How to deal with Benefits medical examinations

A Useful Guide to Benefit Claimants when up against ATOS Doctors

How to deal with Benefits medical examinations

Doctors were hanged at Nuremburg for following Nazi party racial theories and participating in medical experiments. Unfortunately Dr Mengele, the most notorious of them all, escaped the noose.

I’m not suggesting that ATOS doctors deserve to be hanged but a dose of their own medicine would be apt. Hard work for peanuts down a mine might help them understand the effects of illness and the ability to work. But just like the doctors who approve of and participate in making inmates at Guantanamo ready for torture (a practice that Israel has also adopted via the Israeli Medical Association) so ATOS doctors abandon their Hippocratic Oath and owe their first loyalty to the state rather than of those they treat. In that sense ATOS doctors also share the same mentality that Nazi doctors operated under.

Below is an excellent guide from the Edinburgh Autonomous Centre for those undergoing medical examinations and the first lesson is never go in alone.

Tony Greenstein

NEVER FACE THEM ALONE

This leaflet describes how claimants for disability benefits can deal with the medical examinations by medical professionals, which for many claimants are central in deciding whether or not you are entitled to disability benefits.

BEFORE THE EXAMINATION

The examinations are run by Medical Services (MS) which is operated by the private company ATOS on behalf of the Benefits Agency. Before a MS examination your own GP sends info to the Benefits Agency. It is important that this info is as full as possible and states clearly whether or not in their medical opinion you are fit for work at that time and in the forseeable future (at least 6 months ahead).

It is frequently the case that people with a long-term illness gradually minimise in their own minds the effect of their illness on their everyday lives and develop survival strategies to cope on a daily basis in an attempt to lead as normal a life as possible.

This can cause a problem as this habit when taken into a medical examination does not present a true picture of the illness and could be misleading. It might be helpful to discuss the reality of your illness and the limitations it imposes on your life with someone who knows both the illness and yourself well. The reality of your illness is what must be presented to the ATOS medical professional and to the DSS.

If you have a Medical Services examination, either at the MS office or at your home, always have someone accompany you. This is your right. We have often done this. They cannot refuse you this right - if they try then just insist you need someone with you.

To obtain benefits you are legally required to attend this examination, and the information obtained at the examination is used, within a legal framework, to decide on your benefit entitlement - it is therefore vital to make sure your legal rights are protected.

If the date for the examination is not suitable, eg your accompanying person cannot make it on that date, you can get the date changed. If you are unable to travel to the examination you can ask for a home visit instead. If you change the arrangements over the phone write to confirm the changes. You have the right to be seen by a Doctor of the same sex.
Meet the accompanying person beforehand to discuss what's going to happen. Before the examination you should be clear that -

- the examination can be halted to allow you to go to the toilet, have a glass of water, take a pill, or if you feel faint or ill. The examination should only proceed if you feel happy to continue.

- you should refuse to do anything that hurts or distresses you.

The person accompanying you should take a pen and paper and also a watch. If possible, take a tape recorder. Peter Mathison, then Chief Executive of the Benefits Agency, has stated that the taping of medical examinatons can be carried out. Take your medicines, and any aids you use, such as a walking stick or crutches.

You can claim travel expenses for going to the examination - but if you need to take a taxi you must contact the MS beforehand.

AT THE EXAMINATION
You should be aware that the examination begins on entry to the examination centre and does not end until you leave the centre. An evaluation of your medical condition does not only take place when you are in front of the examing medical professional, but also potentially on your way into the building, in the waiting room, and on your way out. They could note the length of time you can sit without apparent discomfort, how you pick up your bag, etc..

At the examination the medical professional should be:

courteous and considerate.

Spend some time explaining the purpose of the examination.
ASK if you are willing to be examined.

Ask you and give you time to explain YOUR OWN VIEW of how you are affected by your condition, including how it affects your ability to do day to day tasks like shopping, cooking, cleaning and so on.

The medical professional should not attempt to 'manipulate' parts of your body.

During the examination you should
Make sure the medical professional realises the full extent of your illness/ disability, including any other conditions/ illnesses you may have. Remember, unlike your GP, this medical professional does not know your medical history.

Describe how you feel on a "bad day", rather than on a "good day".

If you are accompanying a claimant, then you should

Write down the name of the medical professional, their qualification eg if they are a nurse, doctor or physiotherapist, the place of examination, the time of starting and finishing the examination.

Take notes on everything the Doctor and the claimant say, what the Doctor asks the claimant to do, what happens. Especially note any aggressive attitude or manner adopted by the Doctor. Note the exact words spoken.

Intervene and ask for the examination to be halted if the claimant becomes unwell or distressed. The claimant should have a break until they feel well enough to continue.
Object to and stop any attempt by the Doctor to have the claimant do exercises which could injure or distress them. You should have the examination stopped if the claimant is becoming ill or distressed for any reason. If the claimant is not fit to continue then the examination should be postponed until another day.

If the claimant's distress is due to mistreatment by the doctor, stop the interview, then say that you will be making a complaint with a request for an examination at a future date with a different medical professional.

Time the length of the examination and any breaks taken (some medical professionals have been known to exaggerate the length of time of the examination to make it appear more thorough than it was).

At the end of the examination ask the medical professional to read back their notes, to check they made an accurate record. If the medical professional refuses, then note that and what reason he/she gives for refusing. If there seem to be any inaccuracies in the notes, check with the claimant, then if necessary ask the Doctor to change their notes. If they refuse then make a note of that, writing down exactly what they said.

AFTER THE EXAMINATION
If the medical professional did anything wrong, then as soon as posible afterwards write a letter of complaint to BAMS and to the DSS - don't wait for the decision to come through. The letter should be signed by both the claimant and the accompanying person. There is more info on making a complaint in the Disability Rights Handbook (Disability Alliance), or contact us.

HOW YOU CAN BE FOUND INCAPABLE OF WORK EVEN IF YOU DON'T SCORE ENOUGH POINTS
Even if you don’t score enough points under the personal capability assessment – the medical test to decide if you’re incapable of work – you may still have a chance of being found incapable of work either at claim or appeal stage. This is because of the little known ‘exceptional circumstances’ rules.

There are a number of these, but probably the most important is regulation 27(b), which states that you will be found incapable of work if:
‘there would be a substantial risk to the mental or physical health of any person if he were found capable of work’’
This regulation could apply to you on physical health or on mental health grounds.
For example, if you experience severe anxiety attacks and might harm yourself or somebody else if placed in a situation you find threatening, then this might be grounds for applying regulation 27(b).

Or you may have a lung condition which is made much worse by stress and, in the past, such situations have led to a serious deterioration in your health and perhaps hospitalisation. If you would find being found capable of work, having to sign on for Jobseekers Allowance and take part in training or work experience very stressful, then that may be grounds for declaring you incapable of work under the exceptional circumstances regulations.

However, neither doctors nor decision makers are quick to identify people who might be covered by these clauses. And very few claimants even know they exist.

ATOS AND THE BIGGER PICTURE

ATOS are currently recruiting more staff to help meet Government targets to force more people off disability benefits to reduce the public debt problem caused by banks gambling in the financial markets. The process is driven by cost cutting not objective medical opinion. The most vulnerable in society are being made to pay for the greed of others and the inevitable booms and busts of capitalist economics.

Medical professionals, including physiotherapists, with no experience of mental health problems, for example, are only given a matter of days training before making assessments of claimants. They are paid substantially more than NHS doctors and nurses for leaving their ethical concerns at the door. ATOS claim that they do not make the decision as to whether someone can work and have their benefits reduced, but that the decision is made by the DWP from their report and that performance targets are based simply on the number of claimants seen in a day. However they admit that if a medical professional passes all claimants for disability benefits it will not go unnoticed.

We encourage and aid claimants organising together, and linking up with workers in employment, to oppose and take action against these government policies. Why should we put up with a system where everything is run for the profit of a rich elite? Why shouldn't society's resources belong to everyone, and be used for people's needs?

You can view or download the user instructions for the ATOS Lima computer assessment here:

EDINBURGH COALITION AGAINST POVERTY

is based at the Autonomous Centre of Edinburgh (ACE), an open campaign space, infoshop and wholefoods co-op, providing resources and solidarity. Resources available include computer/internet access, cheap copying, free leaflets, books, pamphlets and mags for sale, a small wholefoods shop, and a library.

Every tuesday from 12 noon till 3pm advice and solidarity is available for benefits and debt hassles, housing and other problems. Please contact us at Edinburgh Coalition Against Poverty c/o ACE, 17 West Montgomery Place, Edinburgh EH7 5HA 0131 557 6242 ecap@lists.riseup.net We invite you to join our solidarity phone tree, and get involved.
ACE is also open every Saturday 11am-6pm and Thursday 6-8pm, and other times for particular events (but the advice sessions are only on Tuesdays).