The personal capacity assessment (PCA) is the main medical test for people who claim incapacity benefit. It "sets a threshold of incapacity that must be met as one of the conditions of entitlement to benefit". The majority of claimants will be subjected to the assessment after the first 28 weeks of incapacity. The process starts with the claimant being asked to complete a questionnaire (ref IB50) and the claimant's gp being asked to complete a form (MED 4) setting out the claimant's condition and its disabling effects.
Once the DWP decision maker has received both completed forms, he will decide whether or not to seek a further medical opinion from an approved doctor. The DWP's leaflet on the PCA states- " Given the wide variability of effects of medical conditions between individuals, the majority of cases will be referred for a medical opinion from an approved doctor." The doctor may be able to give sufficent advice from the written evidence or may feel that further information is needed from the claimant's doctor or that a medical examination is required.
The DWP leaflet makes the point that no applicant will be turned down as not meeting the threshold criteria without being offered a medical examination.
The IB Handbook for Approved doctors describes the approved doctor's role as that of a specialist medical disability analyst whose primary function is to "make an assessment of how a person's day to day life is affected by disability, and to relate this to the legislative requirements." Advice provided by approved doctors should be-
The handbook goes on to describe the key skills that doctors need for the interview process-
Doctors are instructed to record the following-
The Typical Day.
The DWP guidance makes the point that a properly completed account of a typical day is of great help to the decision maker in deciding the validity of a claim.
The account is described as "a factual description of how the claimant's condition affects them in day to day life as elicited by careful interview" Doctors are advised that the account should be focused on those areas of activity that are adversely affected by the medical condition.
The guidance also makes the point that the mental health assessment questions can be incorporated into the account of a typical day. Doctors should keep in mind the following four areas when looking at mental health issues:
Doctors are advised to obtain the claimant's consent before proceeding with any kind of physical examination. The guidance recognises that the examination or assessment may bring to light information that should be reported to the claimant's GP- the claimant's consent must be sought and he or she should be -
During the assessment claimants are scored against the following physical activities-
With regard to mental disabilities claimants are scored against the following categories-
