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Criteria for face to face medicals
- micksville
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Reading the guides on here has seemingly thrown up a contradiction. The WCA handbook for medical staff gives the following two quotes which seem contradictory.
"It should be noted that a claimant who has previously been assessed and entered
into the Support Group, either at examination or Filework, will undergo a pre-board
check at re-referral rather than re-referral scrutiny"
"Cases may only be “satisfied” at re-referral scrutiny if a full face to face
LCW/LCWRA medical assessment was completed. Their case cannot be satisfied
if they were found to be in the Support Group at assessment or at pre board check. If
a claimant was previously found to be in the Support Group, the HCP must review the
case as a re-referral pre-board check and decide if there is adequate evidence to
advise that continued inclusion in the Support Group is appropriate. If there is
evidence of improvement in their functional abilities since the last assessment such
that they no longer fulfil the Support Group criteria nor meet any criteria for “treat as
LCW”, the claimant should be called for an examination."
Am I to understand from this that there is the possibility of another paperwork based decision or does the second quote suggest that the fact I gained access to SG initially on paperwork means I am much more likely to face an actual f2f medical this time around?
I have no issues with facing a medical like this, but my medical issues are rather obvious and well documented and I have always, even on Incap been passed on paperwork alone. Any advice on interpreting these seemingly contradictory statements is appreciated, as I simply wish to know what to expect..
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micksville wrote: I am due my review later this year for ESA and wondering if I will have a f2f medical. I was transferred from Incap to Esa Wrag on, paperwork alone,in 2011 then in 2013 ISwas awarded SG again on paper evidence following a deterioration in my condition.
Reading the guides on here has seemingly thrown up a contradiction. The WCA handbook for medical staff gives the following two quotes which seem contradictory.
"It should be noted that a claimant who has previously been assessed and entered
into the Support Group, either at examination or Filework, will undergo a pre-board
check at re-referral rather than re-referral scrutiny"
"Cases may only be “satisfied” at re-referral scrutiny if a full face to face
LCW/LCWRA medical assessment was completed. Their case cannot be satisfied
if they were found to be in the Support Group at assessment or at pre board check. If
a claimant was previously found to be in the Support Group, the HCP must review the
case as a re-referral pre-board check and decide if there is adequate evidence to
advise that continued inclusion in the Support Group is appropriate. If there is
evidence of improvement in their functional abilities since the last assessment such
that they no longer fulfil the Support Group criteria nor meet any criteria for “treat as
LCW”, the claimant should be called for an examination."
Am I to understand from this that there is the possibility of another paperwork based decision or does the second quote suggest that the fact I gained access to SG initially on paperwork means I am much more likely to face an actual f2f medical this time around?
I have no issues with facing a medical like this, but my medical issues are rather obvious and well documented and I have always, even on Incap been passed on paperwork alone. Any advice on interpreting these seemingly contradictory statements is appreciated, as I simply wish to know what to expect..
Hi mv,
I agree that it could be confusing.
We are aware of several members who have been placed into The SG once more on a 2nd or 3rd reassessment who have never had a F2F.
This is why it is important to treat each reassessment as a fresh one with regards to detail given and reiteration that you still fulfill the criteria for The SG.
It will obviously be dependent on each individuals paper evidence on a case by case basis.
bro58
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- micksville
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- Posts: 470
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