Medical Services Referral System (MSRS) ESA User Guide

Medical Services Referral System (MSRS) ESA User Guide

Introduction & Overview of MSRS 1. The Medical Services Referral System (MSRS) was introduced in

October 2008 to provide a portal between Assessment Provider and Jobcentre Plus. The portal enables Department of Work and Pensions (DWP) to register and monitor electronic Work Capability Assessment (WCA) referrals, as all ESA claimants are subject to the WCA process.

2. ESA Managers and ESA processing teams use MSRS to: Register electronic WCA referral Manage daily workflows Monitor the progress on WCA referrals View

Cases and Referrals and action as appropriate View electronic WCA outcome reports and action

as appropriate. 3. The ESA55 Assessment Referral Jacket must be used for this

purpose. 4. DWP staff have the facility to print out reports from MSRS. This

function must only be used where the output report is required for an appeal

submission or the claimant has requested a copy of the report

5. MSRS allows DWP users to view a variety of electronic outputs, for example (not an exhaustive list):

ESA85 ESA85A Scrutiny report View SL1 Components for DNA cases (letter

history, exam history and contact history) Non return of ESA50.

6. MSRS provides a more efficient streamlined process to give a speedier end to end claimant service.

What the guidance provides 7. Since the introduction of MSRS in October 2008 there has been a

series of system enhancements. This guidance has been updated to include all MSRS system changes up to December 2011.

JSAPS MSRS Interface – automatic WCA referrals 8. An automatic interface now operates between JSAPS and MSRS.

The Interface allows for automatic WCA referrals to be made to the Assessment Provider. The majority of both WCA initial and re-referrals will be made via the automatic interface.

9. The automatic interface will not accept auto push referrals where the case details show ‘NV’ not verified medical evidence. This can be

either a self certificate or where a Statement of Fitness for Work (SoFFW) has been issued but not yet received within the department.

10. NSD staff must record medical evidence as ‘NV’ in CAM as they have not had sight of the fit note during the data gathering process.

11. BDC staff can now change the ‘NV’ status to ‘V’ verified to allow the auto push to trigger an automatic MSRS referral. Whenever the medical evidence status is changed to ‘V’ a 7 day user set case control must be set in JA530 to check if the SoFFW has been received from the claimant.

12. If the WCA referral continues without medical evidence BD staff must advise the Assessment Provider that the diagnosis details held in MSRS are from claimant information. This is done by selecting the ‘Taken from client’ field in the MSRS Create New Referral – Referral Details Type screen and also adding the diagnosis details in the Diagnosis free text box.

Note: This action is vital as medically verified and self certified diagnosis details are considered in a different way within Medical Services and may lead to incorrect advice being given.

13. Where the ESA claim is closed due to lack of medical evidence, the WCA referral must be withdrawn from MSRS as usual.

14. The following guidance outlines the processes for making either a manual referral through MSRS or a wholly clerical referral. Guidance around how the automatic interface manages the majority of WCA related referrals starts with the guidance around referring a new claim for an initial WCA.

Faxing Security Measures 15. Whenever claimant details are faxed between assessment provider

and the Department stringent security measures must be followed.

When faxing a document to Assessment Provider you must:-

Telephone the recipient to inform them that you are sending them a fax

Confirm the recipient’s fax number and dial the number carefully

Ask the recipient to ensure they wait by the fax machine to receive it

Ask the recipient to call you to confirm receipt, or, you can call them to confirm receipt. Whichever way, receipt must be confirmed verbally.

When receiving a fax from Assessment provider

You will receive a telephone call from the sender of the fax

Confirm the fax number with the sender You must wait by the fax machine to receive the

fax Call the sender to confirm receipt

NOTE: All fax/cover sheets MUST clearly state the Receiver and Sender’s Name/Section and Fax Number.

How to navigate and use MSRS 16. Once you have accessed MSRS the menu headings on the left hand

side of the page will now be activated and showing up as blue and underlined.

17. Throughout MSRS, any heading or text that is blue and underlined is a hyperlink. Clicking on the hyperlink will take you directly to the part of MSRS indicated by the heading or text.

Logging off

18. When you have completed all appropriate action on MSRS exit the system using the Exit MSRS hyperlink.

.

How MSRS manages referrals 19. MSRS manages each referral on three levels:

Client - Register Client Case - Register Case Referral - Register Referral

Client 20. This is the first level. For Assessment Provider purposes DWP

claimants are referred to as Clients. Each person registered is listed in MSRS as a Client. Mandatory information about the claimant is recorded at the Client level. Once the Client account has been created, this information can be used for any future Cases and Referrals and Re-referrals.

Case 21. This is the second level. The Case is the registration of the benefit

claim. A single MSRS Case is an ‘umbrella’ for all referrals made in respect of a single WCA, e.g. a new case will not be required to be created for a DNA referral as a case will already have been created at the first referral on MSRS. For these types of cases you need to update case details.

Referral 22. This is the third level. The term ‘referral’ is used for each individual

reference to Assessment Provider made by DWP. A full list of referral types is shown at ‘How to enter New Case details’. Therefore, an ESA ‘Case’ may contain a series of referrals covering advice (TI), then potentially several ED (failed to attend assessment) referrals where the claimant fails to attend an assessment (though there can be only one ESA Referral open at any given time). Each referral is registered separately on MSRS, however all referrals are shown under the relevant Client account.

23. As this terminology is different to other systems that DWP use it is good practice to get into the habit of thinking in terms of Client, Cases and Referrals.

The Home Page 24. Once you have accessed MSRS the standard Declaration Screen

displaying the DWP disclaimer will be visible – see Fig 1. Do not access the system further unless you are authorised to do so. By accepting the declaration you will be taken to the Search for Client page Fig 2 refers.

Fig.1.

Create Client Account

Search for Client

25. To begin using MSRS you must first search for a Client to see if an account for the claimant already exists on the system.

Fig.2.

26. To search for a client

Step Action 1 Enter the claimant’s NINO into the Search for Client screen NI

Number field. See Fig 2. Note: The NINO must be entered using the correct format, However this field is not case sensitive, upper and lower case letters can be used.

2 Click Search 3 The ‘Search Results’ screen will be shown

27. Take care when entering NINOs, because the NINO is a unique identifier and should produce only one result for each search. For cases where the NINO has been entered incorrectly, refer to the instructions at Incorrect NINO has been entered on MSRS.

Successful trace 28. If the claimant already has a Client Account on MSRS the claimant

details will be shown in the Search Results section.

Step Action

1 Click ‘View’ shown on the right hand side within the ‘Search Results’ section.

2 This will take you to the ‘View Client’ screen 3 You must update the client details, even if there are no

changes in the details. To do this select Update Client Details from the Client Actions drop down list and click on Go

4 This takes you to the Update Client screen. Check the information is correct, make any amendments if necessary and click on Update.

5 Users must click on update even where no amendments have been made.

6 Once the Update button has been selected the Last Verified Date on the View Client screen shows the latest date the

information on Client details has been updated and allows you to create a new case or referral.

7 To Create a Case select Create New Case from the Client Actions drop down list and click Go.

8 Select Employment and Support Allowance from the Benefit Type drop down menu and click Next

9 This takes you to the Create New Case screen

Unsuccessful trace 29. If a claimant account is not found MSRS displays No records found

for the search parameters in red at the top of the page, see Fig. 3. In this case you need to create a new Client record.

Fig.3

Ownership of MSRS accounts 30. As from October 2010 the Department for Social Development (DSD)

Northern Ireland (NI) previously known Northern Ireland Social Security Agency (NISSA) will also be using the MSRS system. A new ‘Ownership’ section will be visible under the Client account address details, see Fig 5 and Fig 9. Ownership is automatically set to ‘GB’ for DWP users and ‘NI’ for DSD users based on the department creating the account.

31. If when searching for a client, DWP staff enter a NINO for a claimant record owned by DSD an error message will be displayed stating “A matching Client record does exist for this NINO, but is currently owned by the Department for Social Development (DSD). Please contact DSD if ownership of this Client needs to be transferred” See Fig 4

32. As Client accounts cannot be pulled from one authority to another the owning authority must be contacted to close their referral action and transfer the account ownership.

Note: MSRS will prevent duplicate Client records with the same NINO from being created. Assessment Provider staff will not be able to transfer accounts.

Fig 4

How to change MSRS account ownership 33. Where a client account exists on MSRS and is marked as being

owned by GB, but they are now resident in NI, the DSD contact the DWP (as current owning office) to request the ownership be changed.

34. Note: To change the ownership, the DWP member of staff must be in the user group that allows them to change this field (Change Ownership user group).

35. The DWP member of staff enters the NINo in the Client Search field and selects View Client. From View Client, the user selects Update Client Details. Just above the Appointee Details is the Ownership field. As the user is in the correct user group, rather than this field being read only, it is populated with GB, but has a dropdown next to it. The user clicks the dropdown arrow and selects NI. The user clicks the Update button.

36. The ownership is now changed to NI, and the DWP user can no longer access the client. The same process is used to transfer ownership from DSD to DWP however DSD staff must take the appropriate action.

Create New Client 37. To create a New Client record on MSRS for a claimant

Step Action

1 Click on the Create New Client button, see Fig.3 and begin registering the case on the system.

2 This takes you to the Create New Client screen, see Fig 5. 38. Complete the fields that are relevant to the claimant. Some of the

fields on this screen are mandatory and must be completed. If you attempt to create a Client record without completing all of the mandatory fields, MSRS displays an error message, in red text, alongside the mandatory field.

39. To complete Client details populate the following fields:

Step Action

NI Number (Mandatory)

Enter the claimants full NI number in the correct format

Title Select the claimants title from drop down menu Name (Mandatory)

Enter the claimant’s first name. Permitted characters are alpha characters e.g. “Smith” (letters) hyphen (-) apostrophe (‘) or a space.

Surname (Mandatory)

Enter the claimants last name using the same permitted characters

Middle Initials Enter any known middle initials for the claimants. This can be upper and lower case letters

Date of Birth (Mandatory)

Enter the claimant’s date of birth. This must be entered in the correct format, e.g. dd/mm/yyyy. All eight numbers need to be input or separated with accepted characters hyphen (-) full stop (.) or forward slash (/). Alternatively, input the date using the calendar icon on the right hand side of the field.

Gender (Mandatory)

Select the claimants gender from drop down menu

Postcode Enter the claimant’s postcode Building Number/Name

Enter the claimant’s building name or number

Action to take to confirm the address

See section on How to Create Claimant Address

Home Telephone

Enter the claimant’s full home telephone number including area code

Mobile Telephone

Enter the claimant’s mobile telephone number

UCB Code Leave this field blank if there is no UCB marking. If there is an UCB marking, users must select the appropriate code from the drop down menu. See section on UCB cases

Requested Language

Where a claimant requires an interpreter to be present at the assessment, select the requested language from the drop down list. Otherwise leave blank.

Same Gender Practitioner Required

Select this tick box if the claimant has requested a same gender doctor

Date of Death This field is completed by Assessment Provider staff only Ownership This will be pre-populated based on the department

creating the account. See Ownership of MSRS accounts Appointee Tick this box if the claimant has an appointee.

Once ticked, the section expands to complete the Appointee name and address. Where the appointee is a Corporate Other Payee (COP) or Personal Acting Body (PAB) and no representative name is held, enter claimant details in the title, forename and surname (of appointee details) and enter the address manually as c/o COP/PAB name.

40. The main sources of information required to be input during registration will be the information from JSAPS.

Fig.5

View Account 41. Once all information has been input click on the Create button to

save the details and create the Client. 42. This takes you to View Client screen, see Fig. 6. At this point check

all the details are correct. If not, select Update Client from the Client Actions dropdown list.

43. The system automatically allocates the claimant a default Assessment Centre (AC), based on their postcode.

Fig.6

44. Use the View Client screen to:- view client/claimant details register a new case view case details on a previous referral update client/claimant details select/add new FME contact

Note: FME can be either the GP or the Surgery Practice Manager. update case

45. To create a new case:

Step Action

1 Select ‘Create New Case’ from the ‘Client Action’ drop down list. 2 Click on ‘Go’ 46. To view case details on previous referrals from the ‘Case Details’

table:

Step Action

1 Select the case by clicking on the radio button under the column headed Select Case

2 Select ‘View Case’ from the ‘Case Action’ drop down list. 3 Click on ‘Go’ 47. To update client/claimant details

Step Action

1 Select ‘Update Client Details’ from the ‘Client/Claimant Action’ drop down list.

Note: Client details can now be updated during an ongoing WCA referral. See Updating Client details before and during a WCA

referral 2 Click on ‘Go’ 48. To add new FME Contact details

Step Action

1 Select ‘Select/Add New FME Contact’ from the ‘Client Action’ drop down list.

2 Click on ‘Go’ 49. To update Case details

Step Action

1 Select the case by clicking on the radio button under the column headed Select Case

2 Select ‘Update Case’ from the ‘Case Action’ drop down list. 3 Click on ‘Go’ 50. The Client Actions drop down options are:

Select/ Add FME Contact Update Client Details Create Maintain Case View Outputs View FME View Examination History View Letter History

51. The Case Actions drop down options are: View Case Update Case View Outputs View FME

Note: FME can be from either the GP or the Surgery Practice Manager. View Examination History View Letter History

How to Create Claimant Address 52. Although creating the claimant’s address is not mandatory at this

point it does become mandatory at the point of creating the referral.

Therefore, it is good practice to input the claimant’s address at this stage.

Step Action

1 Once the Postcode, the house number (if known) have been input click the Search button.

2 The address is automatically returned in the address key as shown at Fig 7.

3 If only the postcode has been used then this will take you to Select Address screen, listing all the addresses that fall within that postcode.

53. The system has the facility to populate the fields without you having to type in every line of the address.

Fig. 7

Step Action

4 Select the required address from the address key by highlighting the correct entry and clicking the Select button. This takes you to the Confirm Address screen, see Fig. 8.

5 The system allows you to enter an additional first line into the address, e.g. flat number/ c/o details. Check the address is correct and, if so, click the Accept button.

6 The system returns you to the Create New Client screen to complete the action in ‘Address accepted’.

Fig. 8

Step Action

7 If the address is not recognised, click on the Manual Address

Entry button and enter the address. 8 This takes you to the Enter Address screen, see Fig 9. 9 All fields are mandatory apart from the Address Line 0 and

Building Name. After completing the relevant fields, click on the Accept button.

10 Once the address has been returned by the system or input and Accept has been selected, you are returned to the Create New Client screen.

Fig.9

How to Manually enter the Address 54. Use the Enter Address screen (Fig 10) to enter the address manually

if the search does not produce any results. All fields are mandatory apart from the ‘Address Line 0 and ‘Building Name’ which are optional.

Fig 10

55. Click on each line separately to input the address manually:

Step Action

Address Line 0 Input flat number or c/o details (if appropriate) Building Name Input building name (if appropriate) e.g. house name

Building Number

Input building number (if building name not entered)

Road Input road, street, avenue etc Local Area Input local area e.g. Westminster Post Town Input post town e.g. London (if local area not entered) Post Code Input the full post code (this is a mandatory field) To enter address

Click on ‘Accept’

UCB Cases (Previously know as Potentially Violent (PV) cases)

56. 57.

Creating a Case on MSRS

How to create the case 58. To create a case on MSRS, access the View Client screen as

depicted at Fig. 6, select Create New Case from the Client Actions drop down list and click Go.

59. This takes you to the Create New Case screen as at Fig.11 Note: you need to create a new case when the WAR has expired from JSAPS to begin WCA action for both initial and re-referral cases.

Fig. 11

60. To begin creating a new case select Employment and Support Allowance

from the Benefit Type drop down menu and click on Next.

Fig.12

How to enter New Case details

Step Action

Benefit Type This MUST always be Employment and Support Allowance Back Office This field will be automatically populated by MSRS to

show the Back Office based on the claimants post code. Claimant Office (mandatory)

Enter the office name and ID code for the referring ESA team from the drop down menu

Date Created This date will be automatically populated with the date the client details are updated

DV Mandate This field automatically defaults to ‘N’. This field is completed by Assessment providerstaff only

Availability Constraints

Select the appropriate Yes or No option from the drop-down menu. Availability constraints will apply if the claimant has stated that they are for example: Unable to attend an assessment on a certain day of

the week, e.g. regular hospital appointment

Unable to attend an exam over a period of time, e.g. away on holiday

A PWA Should not be examined by a particular HCP or doctor

if DWP staff are aware that the claimant has previously complained about a particular HCP or doctor, or appealed a decision based on a report completed by an HCP, details of the HCP or doctor must be entered in the Availability Constraints field.

Availability Constraints Details

This field must be completed with details of the type of Availability Constraint if ‘Y’ selected in the Availability Constraints field

Availability Constraints Expiry Date

This field must be completed where the date is known. If the date is not known leave blank

First Day of Incapacity

Enter the first day the claimant claimed SSP or ESA, whichever is earliest, using the correct format of dd/mm/yyyy, e.g. 18/04/2011. For example: Today’s date is 07/10/2013. SSP claimed from 22/04/2013 and expires 06/11/2013. Advanced ESA claim made. First day of incapacity is 22/04/2013. Note: If the SSP details are not available use a current date.

Re-referral (mandatory)

Select the appropriate Yes or No option from the drop-down menu. A series of different options apply depending on the initial Yes or No selection. See Creating a Re-Referral Note: Always select No for TI referrals

Previous Support Group

MSRS will automatically default to the logical answer based on the previous referral opinion. Users MUST check the correct option has been displayed as the Decision Maker may not have agreed with the opinion.

Mental Health (Mandatory

Select the appropriate option ‘Y’ or ‘N’.

IB Migration (Mandatory)

ESA teams MUST always select ‘N’

Previously Treat as LCW flag (Mandatory)

Check previous referral and select the appropriate option ‘Y’ or ‘N’. See When to set the Previously Treat as LCW section for guidance

Create Referral for this Case

This field must always be selected – select ‘NEXT’ to create a new referral

Next Selecting ‘NEXT’ will automatically take you through to the ‘Create New Referral’ screen.

Note: Red warning text will be displayed if any of the mandatory fields are not completed.

When to set the Previously Treat as LCW Flag

61. The Previously Treat as LCW Flag field option only appears for completion for re-referral ESA cases (Not IB reassessment) where the Previous Support Group Flag was set to No.

62. Setting the Previously Treat as LCW Flag to Y or N, depends on the outcome from the previous WCA referral. DWP staff must check to see if the claimant satisfied the Treat as LCW criteria on the previous referral outcome.

Note: Previously Treat as LCW does not mean previously in WRAG but refers to the specific legislative set of conditions.

63. After selecting ‘NEXT’ in the ‘Create New Case’ screen this will take you to the PA/Provider Contact Details screen

How to enter PA/Provider Contact Details

Fig.13

64. All initial WCA referrals will need to have a PA/Provider name and address recorded. You must enter the details of the PA who will conduct the first repeat WFI. If at the time the referral is made that information is not known, i.e. Choices Districts, the details of the DWP PA should be entered.

65. To enter PA/Provider contact details the Update PA / Provider screen must be fully completed.

66. Where the actual PA / Provider details are not known the following details should be used:

Step Action

Title Select Mr from drop down menu Forename Type Personal in the forename field. Permitted

characters are alpha characters e.g.’ SMITH letters, hyphen (-), apostrophe (‘) or a space.

Middle initials Leave this blank Surname Type Advisor in the Surname field Address- Type the Postcode, the Building Number/Name (if known)

into the fields Invalid character in Postcode will display where the postcode has not been input in the correct format. Invalid character in building name/number will display if not entered in the correct format

then click the Search button. 67. The address will be automatically returned in the address key as

shown at Fig 7. If only the postcode has been used then this will

take you to Select Address screen (Fig 7) listing all the addresses that fall within that postcode.

Note: Care must be taken to ensure the correct address is entered as many businesses share the same postcode.

68. You will need to click on the Manual Address Entry button to enter the address.

69. This will take you to the Enter Address screen as shown at Fig. 9. All fields are mandatory apart from the Address Line 0 and Building Name which are optional. Once in the Enter Address screen the following fields must be completed:

Step Action

Address Line 0 Enter c/o Job Centre Name/ PA Provider Organisation name Building Name Enter Job Centre / PA Provider building name Building Number

Enter Job Centre / PA Provider building number if building name not entered

Road Enter road, street, avenue etc Post Town Enter post town i.e. London (if local area not entered) Postcode Enter full post code i.e. SR5 9BU Country This field is system populated 70. Once all relevant fields have been completed click on the Accept button, then by clicking on ‘Create Case’ at the bottom of the Update PA/Provider screen, MSRS will take you to the View Case screen at Fig. 15 to begin registration of the referral.

Updating Client Details Before and During a WCA referral

71. Whether there is an existing client account or a new client account has been created, users must always check the client account and update any details as appropriate. The ‘Update’ button at the bottom of the Update Client screen must always be selected even where there has been no change(s) to the client account. See Fig 14

72. As from 14th March 2011 MSRS release 2.3 allows changes to be made to client accounts direct even when there is an ongoing WCA referral.

73. The client details can be changed by overtyping the existing information. However if the updated change is:-

A change of address, a new ESA50 will not be issued to the new address or

A claimant is now classed as UCB status the PV text field must be updated with details of the control measures. Additionally if the referral is already at the scheduling stage i.e. has a WCA appointment allocated, then the WCA referral will automatically be withdrawn and a cancellation letter issued automatically by Assessment provider If the scheduled appointment was within 2 days, and a phone number is held, the cancelled appointment will appear on the ‘View Appointment Cancellations’ screen. DWP staff must contact the claimant to advise them of the cancelled appointment. 74. Although it is not a requirement DWP staff can confirm the claimant

has been contacted by selecting the relevant claimant record and clicking ‘Confirm Notification’. If this action is not taken the View

Appointment Cancellation record will automatically disappear when the appointment date is reached.

Note: Assessment Provider staff do not have access to the PV Text field 75. To update client details follow the instructions at ‘Successful trace’.

Fig 14

76. Updating Case details may be required when: An Availability Constraint is identified or ends the claimant now has a mental health condition

or you forgot to select the MH Flag PA/Provider Contact Details have changed A claimant has been recorded with UCB status

77. To update case details:

Step Action

1 Search for Client 2 At the View Case screen as shown in Fig.15 select the Update

Case option from the Case Actions dropdown list and click on Go 3 Once selected, the Update Case screen displays showing the original

data entered 4 Make the required changes and then click on Update Case. MSRS

returns you to the View Case screen.

Formatted: Font color: Auto

Fig. 15

78. Use the ‘View Case’ screen to: view case details create a new referral view the status of an existing referral

Creating Referrals

How to create a referral on MSRS

79. At the View Case screen: Step Action 1 Click the drop down menu in the Case Actions box 2 Select Create New Referral 3 Click Go

80. This takes you to the Create New Referral screen, see Fig. 16 81. Alternatively if you have clicked the Tick box at the point of creating

the Case, you will be taken automatically to the Create New Referral screen, see Fig.16.

82. You must ensure that all details entered are correct. However following MSRS R2.3 DWP staff can update MSRS where some changes in circumstances occur. See Changes in Circumstances

Note: MSRS does not allow you to create a referral where there is already an open referral for the same case.

Fig.16

83. Use the Create New Referral screen to select the referral category type by completing the following fields:

Step Action

Referral Category (Mandatory)

Select the appropriate referral type from the Referral Category drop down list. For example, S, Q, TI , Advice Note: For an LCWRA Only referral the Referral Category will always be Q to issue the ESA50A questionnaire.

Override Default Rules

Whenever possible MSRS will select the most appropriate referral category. If the category required is not available in the drop down list tick the Override Default Rules box to view more options

Referral Sub- Category (Mandatory)

Sub-Category field displays only if referral category S or Advice has been selected e.g. ED or CZ

Supporting Case File (Mandatory)

Select Yes or No if you have a DS1500, Med 3, or any other documentation to send to Assessment provider in an ESA55

LCWRA Only (Mandatory)

Establish if the claimant can be treated as having LCW. Select ‘Y’ or ‘N’ as appropriate

LCWRA Only Reason (Mandatory)

LCWRA Only Reason field only available where ‘LCWRA Only Field’ is selected as ‘Y’. The LCWRA codes are:

In hospital Pregnancy Infectious disease Regular treatment

LCWRA Only Reason Text (Mandatory)

Enter full details for LCWRA referral. For example, hospital admission details; EDC / ADC / MAP details

Questionnaire Issue Date

This field is only enabled if an ‘S’ referral is being created and there is no previous ‘Q’ referral

Click on ‘Next’ to go to Create New Referral,

Referral Details Type screen

What is a Q (Questionnaire) Referral 84. Both initial and subsequent WCA re-referrals require the issue of an

ESA50 Limited Capability for Work Questionnaire or the issue of an ESA50A Limited Capability for Work Related Activity Questionnaire for LCWRA Only referrals. The only exception will be ESA claimed under Special Rules (TI).

85. A Q referral is created for: Cases where Assessment Provider advice states

that the claimant is not TI (MSRS automatically opens a Q referral from the original TI referral)

Cases where on receipt of the SoFFW Cases where the 28 day WAR WCA Referral’ expires from JSAPS to start the WCA process on MSRS

Cases where the Decision Maker (DM) has accepted good cause for failure to return the ESA50 and the claimant now requires a new form to complete.

LCWRA Only referrals

How to Create a Q Referral 86. To create a Q referral:

Step Action

Referral Category

In the Create New Referral screen select Q from the Referral Category drop down menu as shown at Fig.16

Click on Next to go to enter the referral details See Fig 17 Referral Type

Select ESA QS1 (Initial WCA) or ESA QS3 (Re-referral) from the Referral Type drop down menu, see Fig.17

Transcribed from Med 3

Select the radio button Transcribed from SoFFW if the diagnosis information is based on actual medical evidence provided by the claimant.

Taken from Client

Select Taken from Client if the diagnosis details are from claimant information such as a self certificate.

Diagnosis Text

Input the diagnosis from JSAPS in the Diagnosis Text (Mandatory) free text box or SoFFW

Click on Next – MSRS takes you to Select/Add New FME Contact screen Fig.18.

87. Make sure the latest diagnosis is updated on MSRS at the point of

the WCA referral as the diagnosis cannot be changed on a live MSRS referral. If a diagnosis changes during WCA action notify assessment provider of the changed diagnosis using Annex 5

88. Some changes in circumstance can now be reported between Assessment Providerand DWP. See change of circumstances.





Fig. 17

Update/ Add New FME Contact 89. The claimants GP or Surgery Practice Manager details can be added

or updated a variety of ways. However the most common route used starts with the ‘View Client’ screen.

90. To Update / Add New FME Contact

Step Action

1 In the ‘View Client’ screen select the most recent referral and in the ‘Client actions’ drop down menu select ‘Manage FME Contacts’. Then click Go

2 This will take you to the ‘Select / Add New FME Contact’ screen.

Fig.18

91. Use the Select/Add New FME Contact details screen Fig 18 to enter GP details

92. To update, edit or add new FME details:

Step Action

1 From the ‘FME Contact Actions’ drop down menu select either Edit FME Contact Add New FME Contact Delete FME Contact

2 Click on ‘Go’ 93. To update FME details:

Fig. 19

94. Use the Select/Add New FME Contact screen shown at Fig 19 to update or edit FME contact details.

Step Action

1 Select Contact Type from the drop down menu 2 Enter GP/HCP contact name from either JSAPS, input document,

CAM 3 To search for the address type in the Postcode and (if known) the

Building Number/Name 4 Click search 5 The address will be automatically returned in the address key. If

only the postcode has been used this will take you to Select Address screen, listing all the addresses that fall within that postcode.

6 Select the required address from the address key by highlighting the correct entry and clicking the Select button.

7 This will take you to the Confirm Address screen. The system will return you to Update/Add GP Contact Details.

8 If the address is not recognised click on the Manual Address Entry button and enter the address. This takes you to the Enter Address screen.

9 All fields are mandatory apart from the Address Line 0 and Building Name which are optional. Once all relevant fields have been completed click on the Accept button.

10 The system will return you to Update/Add GP Contact Details: 11 Input the up to date GP/HCP telephone number, including the

area code 12 Input the GP/HCP fax number (if provided) 13 Complete the notes box if appropriate 14 Click on Save.

95. Clicking Save returns you to View Client screen. 96. There will be a small number of ESA referrals where GP details are

out of date or the claimant has not registered with a GP practice. In these cases, contact the claimant by telephone (if a number has been provided) to obtain up to date GP details. Where you cannot

contact the claimant by telephone write to them to obtain the up to date information. You should also remove any out of date GP details from MSRS, including any information previously entered to comply with old workarounds.

97. Where no new details are provided this section should be left blank. But, only after every effort has been made to trace and enter up to date GP details.

98. To create a new Q Referral for cases where the Decision Maker (DM) has accepted good cause for failure to return the ESA50 and the claimant now requires a new form:

Step Action

1 Retrieve the existing claimant record 2 In the View Client screen from the Client Actions dropdown list

select Update Client Details. Select Update even if you do not make any amendments. This resets the last verified date to today, allowing the creation of a new referral

3 Update Case details 4 Create a new referral 5 Update/Add New FME Contact, if appropriate 6 To complete registration Click on Create Referral

When to Create a S (Scrutiny) Referral 99. Create an S Referral if any of the following circumstances apply:

Decision Maker (DM) accepts good cause for failure to attend assessment

DM accepts good cause for late return of ESA50 Questionnaire

Claimant has a mental health condition not previously indicated on MSRS

PWA and NFA cases. 100. In some instances MSRS will automatically move cases

between referral types. For example, a Q referral where the ESA50 has been returned within the time limit or where the ESA50 has not been returned within the time limit and the mental health flag has been set, MSRS will automatically progress the referral to an S referral. DWP user intervention is not required for these types of cases.

How to create a DNA (S) Referral 101. Where the Decision Maker (DM) has allowed good cause for Did

Not Attend (DNA) create a new referral. Check the information on the ESA55 is correct and update if necessary. If no ESA55 held, create one to include BF223, DNA1 (if required). Complete the following fields on the ESA55:

Claimants Full Name Claimants NINO DWP Office ID

102. The DNA1 version 5, is only required where DNA categories

Admin error – Jobcentre Plus, Admin error- assessment provider and Teleprogramming procedure not correctly

followed. 103. To register the referral on MSRS:

Step Action

1 Retrieve existing claimant record, 2 When in the View Client screen from the Client Actions

dropdown list select Update Client Details. Select Update even if no amendments have to be made. This resets the last verified date to today, allowing the creation of a new referral.

3 Update case details, 4 Select radio button of most recent referral and select case actions

choosing “create new referral” from drop down list. 5 At the Create New Referral screen, select S 6 Select Referral Sub-Category (Mandatory) ED 7 The Supporting Case File box will default to “Yes” and cannot be

changed. 8 Prepare the ESA55 for sending the supporting clerical documents.

Ensure that a copy of the DNA1 version 5, BF223 and LT54 are enclosed.

9 Click Next.

Fig 20

104. Open the Create New Referral screen:

Step Action

1 Select ESA ED1 from the Referral Type drop down menu as shown at

2 Make a selection from DNA Reason drop down menu 3 Input details of the UCB control measures in the PV Text

(Mandatory) free text box if appropriate 4 Click on Next 5 Update/Add New FME Contact if GP/HCP/Practice Manager

details have changed. If no changes are required click on Next. 6 At the Confirm Case File Sent screen click on Create Referral

Create a S Referral where FTR ESA50 good cause accepted as claimant has a mental health condition not previously indicated on MSRS

105. To register the referral:

Step Action

1 Retrieve existing claimant record, see ‘Search for Client’ 2 When in the View Client screen from the Client Actions

dropdown list select Update Client Details. Select Update even if no amendments have been made. This resets the last verified date to today, allowing the creation of a new referral

3 Update Case details, see ‘Updating Client and case details’ - ensure that the mental health tick box is selected

4 From the Create New Referral screen, see Fig.16, select S from Referral Category (Mandatory) drop down menu

5 Select S from Referral Sub-Category (Mandatory) drop down menu.

6 Select Supporting Case File, Yes as a Supporting Case File showing the MH flag set and the MH incapacity will be required.

7 Click on Next 9 Click on Next 10 Update/ Add New FME Contact if GP/HCP/Practice Manager

details have changed if no changes are required click on Next 11 If you have selected Supporting Case File as Yes, at the Confirm

Case File Sent screen click on Create Referral

Create a S Referral where DM has accepted good cause for late return of ESA50


Step Action

1 Retrieve existing claimant record, see ‘Search for Client’ 2 When in the View Client screen from the Client Actions

dropdown list select Update Client Details. Select Update even if no amendments have to be made. This resets the last verified date to today, allowing the creation of a new referral

3 Update Case details, see ‘Updating Client and case details’ 4 From the Create New Referral screen, see Fig.16, select S from

Referral Category (Mandatory) drop down menu 5 Select referral Sub - Category S from the drop down menu 6 Select Yes in the Supporting Case file box as you will have an

ESA55 to send 7 Click on Next 8 MSRS will populate the Referral Type field with either ESA SC1

for initial cases or ESA SC3 for re-referral cases as shown at Fig.17

9 Input details of the UCB control measures in the PV Text (Mandatory) free text box if appropriate

10 Click on Next

11 Update/ Add New FME Contact if GP/HCP details have changed if no changes are required click on Next

12 At the Confirm Case File Sent screen click on Create Referral

Confirm Case File Sent Fig 21

107. The MSRS R2.3 provides a new ‘Confirm Case File Sent’

108. The ‘Confirm Case File Sent’ screen will appear when an ‘S’

referral with a supporting case file (SCF) is created AND the claimant back office has changed.

For example: claimant FTR ESA50 Good cause accepted as claimant had moved

address. ‘S’ referral with SCF created and new address

enter in MSRS. MSRS identifies back office location has changed

due to new claimant address entered in MSRS (claimant post code will determine the back office).

‘Confirm Case File Sent’ screen with Release 2.3 fields will appear to inform the user that the back office has changed from the original referral.

109. Ensure that the ESA55 is sent to the correct Regional Administration Centre (RACWhen to Create a TI (Terminal Illness) Referral

110. A TI Referral is created for cases where The claimant has claimed ESA under Special

Rules. Claimants are asked to provide a DS1500 form from their GP/HCP which needs to be faxed to Assessment Provider at the point of creating a referral, if it has been supplied. Claimants who make a claim under Special Rules are referred immediately for a WCA whether or not they have a DS1500.

The next WCA referral case control has matured for a previous TI award.

There is an existing WRAG / SG award and TI has been reported as a change of circumstances before the next WCA referral date.

TI reported during the WCA process 111. Where TI has been claimed during a WCA referral DWP staff

must:- phone the relevant MSC and fax the DS1500 (or

equivalent evidence) to the MSC using the normal fax security measures.

On receipt of the TI details Assessment provider will conduct further file work on the case, and give TI advice if it’s appropriate.

Where TI is not appropriate the case will continue along the initial referral type route

Note: Under no circumstances should an ESA50 or ESA50A questionnaire be issued to customers.

112. If the claimant is in receipt of DLA or PIP under special rules they will have already submitted the DS1500. Assessment Provider must be advised on the Annex 8 fax cover sheet if PIP SR has been considered.

113. Always tick the SCF flag when a fax has been issued on these cases. This will alert the Assessment provider that TI action is required

114. Never delay a SR/TI referral. It should always be made immediately.

Note: When faxing Assessment provider you must always follow the faxing security measures

115. A claim may also be made under Special Rules claim made within assessment phase of the ESA claim.

116. Assessment Provider treat all TI referrals as priority and an electronic response will be received within two working days of making the referral.

117. To ensure that a TI referral is appropriate, check JSAPS/CAM to ensure that the Special Rules indicator has been set.


Step Action

1 Create Client Account 2 Create new case, see How to Create the Case 3 From the Create New Referral screen as shown at Fig.16 you

must select TI from Referral Category (Mandatory) drop down menu

4 Select Supporting Case File, if you are faxing the DS1500 to Assessment Provider because the claimant has provided one. The SCF will be set up by Assessment Provider on receipt of the fax

5 Click on Next 6 Select ESA TI1 from the Referral Type drop down menu as

shown at Fig.17 7 Select Transcribed from Med 3 if a DS1500 or Med3 has been

provided otherwise select Taken from Client 8 Input details from CAM and JSAPS (JA619) in the Diagnosis Text

Box 9 Input details of the UCB control measures in the PV Text

(Mandatory) free text box if appropriate 10 Click on Next 11 Update/Add New FME Contact if GP/HCP/Practice Manager

details have changed if no changes are required click on Next 12 At the Confirm Case File Sent screen click on Create Referral 13 Update JSAPS, see Referring TI claimants for further information. 14 Check CIS to see if a DLA or PIP Special Rules claim is held and

update the Annex 8 fax cover sheet. 15 Ring the PIP Helpline on 0845 850 3322 to find out when the PIP

claim / award was made and if any award has been made under special rules

16 Complete template at Annex 8 and fax with DS1500 toassessment provider. Remember to follow the faxing security measures.

119. On receipt of the WCA outcome decision makers will need to

consider if PIP has been awarded during the WCA process. See DM action on receipt of a TI referral outcome

Treat as LCW – LCWRA Only Referrals 120. MSRS release 2.3 provides the facility to make LCWRA only

referrals on MSRS instead of clerically. 121. There are three potential points in the Work Capability

Assessment (WCA) process where treat as LCW can be identified.

DWP identify ‘Treat as LCW’ before making a WCA referral 122. Where DWP staff identify ‘Treat as LCW’ conditions apply before

making a WCA referral to Assessment Provider, processors should make a Limited Capability for Work Related Activity (LCWRA) Only Referral.

Cases are fully monitored byassessment provider, If further medical evidence (FME) or the ESA50a does not provide

sufficient information for Assessment Provider to provide advice on LCWRA, the Healthcare Professional (HCP) will call the claimant for an LCWRA only assessment.

Note: Claimants in hospital can also be subject to an LCWRA appointment as a Domiciliary Visit (DV). See Hospital in-patients

123. To make an LCWRA Only Referral

Step Action


Select ‘Q’ as the referral type from the Referral Category drop down menu



Referral Sub- Sub-Category field displays only if referral category S

Category (Mandatory)

or Advice has been selected e.g. ED or CZ


Select Yes or No if you have a DS1500, SoFFW, or any other documentation to send to Assessment Provider in an ESA55

LCWRA Only (Mandatory)

Select ‘Y’

Note: By selecting Q referral category and then LCWRA an ESA50A questionnaire is automatically issued to the claimant instead of an ESA50 questionnaire. LCWRA Only Reason (Mandatory)

Select the appropriate LCWRA Only reason from the drop down menu. The LCWRA reason options are:

In hospital Pregnancy Infectious disease Regular treatment

LCWRA Only Reason Text (Mandatory)

Enter full details for LCWRA referral. For example, hospital admission details; EDC / ADC / MAP details


This field is only enabled if an ‘S’ referral is being created and there is no previous ‘Q’ referral

Click on ‘Next’ to go to Create New Referral, Referral Details Type screen Note: Claimants attending full-time education or approved training and are in receipt of both DLA/PIP/AFIP and ESA (IR) must be made as clerical LCWRA Only referrals

124. Where the LCWRA outcome is not known by the 92nd day of the

claim, claimant’s who are “treated as having Limited Capability for Work (LCW)” should be paid the WRAG rate from the 92nd day pending the LCWRA outcome.

Assessment Provider identified ‘Treat as LCW’ 125. Assessment provider can identify ‘Treat as LCW’ at different

stages in the WCA process at pre-board check / scrutiny either on receipt of ESA50 or FME, following

a normal “Q” referral through MSRS or at the face-to-face examination

126. There are 3 possible outcomes when Assessment Provider have identified ‘Treat as LCW’.

Option 1: Treat as LCW and LCWRA established 127. Assessment have advised the claimant is treated as LCW and

provided reasons with fully justified opinion given on LCWRA. This output will allow the Jobcentre Plus decision maker to determine ongoing entitlement to ESA and the relevant component (WRAG or SG) that applies from the main phase.

Step Action

1 Await return of any supporting case file (ESA55) from Assessment Provider

2 On receipt of ESA55, if appropriate, review all evidence, make decision and record in JSAPS as normal. See Outputs from MSRS

3 On completion of decision making action, ensure the Claimant Action in MSRS is cleared

Note: The MSRS Referral Outcome will show Support Group on these cases. This does not mean that the WCA has been deferred; it is a term used by MSRS only and means that the case has been treated as LCW.

Option 2: Treat as LCW established but further action needed on LCWRA 128. Assessment have advised the claimant is treated as LCW and

provided reason but there is insufficient evidence to advise on LCWRA. Assessment provider will continue LCWRA only action clerically by issuing an ESA50a questionnaire, further pre-board check / scrutiny, FME gathering and if necessary a face-to-face examination. Please note claimants in hospital can also be subject to an LCWRA appointment as a Domiciliary Visit (DV). See Hospital in-patients

129. Once the LCWRA assessment has been completed MSRS Browse New Response list will still show the Referral Outcome of either Treat as LCW or Support Group

Option 3: Treat as LCW established but no opinion on LCWRA 130. Assessment Providerhave advised that the claimant is treated

as LCW, but have not given any advice about LCWRA.

Step Action

1 DO NOT CLEAR claimant action in MSRS 2 Await return of any supporting case file (ESA55) from Assessment

Provider When any supporting case file is received it should be returned

clerically to Assessment Provider for Rework, as the opinion given is not in accordance with relevant legislation.

131. The MSRS Referral Outcome will show Treat as LCW on these cases.

Additional action where ‘Treat as LCW’ due to Maternity Allowance Period (MAP)

132. Women who are pregnant or have been recently pregnant and who are around the date of confinement can be treated as having LCW for their MAP. The criteria differ depending on the claimants Maternity Allowance (MA) entitlement.

133. The MAP will be determined as follows:- If the claimant is not entitled to MA, the MAP will

start 6 weeks before the expected week of confinement and end 2 weeks after the actual date of confinement (ADC).

If the claimant is entitled to MA the MAP will be the full 39 week MA award period. The actual award period may can be any 39 week period, the earliest starting date is 11 weeks before the expected week of confinement and the latest starting date is the day after actual confinement.

DWP identify MAP 134. DWP staff must clearly state in the LCWRA Only Reason Text

field whether or not the MAP applies. If the MAP does apply DWP staff must state the start and end dates that LCW is accepted based on the MAP.

Assessment Provider identify MAP 135. If Assessment Providerbecome aware during any type of referral

action that the claimant is within 11 weeks before, or up to 39 weeks after, the expected week of confinement, the Assessment provider admin staff will contact the BC by phone requesting clarification of any MA award.

136. DWP staff must provide details of any MA award and the MAP. If MA is in payment the HCP can treat the claimant as having LCW and if appropriate change the referral type to LCWRA only.

137. If MA is not in payment the HCP will need to identify if the current date is within 6 weeks before the expected week of confinement and 2 weeks after the ADC. If the current date is

within 6 weeks before the expected week of confinement and 2 weeks after the ADC the HCP can treat the claimant as having LCW and if appropriate change the referral type to LCWRA only

not within 6 weeks before the expected week of confinement and 2 weeks after the ADC the HCP can continue the referral action as normal.

138. If the claimant does not conform to the Treat as LCW / LCWRA process see Non-compliance with the LCWRA only process.

Advice and Reconsideration Referrals

Ask for an opinion on terminal illness Advise Assessment provider of any changes to a

claim while a reference is being made. Ask for reconsideration where new medical

evidence has been provided 139. MSRS release 2.3 provides the facility to register ESA advice

referrals on MSRS.

Create a General Advice Referral 140. To create an Advice Referral on MSRS:

Step Action


Select Advice from the Referral Category drop down list.



Referral Sub- Category

Select CN as the Referral Sub-Category Note:

(Mandatory) CN – Refers to any advice question pre WCA decision

CZ – Refers to an advice question post WCA decision where Reconsideration applies.


Select Yes or No if you have a DS1500, Med 3, or any other documentation to send to Assessment Provider in an ESA55


No entry required

Click on ‘Next’ to go to Create New Referral, Referral Details Type screen

Create a Reconsideration Advice Referral 141. Where the claimant has asked for reconsideration and / or

further medical evidence has been provided by the claimant, DWP can refer the case to Assessment Provider

142. MSRS release 2.3 provides the facility to register ESA reconsideration referrals as advice referrals on MSRS.

143. To create a reconsideration advice Referral on MSRS:

Step Action


Select Advice from the Referral Category drop down list.



Referral Sub- Category (Mandatory)

Select CZ as the Referral Sub-Category Note: CN – Refers to any advice question pre WCA

decision CZ – Refers to an advice question post WCA

decision where Reconsideration applies. Supporting Case File (Mandatory)

Select Yes as there will be documentation to send to Assessment Provider in an ESA55


No entry required

Click on ‘Next’ to go to Create New Referral, Referral Details Type screen

Creating a Referral for No Fixed Abode (NFA) or PWA Claimants

144. Claimants who have no Fixed Abode (NFA) or do not have an address are often difficult to contact. Therefore a different process is used when applying the WCA process to these claimants. Please see Creating a Referral for No Fixed Abode (NFA) Claimants and Creating a Referral for Persons Without an Address (PWA)

How to create a Re-referral 145. A re-referral to assessment Provider occurs when a future WCA

case control expires and there is no WCA action outstanding for failure to comply with the LCW assessment.

146. A new case needs to be created for each cycle of the WCA. 147. The JSAPS system action does not differentiate between initial

and re-referral cases for either the case referral or decision making output action.

148. All previous TI awards must be re-referred as a new TI manual referral on MSRS.

Clerical Referrals 149. MSRS enables the majority of ESA cases to be referred

electronically. The only exceptions are: Severely Disabled Military Personnel Miscarriage of Justice cases Rework referrals ESA (IR) claimants in receipt of DLA/PIP/AFIP

and attending full-time education or approved training. This will be an LCWRA Only referral. See Criteria to Treat claimants as having LCW

These cases must be made as clerical referrals. Please note, when preparing a clerical referral to Assessment Provider an ESA55 Referral Jacket will have to be completed.

Special Claimant Records (Formerly known as Nationally Sensitive Cases)

150. Severely Disabled Military Personnel 151. Members of the armed forces assessed by a Ministry of Defence

(MOD) medical panel to be in their highest disability category are an immediate referral to Assessment provider. This is to establish whether the claimant meets the LCWRA criteria based on the MOD medical report (F Med 23). A copy of the F Med 23 is given to the claimant at the time it is established they are in the severe disability category.

152. The referral should be prepared using an ESA55 referral jacket with the F Med 23 MOD medical report tagged inside. Enclose an ESA86MOD with the note “MOD Severe Disability Referral” in the top notes box and mark the “Special Indicator” box of the ESA55 “MOD Referral”

Miscarriage of Justice Cases

153. Claimants who are a victim of a miscarriage of justice and have their convictions overturned at a Criminal Case Review Commission, will receive additional support during their claim.

154. As only 20 cases a year are expected, all claim administration is conducted at one designated Benefit Centre. To ensure such claimants receive the correct level of support, claims are administered clerically. This includes the WCA referral process.

155. All such referrals are made using the ESA55 Referral Jacket clearly marked “Miscarriage of Justice – clerical referral”.

156. The ESA55 should also be marked “In Confidence” and addressed to the Site Manager.

157. On receipt, Assessment Provider will as part of the normal WCA referral action, seek advice from a Mental Function Champion to ensure all appropriate measures are taken to support the claimant.

158. If subsequently, a face to face assessment is deemed appropriate, assessment Provider will arrange a DV appointment.

159. If claimant refuses a DV appointment, the referral is escalated to the Site Manager who will arrange an alternative examination in discussion with the National Performance Manager.

Rework Referrals 160. DWP decision makers must ensure the Assessment Provider

output is fit for purpose before making their WCA outcome decision. 161. If the output is not fit for purpose the case must be returned to

Assesment Provider as Rework. 162. All rework referrals must be made clerically to Assessment

Provider. 163. To make a clerical rework referral:

Step Action

1 Complete and enclose form IB/ESA60 in the ESA55 file 2 On the Return of Clerical Documents side of the ESA55, note R in the

Referral details table in the Referral type column 3 Send the clerical referral to Assessment Provider using the (purple)

polylopes and not the fully tracked (orange) service 164. Non-compliance with this process will result in Assessment

provider rejecting the referral.. 165. If Assessment Provider accept the output is to be reworked the

revised report will be available on MSRS. Note: There will be no entry in the Browse New Response List to advise you that the output has been reworked. You are prompted by the return of the ESA55.

166. To view the reworked output;

Step Action

1 Access the View Outputs screen 2 The reworked report will be marked as authorised. 3 The original report will be marked as superseded and there will be an

option to view the report if required 167. If Assessment provider do not accept that the output is for

rework they will reject the referral and return the IB/ESA60 with the ESA55.

ESA (IR) claimants in receipt of DLA/PIP/AFIP and attending full-time education or approved training.

168. Any ESA claimant who is attending full-time education or approved training and is in receipt of both ESA (IR) and DLA/IP/AFIP

can be treated as having LCW providing there is no ESA ( C ) in payment.

169. Currently these cases cannot be referred to Assessment Provider electronically on MSRS. Instead a clerical LCWRA Only referral must be made until an MSRS system change has been made.

To View Created Cases and Referrals

To view a Case 170. Click the Search for Client hyperlink on the left hand column,

which takes you to the Search for Client screen. Input the claimants NINO and click on Search. Select the View Client button for the required claimant, which takes you to the View Client screen. At the bottom of the page you will see the Case Details table, see Fig 6. Click the radio button in the Select Case column, against the case you wish to view. Select View Case from the Case Actions drop down menu and click Go, which takes you to the View Case screen. At this point you will also be able to create a new referral if required.

To view a Referral

Step Action

1 At the bottom of the View Case Screen at Fig.15 you will see the Referral Details table. Click the radio button in the Select column, against the referral that has been created.

2 Select View Referrals from the Referral Actions drop down list and click Go.

3 At the View Referral screen at Fig. 22 the Referral Status indicates where Medical Services are up to in the process and shows the referral status

171. The referral status will be one of the following:

Questionnaire issue – The MSRS will be issuing the questionnaire the next posting day.

Questionnaire reminder issue – The questionnaire has been issued but the questionnaire reminder date has not been reached yet.

Questionnaire receipt – The questionnaire and reminder letter have both been issued, we are awaiting a reply from the claimant and the full response period has not expired yet.

Case File Receipt – Assessment Provider have not received supporting documentation for the referral

Pre-board Check – HCP is looking at the case Scrutiny – HCP is looking at the case. LCWRA filework – LCW established but

LCWRA to be considered. FME Dispatch – the scrutiny practitioner has

decided to get FME, but the FME has not been issued yet

FME receipt – further medical evidence has been requested by the HCP and is waiting for a reply. If the FME reply is not received by the BF date, the referral will progress to be reviewed again by the HCP.

FME pending exam – further medical evidence has been requested by the HCP and is waiting for a reply. If the FME reply is not received by the BF date, the referral will progress to the examination process.

Extract Case File – supporting paperwork is waiting to be pulled from the BF within Assessment Provider

Extract Case File Pending Exam – supporting paperwork is waiting to be pulled from the BF within Assessment Provider

Workstack – the referral requires an examination but the allocation has not yet been made

Siebel AC Appointment – Assessment Provider are dialling out to the claimant to try to arrange an appointment

Inbound Client Contact – the claimant does not have a telephone number so Assessment Provider have written to the claimant asking them to call the VCC to arrange an appointment process has not been initiated

ACAppointment – an appointment has been scheduled

Offline DV allocation – Assessment provider are waiting to allocate a DV to a practitioner

DV examination – assessment provider have scheduled a DV

OCP FME Scrutiny – unexpected FME has been received, so Medical Services are undertaking a further scrutiny to look at the FME received

OCP Pre- board Check – unexpected FME has been received, so assessment provider are undertaking a further scrutiny to look at the FME received

Clerical Assessment Centre Findings – an examination has taken place (not using integrated LiMA) but the result has not yet been entered onto MSRS

Dr Approval – a pre level 7 nurse output requires doctor approval

Medical Audit- the output has been selected for audit

E-Medical audit – the output (for a referral with no supporting case file) has been selected for audit

Confirmation of Appointment Cancellation – an appointment has been cancelled and assessment provider need to take any relevant action before proceeding.

Claimant Action –assessment providerhave completed their action on the referral further action is required by DWP

Fig. 22

172. Once in the View Referral screen you can also view the following screens below from the Referral Actions drop down list. To access the relevant screen click on Go.

View Contact History – displays the contact history made with the claimant, e.g. how many telephone calls were made by assessment provider to the claimant to arrange an appointment

View Outputs – to view reports View Referral – to view the referral status View FME – to view FME gathered by

assessment provider as a result of pre board check activity. View Examination History – displays the date

appointment made, appointment date and time, outcome and DV allocations (if appropriate)

View Letter History – displays letters issued to the claimant, e.g. ESA50, BF223, AL1.

Exceptional Circumstances, Non compliance, and Reporting Changes.

Creating a Referral for No Fixed Abode (NFA) Claimants

173. An NFA claimant is considered to have an unsafe postal address, e.g. claimants using a care of address for their post or allege persistent problems with their postal delivery arrangements

174. Contact must be made with the claimant to arrange completion of the ESA50 questionnaire. This may involve changing the claimant’s method of payment to Personal Issue if required. DWP staff must maintain a clerical BF to ensure the ESA50 issue and reminder periods are followed before failure to return the ESA50 action can be considered.

175. To register a NFA case once the completed ESA50 has been received in the BC complete the following action on MSRS:-

Step Action

1 Retrieve an existing claimant record or create a new one, see ‘Search for Client’

2 When in the View Client screen from the Client Actions dropdown list select Update Client Details, see ‘Updating Client and case details’

3 Input the BC address in the Client Address fields How to create claimant address

4 If the claimant has provided a phone number then enter the details if not leave the field blank.

5 Add an availability constraint that states NFA, see How to enter New Case details

6 Create or update the Case 7 Create S Referral with supporting case file ticked 8 Enclose the completed ESA50 in an ESA55 case file to send to

Assessment providerComplete the following mandatory fields on the ESA55 file:

Benefit Type Claimants Details section in full Jobcentre Plus Office details (DO number).

9 Remember to update JSAPS JA674 to show the WCA referral

Creating a Referral for Persons Without an Address (PWA) 176. Persons without an address (PWA) are claimants who are

actually homeless not No Fixed Abode (NFA) claimants with an unsafe address or frequently changed addresses. When the JSAPS WAR WCA Referral expires (this applies to both initial and re-referral cases) check if an up to date address has been notified.

PWA – New address available 177. Where a new address is held take action on MSRS to make a Q

referral. These claimants are no longer PWA. PWA – With a telephone number

178. If the claimant is a PWA and a telephone number is held in JSAPS, ring the claimant to enquire if they have an up to date address. If the claimant states they have a new address take the information over the phone and take action on MSRS to make a Q referral

179. If the claimant does not have an address available, tell them that they must obtain and complete an ESA50 to continue with their claim. Advise the claimant to call in at any Jobcentre and obtain an ESA50 to complete.

180. If the claimant needs help completing the questionnaire they can either:

Ring the BC Telephony teams for advice, or Request a face to face appointment at a

Jobcentre. PWA Claimant Without a Telephone Number

181. Contact must be made with the claimant to arrange completion of the ESA50 questionnaire. This may involve changing the claimant’s

method of payment to Personal Issue if required. DWP staff must maintain a clerical BF to ensure the ESA50 issue and reminder periods are followed before failure to return the ESA50 action can be considered.

Step Action

1 Retrieve an existing claimant record or create a new one, see ‘Search for Client’

2 When in the View Client screen from the Client Actions dropdown list select Update Client Details, see ‘Updating Client and case details’

3 Input the BC address in the Client Address fields How to create claimant address

4 If the claimant has provided a phone number then enter the details if not leave the field blank.

5 Add an availability constraint that states PWA, see How to enter New Case details

6 ‘Create’ or ‘Update’ the Case 7 Create an S Referral with supporting case file ticked 8 Enclose the completed ESA50 in an ESA55 case file to send to

assessment provider. Complete the following mandatory fields on the ESA55 file:

Benefit Type Claimants Details section in full Jobcentre Plus Office details (DO number).

9 Remember to update JSAPS JA674 to show the WCA referral

Incorrect NINO

Incorrect NINO already held on MSRS

182. If when creating a client; case or referral you identify that a NINO has been incorrectly entered on MSRS on a previous referral, check that the NINO and claimant details held on JSAPS are correct.

183. Where MSRS is incorrect complete the template at Annex 6 and fax it to the relevant MSC, ensuring the faxing security measures are followed, so that the information can be amended on MSRS.

184. Once assessment provider have completed their action they will fax the template to the BC so that you can register the referral using the correct NINO and claimant details. Again faxing security measures must be followed.

NINO Discrepancies upon receipt of Questionnaire 185. If assessment provider receive a questionnaire (ESA50 or ESA50A)

where the NINO is different to that on MSRS, they will take the following action.

Where there is only a single character difference between NINOs e.g. two numbers are transposed, assessment provider will contact the BC by telephone to confirm the claimant NINO.

If the NINO on the Questionnaire is incorrect, assessment providerwill change the NINO on the Questionnaire and initial the changes.

If the NINO on MSRS is incorrect, the BC must complete an MSRS Change Form and fax it to the RAC at Annex 6. Faxing security measures must be followed.

Once MSRS has been updated the MSRS Amendment Form must be retained by assessment providers for a period of 6 months.

186. If an ESA55 Case File already exists, the NINO on the ESA55 will be updated accordingly.

187. If there are multiple character differences, or it is a completely different NINO, given by the claimant on the Questionnaire assessment provider will:

Contact the BC by telephone and explain what has happened. Advise the BC that the case will be returned to the BC for the NINO

discrepancy to be investigated further. If the referral is on MSRS, assessment provider will record receipt of the

Questionnaire, create an ESA55 (if one does not already exist) and Withdraw the referral.

If the referral is clerical, assessment provider will close the referral and put a note in the ESA55.

Braille version of ESA50 requested 188. If a claimant, or claimant representative, requests a copy of the

ESA50 in Braille use the PASS services process to obtain a Braille version of both the ESA50 and IB/ESA53 reminder letter.

189. Claimants have 28 days, not including posting days, to return a completed ESA50 questionnaire and this timescale is not extended when alternative formats are required. DWP staff must action requests for alternative formats promptly.

How to obtain an ESA50 in Braille

190. DWP staff should complete the Welsh, Braille or Audio Request Form for each form required (ESA50 and IB/ESA53) and

Under the Braille - Request For Quote section select up to 2500 words. The ESA50 questionnaire is more than 2500 words however there is an agreement with ion to provide ESA50’s in Braille.

Under Additional Requirements / Further information request the claimants name and NINO be entered on the Braille document in plain English.

E-mail the completed Welsh, Braille or Audio Request Form and attach pdf versions of the ESA50 and IB/ESA53 for reference.

Note: Each BC is responsible for their own alternative format costs and should use their appropriate cost centre numbers.

Action when the Braille format received.

191. Once the Braille versions have been received issue the Braille ESA50 to the claimant without delay, remember to include a business reply envelope for the appropriate RAC. Record the form issue in JSAPS and set a JSAPS case control for 21 days after the original ESA50 was issued.

192. If the 21 day reminder period has already passed, issue both the Braille versions of the ESA50 and IB/ESA53 at the same time and remember to include a business reply envelope for the appropriate RAC. Record the issue of both forms in JSAPS and set a JSAPS case control for 7 days later.

193. If the completed ESA50 has not been returned by the 7 day case control, check to see if the claimant has a mental health condition.

If there is a mental health condition, and the mental health flag has been set on MSRS, the WCA referral action will continue on MSRS.

If there is not a mental health condition, refer the case to the DM to consider disallowance. Remember to clear action on MSRS as an output may have been produced for non return on the ESA50.

Before setting the N flag always refer to the list of conditions with the missing (*) on the IRG front page

Note: The ESA50 should not be completed in Braille

Hospital in-patients 194. Claimants are automatically treated as having LCW if they are

hospital in-patients, see Criteria to Treat claimants as having LCW. However assessment providermay often need to gather further information before providing LCWRA advice.

195. Wherever possible assessment provider will use details provided on the LCWRA questionnaire (ESA50A) and gather further assessment provider from claimants GPs, consultants etc to provide advice on LCWRA. However if insufficient evidence can be obtained, an LCWRA only face-to-face examination may be required in hospital.

196. Referrals are not to be withdrawn from MSRS when a claimant is admitted into hospital. The change in circumstance needs to be reported to assessment providerusing the Annex 5 template along with full details of the hospital name, ward, date of admission and if known consultant.

Recording WCA Assessments 197. Claimants have the right to request a recording of their WCA

assessment. Previously each claimant was responsible for providing their own recording equipment, which must be able to provide a copy recording at the time of the assessment.

198. The dual recording is required as both the claimant and the HCP need an exact copy recording of the assessment.

Action when a claimant requests a WCA assessment be recorded 199. To facilitate the recording of WCA assessments each MEC has

a Dual Recording Machine. These machines will provide two separate unencrypted CD copies of the assessment recording simultaneously.

200. Once notified of a request for a recorded assessment each MSC is responsible for co-ordinating the provision of the dual recording equipment.

201. A request for a recorded assessment will usually be made directly with the Assessment Provider. However DWP staff may receive requests from claimants for a recorded assessment.

DWP action when a claimant requests a recorded assessment. 202. On receipt of the request for a recorded WCA assessment, DWP

staff must immediately notify their local Services Resource Team of the request by phone.

203. The Resource Team will take all required action to arrange the WCA assessment recording.

Obtaining a transcript of the recording 204. The DM can only request a transcript of the audio recording for

appeal purposes. 205. To request a transcript of the audio recording take the following

action. The transcript will be typed up under the DWP Office Services Contract by Balfour Beatty Workplace.

Step Action 1 Phone the Customer Relations Team Manager on 0113 230

9157, or 0113 230 9175 to request a copy of the WCA audio assessment CD for the relevant claimant

2 assessment provider will send the CD direct to the named member of staff by TNT Fully Documented Service.

3 DWP staff will forward the CD using the secure TNT Fully Documented

Service (Orange Polylope) along with the non fraud Typing Requisition Form (Non Tape Transcriptions) to the typists Set a new BF for 5 working days from receipt of the CD for the return of the transcript.

4 The Typists will compile a typed transcript of the CD and return both the CD and the transcript to a named member of staff using the secure TNT Fully Documented Service (Orange Polylope).

On receipt of the CD and transcript the DM must check that the transcript is fit for purpose and destroy the CD (a master copy will be held by The Assessment Provider) if rework is not required. The transcript is then available for the appeal.

Incorrect referrals, rejections and withdrawals

Code 700 cases 206. Code 700 is used where there is no suitable incapacity listed in

the Incapacity Reference Guide and means ‘other specified incapacity’. This code should only be used as a last resort.

207. Whenever code 0700 has been used details of the incapacity should be noted in JA110 and must be entered in the ‘Create New Referral’ screen ‘Diagnosis Text’ field.

208. If insufficient diagnosis details have been provided the following action will apply:

Mental Health condition applies 209. Code 700 referrals will be returned by the Assessment provider

if the ESA50 has not been returned by the due date. The incapacity will not be known on these cases and the Mental Health flag should have been set to ‘No’ on MSRS.

210. DWP staff must identify the correct incapacity and if a Mental Health condition does apply, an S referral will be appropriate. Users must make an immediate S referral on MSRS and:-

Ensure the MH flag is set to Y provide a SCF and set the SCF flag to Y Before setting the N flag always refer to the

list of conditions with the missing (*) on the IRG front page (set hyperlink here)

Provide the correct diagnosis on the ESA55 file cover

Mental Health condition does not apply 211. If a Mental Health condition does not apply the case should be

referred to a decision maker to consider disallowance for failure to return the ESA50. If good cause is accepted and a completed ESA50 provided users must make an S referral on MSRS and ensure:-

Ensure the MH flag is set to N, provide a SCF and set the SCF flag to Y

Provide the correct diagnosis on the ESA55 file cover

Nonsensical diagnosis 212. When creating a new referral on MSRS completion of the

‘Diagnosis Text’ field is mandatory. the Assessment Provider needs to know the claimant’s current incapacity as this information will advise both the HCPs and process flow.

213. assessment provider will reject any S referral where the MH flag is set as ‘N’ and there is no comprehensive diagnosis. The only exception will be where a late ESA50 has been received, in which case the SCF flag will be set to ‘Y’ and an ESA55 containing the ESA50 will be sent to assessment provider.

214. Any Q or S referral where the MH flag is set as ‘Y’ and there is no comprehensive diagnosis Assessment Provider will phone the BC to find out why the MH flag was set and what the correct diagnosis is.

If DWP can provide valid details, assessment provide will record the phone call and file the details in a constructed ESA55. MSRS cannot be updated as the referral will be live however assessment provider will note MSRS that FME has been received and the SCF flag will be changed to Y.

If DWP cannot provide valid details Assessment Provider will reject the referral. The Browse New

Response List rejection reason will be ‘Reject – other’ and the free text box will show ‘Full incapacity req’d’.

215. Assessment Provider will reject any S referral where both the MH flag and SCF flag are set to ‘N’. There is no identifiable reason for this combination on an S referral. The Browse New Response List rejection reason will be ‘Reject – other’ and the free text box will show ‘MH flag needs setting or SCF provided’

Rejections 216. It is essential to ensure that referrals to the Assessment Provider

are correct first time before issue. This applies to MSRS referrals and any supporting case files. The Assessment Provider will try to rectify issues that have been identified by telephone and DWP staff must co-operate with them to resolve the problem immediately.

217. If you disagree with a rejection, resolve the issue locally. If this is not possible, bring disputed cases to the attention of the HDA Performance Manager for discussion at the monthly Local Interface Meeting (LIM).

218. Ensure that rejections are avoided where possible by ensuring that:

There are no duplicate referrals on MSRS for the same case

Documentation/information is provided, e.g. DNA1, ESA60, up to date address and telephone number, etc

Compliance of the registration process by selecting the correct referral type on MSRS, Mandatory fields are completed, UCB details have been completed. etc

Note: Any case rejected by the Assessment Provider cannot be re-referred as a Q referral unless a new questionnaire issue is appropriate.

Withdrawing Referrals 219. With the introduction of MSRS R2.3 DWP staff have an

additional option to withdraw referrals directly from MSRS. It should be noted that if this option is used, the outcome will not appear in the Browser New Response list.

Note: You can only withdraw a referral if the WCA assessment has not been completed. If the case is within 5 days of assessment it is your responsibility to notify the claimant they should not attend the assessment. This can be by phone text or letter.

220. Under no circumstance should a claim marked as at Audit ever be withdrawn. Once the claimant has had an assessment you must complete the journey to determine LCW/no LCW.

221. To operate this option:

Step Action

1 Access the View Case screen 2 Select ‘Withdraw Referral’ from the Case Actions drop down list

222. This will take you to the Withdraw Referral screen. See Fig 23

3 Select the appropriate Withdrawal Reason, entering text in the Note

box if required 4 Click Withdraw Referral

Fig 23

Atos Withdrawals 223. Atos may make withdrawals without notifying the referring office

for any of the following reasons Claimant unavailable for 4 weeks for non-medical reasons e.g. on

holiday Claimant has returned to work Claimant has gone abroad 224. If they need to withdraw a referral for any other reason they will

contact the referring office for approval first. 225. The reasons for the withdrawals will be

Client dead Other – this will generally be because the claimant is unavailable for

more than 6 weeks.

Non- compliance with the LCW process.

What is non compliance?

226. The responsibilities and behaviours expected from ESA claimants are explained to them when they claim benefit through the Contact Centre, attend mandatory interviews and contained within a variety of letters regarding the WCA process.

227. Claimants who do not, without good cause, return requested information i.e. ESA50 attend scheduled appointments i.e. WCA assessment answer questions or respond appropriately within an assessment

are regarded as being non compliant.

Unable to Attend (UTA) Cases 228. Claimants who have been scheduled a WCA appointment either

by an agreed telephone call (teleprogramming) or an appointment letter can rearrange the appointment if necessary.

229. Assessment provider will automatically rearrange the first UTA appointment when required.

230. The appointment can only be rearranged once and if the claimant fails to attend the rescheduled appointment, even if they have made contact to say they cannot attend, they will be treated as a ‘Did Not Attend (DNA)’ case

Did Not Attend (DNA) Cases

231. Where the claimant fails to attend their WCA, assessment provider will issue a BF223 to the claimant to ask them why they did not attend. The claimant is given seven calendar days to provide reasons for non-attendance. If there is an ESA55 this will be returned to DWP. Where there is no case file, use the Browse New Response List to generate a worklist of cases.

232. Once the output has been received, plus any supporting documents clear the response from MSRS and update JSAPS Note: The date on which the BF223 was issued is displayed in the MSRS Letters History screen and on any ESA55.

233. To determine if good cause for failure to attend assessment can be accepted the DM will need to consider the reasons provided by the claimant on the BF223 and view Contact History, Examination History by MEC and Letter History on MSRS before making an outcome decision. To navigate to these screens:

Step Action

1 Click the Search for Client hyperlink on the left hand column, which takes you to the Search for Client screen

2 Input the claimants NINO and click on Search 3 Select the View Client button for the required claimant, which takes you

to the View Client screen 4 Select View Examination History, View Letter History or View

Contact History from the Client Actions drop down menu on the right hand side of the page.

5 Click on Go

Non-compliance with the LCWRA only process.

Failure to return the LCWRA questionnaire (ESA50A) 234. There are two points during the treat as LCW process that the

claimant may fail to comply with the request for information. 235. This could be when Jobcentre Plus makes an LCWRA only

referral to The Assessment provide or where the Assessment Provider identify Treat as LCW within a Q or S referral process.

236. Usually the Assessment Provider will issue an LCWRA questionnaire (ESA50A) to the claimant. The claimant may fail to reply to the LCWRA questionnaire (ESA50A). assessment provider will continue with the assessment process and provide LCWRA advice.

237. There is no legal requirement for the claimant to return the ESA50A, therefore no good cause consideration is required, as there are no grounds on which ESA could be terminated for non return of the ESA50A. The ESA DM should consider on-going ESA entitlement based on the information available about why the claimant is treated as LCW, and LCWRA advice.

Failure to attend an LCWRA only examination 238. Where a LCWRA only assessment was arranged, the claimant

may show non-compliance with the process by failing to attend at the appointment time. Assessment Provider will return the case file (ESA55) to the BC.

239. There is no legal requirement for the claimant to attend a LCWRA only appointment; as a result assessment provider will not issue a BF223 to the claimant, although the MSRS system will indicate that a BF223 has been issued. The ESA DM should consider on-going ESA entitlement based on the information available about why the claimant is treated as LCW, awarding the WRA component from the main phase as the claimant has not provided information to support an LCWRA component award.

240. On completion of decision making action and JSAPS update, check MSRS for a live ESA referral and ensure that the Claimant Action is cleared

Change in Circumstances 241. MSRS release 2.3 provides the facility to report some changes in

claimant circumstances during an open WCA referral. The changes are reported between DWP / assessment provider electronically using MSRS.

242. Claimant changes which can be notified using MSRS are: name date of birth address telephone numbers UCB status

243. The action to take will depend on what the change is and who the change is notified to.

Claimant notifies the change to DWP

244. Where a claimant notifies DWP of a change, DWP staff need to decide if the change impacts on the current WCA referral. Where the change is relevant to the WCA referral to Assessment Provider must be notified of the change.

245. MSRS R2.3 enables DWP staff to update the following fields:

Title Surname Forename Middle Initials Date of Birth Sex M/F Address (including post code, maintained

through UC0004) Home telephone number Mobile telephone number Appointee - option to update appointee details

(only 1 appointee): o Appointee Title o Appointee Surname o Appointee Forename o Appointee Middle Initials o Appointee address o Appointee telephone number

PV code PV text Requested language – from list Male/female practitioner required Date of Death Ownership (i.e. GB/NI)

246. To report a change in circumstances to assessment Provider

Step Action

1 Search for the relevant claimant’s Client Account 2 Click ‘View’ shown on the right hand side within the ‘Search Results’

section. 3 This will take you to the ‘View Client’ screen 4 Select ‘Update Client details’ from the ‘View Client Action’ drop down

menu and click Go 5 This takes you to the Update Client screen. Amend the details by

overtyping and click on Update. See Fig 24 247. Assessment Provider staff are automatically notified of the changes

that have been made. However the change will usually be taken into account at the next Assessment Provider action.

For example: Claimant reports a change of address during the ESA50 questionnaire return period and MSRS is updated. A new ESA50 is not issued to the new address however any reminder letter issued after the Client Account update will be issued to the new address.

,. ... -·---~---.. .-... ~-,.._ M.>;ll'!;. Ml<'m.otl "'."'"''I ~pomr JHO'VI,,.~ by Al-Oda:b• &141£31

c• "" 'l!I- ... _ . ..... !.°"'" u.rri. ..;)I ..... # "WOo i:)~ .til fi • 1"'-C:t< • ......CH 4J l>OS-'11 - ......... -iW. '1 ,..,._,-~· f/I -· 4J ,,..,.,_fl ............. , .. _ _..,~HSI!> ~ .. ......,. .. ,,....., ff,,_.~

!t or • ~.._. •-~,..,.... • - ~ . • : t e- • ~·• · ...

M$&is£M upaarc c 11cnt

.......... """'""'

~J.1CC Apfe!Qll) l!t'•* •d9 •• ttti ....... -·•O.• ............ .o; .... ,

o .. ,_,,r• .. ..J••"~' eu ... tAddr••• ~-. ............ .

Y&1wO.n11Mtd!n~· l>.llCl!lll(llhM!W .. 11*'",. ,,.. ... Vlt\ocC'eM' flln f l( U.ttd.t• ~c.,. .... .,.,,, .. , -....,,....-

.....

....

~ ... ~ ......... . ...... 0...-• ~ ........... ""''""

""" ... °"""""' Af)pol nt•• l\.lo¥FJIC111te.•D

..

- ~

n Ill

Claimant notifies the change to Assessment Provider 249. MSRS release 2.3 includes the facil ity to view and action a change

reported by the claimant to AP. 250. Where claimant notifies AP of a change, for example by phone or on

the ESA50, AP will record the change in MSRS. 251 . MSRS will then produce a visible output for each change in the 'View

Change of Circs Records' screen. 252. The new facility allows the user to view a list of changes/updates

made by AP relating to the claimanUappointee details held on MSRS. See Fig.25

How to access and action the 'View Change of Circs Records'

253. The 'View Change of Circs Records' screen can be access by clicking the blue View Change of Circs Records hyperlink from the list menu on the left side of the MSRS Options view.

Fig 25

254. To access and filter the list of Change of Circs records: 255. Users can filter the ‘View Change of Circs Records’ to select

specific changes or claimant alpha groups. 256. Take the following action to view the changes records. 257. When the required search criteria ‘View Change of Circs’ is entered

MSRS will display a list of all outstanding Change of Circs records.

Step Action

Claimant Office (Mandatory)

Select the ESA office

Item Changed Select the appropriate change from the drop down menu. Drop down values are:

Client name Client address Client telephone no Client mobile no Client gender Appointee name Appointee address Appointee telephone no GP name GP telephone GP address Client date of birth

Select a value from the list or select blank to list all changes.

Client Surname Enter the first 3 letters of the claimants surname – this is optional

View Change of Circs Record

Select to view the changes list. This will take users to the ‘Change of Circs Records’ screen. See Fig 26

Fig 26 258. The Change of Circs list provides a sort option. The list can be sorted

by NINo, Surname and Changed Date from the above header fields. 259. Only one page can be actioned at any one time. Individual or multiple

records can be cleared from the list on the chosen page. 260. It is essential that users correctly maintain the change of

circumstances records. The changes list must be viewed and actioned on a daily basis. Changes will remain visible on the list for 2 months only before they are removed automatically. The change details cannot be retrieved once removed

261. Minor cosmetic changes, such as changing St to Street, do not represent essential changes and can be cleared from the ‘Change of Circs Records’ without further action.

Notifying changes to Jobcentres and Providers 262. BC staff must always consider whether or not the Jobcentre or

Provider need to be advised of the change. 263. The BC is then responsible for advising Jobcentres and Providers of

the relevant change. 264. BC staff advise the change to Jobcentres using the A8 electronic

Change of Circs and Enquiry template. or clerically using ESA23. 265. Providers are directly notified clerically using form WP07b. 266. The Jobcentre Admin Support Officer (ASO) will update LMS on

receipt of the Change of Circs template or ESA23. 267. On completion of assessment provider action you will receive a

variety of electronic outputs from MSRS which can be accessed via the Browse New Response List, Change of Circs List and View Referral options.

268. The outputs will lead to the WCA outcome decision. The viewable notifications/reports will be:

View Letter, and Contact History for failure to attend/comply/participate with LCW assessment where the claimant DNA

View Letter and Contact History for failure to return ESA50

Recommendation for Terminally ill report (ESA85A)

Recommendation for Support Group (ESA85/85A)

Recommendation for LCW Assessment report (ESA85)

Scrutiny report (re-referrals) (ESA85A) 269. MSRS R2.3 provides output information in the following additional

screens View FME View Appointment Cancellation and View Change of Circs

270. When MSRS has produced outputs DWP staff must clear the response. This prevents congestion within the MSRS system.

271. BC staff must always advise the Jobcentre and Provider of the WCA outcome.

Treat as LCW applies within the WCA decision 272. Additional action is now required where the claimant has been

‘Treated as having LCW’ either; before the referral is made leading to an LCWRA

Only referral or where assessment provider identify the Treat as

LCW criteria apply during the LCW assessment. 273. DWP staff must take the following action when the WRAG

component is awarded

Step Action

1 Check to see if the DM has applied the Treat as LCW criteria as part of the WCA decision and the WRAG has been awarded

2 If Treat as LCW is part of the WCA decision, access JSAPS screen JA110111 to input a generic note stating ‘Treat as LCW applies, do not remove until after next WCA referral’ and ‘today’s date’.

Note: This action is necessary as DWP staff need to identify and set a Previously Treated as LCW flag on the MSRS re-referral. This action will in turn decide if The Assessment Provider will conduct a pre-board check or take scrutiny action. See also When to set the Previously Treat as LCW Flag

The Browse New Response List (BNRL) 274. MSRS now has a new case control, S372 (WCA Result

Available). This case control alerts DWP staff that a WCA outcome is available in the MSRS Browse New Response List. Specific instructions around how the new case control should be handled are outlined in the WCA outcome guidance.

275. Access the Browse New Response hyperlink from either the homepage or the hyperlink list shown on the left hand column on MSRS screens. This will take you to Browse New Response List screen, see Fig. 27.

276. ESA Team Leaders need to access the Browse New Response List hyperlink daily to manage workflows between DWP and the Assessment Provider and to check the progress of uncleared responses on referrals.

277. The link assists team leaders to manage workflow by viewing the ESA85 and ESA85A, identifying cases where ESA55s are due in the

next few days, identifying cases where ESA50 not returned.

278. The BNRL will only contain ‘authorised’ output reports. Where the claimant’s NINO is entered any ‘draft’ reports may be visible on MSRS. A draft report is where the report is undergoing audit following an assessment. Do Not Use the draft report.

Creating a BNRL work list

Fig. 27

279. Work lists can be requested from the BNRL to assist workflow management.

280. To generate a work list from the BNRL consider the following filter options:

Step Action

Claimant Office

Select claimant (DWP) office from the drop down menu

Benefit Type Select Employment and Support Allowance from the Benefit Type drop down menu

Client Surname Input the first three characters on which to filter Client Surname, e.g. sco-sto. This sort facility is optional

Referral Category

Select the appropriate category from the Referral Category

Referral Outcome

Referral Outcome, this field defaults to Show All. You can select a category from the following: Accepted Rejected Withdrawn Advice given Treat as LCW

Support Group

Not Support Group (LCWRA only referrals)

Could not be examined

Examined

DNA

Not returned

Returned

Referral outcome definitions listed in the Browse New Response List

Found to be LCW but not LCWRA at Scrutiny

Used when a referral has been rejected

Used when a referral has been withdrawn

Used in response to an Advice referral

Found to be Treat as LCW but not LCWRA at Scrutiny/Pre-board check

Used where the HCP opinion is Support Group, identified either at filework or face-to-face assessment (note that the outcome sub-code will identify any clients that are in the Support Group because they are terminally ill).

Used in response to LCWRA referrals

Used when it has not been

possible to conduct the required face-to-face DV assessment (for instance because the claimant was not present, or refused to be examined, or if the given address is incorrect).

Used when a claimant has attended a face-to-face assessment

Used when a claimant has not attended a face-to-face AC assessment

Used when a non-MH

claimant has not returned an ESA50 (Q referrals only)

Used when a claimant has returned an ESA50

Referral Outcome

The options for referral outcome subcode are (in the order in which they’ll be displayed):

SubCode Terminally ill Client now PV Threshold Met Threshold Not Met Chemotherapy Physical or Mental Health Risk Pregnancy Risk Severe Functional Disability Treat as LCW Not treat as LCW Client dead Client gone abroad Client returned to work Other Previous referral missing for re-ref case Full postal/current address of claimant Full postal address/full GP details need Claimants NI number missing Claimants date of birth missing This is a duplicate referral Form IB55/ESA55 not completed Referral type is missing/incorrect Details are not clear/legible Correct file jacket has not been used Date of incapacity is missing/incorrect PV details are missing Missing document/information Other

The outcome subcodes are used to identify TI outcomes, to distinguish between above/below threshold, exam outcomes and withdrawal or rejection reasons. Note: The first ‘Other’ in the list is a withdrawal reason, whilst the second is a rejection reason.

Supporting Case File

Select the appropriate Supporting Cases File option.

IB Migration The IB Migration option is only to be used by IB (IS) Reassessment cases. This section should always be set to No for ESA cases. Note: IB (IS) Reassessment referrals must be made as ESA re-referral cases with the IB Migration flag set. If the IB Migration flag has not been set correctly then reassessment cases could appear as ESA case load.

Threshold Met Flag

The Threshold Met Flag is an indicator as to the score following the LCW output. Select Yes, No, or Either to filter outcomes. Note: Selecting ‘Threshold Met’ ‘Yes’ and ‘Threshold Met’ ‘No’, will not equal all output cases. The Either option must be selected to include non compliance cases i.e. DNA

281. Once the filter options have been applied, click View Response List.

282. This will take you to the Browse New Response List. See Fig 28

283. You can view the list of responses shown at Fig. 28 and sort the results by clicking the headers at the top of each column.

284. The column headed ‘IB Mig’ has been added for IB (IS) Reassessment cases. This is for IB (IS) Reassessment teams only.

285. Note from 27/04/12, the following minor changes have been made to both the Browse New Response List filter option screen and search results screen.

The “(Referred by) Surname” and “(Referred by) Forename” have been removed as filter options in an attempt to improve search download times.

The search results table now includes the total number of records found for each search at the bottom right hand corner.

Fig. 28 286. To view an individual case from the BNRL:

Step Action

1 Click on the radio button in the last column for the selected case and press View Referral.

2 MSRS will take you to the View Referral screen at Fig.22 Note: A padlock is displayed if another user currently has the referral open.

287. The output data will only be held on the BNRL for 6 months. See Automatic Clearance of BNRL and Change of Circs Records

Threshold Met Flag

288. MSRS R2.3 provides an additional BNRL filtering option based on the outcome score sheet. The filter assists referral teams to manage workflow but does not provide a definitive outcome as the decision maker must evaluate all of the evidence before the WCA outcome is decided.

289. Not every output will have a threshold met indicator as a face-to-face assessment is not conducted in every case. There is not the facility to include the threshold met flag on hand written reports.

Viewing Reports 290. DWP staff can access both scrutiny (consideration of paper

evidence) outputs and assessment (face to face) assessment output reports on-line via MSRS.

291. To view do this:

Step Action

1 Navigate to the View Case screen for the claimant 2 Select the relevant referral from the table using the radio button in the

Select column 3 From the Referrals Action dropdown, select View Outputs and click Go 4 This takes you to the View Outputs screen, see Fig 29. 5 At the View Outputs scren you can then view a report 6 Make a selection from the list See Fig. 29 7 Click the radio button in the column headed Select 8 Click

View HTML to view ESA85 assessment reports and maximise the screen on the top right hand corner of the screen so that you can view whole pages of the report, or

View PDF Reports to view ESA85A reports again maximise the screen on the top right hand corner of the screen so that you can view the whole page of the report.

9 Once you have viewed the required report, close the report by selecting the X at the top right hand of the page.

Fig. 29

292. Users must ensure that the report status is shown as ‘authorised’. Any ‘superseded’ or ‘draft’ output report must not be used. See Fig. 30

293. DWP staff will now have the facility to print out reports direct from MSRS. This function must only be used where:

the output report is required for an appeal submission or

the claimant has requested a copy of the report 294. A copy of the score sheet can be viewed by selecting from the

Supplementary reports drop down menu.

View Appointment Cancellations 295. MSRS Release 2.3 includes two new screens to show

Appointment Cancellations. 296. The Appointment Cancellations list must be monitored on a daily

basis. 297. To view the ‘Appointment Cancellations’ screens access the

hyperlink on the list on the left side of the MSRS Options menu.

Fig.31

298. Take the following action to view the appt cancellations records.

Step Action

Claimant Office Select the ESA office

(Mandatory) Migration Flag Select ‘No’ as the Migration Flag only refers to IB (IS)

Reassessment cases Client Surname Enter the first 3 letters of the claimants surname – this is

optional View Appointment Cancellation

Click on ‘View Appointment Cancellations’. This will take you to the ‘View Appointment Cancellations’ screen. See Fig 32

Fig.32

299. The ‘View Appointment Cancellation’ screen shows of all appointments that have been withdrawn/cancelled by DWP at short notice i.e. within 2 days of the appointment date.

300. An appointment cancellation letter will be issued automatically by the MSRS system when the withdrawn/cancellation reason is entered.

301. Appointments that have been withdrawn/cancelled at short notice i.e. within 2 days must be actioned immediately.

302. BFD must contact the claimant to inform them of the cancellation and, where appropriate, a new referral will be created at a later date.

303. This action must be completed immediately to ensure the claimant does not attend the cancelled appointment

304. Although it is not a requirement DWP staff can confirm the claimant has been contacted by selecting the relevant claimant record and clicking ‘Confirm Notification’. If this action is not taken the View Appointment Cancellation record will automatically disappear when the appointment date is reached.

Non compliance Outputs 305. Non compliance output can be either where the referral has

been made incorrectly and rejected or where the claimant has failed to return the ESA50 or attend an assessment.

306. Where a referral has been rejected see Rejections 307. Where the decision maker accepts good cause for claimant non

compliance

Reworked outputs 308. DWP decision makers must ensure the Assessment provider

output is fit for purpose before making their WCA outcome decision. 309. If the output is not fit for purpose the case must be returned to

Assessment Provider as Rework. 310. To make a rework referral see Rework Referrals 311. Where the Assessment Provider accept the output is to be

reworked the revised report will be available on MSRS. Note: There will be no entry in the Browse New Response List to advise you that the output has been reworked. You are prompted by the return of the ESA55.

312. To view the reworked output;

Step Action

1 Access the View Outputs screen 2 The reworked report will be marked as authorised. 3 The original report will be marked as superseded and there will be an

option to view the report if required 313. If the Assessment Provider do not accept that the output is for

rework they will reject the referral and return the IB/ESA60 with the ESA55.

Change of Circumstances Outputs 314. MSRS R2.3 allows changes in circumstances to be reported

between both DWP and assessment provider electronically. See Change in Circumstances

315. An MSRS output is produced whenever a claimant notifies the change to assessment provider

316. Where claimant notifies assessment provider of a change, either by phone or on the ESA50, assessment providerwill record the change in MSRS.

317. MSRS will then produce a visible output for each change in the ‘View Change of Circs Records’ screen.

318. The new facility allows the user to view a list of changes/updates made by assessment provider relating to the claimant/appointee details held on MSRS. See Fig. 25

319. To view either lists or individual claimant changes see How to access and action the ‘View Change of Circs Records’

320. BC staff must always consider advising the Jobcentre and Provider of the change. See Notifying changes to Jobcentres and Providers

Clearing Responses 321. The timing to clear claimant action depends on whether or not

DWP are receiving associated paperwork. If there is no supporting case file the output should be reviewed and cleared immediately. However if there is a supporting case file DWP staff must wait for the paperwork to arrive before clearing claimant action.

322. When you receive the associated paperwork, or if none is required access MSRS to view the outcomes, clear cases that have been rejected and clear the Browse New response List by:

Step Action

1 Selecting Search for Client 2 Entering the claimant NINO 3 Click Search 4 The search results will be shown. 5 Check the claimant details are correct 6 Click View to access the claimant case details 7 This takes you to the View Client screen 8 Click the appropriate Select Case radio button 9 Select View Case in the Case Actions drop down menu and click Go 10 The Referral Details are then shown, with the Referral Status column

showing Claimant Action 11 Click on the Claimant Action link 12 This opens the Clear Response screen, see Fig.33 13 Click on Confirm to clear the referral from the list

Ensure that the appropriate action is also completed on JSAPS 14 Access the claimant’s account in JSAPS screen JA674693 ‘PCA

Assessment Details’ and record the return date of the report from assessment provider in ‘Return from MSRS Date’

15 Note the Destruction Date on ESA55) Note: If associated paperwork is not received after 5 working days see action in receiving associated paperwork.

Fig. 33

Automatic Clearance of BNRL and Change of Circs Records.

323. To ensure the MSRS system operates efficiently it is important to effectively maintain the data held. This means that DWP staff need to action outputs within timescales.

324. The MSRS system will automatically remove data held for longer than reasonable. This data cannot be retrieved, so it is vital that staff do not delay their actions.

325. The automatic data removal periods are 6 months for outputs shown on the Browse New

Response List 2 months for outputs shown on the View Change

of Circs Records list.

MSRS Viewing Screens 326. There are a number of different viewing screens within MSRS to

assist DWP staff with the decision making and overall WCA process. 327. To access the various viewing screens select the options from

the Referral Actions drop down menu in the View Referral – Referral Details screen. See Fig 34

Fig 34

328. The various viewing screen are: View Contact History View FME View Examination History View Letter History

View Contact History 329. The View Contact History screen allows DWP staff to view

details of all contacts between Assessment provider and either the claimant or their appointee, see Fig 34.

330. MSRS lists all contact records for the claimant. DWP staff can view contact records just for a specific referral, just those for a specific case, or all items for the selected claimant. The initial view will default according to whether a claimant, case or referral was selected.

331. When listing contact history for more than one case, each case will be identified by the benefit type and date created. For each contact record, the system will show:

The contact date and time The contact type (e.g. none, in-bound, outbound,

no contact, letter) The number dialled Who the contact was with The contact reason (e.g. teleprogramming, 1st

UTA, etc.) The contact result (e.g. accept, cancel, mob

unobtainable, etc.) Notes

Note: By default, failed dialler records will not be displayed in the list, though staff may toggle to display or hide any such records.

Fig 35

Viewing Further Medical Evidence (FME) 332. MSRS R2.3 provides a new facility where decision makers can

view further medical evidence (FME) gathered by the provider including FME gather by telephone. See Fig 36

333. In the View Referral screen, the Referral Action field allows the DM to access the ‘View FME’ screen to see FME gathered by as a result of pre board check activity.

By selecting ‘Requested Text’ shows specific questions asked by the HCP in a paper report. The report is returned to Assessment provider and held in the ESA55.

By selecting ‘Evidence Text’ if the ‘Contact type’ is

blank, then the evidence text is the diagnosed cause of incapacity recorded by DWP.

populated, then the evidence text is the telephone FME gathered by Assessment Provider

Fig.36

View Examination and Appointment History 334. The View Examination History shows all of the Assessment

Centre (AC) appointment requests, DV allocations, and the outcomes of each.

335. The user may view just those for a specific referral, just those for a specific case, or all items for the selected claimant. The initial view will default according to whether a client, case or referral was selected

336. When listing items across more than one referral, each referral will be identified by the referral category. When listing items across more than one case, each case will be identified by the benefit type and date created.

337. For each AC appointment request the system will show: the date and time that the request was made the expiry date and time of the request for each related appointment:

o Date and time appointment was made o How the appointment was made (e.g. inbound / outbound /

no contact) o AC name o Appointment date and time o Appointment outcome (e.g. examined, DNA, UTA, CSHU,

rescheduled by assessment provider) 338. The user may select a particular appointment to view full details:

AC reference code AC name Appointment date and time Appointment outcome Examining practitioner type (e.g. doctor,

registered nurse, etc.) Examining practitioner professional registration

number

Examining practitioner name Examination duration Total case duration Language requested Language provision planned (internal, external,

none) Same gender requested (Y/N) Same gender requirement met (Y/N)

339. For each DV allocation the system will show: the date and time that the allocation was made the name and practitioner registration no of the

practitioner to whom the DV was allocated the allocation outcome (e.g. re-allocated,

examined, unsuccessful, withdrawn) whether or not a PCP was granted (displayed for

Assessment Provider users only) 340. Where an internal appointment is converted to DV, the AC

appointment outcome code is set to ‘Cancelled by Assessment Provider.

Fig 37

341. The View Examination History screen is used to view the claimant examination history.

342. To view an AC appointment:

Step Action

1 Select the appointment from the ‘MEC Appointments’ result table and click on the radio button in the ‘Select’ column.

2 Click on ‘View Appointment Details’.

343. To view a DV appointment:

Step Action

1 Select the appointment from the ‘DV Allocations’ result table and click on the radio button in the ‘Select’ column.

2 Click on ‘DV Details’ (See Fig 37).

344. To view another referral or all referrals for the selected case, another case or all cases for the claimant:

Step Action

1 Make a selection from the ‘Case’ and ‘Referral’ drop down boxes.

2 Click on ‘Go’.

345. This will take you to the Progress DV screen see Fig 38

Fig 38

346. The Progress DV screen is used to view the progress on Domiciliary Visits.

347. The field in the screens are:

Field Notes for Completion

Appointment Date Displays the date of the appointment had been arranged.

Outcome Displays the outcome of the visit. Abortive Visit Note Displays the reason if the visit was unsuccessful.

348. This will take you to the View Examination History MEC

Appointment Details screen, see Fig 39.

Fig 39

View Letter History

Fig 40

349. The View Letter History screen allows DWP staff to view details of letters sent to the claimant or their appointee.

350. The system lists letter records for the claimant. The user may view just those for a specific referral, just those for a specific case, or all items for the selected client. The initial view will default according to whether a client, case or referral was selected.

351. When listing items across more than one referral, each referral will be identified by the referral category. When listing items across more than one case, each case will be identified by the benefit type and date created.

352. For each letter, the system will show: Date triggered Letter type Addressee type (i.e. appointee or client) Address