Some people who make a claim for DLA may be asked to have a medical examination. This is usually because more information about your disability or illness is needed before a decision on your claim can be made.
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 medical 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.
The people and organisations involved in the medical examination process are:
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 DLA, you are sent a claim form to complete. Your completed claim form is assessed by the decision-maker, who must decide:
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.
The decision-maker can approve your claim without a medical examination if they’re happy with the information that they have obtained.
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 to attend a medical examination.
If you’re already receiving DLA, you may be asked to attend a medical examination as part of the 'Periodic Enquiry' system. Under Periodic Enquiry, any DLA award may be checked to make sure the person is receiving the right amount of benefit.
If you’ve been asked to attend a medical examination as part of Periodic Enquiry, don’t worry – you haven’t been singled out for any reason. The Periodic Enquiry system is not targeted – the cases to be reviewed are selected proportionally across all levels of ‘award’.
If you’ve been awarded DLA 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.
If your benefit award is for an indefinite period, you will not usually have to make a renewal claim. However, indefinite awards can sometimes be reviewed and you may need to have another medical examination as part of the review.
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 (MEC) 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:
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.