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Systemic problem with the Healthcare Professional PIP and ESA assessment process, suggests President of Appeal Tribunals (Northern Ireland)

10 May 2021

In many PIP and ESA appeals the medical notes and records viewed by the tribunal causes it to alter the DWP’s decisions and suggests a systemic problem with the Healthcare Professional (HCP) PIP and ESA assessment process, the President of Appeal Tribunals (Northern Ireland) reports.

In his newly published Report on Standards of Decision Making by the Department 2017/2018, the President highlights “overall levels of incorrectness” in DWP initial decision making and makes three major points.

  • the number of ESA and DLA (and now PIP) decisions being overturned as a result of the provision of further medical evidence:

“The fact that previous reports and this one continue to reveal concern ... suggests that the Department really must consider what further steps can be taken prior to hearing in order to source additional medical information from or on behalf of appellants. It may be that as a matter of standard practice in all cases a report should be obtained at an early (pre-decision) stage from a general practitioner.” 

  • possible continuing problems with  the HCP assessment process:

“It may be that HCPs do not have sufficient training to assess the medical conditions of some individual claimants. It is fundamentally important that claimants with complicated and/or chronic conditions are examined by a professional who has sufficient expertise to carry out an appropriate examination/assessment.

As an example my own view is that appellants with long-standing mental health problems should always be assessed by a medical doctor. In general it should be possible to match the expertise of the individual healthcare professional to the individual claimant’s medical conditions.”

  • the provision of relevant and focused extracts from GP notes and records remains fundamentally important for the proper determination of DLA and PIP appeals -

“I repeat my previous requests that departmental presenting officers should recommence the practice of viewing those documents prior to hearing. I remain unconvinced by the Department’s arguments for failing to authorise presenting officers to view those documents. The practice will enable the Department to obtain feedback from presenting officers in relation to their decisions and I have no doubt that it will facilitate concessions in deserving cases, thus avoiding the trauma experienced by appellants in having to provide unnecessary oral evidence.”

The President of Appeal Tribunals Report on Standards of Decision Making by the Department 2017/2018 is available from communities-ni.gov.uk.

See also the DR UK news story DWP spent £120 million pounds defending challenges to ESA and PIP decisions in just two years.