Ask CPAG Online - Have you failed to attend a medical examination?
Have you failed to attend a medical examination?
You are normally required to attend a medical examination arranged and conducted on behalf of the DWP by a private company called Maximus, as part of the LCW assessment process. The examination is an assessment of how your illness or disability affects you with reference to the activities tested under the WCA.
You must be given written notice of the date, time and place of the medical at least seven days in advance (unless you agree to less notice – e.g. to fill a cancellation).
If you fail to attend or submit to a medical examination without good cause, you are treated as not having LWC and cannot get ESA.1
If you are unable to keep an appointment to attend a medical (e.g. because of sickness or another commitment), you should contact Maximus as soon as possible to arrange another appointment. This may stop the DWP issuing a non-entitlement decision.
If you are unable to travel to the examination centre because of a disability, it may be possible for the examination to be conducted in your home. If you did not receive an appointment letter, you can make representations to the DWP, but it is often difficult to establish that a notice was sent to you. The DWP has a policy of contacting claimants with mental health problems who fail to attend a medical before making a decision to refuse ESA.
It may be possible to persuade the DWP to decide that you have LCW without an examination if there is strong evidence that you score 15 points in the WCA or that there would be a significant risk to your health if you were found not to have LCW. If you have a mental health condition, a learning disability, or another condition which affects your communication or cognition (e.g. a stroke, autistic spectrum disorder or drug or alcohol addiction), you should be classed as 'vulnerable' by the DWP and subject to 'safeguarding procedures' which include a home visit if you have not previously had contact with the DWP, and the referral of your case to a Manager before a non-entitlement decision is made. You can read more about the safeguarding procedures here.
If a non-entitlement decision has been made, you can request a mandatory reconsideration and appeal, on the basis that you had good cause for the failure to attend (e.g. due to illness or non-receipt of the notice). If you reclaim ESA within 6 months, you will only get paid pending assessment if the previous decision has been revised in your favour, or you are suffering from a new or significantly worsened condition (see Can you get paid ESA while waiting for a decision?).