[log in to unmask],Net wrote at 15:13 on 29/11/98 
about "Re: Benefits
Agency-Fair,Consistent,Up-front,Straight-dealing,Transparent?.":
-----------------------------
><< 
> The correlation between successive applications of the "all work 
> test" which is what you are talking about, rather than the BA, has 
> been studied, and is at least in principle in the public domain.  I 
> gather it was accepted to have been shown to be much less variable 
> than the previous situation.
>  >>
>Do you have the reference to this.
No, but it will be in the public domain, part of the original work 
(which was approached rather more scientifically than other 
countries have).
When the all work test was introduced a considerable proportion of 
the claimants were found to score zero - IE to have no objectively 
measurable incapacity.

>Is this compared to certificating GP's who
>probably were inconsistent - different partners, trying to maintain
rapport
>etc etc.. 
Amazingly so, also illegible, cursory...
Trying to retain rapport by signing a false declaration in order to 
obtain a pecuniary gain for the pateint is not recommended.


>I accept that the appeal relates to the medical state at the time of
the
>original assessment but what I don't understand is how this can be
challenged
>if the case is that the medical examination failed to elicit salient
points.
The patient says that there was more, which he didn't fill in on the 
original questionaire;  that the doctor is wrong in thinking he was 
capable of certain activities; that at teh tiime he was depressed; 
alcoholic or otherwise mentally ill, but had not said anything about 
that and was therefore not examined with respect to that...

>The only evidence that the appellent can offer is from a further
medical
>examination by a different doctor at a different time and place. 
On the contrary.  It is uncommon for patients to offer this as 
evidence, and in my experience wholly unknown for such an 
examination to provide any evidence which appears useful to the 
Tribunal (but I don't sit in with them as they deliberate).
This is because few doctors know what the rules are and therefore do 
not report in relation to them...

>In a static
>condition such as the one in question this is probably not critical
but it
>could be if the condition was changing. 
If the condition changes then they should reapply for incap 
benefit...

>I am aware that the doctor doesn't
>make the final decision as to fitness - but how often are primarily
medical
>assessments overturned by non-medical staff?
Rarely.  Mansel Aylward would perhaps answer that one (actually I 
would be interested).  Certainly I have seen a couple where either 
through a literal error or through a disagreement in favour of the 
patient the adjudicating officer has raised the score, and these are 
only the ones where it has not been raised to 15.

>>>>allegedly asks very personal and apparently irrelevant questions
such
>as "do
>>you beat your wife" and "can you handle your drink?" 
I suppose they might be relevant, in the context of alcoholism, at 
least the latter one.

>I have seen the full papers relating to his assessment in Nov. '97 and
>subsequent appeal. There were some null scores which surprised me and
were at
>variance with what he said he told the doctor he could/couldn't do. 
The doctor doesn't have to believe everything the patint says, but 
should usually record what they say in the first part of the 
examination.
The IB50 the patient fills in also records what the pateint declared 
as incapacity.

>>>The BA is in charge of Benefits, and has a lifetime (or at least 
>working lifetime) record of each claimant.  

>Yes, but what are the examining doctors told? Does the BA only hold the
>contribution record? 
They hold records of sickness absence etc, all payments made AFAIK.
I don't know how much is told to the doctors, they are pretty busy.  
The adjudicating officer has the whole file AFAIK.

>It would certainly simplify things for me if I could tell him that he
has
>demonstrated his ability to work by following a University course and
that he
>is therefore automatically disqualifying himself from claiming
Incapacity
>Benefit. 
Hard to argue against.  Mind you, I think the university student 
grant should be enough to live on, and anyone who doesn't have a 
degree and can get accepted should be eligible for it.

>Agreed. In my experience  though this has not been an isolated
incident, I've
>had a few patients appeal successfully. 
The rate of successful appeals is thought to be quite high.  If one 
assumes that a higher proprotion of rejections which the client 
regards as justified are not pursued to appeal than of rejections 
which they feel are unfair, a reasonable assumption, then this is 
what one would expect.

>It's a long drawn out process, often
>quite distressing to the patient 
and very often could have been avoided if the pateint had filled in 
the IB50, or asked the CAB to fill it in, listing the things they 
appear at appeal to claim.

>Obviously this will happen - patients give different histories to
different
>doctors. But this is supposed to be a very structured interview, 
No, actually it is an examination.
The history, AIUI, is given by the patient in the IB50.
Each section of it, which corresponds to each section of the all 
work test, offers the choices of declaring a problem, of varyng 
levels of severity, or of ticking "I do not have a problem doing 
this"

There is a check, an opportunity for the patient to add in anything 
they didn't put down, but the test is primarily an examination, and 
there is little likelihood of the examining doctor examining 
something which the patient has made a statutory declaration that 
they do not have a problem with.

>unlike a
>standard history taking, and if different people extract very different
>conclusions on different occasions on a regular basis then either the
process
>is at fault or the operators of the process are at fault. 

>If a scientist
>conducting an experiment gets one rogue result he discards it but if
he gets a
>number of rogue results then he takes a long hard look at his
experimental
>design and his technique and then probably sets about repeating the
>experiment. 

Yes.  The process is being amended so that if a client declares that 
they did not declare their relevant incapacity in the IB50 they can 
be sent back for a repeat all work test, rather than sent on to 
appeal.  This should be better and quicker.
--- OffRoad 1.9r registered to Adrian Midgley


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