will recognise this extract from an Atos HP’s PIP mental state examination:

Does not look tired.

Looks overweight.

Well kempt.

Neatly dressed.

Looks well.

Did not appear to be trembling.

Increased sweating was not apparent

Normal facial expression.

Interaction normal, not restless or withdrawn.

But Capita also has its standard phrases, for example in the General appearance’ section..

We did see one example of a Capita assessor giving their qualification as ‘Health professional’, rather than something more specific, such as physiotherapist, for example. They did this both at the start and the end of the medical report, something which is entirely unacceptable. We saw no examples of Atos staff failing to give their medical qualification

Overall, however, there was enormous variability in the quality and level of detail of reports from both companies and we can see no advantage in being seen by either.

Be prepared for your medical
Here’s our five top tips to help ensure you are prepared for your medical:

  • make the best job you can of your questionnaire, giving as much detail as possible, and read through it before your medical;
  • provide supporting evidence if you are able, medical and/or otherwise;
  • before your medical, learn as much as you can about the procedure and the types of evidence that will be collected;
  • your medical starts when you leave your home - give very careful thought to how you travel to the medical, because it will be taken into account and inaccurate assumptions may well be made;
  • be aware that you are being observed and unspoken judgements are being made about you throughout the assessment – so if anything causes you physical or emotional pain or discomfort, say so clearly.

Then accept that none of this will necessarily make the assessment report more accurate. But it will greatly improve your chances of being successful at appeal.

You can download a copy of the sample PA4 medical report from the PIP members page.


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