Unusual PIP problem, legal advice would be helpful

CameronLove

Hi,

My wife has an illness that required her to seek a private consultant (paying private fee's) to assess her illness and help her get started on treatment to control it, as the NHS were are not equipped, nor have the treatments available to help.

As the illness is considered life-changing and without cure she was advised to do a PIP claim as she is finding it is affecting her work (how many hours a day/week she can do, how many days of sick she has to take when it flares off, etc).

She has had the interview assessment and was told the claim had gone through the DWP and was being reviewed and all was going well.

However, this morning we received an invoice from her private consultant requesting a £120 fee be paid for filling out some form (that we knew nothing about) on behalf of the PIP Assessors "Capita" who had requested an "extensive review" of her illness from the consultant who diagnosed and is treating it.

Firstly, we knew nothing of Capita wanting to contact the consultants, and also knew nothing about the consultants doing this form for them. So this was out of the blue. And it is also concerning because we had already provided copies of the consultants full assessment he supplied to her GP, with the assessment forms we sent to PIP, so there would be no need to have asked for this review from them.

We contacted the consultant and his secretary confirmed that Capita requested the forms filled in and sent back 3 weeks ago and that the rate the consultant charges for doing this is £120. And that although they were filled in, because Capita had not paid the fee, they were not releasing the forms to them, but still wanted payment for the time spent doing them. As Capita did not pay, they have forwarded to bill to be paid by us as it was outstanding and now needed to be paid immediately.

We contacted Capita (who were very unhelpful) who said that they no longer had my wife's case on file as they had collected all evidence and reports and had sent it on to the DWP to be reviewed and as such had "closed the file" and no longer had any access to it. When asking for a manager she was told there was none that could talk to her, and when asked what to do about the fee, was told to contact DWP as its in their hands and there was nothing they could do about it as its a "closed file" now. He couldn't even provide a phone number or contact details for the consultants secretary to contact to resolve it because "she would need your security details to talk to us and so we can't talk to her at all!"

We contacted the DWP and a very helpful woman explained that they had received the file and it was due to be reviewed, but that they HAD NOT requested an extensive review, that only THEY can request the review, and that THEY would pay any fee's to a consultant to get that review, that a claimant like my wife would NEVER be asked to pay any fee. That this was clearly a Capita mistake. She also went on to explain that she had looked at the rules and regulations handbook they have regarding Capita and that it is AGAINST THE RULES AND REGULATIONS for them to request anything from a consultant because it involves fee's and so only the DWP have the authority to request anything from a consultant and only if they feel its worth the cost they have to pay, so if Capita did ask for a review, they have broken the guidelines.
She told us that WE should take it up with Capita and the Consultants because Capita are clearly the ones at fault. That we should NOT pay the fee ourselves as we are not liable, and that if we DID pay the fee, it could be seen as a claimant paying a consultant to write a report that could be considered as improper influence of the report.

Tried again with Capita who again said they can't tell me anything as my wife's file is now closed and its a DWP issue to deal with, that they can't get anyone higher up to see into what is going on as "There is nobody higher up!" and can't give me any numbers of anyone to deal with the issue as "That is what I am here for, and I can't help!".

Contacted the consultants secretary once again to explain all that has been said and her advice was "You HAVE to settle the bill, as the form was requested about you so its your bill now they have not paid it." and when we explained that we had not requested (nor had knowledge of) any form being filled out for Capita, nor did either Capita or the Consultant ask for consent to do it (or more importantly bill us for it) and that we were advised NOT to pay it by the DWP so as not to get into any legal issue over influencing any confidential reports, her answer was "Well just stick the invoice in an envelope and send it to Capita or something, I am too busy for this right now! But if the bill is not settled soon then we may refuse to allow you further treatments with the consultant." and hung up.

So basically I am wondering if anyone with experience could tell me:
- Are we in any way liable to pay this fee, even though it was requested by Capita without our knowledge or our consent that we would pay for it? Surely its against some Services and Goods act being charged for a service we never knew anything about, let alone asked to pay for? Otherwise I could turn up with an empty cardboard box at the consultants and request £120 for the box even though they never asked for it?!?
- How on earth do you get it resolved when DWP are clear it is NOT their issue its Capita's, Capita don't have a clue about anything and say there is nobody to contact about it because its "file closed" for them. And the Consultant is demanding that it be paid by us if we wish to continue private treatments (the only treatments she can get because the NHS won't do them!)

And considering that this payment (which we don't even know if we are entitled to yet!) is meant to help financially ease the pain and stress my wife is going through, it is hardly doing that by adding a £120 bill and immense stress to it!

Many thanks for any advice

nannytone_2

unless you specifically asked the consultant to fill in a form for you, i would tell them where to go.

you cannot be made to pay for a service provided to a third party without agreeing that they provide that service

CameronLove

We never requested it. The invoice itself sent to us, states that they were asked by Capita regarding a PIP extensive review be sent to them. So the invoice itself explains who requested it and what they requested. But then says "This bill now requires payment in full."

Apart from providing the PIP Assessor at the interview stage a copy of the Consultant -> GP report (which obviously had the name and address for the private consultants clinic) which has NOTHING to do with PIP as we were supplied that report by our GP for free and 2 months prior to ever applying for PIP, we have no knowledge at all regarding any of this.

nannytone_2

tell them that you didn't ask for it ... capita did.
so go ask them for the payment!
they have no contract or agreement with you to pay for a service provided to a third party without your authorisation

Poppie68

The PIP forms do state they may contact your GP etc for extra information, your wife signed the forms, so agreed to it. However the cost of the forms they send for completion by the GP etc should be paid by Capita or the DWP.

CameronLove

Thanks for your advice. That is exactly what I was thinking too but thought I would get a second opinion before I tell them that, because obviously I might be in the right refusing to pay it, but I am also jeopardising the only treatment available to help my wife if they then refuse to help over an unpaid bill! But it would be harder for them to refuse if it is not our bill or our liability x

CameronLove

Poppie68 wrote: »

The PIP forms do state they may contact your GP etc for extra information, your wife signed the forms, so agreed to it. However the cost of the forms they send for completion by the GP etc should be paid by Capita or the DWP.

Yep, that is right, no issue at all about the consultant being contacted by someone, only that we then get landed the bill and without knowledge or consent. but according to DWP, Capita has no right to ask for further information from a private consultant. Only from the claimants local NHS GP. And if the DWP themselves do request the extra information, they agree to pay any and all fee's regarding the forms, but as they never asked for them, so they are not liable, only Capita, who don't have the right to ask for them (but did!) and so are not accepting anything about it.

This is what happens I guess, when you tender out government services to a private company for the cheapest rate you can get for them and then hope they do a professional service. The difference in customer service between the public DWP and the private Capita is unbelievable.

pmlindyloo

CameronLove wrote: »

Yep, that is right, no issue at all about the consultant being contacted by someone, only that we then get landed the bill and without knowledge or consent. but according to DWP, Capita has no right to ask for further information from a private consultant. Only from the claimants local NHS GP. And if the DWP themselves do request the extra information, they agree to pay any and all fee's regarding the forms, but as they never asked for them, so they are not liable, only Capita, who don't have the right to ask for them (but did!) and so are not accepting anything about it.

This is what happens I guess, when you tender out government services to a private company for the cheapest rate you can get for them and then hope they do a professional service. The difference in customer service between the public DWP and the private Capita is unbelievable.

I am hoping that this link might help you (at least with further discussions with the DWP/complaints to Capita)

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/449043/pip-assessment-guide.pdf

page 16 says about Health Professionals (ie Capita) requesting further evidence

and page 142 says about fees for further evidence

Interesting bits are the HPs should check whether it is a private consultant (did your wife state on the form that the named doctor was a private doctor?)

and whether the report was necessary as deemed by the DWP.

Second part of your question is the HP did not actually receive the report as the private consultant asked for payment first - is that right? So, am not sure how they could raise an invoice before report/forms were sent???????

I am trying to think of someone who might be able to help you with this - CAB? - maybe - perhaps they could signpost you to someone who could help.

Anyone else got any thoughts?

Poppie68

CameronLove wrote: »

Yep, that is right, no issue at all about the consultant being contacted by someone, only that we then get landed the bill and without knowledge or consent. but according to DWP, Capita has no right to ask for further information from a private consultant. Only from the claimants local NHS GP. And if the DWP themselves do request the extra information, they agree to pay any and all fee's regarding the forms, but as they never asked for them, so they are not liable, only Capita, who don't have the right to ask for them (but did!) and so are not accepting anything about it.

This is what happens I guess, when you tender out government services to a private company for the cheapest rate you can get for them and then hope they do a professional service. The difference in customer service between the public DWP and the private Capita is unbelievable.

If you're private consultant is listed on the form they can contact him, as it seems he is her main medical professional dealing with her illness then it was appropriate to ask him for further information.

Maybe speaking to someone senior at the DWP may help?

Poppie68

I would be very surprised if the Doctor hasn't completed the forms for other patients as a Private doctor.... Could you call the Secretary again and ask if the doctor has completed these forms for any other patient, she should be able to check who paid previous invoices.

CameronLove

pmlindyloo wrote: »

I am hoping that this link might help you (at least with further discussions with the DWP/complaints to Capita)

[
page 16 says about Health Professionals (ie Capita) requesting further evidence

and page 142 says about fees for further evidence

Interesting bits are the HPs should check whether it is a private consultant (did your wife state on the form that the named doctor was a private doctor?)

and whether the report was necessary as deemed by the DWP.

Second part of your question is the HP did not actually receive the report as the private consultant asked for payment first - is that right? So, am not sure how they could raise an invoice before report/forms were sent???????

I am trying to think of someone who might be able to help you with this - CAB? - maybe - perhaps they could signpost you to someone who could help.

Anyone else got any thoughts?

Many thanks, that is really useful reading.

Having read through it, the DWP seem to be correct. That Capita can contact (and pay a fee) for a GP report, but a GP or Consultant DP1500 report can only be requested by the DWP and only paid for by the DWP. Capita have no right to request or pay for a DP1500.

So if the consultant received this form, then they shouldn't have if DWP didn't authorise it (and she says they haven't even reviewed the file yet to know whether they do or not!)

And the consultants secretary definitely said both in the invoice and on the phone that the report would not be sent back until payment was received, at which point she would release it.

So there is some form/report sitting in a consultants waiting to be paid for, that Capita may not have had the right to ask for, that the DWP will only pay for if they receive it first and THEY had asked for it in the first place, that I am now being asked to pay for even though I never asked for it, because three different groups of people can't seem to get their act together!