Sources of evidence

Self-assessment is the prime source of evidence and in most cases the needs will be clear from the claim pack. The claim pack should however be checked to see who has completed it and that it is an accurate and reliable description of their problems.

If the claim pack has been completed on behalf of the customer, by someone who has a good understanding of his or her needs, then it should provide good evidence.

Hospital Factual Report

In cases of acute and chronic disorders, a Consultant Urologist would normally have been involved in the diagnosis, management and treatment of the individual. In the case of stones, the admission may have been urgent and there should be relevant hospital records available.

The absence of any documented history of a specialist consultation should raise doubts about the nature and/or severity of the given diagnosis. Hospital factual reports should therefore be obtained if required.

General Practitioner Factual report

Conditions such as acute infections would usually be treated by the GP. Also, the General Practitioner would normally have made the initial referral of the claimant to the Consultant (if a referral has been made) and would normally be aware of the results of tests, treatment and current medication. Therefore a GPFR is often most useful in these cases.

HCP examination report

An HCP report would be likely to be necessary when:

• The person claims significant disability (equivalent to a moderate or

severe condition),

• In the absence of supporting evidence from the GP or Hospital Specialist,
• If no corroborative evidence has been able to be obtained, or
• If it is the only means whereby the claimant’s needs can be clarified.

Medical Services

The Medical Services doctor may be asked to request relevant information such as test results from the GP or Hospital Consultant and to interpret test results and other information. Complex claims may also be referred to Medical Services for discussion.

Amended June 2008