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Some people who make a claim for Disability Living Allowance may be asked to have a medical examination. This is usually because more information about your disability or illness is needed before a decision on your claim can be made.

What is a medical examination?

A medical examination involves an interview and sometimes a medical examination with a doctor who has completed specialised training in disability and benefit awareness.

The medical examination is likely to be different from what you would expect from your own doctor. The Medical Services doctor's examination is not to diagnose or discuss treatment of your medical condition; it is to assess how your condition affects you and the doctor may not need to carry out a physical examination.

Who does what

The people and organisations involved in the medical examination process are:

Why you've been asked for a medical examination

You may have been asked for a medical examination for several reasons. It doesn't mean the information you've provided on your claim form is being treated as suspicious or that your claim will be turned down. One of the reasons for a medical examination may be to check you're receiving the full amount of benefit you're entitled to.

When you first apply for Disability Living Allowance, you are sent a claim form to complete. Your completed claim form is assessed by the decision-maker, who must decide:

Decision-makers may ask for a medical examination if they need more information before they can make a decision, or they're unsure about any details.

The decision-maker can approve your claim without a medical examination if they're happy with the information that they have obtained.

Special rules - if you are terminally ill

If you have a progressive disease and are not reasonably expected to live for more than another six months, there are special rules to help you get your benefit quickly and easily. It is very unlikely that you will have to attend a medical examination.

Medical examinations when you're already getting DLA

Receiving the right amount of benefit - 'Right Payment Programme'

If you're already receiving Disability Living Allowance, you may be asked to attend a medical examination as part of the Right Payment Programme.

Under the Right Payment Rrogramme, any Disability Living Allowance award may be reviewed to make sure the person is receiving the right amount of benefit.

If you receive an enquiry form, don't worry, your current benefit award will only be changed if the review highlights a change in your current entitlement. If this happens, your award will be adjusted accordingly - this could be up or down. If there are no material changes, your award will remain the same as before.

Renewal claims and reviews

If you've been awarded Disability Living Allowance for a fixed period, you will have to make another claim to renew your benefit just before your entitlement ends. This is called a 'renewal claim'. Renewal claims are treated exactly the same as new claims, so you may be asked to attend a medical examination.

If your benefit award is for an indefinite period, you will not usually have to make a renewal claim. However, indefinite awards can sometimes be reviewed and you may need to have another medical examination as part of the review.

Your rights at a medical examination

The medical examination will usually take place in your own home (or where you live) at a time that suits you. It may also take place at a Medical Examination Centre (MEC) near where you live. You should be given seven days' notice of your examination but you can ask for an earlier appointment if that suits you better.

If you miss your first examination appointment, the doctor must make a second attempt to visit you. If you miss two appointments, or refuse to attend, your benefit claim may be turned down.

You have the right:

You need to let Medical Services know ahead of time if you want an interpreter or same-gender doctor. They will try to find one for you, but this may not always be possible in some areas.