A Derry community worker has questioned why medical evidence from a GP is no longer deemed mandatory when determining whether an individual is entitled to disability benefit.
Kathleen Bradley, Advice Co-ordinator at Dove House in Derry, has claimed that under the new Personal Independence Payment (PIP) a GP’s expert medical opinion on the patient and his or her needs was no longer automatically required as part of the evidence in the assessment.
PIP was introduced almost a year ago in Northern Ireland as a new benefit replacing Disability Living Allowance (DLA) for people aged between 16 to 64 years. Thousands of local people were affected by the change.
Ms. Bradley claims there has been widespread concern over the changes to the assessment process for the new benefit.
However, she said: “Assessments are being made by an outsourced company which decides whether or not to send for a medical report.
“This is based on a 45 minute assessment and the information on the application form.
“The person doing the medical assessment - is it a GP? We don’t know what their previous medical profession is.”
Ms. Bradley said that, unlike the DLA process, the new assessments were not considering any medical evidence from an applicant’s doctor as a matter of course.
She also warned that many local people did not have the means to pay for doctor’s letters and reports to support their applications for PIP.
Referring to the Scottish Government’s recent decision to rule out the use of private companies in assessing people for the benefits, Ms Bradley added: “We had a mechanism that worked with DLA, with GP medical reports. Now our taxes are paying for the government to outsource a complete process.
“There needs to be the ability for the government, the Department for Communities, to intervene .”
Under the benefit changes, most people living with a disability have been referred onto PIP, which has been outsourced to a private company.
This is with the exception of children up to the age of 16 years who are assessed for DLA. Recipients aged 65 years as of June 20, 2016, are also still assessed for DLA.
The Department for Communities (DfC) has confirmed that medical evidence from a patient’s doctor is not always requested to make PIP assessments on disabled people.
A DfC spokeswoman said that while Personal Independence Payment (PIP) has replaced the Disability Living Allowance (DLA) it was “not appropriate”to compare them because “PIP has completely different entitlement criteria.”
The spokeswoman went on: “In terms of evidence provision, the recently published independent review of PIP in GB concluded that the onus of responsibility for gathering further evidence (other than that already held by the Department) should primarily sit with the claimant as he or she is in the best position to supply what evidence is available.”
She added: “PIP assessments are carried out by an independent health professional. Each disability assessor must have a minimum of two years post registration experience which must be fulfilled within an approved health profession and receive extensive training in line with DfC guidelines before they undertake PIP assessments. These professions include nursing, physiotherapy, paramedic as well as occupational therapy.
“They will look at the information provided and may ask the GP or other contacts given on the form, for any extra information they need. In this scenario the department meets the costs. The claimant is advised in PIP literature, including the letter that accompanies the claim form, that they can provide copies of any medical evidence they already hold in support of their claim. However they are advised not to go and obtain such evidence if not already held, because that may incur a cost.
“In some instances it will be possible to complete the assessment by just using the written information provided, but most people will be asked to attend a face-to-face consultation. This is an opportunity for a claimant to explain their needs in their own words. They can take someone for support who can take part in the discussion too.”
She said that DfC has provided £2.5m to advise organisations to deliver a freephone telephone helpline and face-to-face assistance on benefit changes.
“Customers who are unhappy with the PIP outcome decision, can dispute this by lodging a re-consideration request and provide any additional evidence which, they feel, was not considered in the initial decision. If still dissatisfied with this outcome, they can appeal to an Independent Tribunal,” she added.