Employment and Support Allowance (ESA)
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Confusing situation regarding backdated medical certificates and DWP

CaptainTeoCaptainTeo Member Posts: 8 Listener
Howdy,

I've been in the process of an appeal related to ESA for the last seven months (I might ask for advice on that, soon, but not in this post), but I'm in a rather awkward situation regarding medical certificates. I'm being asked by the DWP to provide a backdated certificate for a period of six months (!) last year, but my doctor and surgery staff are telling me that it's not legal to provide a backdated medical certificate if I didn't see them about it during that period. The problem is that the reason that I didn't see them at the time is because the DWP outright didn't tell me that they didn't have a valid medical certificate for me until several months after that period, when I called to ask why I wasn't being paid after my payments had been reinstated as part of the appeal process.

The DWP staff that I talk to on the phone appear to have no knowledge that it's not legal to do what they're asking me to do, and I've had to explain to them several times that my doctors are telling me that it isn't legal (to their surprise). To attempt to remedy this, they sent me a form highlighting that I need a medical certificate for that period to give to my GP, which I did, but I just got another letter back saying that they can't give me one because they didn't see me during that period. I'm very confused about what to do, here; the DWP is apparently asking me to do something illegal, and I currently have a gigantic chunk missing from my payments because they neglected to tell me that they didn't have a valid medical certificate for that period, so they are entirely to blame for this problem in the first place. Has anyone been in this situation before, or does anyone have any advice on what to do about this? Thank you.

Replies

  • Sam_AlumniSam_Alumni Scope alumni Posts: 7,731 Disability Gamechanger
    How frustrating for you @CaptainTeo
    I have passed this on to our @BenefitsTrainingCo so I hope they will be able to offer some support soon.
    Scope
    Senior online community officer
  • mikehughescqmikehughescq Member Posts: 5,980 Disability Gamechanger
    It’s not illegal at all. Backdated fit notes are entirely at their discretion. It is however very difficult if they didn’t in fact see you in that period. If they received letters from consultants etc. in that period those could be persuasive but they could still refuse. It then comes down to your specific issues and the reason why you consider yourself unable to work. It would be arguably unreasonable to refuse if your reason was that you are, for example, suffering from a degenerative condition. It would be reasonable if you have periods of remission or huge variability. However, if they still refuse you’re into a complaints process that could lead them to strike you off their list. It’s a fine line.

    if you have a representative for your appeal they ought to have advised you at the time of the need for a fit note else you’ve no proof of capability for the period after ESA stoppage but prior to your appeal. If you don’t have a fit note then it’s up to you to think it through. 

    DWP call centres are often out sourced but even when they’re not they would never have the level of knowledge you need. DWP are literally the last place to go for advice. 
  • poppy123456poppy123456 Member Posts: 22,218 Disability Gamechanger
    GP's can backdate a fit note for a long as they want. You'll need the fit note to claim for those months you weren't fit for work, without it i'm afraid you will lose that money.
    Community champion and proud winner of the 2019 empowering others award. This award was given for supporting disabled people and their families for the benefit advice i have given to members here on the community.
  • CaptainTeoCaptainTeo Member Posts: 8 Listener
    Thank you very much for the responses. I spoke to reception at my surgery again and they're also confused about the situation, so I'm making another appointment to talk to a doctor about it properly - I feel like there must be some way to fix this situation (otherwise the DWP could conveniently forget to ask for a medical certificate at any time and have someone lose out considerably).

    In my situation, I don't have a progressive condition, but I do have a number of constant mental conditions including an autism spectrum disorder, depression and anxiety disorders; the former won't go away, ever, which is one of the things that I've been fighting the DWP over while they keep trying to claim that I'm "cured" of autism, and I'm still waiting for any help on the others because I keep being told by doctors that there isn't much help available for me, so, at the very least, I can say that my condition hadn't got any better during that period. The variations on intensity with these conditions are on a scale of days at the most, rather than months. I suppose that I'll just wait to see what the doctor says and report back afterwards (which will be another month away, sadly), but I'm very concerned about the possibility of just being told the same thing.
  • mikehughescqmikehughescq Member Posts: 5,980 Disability Gamechanger
    I doubt they think you’re cured of autism. It’s more likely that they didn’t see any evidence of it during their snapshot and consequently it’s hard for them to figure out what you can’t do reliably, safely, repeatedly or in a reasonable time. 
  • BenefitsTrainingCoBenefitsTrainingCo Member Posts: 2,692 Pioneering
    edited April 2018
    Hi CaptainTeo,

    I understand you are frustrated that the DWP didn't tell you at the time that you needed a new fit note, but they will argue that a) they don't need to tell you as they decided you were fit for work and therefore not requiring a fit note and b) when you hand a fit note in claimants should make a note of the date it expires as a way of helping themselves to renew it, although I know that wouldn't be an issue if you were coming into the review already in WRAG or support group.
    Again, I agree with Mike in that it is not illegal to get a backdated fit note. If you have long term health conditions that your doctor has seen you for over a number of years that affect your daily functioning I would have thought that your GP could conclude that you weren't fit for work for the required period even if they didn't see you during it. Surely someone with long term health conditions isn't going to suddenly be free of all ailments and their effects for a few months and then be affected again? The only way forward with this is to keep on at your GP, the DWP are not going to pay ESA when there's no evidence of incapacity for work. Good luck!

    Lee
    The Benefits Training Co:
    Paul Bradley
    Michael Chambers
    Will Hadwen
    Sarah Hayle
    Maria Solomon
    David Stickland
  • CaptainTeoCaptainTeo Member Posts: 8 Listener
    Thank you, Lee! That was a very reassuring response. I'll try to make an appointment with the doctor who originally recommended me for ESA and report back. It'll be a while because they've been having to book appointments over a month in advance and I'm not able to get there by myself, so I've just been having to see anyone who's available so that I'm not waiting even longer. Maybe that'll help.

    I know that it's not terribly important for me to touch on it, but, as for the part about them saying that they don't need to tell me and everything, that's one of the things that they've been surprisingly nice about; the person I initially spoke to about it apologised and looked into what happened for me, then had someone else send a notice my way so that I at least had something to give to the doctor to say that I needed a backdated certificate. As much of a mess as this whole appeal situation's been, I appreciate that the call centre staff have been treating me like a real person.
  • CaptainTeoCaptainTeo Member Posts: 8 Listener
    Howdy. Sorry that this is a bit of a thread bump, but I wanted to say thanks for the advice from before. I tried again and finally got another doctor appointment, and... well, I explained the situation to the doctor I saw and he just said "Oh, yeah, I can sort that out for you," then just printed off a medical form for the date that I needed and signed it. So... that's that. A bit weird that, after nearly a year, it end just like that, but I'm not exactly complaining. I suppose that it depends on the specific doctor you see as much as anything else. Thanks again, guys.
  • TopkittenTopkitten Member Posts: 1,263 Pioneering
    I think, from the way you phrased it, that the surgery were saying they couldn't provide a backdated note if they didn't know you were ill. Technically I suppose that could be illegal. However, receptionists in surgeries do not have the full details of your situation so would not know of your condition and hence gave a generic response. Often they are unaware of procedures anyway.

    Recently I contacted my surgery requesting a referral to O/T. The first lady I talked to said fine it would be done in a couple of days... then did nothing. When I chased it up the second lady said there was no such procedure and then, when I explained how the GP does it, insisted I needed to see a GP first. This point was also untrue but she would not budge and I had to hang up due to a panic attack. This matter and others has taken 3 weeks to sort out and then only because I complained to NHS England. Unusual circumstances are always beyond the knowledge of receptionists to resolve.

    For those that are unaware..... if you really cannot sort out problems with a GP surgery contact NHS England with your problem / complaint though technically you are supposed to write to the Practice Manager first. Not all surgeries provide an email system for this so if you cannot write such a letter go straight to NHS England and explain why you didn't write such a letter.

    TK
    "I'm on the wrong side of heaven and the righteous side of hell" - from Wrong side of heaven by Five Finger Death Punch.
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