Capita - Decision without face to face assessment

SMW83

Hi,

Long and protracted issue so I’ll keep it short.

Basically, having spoken with Capita today with regards to the status of my claim, I have been told that I will not need a face to face assessment with them as a decision has been reached on my medical evidence alone.

Should I assume this means it has been decided in my favour? Or can they make a decision to refuse my claim without a face to face assessment?

TIA

Yadnad

SMW83 said:

Hi,

Long and protracted issue so I’ll keep it short.

Basically, having spoken with Capita today with regards to the status of my claim, I have been told that I will not need a face to face assessment with them as a decision has been reached on my medical evidence alone.

Should I assume this means it has been decided in my favour? Or can they make a decision to refuse my claim without a face to face assessment?

TIA

It can go both ways.
The evidence clearly shows that you should get no award and the evidence shows that you clearly are entitled to an award.

Chloe_Alumni

Hi @SMW83, I guess it wouldn't be logical to refuse a claim without having a face to face. However, I would still wait for the letter. I have my fingers crossed for you!

SMW83

Yadnad said:

SMW83 said:

Hi,

Long and protracted issue so I’ll keep it short.

Basically, having spoken with Capita today with regards to the status of my claim, I have been told that I will not need a face to face assessment with them as a decision has been reached on my medical evidence alone.

Should I assume this means it has been decided in my favour? Or can they make a decision to refuse my claim without a face to face assessment?

TIA

It can go both ways.
The evidence clearly shows that you should get no award and the evidence shows that you clearly are entitled to an award.

Ok thanks. I’ve just been awarded ESA (support group) on evidence alone so I’m assuming that I wouldn’t have been awarded that if it was believed it wasn’t entitled to it.

SMW83

Chloe_Scope said:

Hi @SMW83, I guess it wouldn't be logical to refuse a claim without having a face to face. However, I would still wait for the letter. I have my fingers crossed for you!

Thank you. That’s what I thought too. As I’ve just said to the previous reply, I’ve recently been awarded ESA (Support Group) no evidence alone so I’m assuming I wouldn’t have been awarded then if they didn’t believe I was entitled.

atlas46

Hi @SMW83

Simple solution, contact PIP helpline and ask for copy of paper based assessment report, that Capita has submitted to DWP.

Then you can score the points!

Keep us informed.

SMW83

atlas46 said:

Hi @SMW83

Simple solution, contact PIP helpline and ask for copy of paper based assessment report, that Capita has submitted to DWP.

Then you can score the points!

Keep us informed.

They haven’t as yet sent the paperwork to the DWP as apparently the decision was only made earlier today. I’ll give it a week or so then I will contact the DWP!

Yadnad

Chloe_Scope said:

Hi @SMW83, I guess it wouldn't be logical to refuse a claim without having a face to face. However, I would still wait for the letter. I have my fingers crossed for you!

It depends if the evidence is strong enough to say that no award would be made.

SMW83

Yadnad said:

Chloe_Scope said:

Hi @SMW83, I guess it wouldn't be logical to refuse a claim without having a face to face. However, I would still wait for the letter. I have my fingers crossed for you!

It depends if the evidence is strong enough to say that no award would be made.

As I’ve said the ‘evidence’ was strong enough to be awarded ESA support group without an assessment  so it would be hard for them to argue a case that I was not entitled to any form of PIP.

poppy123456

Hi,

The health assessment providers don't make the decision on any claim, it's the DWP decision maker that does this. The health assessment providers are there to make a recommendation only. For PIP not having a face 2 face assessment means nothing unlike ESA. With ESA you can't be found fit for work without a face 2 face assessment. For PIP you can be refused without one, although it's rare.

SMW83

poppy123456 said:

Hi,

The health assessment providers don't make the decision on any claim, it's the DWP decision maker that does this. The health assessment providers are there to make a recommendation only. For PIP not having a face 2 face assessment means nothing unlike ESA. With ESA you can't be found fit for work without a face 2 face assessment. For PIP you can be refused without one, although it's rare.

Yes, I would assume it would be unusual as if I was to take it to appeal court and they hadn’t conducted a face to face assessment, that would reflect poorly on the DWP.

SMW83

Hi, just a bit of an update. I’ve been told by the DWP this morning that although Capita have reached a decision that my medical evidence is enough to warrant me not having a face to face assessment, it is dependent on a case managers decision if they believe said evidence is enough to award me PIP. If they decide it isn’t then it will be referred back to Capita for an assessment. This seems extremely nonsensical to me as surely it would have been easier just to assess me face to face than having to keep passing it back and forth between Capita and the DWP and prolonging the matter. I will obviously update you when I hear anything further.

Yadnad

This reminds me of the story of council workers digging a hole in the road.
None can agree where it should be dug!

sarah50

Sounds like capita can't cope with the number of f2f's and are trying to do reports based on medical evidence, DWP on the other hand are questioning this practice and you are caught in the middle, hope you get it sorted. But as has been said capita don't decide they fill in their assessment and pass it to DWP decision maker.

cokeen43

I got awarded esa supoort group and got a lot of backdated money then 4 months later my pip was taken off me as apparently i have nothing wrong with me, good luck

poppy123456

The assessment providers don't make any decisions. They write reports with recommendations and a decision maker then makes a decision based on the report.

Yadnad

poppy123456 said:

The assessment providers don't make any decisions. They write reports with recommendations and a decision maker then makes a decision based on the report.

….which as we all now know is likely to be what the assessor says. The DWP have been pulled over the coals for being too accepting of these assessment reports without making any real effort to look at all of the evidence - all done to save them time.

sahara01

I didn't have an assessment for esa it was based on medical evidence alone however I had a home assessments for pip on Monday dwp received it on Wednesday have been informed the decision will take 6 weeks 

wizzwoz

SMW83 said:

Hi, just a bit of an update. I’ve been told by the DWP this morning that although Capita have reached a decision that my medical evidence is enough to warrant me not having a face to face assessment, it is dependent on a case managers decision if they believe said evidence is enough to award me PIP. If they decide it isn’t then it will be referred back to Capita for an assessment. This seems extremely nonsensical to me as surely it would have been easier just to assess me face to face than having to keep passing it back and forth between Capita and the DWP and prolonging the matter. I will obviously update you when I hear anything further.

SMW83 i read your blog
If you are on the suport side of ESA thats strong enough evedence that you will receave a pip aword 
You still may be asked for a ftf assessment people who are on suport side of ESA do not have a ftf with ESA and there is no benifit cap on that ither but make shure you get the dissibility premium on your ESA aswell
Good luck x

poppy123456

wizzwoz said:

SMW83 i read your blog
If you are on the suport side of ESA thats strong enough evedence that you will receave a pip aword 

Sorry but this is not correct. PIP and ESA have different criteria and it totally depends on what points you scored in the PIP. A PIP award doesn't automatically mean you have limited capability for work.