DWP announcement about the next Work Capability Assessment provider

The Department for Work and Pensions (DWP) has announced that Atos Healthcare will be handing over our contract to deliver the Work Capability Assessment (WCA) and other smaller volume benefits to Maximus Health and Human Services Ltd on the 1st of March 2015. At the moment there are no changes to the WCA process for those people already going through it. Please continue to follow any information you have already been given, such as to return the ESA50 questionnaire or attend an appointment for an assessment.

Whilst we can’t answer questions for you about the new contract that the DWP have signed with Maximus, we are still the people to contact for any questions or feedback you have if you are currently going through the assessment process. You can find our feedback process and contact details on our website, which will also continue to provide information about the WCA process until we have handed over to Maximus.

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What to have with you for a PIP consultation?

One of the key things people want to know before their Personal Independence Payment (PIP) consultation is what they should have with them.

It is important that you can prove your identity when you attend a PIP consultation, the Department for Work and Pensions (DWP) will not allow us to proceed with the consultation if you are unable to prove your identity. It is also important that you can explain to the Health Professional how your condition or disability affects you in daily life.

Why you should bring your appointment letter?

The appointment letter gives you exact details of where to go for your consultation and the phone number of the customer service centre should you need to contact us.

What is suitable for Proof of Identity?

We are required by DWP to carry out a proof of identity check when you have a consultation. Suitable proof is two types of identification from the list below.

  • PassportAtos-Healthcare- proof-of-identity
  • UK driving license
  • UK travel pass with photograph
  • Birth certificate
  • Marriage certificate
  • Debit/credit card
  • Council tax demand
  • UK utility bill
  • Council/housing association rent or tenancy agreement document
  • Foreign national ID card
  • Evidence of entitlement to state or local authority benefit

In some circumstances we will be able to verify your identity without these documents but it is far easier and quicker if you bring the appropriate documents.

Bringing a Companion

You are encouraged to bring a companion or support worker who knows your situation well with you to your consultation. They can also participate in the consultation itself (if you like) and are frequently helpful in ensuring that the HP gets a full understanding of your situation.

Bringing Additional Supporting Materials

You may have already provided evidence that you had when you completed and returned the ‘How Your Disability Affects You’ form to DWP. The Health Professional will have access to this information at the time of your consultation.

However, you can bring new or additional information with you to the consultation. Of particular value will be:

  • Tablets and other current medication, such as inhalersAtos-Healthcare-hearing-aid
  • Any medical aids, such as walking aids, hearing aids, glasses and contact lenses
    which you would normally use or take with you if going out. You don’t need to bring any aids or adaptations you only use at home however, but the HP will want to talk about these during the assessment
  • Any extra medical information, such as test results, or letters which you have from GPs or specialists about your disability or condition, which you’ve not already provided as part of your claim. Anything you have already sent to DWP will be on the system and the HP will be able to see them

You can also see more information on the additional evidence blog

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What to do with new information about your health during the WCA process

We have said before on this blog about the importance in the Work Capability Assessment (WCA) of up to date information about how your illness or disability affects you.  You can include information with the ESA50 questionnaire that you complete and send in as well as bringing in information to the face-to-face part of the assessment if you need to have one.  It is important to remember though that new information can be submitted at any stage in the assessment process.Atos-Healthcare-new information-folder

When a healthcare professional (HCP) reviews your referral to us from the Department of Work and Pensions (DWP) they take into account all of the information that is available to them at the time.  Depending on the stage in the process, this might be your completed questionnaire, information that you sent in with the questionnaire or information that we have obtained from a health professional involved in your care, such as your GP.  If the HCP has enough information to be able to provide a report to DWP without you needing to have a face-to-face assessment they will do so.

It is helpful to make us aware if you receive new information about your illness or disability or your condition changes at any stage during the assessment process.  The new information can then be taken into account. It might mean that you don’t need to be seen face-to-face or it might mean that you can be seen at home instead of an assessment centre.

Atos-Healthcare-new information-contact-usWhat you need to do with any new information will depend on the stage in the process you’re at and what the new info is.  To find out what to do in your case you can call us on 0800 2888 777 and speak to an advisor.  If we have already sent a report to DWP we can tell you this so that you can send the information to them.  The Decision Maker at the DWP who makes the decision on your ESA claim has access to all of the information that you have sent in or that we have obtained, and takes it into account along with the report that we write.

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When would you have a consultation at home for PIP?

Most people who claim Personal Independence Payment will need to have a face to face consultation as part of the assessment process.  A consultation may not be needed if enough supporting information is available for a report to be completed by a Heath Professional and sent to the Department for Work and Pensions (DWP).

Atos-Healthcare-pip-home-consultation-front-doorWhere does Atos Healthcare carry out PIP consultations?

For people who do need to be seen in person most consultations take place in one of the consultation centres around the country.  However, if it is clear from the information that we have that travelling to a consultation centre would cause significant distress we will automatically arrange for the consultation to take place in the claimant’s home.

If someone is given an appointment in a consultation centre, but does not think that they would be able to attend due to their health problems, they may still contact us and request a home consultation. All claimants are treated as individuals and the offer of home consultations is done on a case by case basis.

How a home consultation decision is made

A consultation will take place at your home if you are unable to travel to a centre due to your illness or disability.  This would apply if, for example, your GP needs to see you in your home rather than their surgery.  It is worth saying though that even if you do travel to your GP surgery it does not mean you won’t be eligible for a home consultation.Atos-Healthcare-pip-home-consultation-contact-us

Other reasons why you might have a home consultation

A small number of home consultations may take place for reasons other than your inability to travel.  For example, this might be because you live in one of the small number of places where there isn’t a consultation centre within 90 minutes travel time by public transport.  A list of all of our PIP consultation centres can be found on our website.

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The PIP claim process for people who are terminally ill

For anyone who is terminally ill and not expected to live more than 6 months, there is a special fast-track PIP claim procedure called Special Rules for Terminally Ill.

The UK Government Welfare Reform Act defines someone who is terminally ill as ”suffering from a progressive disease, and death in consequence of that disease can reasonably be expected within six months.”

Obviously this is a very stressful and challenging time for any individual and for their family and friends. Both DWP and our staff will try to simplify and ease the process for claiming PIP.

People who meet the criteria for claiming under the ‘Special Rules’ for terminally ill people:

  • Don’t have to complete a ‘How your disability affects you’ form
  • Don’t need a face-to-face consultation
  • Are guaranteed to receive enhanced rate of the daily living component of PIP
  • May also receive either the standard or the enhanced level of the mobility component depending on individual circumstances

How it works:

1. Someone needing to claim under the ‘Special Rules’, process should start by Atos-Healthcare-pip-terminal-illness-phonetelephoning the DWP on the PIP new claims line on 0800 917 2222 – callers should select option 1 for a new claim and then option 3. A dedicated special rules team will take the call and complete the claim. This phone call can be made by the individual or someone calling on his or her behalf. Some people are unaware that they have a terminal illness and it is not always in their interest to inform them. This is something that should be discussed with the health professionals providing care to the individual. The individual could still be entitled to PIP even if they are unaware of their diagnosis. When claiming on behalf of someone with a terminal illness it is important to let DWP know if they are not aware of the situation.

2. We understand that this is a very difficult time for individuals and their families and our health professionals will try to be as tactful as possible.

3. During the call the DWP agent will ask some questions about you and the person on whose behalf you are calling.

4. In most cases where there is a diagnosis of a terminal illness the GP or other Health Professional dealing with the case will have provided a DS1500 medical report. You will not be charged for this report.

5. The DS1500 should be sent to the DWP when you apply for PIP, however, you should not wait for this if it will significantly delay your application. If you have already sent a DS1500 form to DWP in the last six months, then you don‘t need to send a new one unless the condition has changed.

6. Once the claim has been registered by DWP, they will refer it to an assessment provider who will review the information and the evidence provided and respond to DWP, generally within 48 hours.

If you, or the person on whose behalf you are claiming does not meet the DWP criteria for terminal illness they will ask you to make a claim under the ‘Normal Rules’, and will send a ‘How your disability affects you’ form. This is likely to result in a face to face consultation and may take significantly longer to arrange. If the condition then deteriorates during this time it is important that you let DWP know that the circumstances have changed.

If you are already receiving Disability Living Allowance

If you are already getting Disability Living Allowance (DLA) under ‘Special Rules’ for terminally ill people, you will be invited to claim PIP once your DLA award has ended. If you are already getting DLA under the ‘Normal Rules’ and you have become ‘terminally ill’ as defined by the DWP, you should speak with DWP to find out if you will be invited to claim PIP.

If you are claiming for another person

Once an award has been made DWP will send payment directly to the person with the terminal illness. He or she does not need to know that that the claim has been made under the ‘Special Rules’ for terminally ill people and this will not be mentioned by DWP.

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