Incapacity assessment

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Statutory Certificates England, Wales & Scotland

QuotationMarkLeft.png The duty to provide a statement rests with the doctor who has clinical responsibility for the patient at the time. Hospitals are required to provide all certificates for social security and Statutory Sick Pay purposes and doctors' statements for both in-patients and outpatients who are incapable of work. The Med 3 should be issued on discharge from hospital where a hospital doctor advises a patient to refrain from work, and the doctor was attending and had clinical responsibility for the patient at the time this advice was given. In such cases the Med 3 should be issued for an appropriate forward period. Responsibility for issuing further certificates rests with the doctor who assumes clinical responsibility for treating the incapacitating condition. In cases where the GP has not taken over responsibility for the incapacitating condition, responsibility for issuing further certificates will rest with the treating clinician. When the patient has been referred for treatment of short duration, or to a consultant for an opinion or advice, the responsibility for issuing Med 3 statements will normally rest with the patient's own doctor. QuotationMarkRight.pngIB 204 Department Work & Pensions Aug 2004


Generally no separate fee will arise, notionally they have been part of GP's basic practice allowance (no longer extant) and hospital doctors' salary. The document DWP IB 204 (Aug 2004) gives guidance in medical evidence for:

Statutory Sick Pay

  • Med 3
  • Med 5
  • Med 6
  • RM 7

Statutory Maternity Pay

  • MAT B1

Social Security Incapacity Benefit

  • Med 4
  • IB113SS


Disability Living Allowance, Attendance Allowance or Incapacity Benefit with Terminal Illness

  • DS 1500 - A fee will be paid


Generally you will get a fee for providing a report to the DVLA. The form will be sent to you.

Fitness/unfitness to work

Incapacity for work is just that - ask yourself if they are capable of doing their normal job, which nowadays doesn't mean that they could just about sort of do it, it means they are not going to do it properly without undue discomfort.

Employers may ask for details about a patient's capacity, what operations they have had done, what they can do, and so forth. Remember that confidentiality means that they are not entitled to details of medical conditions, treatments, or operations. They are entitled, however, to know whether and how the patient's ability to do his or her job is restricted.

Explaining this requires the doctor to understand not only the pathology affecting the patient and the effects of treatment, but also to have a sufficient understanding of the nature of the patient's job and the effect of restrictions to it. A GP might be acting outside their area of expertise if they advise on this without having sufficient occupational health knowledge, so it may be safer to recommend that the employer seeks this advice from an occupational health specialist.

Fitness to work after surgery

See guidance compiled by Dr Williams,[1] and recommended by others on a DNUK thread.[2]

See also

"Get a note from your doctor" page, which discusses in detail how to respond to patients's requests for certificates.

External links