I am currently dealing with several appeal cases and in the process of requesting medical evidence from the GP I have been informed that it is now mandatory to charge a fee for doing this. Is there any legislation that states that if a medical report is requested for a claimant to get benefit the service should be free of charge?

We made enquiries of the PCT about this some time ago - were told that reports such as these are outside of the GP's contract terms, and as such they have discretion as to what they charge, if anything. When we suggested that the PCT might bring pressure to bear on Surgeries not to charge for those on benefit, phrases such as law unto themselves were bandied about. In the meantime, fees in this part of the world depend upon the Surgery, and vary from nothing to £25.

I work in the Matlock and Buxton areas and find that with the odd exception fees are charged in Buxton but not in Matlock, Ahbourne or Wirksworth. So it definitely is not mandatory to charge. One or two of the doctors around here are very keen to provide evidence as they are aware of the importance of someone's financial position on his/her health. I realise how lucky I am to have so many supportive GPs and while some manage a few lines in response to a request others provide pages of very useful stuff indeed.

Have also had some valuable support, all free, from hospital doctors, psychiatrists etc.

You are very lucky to have such co-operative GPs in your area. We have trouble getting reports from either GPs or consultants. If we do manage to get a report they are often unhelpful and the client can be asked to pay anything up to £50 from a GP or even up to £120 from a consultant.

What really annoys me is when the GP says it is their policy not to get involved as the Benefit Agency will gather all relevant information.

We find that the majority of uncooperative GP's labour under the impression that the DLA are good at obtaining facts, and even better at understanding such information as they do obtain. In addition they don't always understand the subtle but crucial difference between medical fact and medical opinion.

At present we have a classic - young lady (8) who is totally allergic to all dairy products - they produce anaphalatic shock - has to be supervised all the time to avoid foodstuffs with dairy products in. All this, and the risks involved were made crystal clear in the claim forms.

First decision from DM was no entitlement - didn't even ask for a GP report - on reconsideration request, DM writes to GP merely asking for diagnosis of medical condition (didn't say which one) GP replies "what condition?" - we even sent copy of a recent CD heavily in favour of client - you've guessed it, obvious result, recon turned down. Now at Appeal stage.

At least two of our surgeries also have GP's who carry out work for SEMA as well - whether this colours the collective views of the practice as a whole is another thing.

Unfortunately supporting evidence other than that gathered by the DWP is outwith GP contracts, although there is still some debate other whether GP's can charge for completing best person statement on DLA forms and my understanding is that they should not charge for this.

When writing out to GP's i include a statement that as a registered charity we are not in a position to be able to pay fees, but hope for GP co-operation in the best interest of patient. It is also useful to try get a meeting with local GP's or practise managers explaining the role and value of welfare rights services etc.

Hi - I believe report charging is not mandatory as GPs in this area charge from £0 to £75 per letter.

Several GPs are refusing to write anything at all (time, pressure etc.) and some are taking particularly funny stances (one said they could not comment on possible care needs as they do not live with the client - another said they would write a report the day after the hearing 'but only if unsuccessful').

I agree 'A law unto their own' describes GPs to a tee!

came across this letter today (dated sept 2004)-

'General practitioner factual reports for Disability Living Allowance and Attendance Allowance -

I write to let you know about some changes that we are making to the report forms that General Practitioners are asked to complete to assist their patients’ claims for Disability Living Allowance (DLA) and Attendance Allowance (AA). In particular, I am delighted that an increased fee will be offered for the provision of a complete report from 1st October 2004. The fee will increase from £17 to £32.'

Not sure if you’ve seen this thread or not click here for link about Legal Services Commission consultation on the use of experts, including GPs and other medical consultants?

If these proposals are taken forward as they stand, it seems that GP’s will be able to charge the following for preparation of a medical report:

Preparation per hour

Band A - £33 - £63
Band B - £64 - £99
Band C - £100 - £130

To explain the bands, from the appendices of the paper:

The “B” rates shown in the Experts’ Rates Table are the rates that the Commission expects normally to pay for an expert who is neither at the top of their specialism nor is within five years of qualification. The “B” rates are the rates that the Commission expects to pay in most cases. However, there will be occasions when “C” rates or “A” rates are appropriate. Exceptionally, rates above the “C” rates may be allowed, but only exceptionally - for example, where it is necessary to instruct an expert at the very top of their profession.

Experts, entitled under this guidance to charge a “C” or a “B” rate, should be willing to charge a “B” or an “A” rate where such rates are, under this guidance, appropriate for the job in hand and experts endorsed by the Commission will be expected to do so.

So that’s cleared that one up then???

My experience of getting GP reports is similar to most others. Its very mixed. I only seem to get free reports from GP's who are personally sympathetic to the claimant.

To be realistic, I do not expect this to change. I cannot see a GP taking extra time to do a report unless they want to do it or are paid. I am not sure that pressurising a GP is productive since it is so easy for them to give negative reports.

Where I have difficulty, it can sometime be productive for the client to obtain copies of their recent medical records under the DPA. The practice can charge for this but most will only make a nominal copying charge.

Because of this I wonder what will happen if and when the NHS ever get medical records on-line. Would this solve the problem of getting free medical evidence?

On two or three occasions recently, having tried and failed to get GP reports without the client having to pay exhorbitant fees, we have informed the tribunal of this and the Chair has adjourned the hearing with a direction that Nottingham obtain medical reports.

On one of these, the direction was to obtain records going back to 2000 - they got a complete printout from the GP's computer records - about the same thickness as the appeal papers themselves: I guess it depends on how far back you need to go.

Same sort of scenario here. We have GP's who give great reports and either don't charge or charge up to £25. Then we have GP's who give useless reports and charge over £25.

We actually sent one report and invoice back to a GP who had written two lines, which were just diagnosis and medication and charged £35. This GP was an EMP too but has now thankfully moved out of the area.

We've one surgery that tried to charge £85 for a report before actually providing it. We wrote and complained to the practice manager and declined the offer, needless to say we never heard anything about our complaint. We also no longer even request reports from this surgery.

We also have one surgery who will not under any circumstances complete the back of the DLA form. We have quoted all the usual stuff like them being required to do this under their contract to no avail.

Minefield innit!!

When I used to work for a solicitor under an LSC contract G.P.'s would charge anything from £25.00 to £120.00 for a report. This was paid from the LSC contract. The hourly rate claimed on the contract for benefit work by the solicitors was £47.80 so it used to do my head in when I recieved a bill for £120.00 for a five line letter. G.P.'s can charge what they like.

Now I'm in the not for profit sector and so far, touch wood, I have not been asked to pay a fee. However instead of asking for a medical report, I ask for a letter of support.

By the way if a surgery will not complete the back of the DLA form then complain to the PCT or GMC or BMA. (I hate jargon)

With the advent of the Freedom of Information Act, I'm not too sure that GP's can make such charges anymore - if they still can then we will just ask for copies of the clinical records going back as far as we need, bearing in mind that these can be decyphered by the medical member on the tribunal.
Some of these can be quite helpful, in that they will give the frequency of GP visits, the reasons, the advice and/medication prescribed and occasionally some other little snippits that they which they hadn't put on the record.

On several occasions a GP has sent me a report/letter along with a request for a fee. I've politely written back explaining that neither my employer nor the client are in a position to pay and, to this date, have never been pursued further. I've then used the report anyway.

"these can be decyphered by the medical member on the tribunal"

That's fine if you can decipher them yourself beforehand. We were caught once out by medical notes that we thought meant one thing when the doctor on the panel knew they meant another. Embarrassing and didn't help the client.

This is true of course - mind you I have difficulty with most Doctor's handwriting anyway, although you do seem to learn at least some of their language over a period of time.........

As part of their training, doctors have to learn over 200,000 new medical related words. It's no wonder that they speak a different language to the rest of us.

Although my favourite term is - S.L.R.

...........are we allowed to say that before the 9 o/clock watershed...?

just to take the discussion off laterally, we have much more success getting statements completed when we ask the claimant to take it to their GP in person... (i.e. make an appointment to see them)

Guess it's harder to say 'no' face to face than it is to an advisor by post...

Oh the equality of arms, if you have lots £££££££££'s that is.

Hang on a minute I once did that and got a fantastic letter from a GP saying I was trying to jeopardise the relationship between him and his patient. Something about non-medical appointments I think.

If I do this now I get clients to okay it with receptionists first (which is something I'm loathe to do, but there you are).

I'm not sure the FOA will help. I'm a bit shady on this but I think information that is already available under alternative legislation is exempt from FOA. I think theres an act re access to medical records which sets out maximum charges. Quite ready to be proved wrong though as only going from memory.

Find below an extract from the December 2004 newsletter on the Glasgow Local Medical Committee website

"Application/Appeals for Disability Living Allowances (Again!)


As we have said previously, unless there is a significant change to the patient’s condition that you think may have a bearing on their case, or you may believe that the patient has been treated unjustly, please do not undertake such reports/form filling for organisations such as the Citizen’s Advice Bureau or ‘Money Matters’ (who seem to think the patient can sue them if they do not ask for a GP report). Welfare Rights Officers have stated that statistically an additional GP report enhances the chance of a successful claim, this may well be the case if GPs only do such reports rarely as in the cases above.

However, The Department of Works and Pensions do not want additional reports as it just ‘muddies’ the water. Their decisions are based on the patient self-report and reports from GPs or, if necessary, an independent medical assessment which then takes precedence over the GP report. The LMC is also considering producing a fact sheet for such groups similar to that for housing associations.


Can we also remind our colleagues that from 1st October 2004 the fee for completing DLA reports was increased to £32 however, this is dependent on the GP meeting new turnaround targets (10 days). If for any reason the GP is unable to meet this target, for example the GP most familiar with the patient is on holiday, please inform the department of work and pensions of a delay. The reports are also to be made shorter and will ask for factual information rather than functional based questions. "

Thanks for publishing this Chris, but it's just about the most depressing three paragraphs I've ever read.

This just makes me so angry!

We've all read emp reports that bear no relation to the claimant, and/or make inappropriate and often offensive comments about claimants (and sometimes their accommodation or hobbies). I'm sure some of you will remember the extremely entertaining thread where posters listed examples - I loved the one about "nice lady - keeps goats" and wasn't there one about the house decorated with "Man United wallpaper" - or did I dream that one!

The extract Chris posted shows someone completely buying into the DWP line that an emp report is always fair and objective. I wonder if, when writing to GP's, we enclosed a copy or referred to some of the comments made by a doctor who has met the client for sometimes no longer than 20 minutes this would help shatter their illusion?(and yes I can hear the "20 minutes? You were lucky!...." jokesters out there!)


I have done this in two or three cases in extreme cases, but appreciate there is a tension in effectively saying "contradict a colleague", so reserve this tactic for the most shocking misrepresentations where I know the GP is supportive of their patient.

The hurdles we already face range from DM's who don't seem to have an awareness of the legislation, GPs who have no little or no understanding of the criteria used to decide DLA claims, the overreliance of tribunals on medical evidence to the blatant disregard and sometimes outright contempt for testimony from claimant/carers/OTs etc - in fact anyone who doesn't have a medical degree.

And then! Some newsletter suggests that the GP who is often our most vital source of informed and acceptable evidence should not bother responding to our request because it MUDDIES THE WATERS?

I know GPs have a huge workload. And I know that they deal with patients with life threatening illness - the same people we try to get benefit for! I just hope the GPs who are too busy to sign the back of DLA forms, or respond to requests for evidence that may enable their patients to afford to be ill, are too busy to read newsletters, or at least can think independently about the agenda behind the author of such a strangely biased article.

chris -

many thanks for posting the extract ... we'll publish something in news too in case people miss it here

cheers - shawn

news story now @

Doctors should only rarely provide DLA medical reports: Glasgow Local Medical Committee recommendation to GPs

thanks again to chris .....

This might sound like fighting talk but...

Is there a report on any of the case management software floating around that'd give us an easy comparison on WBDS REV and APL case results where there's been a disbursement to a G.P?

If we can get some statistical gubbins going to show that our version of G.P's evidence actually does do some good it'd go some way toward demonstrating what an anaemic view this here Glasgow business is demonstrating.

I've got a terrible feeling this'll spread; having worked in three very different geographical areas, and having seen a lot of G.P's responses to requests for what are all too often vital components to my appeal cases. We should do something to at least try and stop it beoming the standard response.

If we had an access database monitoring end codes, case types and whether there's been a disbursment to a G.P it'd be easy to draft a relatively simple query or two to show the stats.

If anyone's got access databases and they can delete names and confidential gubbins so as to email it across Data Protection Act sensitive channels then I'll do it if needs be. It'll keep me busy on lonley nights now the better half works late.

And to anyone who might quote the Access to Medical Records Act, I'd think a lot of us on have seen situations where the records don't paint a decent picture of someone's difficulties.

Any takers?

Mail me...

Years ago the GMC advised all surgeries to charge solicitor rates for what was considered to be 'beyond the normal service' letters. Fortunately many a good G.P. ignored this and continued to help out where they could. Of late, there is much talk within The Appeals Service of obtaining records of visits to the doctors surgery instead of instigating EMP reports, when more medical evidence is required for a tribunal to make it's decision.

I would generally suggest, where it is practical, for an appellant to seek copies of hospital records. These normally only cost about £10.00 for the admin fee and a small charge for photocopies and can be invaluable. I know that this is not the question posed and that I'm probably teaching grandmother to suck eggs here.

A few months ago there was a thread about appropriate or ironic songs being played to people in telephone queues. Try the following:

I be bound to write to you, 1942
You gonna need my help, 1964
My pencil won't write no more, 1972 (ooo - er)
Sad letter, 1972
Who do you trust, 1978

All songs by McKinley Morganfield, better known as legendary bluesman Muddy Waters.

Given that the Data Protection Act would apply for requests for medical notes, howsabouts Forty Days and Forty Nights???