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Courts carry out review after study reveals GP evidence was factor in only 2.9% of disability benefits appeals

The Government has carried out an assessment of the key factors in deciding appeals against decisions to remove disability benefits from claimants, after a pilot study revealed GP evidence was the deciding factor in only 2.9% of cases, Pulse has learnt.

The Department of Work and Pensions asked judges to provide a written summary explaining their decisions in individuals’ appeals against the removal of the Employment Support Allowance, including the importance of the GP report.

It followed a study last November that showed judges cited GPs’ supporting evidence as the principal factor in only 2.9% of successful appeals when provided with a list of potential reasons from a drop-down menu.

GP leaders said that practitioners are increasingly being asked to provide evidence to support such appeals – which they say is increasing workload and causing problems with the doctor-patient relationship – despite these figures showing they are of relatively little importance in judges’ decisions.

The ‘Social Security and Child Support Tribunal hearings: Early analysis of appeals allowed from pilot data’ report was released in November 2012, and asked decision makers to select the primary factor affecting their judgement.

The study reviewed around 26,500 successful appeals relating to disability benefits between July and October 2012. Of these appeals 2,170 (8.2%) were overturned based on new documentary evidence, medical or otherwise, and GPs’ evidence was the main factor in 768 – 2.9% - of cases.

The most significant factor was new oral evidence, which was the primary reason given in 41.7% of successful appeals.

A DWP spokesperson told Pulse: ‘Building on this drop-down menu feedback, HM Courts and Tribunals Service agreed to the controlled start of an initiative for the Social Security and Child Support Tribunal to provide written summary reasons for their decisions on ESA appeals. The initiative started on 10 June, for 8-weeks at four hearing venues.  The exercise has improved feedback for our decision-makers.’

The spokesperson added that, at the appeals stage: ‘There is a wide range of evidence that can be used including evidence from the WCA and all the supporting medical evidence provided by the claimant, including that from GPs.’

But GP leaders warned that GP practices find themselves under increasing pressure to provide extra evidence above and beyond the initial assessments that the DWP requires.

Dr Robert Morley, executive secretary of Birmingham LMC, said that people seeking additional supporting evidence was a widespread and ‘increasing problem’.

He said: ‘It’s not just in my area, in all areas it’s an increasing problem. Part of the problem is that the letters given to appellants. Though they do not say “go and get a letter from your GP”, they say it may be helpful to your case if you get supporting medical evidence.’

‘Now straight away the one port of call for all patients will be to go to their GP. So it causes increased numbers of appointments, so obviously increased workload. If the GP doesn’t feel it’s appropriate to provide anything, then it can cause difficulties in the relationship between doctors and patients.’

‘It’s very difficult to get across to patients that it’s not going to make that much difference anyway because any medical evidence a GP has given will have been in the original report when the patient applied for the benefit in the first place. So there’s not a great deal more to add.’

Dr John Canning, chair of the GPC’s professional fees and regulation committee and a GP in Middlesbrough, said: ‘Only in a small number of appeals, is medical evidence actually the reason someone has won their appeal, the vast majority of appeals are won because of somebody’s capability. And the best way to show you’re incapable, at an appeal, is to turn up. There’s a sort of very basic logic in that.’

Dr Peter Holden, a GPC negotiator, said: ‘You are not required to produce evidence for anything, unless you are paid for it, except for the certificates that are in our terms of service. And preparing an appeal for a patient is not in it and it must stay out of it.’

‘My message to GPs is “do not do this”. You only have to respond to enquiries from DWP officials and their agents, there are proper systems for seeking your advice and those are the only ones you are able to use.’