This is an HTML version of an attachment to the Freedom of Information request 'Fit for Assessment'.

 
 
 
 
To: Mr B Adams 
C/o xxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx 
 
 
 
 
 
 
 
 
 
18 February 2013 
 
 
 
 
Dear Mr Adams 
Freedom of Information Act – Request for Information 
 
Our Reference: FOI 0518 
 
Thank you for your Freedom of Information request which we received on 4 February 2013.  
 
You asked: Could you clarify the following information contained in your response... 
 

 1) You state .. ."There is no compulsion for claimants with mental function problems to 
complete the Limited Capability for Work questionnaire ESA50".... I would presume that this 
does not provide any exemption for those claimants, but alternatively allows another     
person to fill the ESA50 in on the claimants behalf.. Is this correct?
 
      
  2) You state .."HCPs are registered medical or nursing practitioners who have in depth 
knowledge of the practices and principles of diagnostic techniques" .... As a Disability 
Analyst is not included in the Nursing and Midwifery Council Registration “recordable 
qualifications”, then what additional qualification  enables the nurse to achieve the title 
“nursing practitioner” which is a standard of proficiency for a level beyond initial     
registration.. 
      
3) With regards to the part “in depth knowledge of the practices and principles of diagnostic 
techniques” … 
      

 a) What relevance does this have in the assessment process, and 
 b) As the scope of a nurses on initial registration does not  include diagnosis or 
prognosis, when do they obtain this in depth knowledge? 

 
4) You state.. “When a claimant has a mental function problem, DWP identify these cases 
in their referral to Atos Healthcare at the  commencement of the WCA process”.... In other 
FOI requests you state....”In order to establish a claimant’s entitlement to ESA, the DWP 
Decision Maker (DM) will make a referral to the Medical Services Contractor to issue a 
Limited Capability for Work questionnaire (ESA50)”.... 
      



This would indicate that as the ESA50 has not been completed at the referral stage, the 
DM would have no knowledge of the claimants mental function problems. The ESA 50 is 
returned to Atos and as described in the other FOI requests,... “the HCP will at that stage 
decide if a face to face WCA is required”. 
      
 5) Please could you clarify your statement: how the DWP identifies when a claimant has a
 
mental function problem in their referral to Atos Healthcare at the commencement of the 
WCA process, when no such information is yet available? 

      
 
 
In response to Q 1:  Whilst there is no restriction on a third party assisting the claimant in 
completing the ESA 50, I can confirm that we hold no information to support your assumption 
that a third party would be required to complete the form on the claimant's behalf with mental 
function problems.  However for claimants with mental health conditions the Department do not 
compel the claimant to complete the questionnaire. 
 
In response to Q 2: I note that DWP quoted an incorrect generic term “nursing practitioners” in 
their decision dated 31 January 2013, however, an approved Health Care Professional is 
prescribed in Statute as: 
  a registered medical practitioner; 
  a registered nurse; or 
  a registered occupational therapist or physiotherapist. 
 
In response to Q 3:  The Welfare Reform Act makes provision for medical assessments in 
connection with benefit entitlement to be carried out by a range of Healthcare Professionals 
specified in the legislation. The relevance to the assessment process is because nurses and 
other HCPs are increasingly being used for disability assessments, which were once reserved to 
doctors.    
 
HCPs are also fully trained in Disability Assessment Medicine. Expertise in this field qualifies the 
HCP to give an impartial, independent assessment on the way in which a claimant’s illness or 
disability affects them in carrying out of a range of everyday work-related activities. Training 
includes the assessment of the effects of specific conditions, for example claimants with mental 
health conditions. 
 
I note that Evidence Based Protocols were sent to you on 04 December 2012 (ref 3958) which 
explains the scope of diagnosis and/or prognosis.  For clarification, clinical features are identified 
at the face to face assessment.  HCPs can subdivide categories of a claimant’s mood swings 
into the biological symptoms of their disabling condition and use diagnostic techniques at the 
examination of the claimant’s mental state. 
 
In response to Q4 & 5: When DWP refer a claimant to Atos Healthcare to commence the Work 
Capability Assessment process, they record the individual claimant’s incapacity on the computer 
system referral, they obtain this information from the claimant’s Statement of Fitness for work 
medical certificate (Med 3) which has been completed by their GP at the onset of their claim.  
There are no circumstances when “no such information” is available.   
 
The DWP referral commences the process and the Limited Capability for Work Questionnaire 
(ESA50) is generated automatically by the computer system and sent out to the claimant.   On 

occasions where form ESA50 is not returned by post to Atos Healthcare, they consider whether 
the DWP referral includes mental health conditions.  If so, the claimant is not exempt from a face 
to face assessment but there is no compulsion for them to complete the Questionnaire.    
 
 
 
 
Yours sincerely 
 
 
 
Business Management Team 
Health & Disability Assessments (Operations) 
xxx.xxxxxxxxxxxxxxxxxxxxxxxxxxxxx@xxx.xxx.xxx.xx 
 
 
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Your right to complain under the Freedom of Information Act 
 
If you are not happy with this response you may request an internal review by e-mailing freedom-of-information-
xxxxxxx@xxx.xxx.xxx.xx or by writing to DWP, Central FoI Team, Caxton House, Tothill Street, London SW1H 9NA. 
Any review request should be submitted within two months of the date of this letter.  
 
If you are not content with the outcome of the internal review you may apply directly to the Information 
Commissioner’s Office for a decision. Generally the Commissioner cannot make a decision unless you have 
exhausted our own complaints procedure. The Information Commissioner can be contacted at: The Information 
Commissioner’s Office, Wycliffe House, Water Lane, Wilmslow Cheshire SK9 5AF www.ico.gov.uk