Work and Income is using "chequebook doctors" to move sick claimants off welfare, advocates say.

State insurer ACC has been criticised for paying medical assessors to examine long-term clients, and lawyers and claimant groups have questioned the assessors' independence, calling them "hatchet men and women".

Now those charges are being levelled at Winz. Critics say it is operating a similar system by employing almost 300 "designated doctors" to assess beneficiaries.

The Government wants to reduce the number of people on a working-age benefit for more than 12 months by 30 per cent within five years, with welfare reforms expected to save $1 billion over four years.

Winz head Debbie Power said designated doctors were "completely independent", and made recommendations on the basis of their medical opinion as to whether a person was unfit for work.

But barrister Frances Joychild was struck by the similarity of allegations about ACC's assessors to welfare cases she handled. "There are plenty with a reputation as hatchet people."

Joychild acted for a client with mental health problems who appealed an assessment from a designated doctor, and she said he received a "brief, inadequate" assessment .

"The doctor pre-judged him and was not in the least bit interested in giving a neutral and careful assessment of whether he was ready to work."

The doctor wrote "lazy, unmotivated and unreliable" on the man's file, even though he had made a number of attempts to return to work, Joychild said. The Social Development Ministry settled the case, but a confidentiality clause surrounds the details.

Kay Brereton, of the Beneficiary Advocacy Federation, also drew comparisons with ACC.

"Designated doctors . . . are paid much better than an ordinary doctor, around $97 a visit. My concern is that they are sometimes making assessments about what benefits someone should be on. That is not their role, which is to say if someone is capable of working for X number of hours a week."

She was also concerned about the training offered. GPs and designated doctors were taught that "putting someone on to a health-related benefit is bad for their health".

The Green Party has been vocal in its criticisms of a "culture of disentitlement" at ACC, and feared it had spread to Winz. "We don't want a repeat of the ACC scenario where we have chequebook doctors who get paid based on getting people off the benefit," MP Jan Logie said.

She pointed to a 130 per cent rise in the number of cases brought before Winz's Medical Appeals Authority in 2008 and 2009. The board's fees and expenses rose from $91,555 to $605,137 in the two years to June 2010, although last year that dropped to just under $450,000.

A ministry spokeswoman said the process was transparent and designated doctors were paid the usual rate for a visit to a GP. Of 368,000 cases last year, only 3060 were referred to a designated doctor.

"If anyone disagrees with a decision from a designated doctor, they can have it reviewed by an independent Medical Appeals Board."

- © Fairfax NZ News