No realistic Advice on this As per criterion 1 A person within the prospect of should be on 12 months following a recovery of currently significant stroke who function available may recover function treatment and not during rehabilitation , so on the prospect of whilst the condition is scientists lifelong, function might discovering a improve cure in the future Unambiguous They have been Non-specific symptoms condition through relevant not formally diagnosed clinical or undergoing investigation and investigation a recognised medical diagnosis has been made all of the above and any of the LCWRA criteria are met, advise the decision maker that the claimant has a Severe Condition and has LCWRA. per filework guidelines request further evidence if it is possible that one or more of the LCWRA criteria might be met but the information has not been provided. request for further evidence should be based on indicators in the clinical information available to you. further evidence is considered necessary to enable advice regarding review or no review for a longer term prognosis further medical evidence review should always be chosen. As per current process only one request for written medical evidence should normally be made and at review only one telephone attempt to chase the evidence is required. If the claimant or their representative needs to be contacted for further evidence then a maximum of two telephone calls should be made. These should be documented on an FRR4. If the evidence is not available, you cannot advise that the claimant has a Severe Condition and normal filework case control action applies. HCPs should not default to calling a claimant to an assessment if the evidence required to meet the criteria is not available. If at filework a HCP feels that enough evidence is available on which a LCWRA the longer term’ recommendation can be made, but is unable ‘in to make a recommendation based on the Severe Conditions criteria, the advice is that they do not seek to call for exam but instead make a paper-based recommendation that change is not expected the longer-term’. The reason being that DWP believes that to increase the burden ‘in on this group of claimants would be unnecessary and go against the spirit of the policy announcement. none of the criteria are met, continue with normal case action. HCP’s default position should be that a future review is required. If you are certain that the evidence indicates that a claimant meets the Severe Conditions criteria, and a future review is therefore not required, this should be fully justified.
No realistic prospect of recovery of function Advice on this should be on currently available treatment and not on the prospect of scientists discovering a cure in the future As per criterion 1 A person within the 12 months following a significant stroke who may recover function during rehabilitation , so whilst the condition is lifelong, function might improve Unambiguous condition They have been through relevant clinical investigation and a recognised medical diagnosis has been made Non-specific symptoms not formally diagnosed or undergoing investigation all of the above and any of the LCWRA criteria are met, advise the decision maker that the claimant has a Severe Condition and has LCWRA. per filework guidelines request further evidence if it is possible that one or more of the LCWRA criteria might be met but the information has not been provided. request for further evidence should be based on indicators in the clinical information available to you. further evidence is considered necessary to enable advice regarding review or no review for a longer term prognosis further medical evidence review should always be chosen. As per current process only one request for written medical evidence should normally be made and at review only one telephone attempt to chase the evidence is required. If the claimant or their representative needs to be contacted for further evidence then a maximum of two telephone calls should be made. These should be documented on an FRR4. If the evidence is not available, you cannot advise that the claimant has a Severe Condition and normal filework case control action applies. HCPs should not default to calling a claimant to an assessment if the evidence required to meet the criteria is not available. If at filework a HCP feels that enough evidence is available on which a LCWRA ‘in the longer term’ recommendation can be made, but is unable to make a recommendation based on the Severe Conditions criteria, the advice is that they do not seek to call for exam but instead make a paper-based recommendation that change is not expected ‘in the longer-term’. The reason being that DWP believes that to increase the burden on this group of claimants would be unnecessary and go against the spirit of the policy announcement. none of the criteria are met, continue with normal case action. HCP’s default position should be that a future review is required. If you are certain that the evidence indicates that a claimant meets the Severe Conditions criteria, and a future review is therefore not required, this should be fully justified.
Severeconditionsguidance.docx