{% extends path+"/scenario_03n/_layout-case-simple.html" %}

{% block citizen_content %}

{{ data.nuggets | log }}



<p class="no-kdBar mb20"><a href="javascript: history.go(-1)" class="link-back">Back</a></p>

<form action="reviewPeriod" method="post">

<div class="grid-row">
  <div class="column-two-thirds">

	<p class="caption-large" class="mb0">File report: accept ongoing LCW</p>
	<h1 class="heading-large mt10">What does the evidence show?</h1>

<div class="form-group">
			<label class="form-label" for="evidenceKeyFacts">Summarise any other key details from the evidence to support your recommendation.</label>
			<textarea class="form-control form-control-1-1" name="evidenceKeyFacts" id="evidenceKeyFacts" rows="4"></textarea>
</div>

<div class="form-group">
			<label class="form-label" for="notLCWRAjustification">Explain why the claimant does not meet the criteria for LCWRA.
			<span class="form-hint">For example, they may have indicated an LCWRA descriptor on the questionnaire.</span></label>
			<textarea class="form-control form-control-1-1" name="notLCWRAjustification" id="notLCWRAjustification" rows="4"></textarea>
</div>

<p><input type="submit" class="button" value="Save and continue" id="submitButton"></p>
      </form>

  </div><!-- column -->



<div class="column-one-third">

<div class="summary-panel">
<h4 class="bold mb10">Justification so far</h4>
<p class="font-small">The {{ keyEvidence }} Fit note (Med3), Questionnaire (ESA50) and previous medical report ({{ previousReportDates }}) suggest the claimant meets the criteria for having limited capability for work due to {{ diagnosedConditions }}.</p>
</div>

</div>
<!-- right hand column -->



</div><!-- row -->



{% endblock %}


{% block page_scripts %}

{% include path+"/scenario_03i/autocomplete/_autocompletedata.html" %}
  
 
{% endblock %} 