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Attendance Allowance - medical examination

Some people who make a claim for Attendance Allowance may be asked to have a medical examination. This is usually because more information is needed about your disability or illness before a decision can be made on your claim.

What is a medical examination?

A medical examination involves an interview and sometimes a medical examination with a doctor who has completed specialised training in disability and benefit awareness.

The examination is likely to be different from what you would expect from your own doctor. The Medical Services doctor's examination is not to diagnose or discuss treatment of your medical condition; it is to assess how your condition affects you and the doctor may not need to carry out a physical examination.

Who does what

The people and organisations involved in the medical examination process are:

  • the Disability and Carers Service - who are part of the Department for Work and Pensions - who handle benefit claims
  • Medical Services - who organise medical examinations on behalf of the Disability and Carers Service
  • the 'decision-maker' - a non-medical person within the Disability and Carers Service who is responsible for making a decision on your benefit claim
  • the Examining Medical Practitioner - the doctor who carries out the medical examination

Why you've been asked for a medical examination

You may have been asked for a medical examination for several reasons. It doesn't mean the information you've provided on your claim form is being treated as suspicious or that your claim will be turned down. One of the reasons for a medical examination may be to check you're receiving the full amount of benefit you're entitled to.

When you first apply for Attendance Allowance, you are sent a claim form to complete. Your completed claim form is assessed by the decision maker, who must decide whether to approve your claim and if so, whether you're entitled to receive Attendance Allowance at the higher or lower rate.

Decision-makers may ask for a medical examination if they need more information before they can make a decision, or they're unsure about any details.

If you are terminally ill

If you have a terminal illness and are not expected to live longer than six months, there are special rules to help you get your benefit quickly and easily. It is very unlikely that you will have a medical examination.

Medical examinations when you're already getting Attendance Allowance

If you've been awarded Attendance Allowance for a fixed period, you will have to make another claim to renew your benefit just before your entitlement ends. This is called a 'renewal claim'. Renewal claims are treated exactly the same as new claims, so you may be asked to attend a medical examination.

Your rights at a medical examination

The medical examination will usually take place in your own home (or where you live) at a time that suits you. It may also take place at a Medical Examination Centre near where you live. You should be given seven days' notice of your examination but you can ask for an earlier appointment if that suits you better.

If you miss your first examination appointment, the doctor must make a second attempt to visit you. If you miss two appointments, or refuse to attend, your benefit claim may be turned down.

You have the right to:

  • have a friend, relative or support worker with you at the medical examination
  • ask for an interpreter if you need one
  • ask to be examined by a doctor of the same gender as yourself

You need to let Medical Services know ahead of time if you want an interpreter or same-gender doctor. They will try to find one for you, but this may not always be possible in some areas.

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