GPs, Sick Notes And Incapacity Benefit, UK
Statutory sickness benefit is payable from day three of an illness and is available for 26 weeks.
From day three to day seven of an illness the patient should fill in a self certification form (SC1) provided by the employer.
On day seven the GP or the doctor looking after the patient, becomes responsible for certification of the illness in relation to sickness benefit.
GPs are responsible for issuing sickness certificates from day seven of a patient's illness to the end of week 26. A specific time must be stated (eg the certificate cannot say "until further notice").
After week 26, patients move to the Incapacity Benefit system if they qualify. Unlike the sick note scheme which states you are not well enough to do your own job, the IB scheme talks about whether the patient is capable of doing ANY job.
If a patient is still off sick after about week 20 the patient is told by the Department of Work and Pensions (DWP) to get a "Med 4". They go back to the GP for this form which gives fuller details of the patient's condition than the original Med 3 sickness certificate. Based on the information in Med 4, the DWP may be able to decide that a patient is incapable of work and would therefore qualify for Incapacity Benefit. An example might be someone with a fractured femur, with no unison of the bone, and scheduled to go into hospital for surgery to insert a pin and plate.
However, if further details of the illness are required by the DWP, the DWP writes to the GP and the NHS GP has to complete a form IB113 (contractual obligation).
On the basis of IB113 information, the DWP decides if the patient gets called up for a Personal Capacity Assessment (the All work Test). This assessment is not done by the patient's GP.
If a Personal Capacity Assessment is required it will be conducted by an examining medical practitioner employed by a contracted agency who act as agents for the DWP.
The examining doctor does not decide if the patient gets the Incapacity Benefit. That decision is made by a lay adjudication officer.
When the Personal Capacity Assessment has been done and a decision made by the lay adjudicator, a letter will go to the patient's GP to say whether the patient has been accepted for Incapacity Benefit or not. If the decision is that the patient is capable of work (ie any work) the GP must not issue any more sick notes unless the patient's condition changes.
If the patient gets the IB they do not go back to the GP for any more sick notes. The GP does of course continue to provide medical care.
NB The Disability Living Allowance is another quite separate benefit but again the patient's GP does not make the decision as to who gets it, and neither does the doctor employed by the contracted agency who carries out the medical examination of the patient. The decisions are made by lay adjudicators.
In short GPs are required to provide facts (not opinions) and do not take decisions on who gets benefits.
Dr Peter Holden, BMA's GPs Committee says:
"GPs are often placed in a difficult position between their patients and the system when issuing sick notes in the early stages of illness. Confirming that a patient is unwell is very different from making a judgement on whether someone is well enough to do their job. This may be determined by a host of other non-medical factors concerning the equipment they are using or the physical environment in which they work. GPs should not be there to police the system.
"For over ten years the BMA has called for the incapacity benefit process to be reviewed and reformed. There is often too much focus placed on the doctors' role in giving a medical assessment. This is only part of the process in deciding when benefits should be given. Employers should be encouraged to provide staff with access to proper occupational health services that will help them get back to work.
"GPs are only involved in certification for sick pay for the first six months, after that the medical adjudication role is the responsibility of the Department of Work and Pensions. The decision to award incapacity benefit is made by a lay adjudication officer."
http://www.bma.org.uk
GPS, note de rãu ºi de incapacitate beneficia, Marea Britanie - GPs, Sick Notes And Incapacity Benefit, UK - articole medicale engleza - startsanatate