What is a Social Security medical assessment?
Medical assessments are appointments in our Customer and Local Services office with one or two specially trained doctors. These doctors have experience in assessing the effect of illness and disability on your everyday life.
You may be asked to attend a medical assessment if you’ve applied for (or are claiming) a Social Security benefit or an impairment component of Income Support. This includes:
- Short Term Incapacity Allowance (STIA)
- Long Term Incapacity Allowance (LTIA)
- Invalidity benefit
- Incapacity pension
- Income Support (only if you are claiming an impairment component)
- Home Carer’s Allowance (person being cared for will attend medical assessment)
- Child Personal Care benefit (child will attend medical assessment with parent / guardian)
You may be regularly reassessed to make sure you’re getting the right support.
Why you need a medical assessment
You may need a medical assessment so we can work out if you are eligible for a benefit and the level of help you get. Our doctors look at:
- your claim form
- your GP’s report
- any supporting information you bring with you (this could be your hospital records and x-rays)
The medical assessment will review information provided about your illness or disability and report back to us. This helps to show whether you qualify for a benefit or not and allows us to process your claim correctly.
How long a medical assessment will take
Most medical assessments take about 45 minutes, but your appointment may be shorter or longer, depending on what is being assessed.
What the doctors will assess
- Short Term Incapacity Allowance (STIA)
- Incapacity Pension
- Invalidity Benefit
The medical assessment doctors will consider if you are fit or unfit to work.
They will consider whether you would be able to do any work, even if you’re not fit enough to go back to your own job or the same type of work.
If you’re able to do any work, this may affect your benefit payment.
- Long Term Incapacity Allowance
- Disablement Benefit
The medical assessment will find out to what extent your illness or disability affects your life.
The doctors do this by comparing you to a person of the same age and sex as you, who doesn’t have your illness or disability.
A percentage award will be given and this will be used to work out the rate of benefit you will be paid.
- Income Support impairment component
|The medical assessment will help to find out how your disability affects your:|
- state of mind
- ability to care for yourself
- ability to get about
The doctors will consider what you have said on the claim form and any other evidence you have provided.
This will be used to decide if you should get (or continue to get) the benefit and the rate you will be paid.
What to do before the medical assessment
If you’re applying for a contributory benefit, we’ll send a medical assessment form to you to give to your doctor for them to complete. They should send it back to us before your appointment.
If you’re applying for an impairment component of Income Support, we’ll send a medical assessment directly to your doctor or primary care provider for them to complete. They should send it back to us before your appointment.
What to bring to the medical assessment
You can bring:
- a relative / friend / care worker over 18 (optional)
- somebody who can translate for you (if you can’t speak English)
- psychiatric records (the hospital won't share these with us, so bring a copy if you want us to look at them for your claim)
- other supporting information and letters about your illness or condition that we haven’t already seen, including:
- letters from anyone treating you (such as consultants, specialists, chiropractors, physiotherapists, carers, support workers, counsellors and social workers)
- occupational health assessment (if you have one)
- list of current medications
All information is treated in confidence.
What happens in the medical assessment
Where to go
Currently all medical assessments are being completed by telephone and you will have been contacted prior to the assessment about this.
Don’t forget to have everything you need from the list above and listed on the letter you receive to hand.
What will happen
During your medical assessment, the doctors will talk to you about your illness or disability. They’ll consider how your condition affects your daily life, including hobbies, work, housework and exercise.
The doctor may need to examine you, but will not carry out additional tests, recommend treatments or give you prescriptions.
If you can’t / don’t attend the medical assessment
If you can’t attend your assessment because of your medical condition, you need to give us written evidence from a doctor or medical professional. Your GP can explain this on the medical assessment form or in a separate letter.
If you miss your assessment, we’ll not be able to work out if you’re eligible for the benefit. You’ll have to attend another assessment, or give us medical evidence to explain why you can’t attend.
If you can’t attend your appointment for any other reason, call us immediately on +44 (0) 1534 444444 to make another appointment.
How your benefit will be affected if you don’t attend the medical assessment
If you have a genuine medical reason why you can’t attend the medical assessment and you’re already claiming benefit, your benefit payments will carry on. Please note that Long Term Incapacity Allowance claims can only be extended by up to two weeks, even with good cause.
If you don’t turn up without good reason, this may affect your rights to receive the benefit and payments may stop.
How you’ll get the result
After the medical assessment, you’ll receive a letter to inform you of the results. It will tell you whether you’ll receive benefit and how much it will be.
If you don’t agree with the result
If you disagree with our decision, you can ask for your claim to be reviewed.
If you think your Long Term Incapacity (LTIA) award is wrong