Jobcentre Plus

Products & Transformation Division

Incapacity Benefit /Employment & Support Allowance Team

3S25 Quarry House

Quarry Hill

Leeds

LS2 7UA

Telephone: 0113 232 7418

[email address]

Our ref: FoI 595

30 April 2009

Dear Mr Gardner

I am writing in response to your request for information about Employment and Support Allowance (ESA) which you asked for on 2 April 2009.

You have asked for copies of the legislation which gives effect to the handling, acceptance and rejection of applications for ESA. I have attached copies of the Welfare Reform Act 2007, the Employment and Support Regulations, 2008, and the Social Security (Medical Evidence) Regulations, 1976 (as amended).

You have also requested details of how a medical examination and opinion of an individual's health, performed by a Doctor (or other medically qualified person) working on behalf of the Department for Work and Pensions (or agents), takes precedence over the medical examination and opinion of an applicant's own General Practitioner or Consultant.

The decision on whether or not someone has limited capability for work and is entitled to ESA is made by a decision maker on the basis of the available evidence. This evidence includes medical opinion, or advice resulting from a Work Capability Assessment (WCA) carried out by a healthcare professional employed by Atos Healthcare to carry out medical examinations for the DWP. It also includes information provided by the customer in a questionnaire before the WCA is carried out.

A decision maker may also consider evidence provided by an applicant's General Practitioner or Consultant. Though the General Practitioner or Consultant may know their patient very well their primary role is to diagnose and treat a condition. This is not the same as advice provided by independent healthcare professionals designed to help decision makers decide whether or not someone has limited capability for work for benefit entitlement purposes.

The WCA has been designed as a positive assessment, focusing on what an individual is capable of as well as their limitations with regard to work. Healthcare professionals are trained in disability assessment which enables them to provide advice to decision makers.

For these reasons it is possible that a decision maker may give more weight to the evidence of the Healthcare Professional than to the evidence of the applicant's GP or Consultant or to the evidence of the applicant. However each decision is made on the basis of the available evidence and it is also possible that a decision maker may prefer the evidence of the GP, Consultant or customer.

If you are not satisfied with my handling of your request or reason for not giving you all the information you asked for please tell me why within two calendar months of the date of this letter. I will then arrange for someone to conduct an internal review of your request and my handling/decision. The review will be conducted by another officer, usually of a more senior grade to myself. This person will have taken no part in my original decision. You will be advised of their decision in writing.

If you are still not content with the outcome of the internal review you have the right to apply directly to the Information Commissioner to look into the way your request has been handled. Please note that generally the Commissioner cannot make a decision unless you have first exhausted DWP's own complaints procedure. The Commissioner can be contacted at:

FoI Complaints Resolution

Information Commissioner's Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF
Fax: 01625 545 510

email:[email address]

Yours sincerely

Steve Brooke

A part of the Department for Work and Pensions

Mr George Gardner