Your GP refuses to issue ‘fit-notes’ after DWP says you are ‘fit-for-work’ – What can you do? #ScrapTheLetters

If you have been found ‘fit-for-work’ (FFW) by a Work Capability Assessment and your GP/Dr was sent an ESA65B letter (pdf) and the GP now refuses to continue issuing ‘fit-notes’ and you have requested a Mandatory Reconsideration or appealing to a Tribunal against the FFW decision, or your health condition or disability gets worse or you have a new medical condition or disability. You could provide a copy of or send your GP or GP practice links to ‘A short guide to the benefit system for general practitioners‘ and this letter of 5 April 2019 as they advise GPs when they should to continue issuing ‘fit-notes’.
(See footnote below)

Tribunal appeals found in favour of the customer:
ESA at 74%
Ministry of Justice – ‘Tribunals and gender recognition certificate statistics quarterly: October to December 2018‘ – 14 March 2019

When found FFW you may be able to claim Jobseekers Allowance (JSA ‘New Style‘) or claim Universal Credit (UC) or you will be placed in a new ‘work related activity group‘ for an existing UC claim. In these circumstances a GP/Dr can consider issuing ‘fit-notes’ so a JSA or UC Claimant Commitment (CC) [Check UC CC info] takes account of your health and disability and does not create disability discrimination.

Complaint about a GP

Template complaint letter (.doc),  for use when a GP refuses to issue ‘fit-notes’, contrary to DWP guidance to GPs and this letter. This FOI response of April 5th 2019 also advises GPs to issue ‘fit-notes’ when a claimant is pursuing a Mandatory Reconsideration (See footnote below), which is the stage that must be completed before an appeal can be lodged to a Tribunal.

Help to make a GP complaintHow to complain to the NHSGP and doctor complaintsBMA: Dealing with complaints
STOP a GP/Dr getting the ESA65B letter

There is more discussion on this in ‘Getting GP ‘fit-notes’ after being found fit-for-work by a Work Capability Assessment – #DoNotConsent‘, which also gives tips on how to STOP a GP/Dr getting the ESA65B letter.

Footnote: Guidance for GPs to follow and Challenging an ESA decision

Guidance for GPs to follow

The ‘guide‘ quoted below does not mention Mandatory Reconsideration or issuing ‘fit-notes’ due to “a new disability” but the letter quoted below does. The letter also tells GPs to issue ‘fit-notes’ when “their patient’s condition gets worse”, whereas the ‘guide‘ below refers to issuing ‘fit-notes’ when a “condition worsens significantly”. Use of the word “significantly” and absence in the ‘guide‘ of any reference to “a new disability” means it may well be best to share the letter with a GP or GP practice and not the ‘guide‘.

Challenging an ESA decision – mandatory reconsideration

‘You have 1 month from the date of the Work Capability Assessment decision to ask for mandatory reconsideration’ and “The DWP say they take as long as necessary to complete a mandatory reconsideration. This could be as little as 14 days in simple cases, but it can also take much longer.” “If you miss the deadline”, check this guidance, as “It’s still worth asking for a mandatory reconsideration, as long as it’s within 13 months of the decision”.


“GPs don’t have to provide fit notes where their patient has been found fit for work following a Work Capability Assessment (WCA) unless:

  • their patient’s condition gets worse
  • their patient develops a new disability or health condition
  • their patient asks the GP for evidence for a reconsideration or appeal against a
    WCA decision” (emphasis added)

DWP FOI reply: ‘Fit-for-Work ESA65B letter: Current and 2010 versions and claimant consent to send it to a Doctor/GP‘ – 5 April 2019


“Fit notes are required until DWP makes a decision on their claim if the patient remains unfit for work. Once DWP has made a decision on whether to award benefit, they will write to you and your patient to let you know.

No further fit notes will be required unless the patient wishes to appeal the decision.

If your patient’s appeal is unsuccessful, you should only issue further fit notes if their condition worsens significantly or they develop a new condition.”
A short guide to the benefit system for general practitioners‘  – Published 21 August 2013 – Last updated 19 March 2018

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