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The importance of medical evidence for disability assessments

When it’s their word against yours, medical evidence is what proves you’re not the one lying. Medical evidence is what says that you are in pain, or you are blind, or you are mentally ill. It’s what confirms that you aren’t making things up or exaggerating. It’s what tells the decision maker to believe your evidence over what the Atos assessor said, or simply to believe your evidence at all.

It’s the medical evidence to counter the medical opinion of the Atos assessor. It’s the view from the person who has seen you repeatedly over months and even years; who knows what is medically wrong with you; who knows what that condition is like and what its specific effects on you are, how you respond to it and how it responds to treatment. It’s the evidence that says you have been diagnosed with Crohn’s, which is why you should be believed when you say you’re exhausted and in pain and have incontinence. It’s the evidence that says that whilst you appear normal to the Atos assessor, who doesn’t know you, actually you’re severely schizophrenic and the only reason that you look and sound and even yourself believe that you are okay is that you have recently left hospital after being sectioned to receive treatment.

When the decision maker has to decide how much weight to give your evidence, it is so vital to have expert evidence from someone else. The Atos assessor knows only what you tell them and what he or she observes. That’s hearsay and snap-shot opinion. What your GP, consultant or social worker can do is give their expert opinion – their knowledge based on years of medical training, experience of treating patients in general and experience of treating you in particular. They have the results of multiple examinations and consultations spread over months, not minutes. They have the results of what happens when particular medicine is given or therapy tried.

Medical evidence isn’t everything. Doctors know your medical history, but it has been argued that they do not know your disability because they have not seen you in day-to-day life. Supporting evidence from people who have seen you in day-to-day life – family, friends, colleagues, support workers – is also useful in validating your own appraisal. But then this supporting evidence isn’t everything either. What is needed is all three – your own evidence, evidence from those who know you personally and evidence from those who know you medically.

Government-appointed assessors can’t elicit this medical evidence. It simply isn’t possible for them to get anything more than hearsay evidence and a one-off set of observations. They don’t even have the option to take physical examinations such as blood tests that have to be sent off for the result. A judge ruled recently that Atos physiotherapists are not able to give expert medical evidence on mental health problems, for the simple reason that they are not qualified mental health workers; statements from a physiotherapist in this situation are opinion, not evidence. Expert medical evidence can only come from a medic who has oversight of the claimant.

Even worse, the reports by Atos assessors are known to be inaccurate with omissions, unfounded claims and incorrect recordings.

We, the sick and disabled, need our doctors to support workers and therapists to stand up for us. We need them to support us be providing the evidence that only they can give. We need them to care for our health, recognising that stress and poverty are only going to hold us back. We need them to stop thinking of our symptoms in isolation and treat all of us. We need them to believe that establishing stability and financial support is as much a part of good healthcare as is prescribing drugs or referring us to consultants.

What we do not need is the DWP telling us to get medical evidence, and our medics refusing to provide it. We do not need medics who say they are too busy to care for us properly, who pretend that medical evidence is not necessary, or who claim that the Jobcentre will pay the fees charged by doctors for medical reports. We do not need medics who will only provide evidence when an Atos assessor or Jobcentre worker asks for it, ignoring the fact that for most Atos assessments this evidence is not requested by the Atos assessor and when it is requested, one quarter of the time medics do not give it. We do not need to be abandoned in a situation where the only medical ‘evidence’ the decision maker receives is the opinion of the assessor, because no official asked for the appropriate evidence from the appropriate medic.

We are facing massive difficulties. Hundreds of thousands of us are affected by the Bedroom Tax, by limiting of ESA to one year, by the 1% uprating, by the change from DLA to PIP and by the loss of social services as well as by all the challenges faced by able-bodied people in a depression. We are losing our homes, losing our health and losing our lives. Please doctors, don’t abandon us now.

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