Request for information for IB/ESA Appeals

A patient has asked for a report to support his appeal after having his Incapacity Benefit withdrawn. Do their GP have to provide a report?

No. GPs, as certifying medical practitioners, have a statutory obligation to provide statements of incapacity to patients on their list and certain information to a healthcare professional working for Atos Healthcare on behalf of DWP when requested. However, under their NHS contract there is no requirement for GPs to provide reports or offer an opinion on incapacity for work to anyone else unless requested to do so by Jobcentre Plus.

Claimants should contact Jobcentre Plus or the Appeals Service, where appropriate, if they think that further medical evidence is necessary to support their claim or appeal. They should state clearly their reasons for believing that further evidence is necessary.

If Jobcentre Plus or the Appeals Service consider that further medical evidence is necessary, they will seek it. They will be responsible for paying any fee to the doctor providing the report.

So NHS GPs are under no obligation to provide such evidence to their patients nor to provide it free of charge. If a GP does not agree to provide additional evidence for their patient then it is a private matter to be resolved between the GP and their patient.

GPs can chose how they respond to requests for supporting an appeal and this might range from declining to do anything to providing a full report of the patient’s functional capacity.  Anecdotally colleagues who work for the Appeals Service say that many GP reports are unhelpful because the GP is unaware of the law relating to the benefit in question and suggest that GPs who wish to do these reports might like to consider studying the regulations so that they are not wasting their time.

If GPs do provide a report then they are entitled to charge for it if they wish but should seek agreement that their fees will be meet before doing so. A useful ready-reckoner can be found on the BMA Website to help in setting an appropriate fee.

As a compromise CDD LMC suggest that GPs could choose to provide a summary printout of the patient’s medical history / current medication and attach the following letter without charging.

To Whom It May Concern:

I have been asked to provide a report to support an appeal against withdrawal of IB/ESA and I enclose a summary of the patient’s medical history and current medication.

If the Appeals Service feels that further medical evidence is required then they will request this directly.  It may be appropriate for the claimant to state clearly as part of their appeal the reasons why further medical evidence is required.

If you would like additional information from me in the meantime then please put this in writing together with consent from the claimant and agreement that you will meet any reasonable fees.

Yours sincerely,