Around 60 percent of people completing an IB50 form will be asked to attend an examination conducted by a Medical Service doctor (paid for by the DWP). This figure rises steeply for people with mental health problems. This service was run until recently by SEMA, but they have been bought up by a company called Atos.

Not all these doctors are bad, and not all medical examinations result in people losing their incapacity status. The picture welfare rights workers get of the system is probably heavily skewed by the fact that we are never contacted for help by people who keep their incapacity status, who found the doctor charming and sympathetic, and who felt they had been given plenty of time to explain their difficulties...

It should also be remembered that at the end of the day, the actual decision on incapacity status is taken by a DWP Decision Maker who DOES have the power to question and discount the  doctor’s choice of descriptors - but in practice it seems extremely rare for them to do so.

A high proportion of decisions finding people fit for work are overturned at appeal - time and time again, appeals are being won simply because the quality of the doctors’ reports are so poor and therefore easily challenged. Doctors are required to justify their choice of descriptors and where they have failed to do so properly, the DWP decision maker simply shouldn’t accept them in the first place. new IT introduced recently may improve things, but the jury's still out on this.

As well as their reports being bad, there are many all-too-real horror stories about some examinations being cursory at best, distressing and insulting at worst. If you feel your medical examination was not conducted properly, then jot down the details whilst it’s still fresh in your mind and consider complaining. It’s also worth recording how long the interview lasted; this sort of information can be very valuable when it comes to appeal.

The administration of the mental health part of the assessment seems particularly fraught with problems. The doctor will not usually ask you directly about the mental disability descriptors, but will draw his or her conclusions from other questions - e.g.. a positive response to the question “Do you speak to your mother on the phone?” has later resulted in a doctor deciding that the claimant can take a telephone message reliably! Another woman who mentioned that she was stressed was told “Not today you’re not - I’d have to fill more forms in.”!!

Another doctor examining a claimant with a bad back as well as mental health difficulties decided that because she has varnished toenails her back problem didn’t exist. Had he chosen to ask her about this at the time he would have found that her grand-daughter visited every Sunday and loved to paint Gran’s toenails - but he just jumped to his own (wrong) conclusion.

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