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Another ESA medical Options
maei56
#1 Posted : Saturday, November 06, 2010 4:27:13 PM Quote
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Hi everyone,
Just got a date for my 2nd medical for ESA, Sad Its not been that long since I won my tribunal appeal for ESA and now I have to go through it all again.
I originally applied in July 2009 after having to give up my B&B business because I just couldn't do the work needed and had a medical on FRIDAY THE 13th November 2009 for which they awarded me 0 points (15 was needed) so I appealed but they went off what the vet said, oops sorry, doctor said RollEyes and agreed i wasn't eligible for ESA so I went to tribunal in May 2010 and won it and now Its happening again, I just know with what the goverment has been saying about cutting people off benefits that I wont pass it and have all the stress and anxiety of fighting for what i should get automatically, plus in Dec 2009 I applied for DLA and was told I couldn't have it and so appealed and they went off the same medical score as the ESA and I was refused so I went to tribunal and won that too in August but now I dont know whether I will lose that as well if I get 0 points again.
All this worry is getting me down, feeling a bit low, need a cuppa
love to everyone....Eileen xx
RedDog
#2 Posted : Saturday, November 06, 2010 5:28:36 PM Quote
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When you got your result from the tribunal for ESA how long did they give it to you for? They don't usually recall you so quick. If I was you I would ring them up and tell them about the tribunals. I reckon it's just the usual cock up!ThumbDown
A friend is someone who knows all about you but loves you anyway!
maei56
#3 Posted : Saturday, November 06, 2010 10:03:26 PM Quote
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Hi RedDog, thanks for your post.
I haven't got a date on the tribunal letter for when it runs out, its just got the date I was awarded the ESA, nothing else. I will ring them on Monday to check if its a cock up but I dont expect too much, it took them from early july 2009 until late may 2010 to sort out, but fingers crossed ...Eileen x
dorat
#4 Posted : Saturday, November 06, 2010 10:28:58 PM Quote
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I hope it is just a mix up Eileen, you don't need all this so soon after the tribunal.
Fingers crossed for you.

Doreen xx
maei56
#5 Posted : Saturday, November 06, 2010 10:38:04 PM Quote
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thanks doreen xx
RichC
#6 Posted : Monday, November 08, 2010 9:31:19 AM Quote
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Hi Eileen,

The original decision , AND the Tribunal decision was about your health at the time of your Medical and claim in Late 2009 . This in effect means it has been a year since they have heard about your health .

However , when you attend a medical , there are two parts to this ... one is to see the extent of your "Limited capability for work" this will decide if you are fit for work , will have to go into the Work Related Activity Group , or can go in The Support Group.

If you are given enough points (15) to get into the Work Related Activity Group , then there is a second medical called the Work Focussed Health Related Assessment, which is supposed to concentrate on the difficulties you are likely to have in getting and staying in employment , and your views on these issues too.

This part of the medical is often done at a later date than the Limited Capability for Work part of the medical .It is quite possible that this is the case, as if they decided that you did not have "Limited Capability for Work (ie scored 0 points) from the first part of the medical, then you might not have had the second medical (since you would not have needed it) .

I would telephone ESA on 0800 055 6688 , choose the option for ESA and query what medical it is exactly. Ask whether it is the Work focussed Health Related Assessment. If it is then it is just the second part of the ESA medical and will not directly effect your claim.

I am sure this is the case, If it isn't then please get back here when you have checked .
I am also hoping you have received all the backdated Work Related Activity Component backdated to your 14th week on ESA :)

It should also be noted that if you are of an age where you can claim Pension Credit , that at present you are exempt from Work Related Activity and thus exempt from the second Work Focussed medical , although it appears this is not done automatically. This will change .

All the Best
Rich :)
"The difference between 'involvement' and 'commitment' is like an eggs-and-ham breakfast: the chicken was 'involved' - the pig was 'committed'."
Dorothy-W
#7 Posted : Monday, November 08, 2010 12:12:59 PM Quote
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sorry to but in, but one for rich, i have had one medical assment and have gone from breavemnet benifit to work related esa,does this mean i have to attend a 2nd assment because i have no idea or word of one,infact i have had no letters as yet about anything which is not like the dept, i know nothing about all this to be honest.sorry eileen but like yourself i get miffed by it all
Rose-B
#8 Posted : Monday, November 08, 2010 12:42:58 PM Quote
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Eileen

So sorry to hear of your troubles. ThumbDown We so have to fight for everything don't we. Rich is the
'disability king' so hope his advice helps you.

Good luck when you ring today.

Rose ThumpUp
RichC
#9 Posted : Monday, November 08, 2010 1:13:49 PM Quote
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Hi Dorothy ,

some medicals are done all in one session and there seems to be no rhyme or reason to when they do both at the same time , if you are already getting work related ESA then it is likely that both your medicals were done at the same time for you especially if your claim included the Work Related Component from a while ago.. This info is then in theory used for any "Work Related Activity" you are required to do. (Different areas seem to have different requirements)

In Eileen's case the most likely reason for this medical is because her medicals were not done at the same time .Although this is not a definite (hence she needs to check with Job Centre Plus).
Work focussed Health related Assessments(WFHRA) have been suspended from July 2010 , however the fact that Eileen's Tribunal decision was before this date could mean that it is in fact the WFHRA . It is normally referred in the ATOS letter as a "second" medical. This needs to be checked with JCP.

You can be asked to supply further information and attend a medical at any point , i have yet to confirm this but i believe i have seen "3 months " stated somewhere (i will look into this.)
It is also possible that it is indeed the start of the assessment process again , although i would have expected Eileen to have received a medical questionnaire(ESA 50) prior to her being asked to attend a medical, as a DWP decision maker needs all the facts to make a decision, and that omission could be regarded as good grounds for appeal.

Rich


"The difference between 'involvement' and 'commitment' is like an eggs-and-ham breakfast: the chicken was 'involved' - the pig was 'committed'."
barbara-o
#10 Posted : Monday, November 08, 2010 3:14:29 PM Quote
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Hi Eileen,

I've not been on the forum a lot of late, but can sympathise as many of us here have gone through similar experiences when dealing with the DWP. I was ill health retired earlier this year, and applied for ESA whilst I was off work and during the process of being retired. I went for an ESA medical and received 0 points, suffice it to say, I appealed, but also put in a complaint to ATOS in respect of the manner in which the Dr carried his examination, and lack of attention paid to the medical reports I submitted. During this period, I also applied for DLA, and was turned down. As part of the DLA's explanation for a negative outcome they used the information from the ESA medical. Again, I challenged the decision by arguing that the ESA examination is related to one's ability to work where as DLA relates to a person's mobility and care needs. In fact people do work whilst receiving DLA, and it helps them to stay in work.

I won my ESA tribunal and was placed in the "Support Group," and did not have to go for another ATOS medical. I also received an apology from ATOS with regards to my complaint and an acknowledgment that my examination by the Dr had failed to take into account the medical reports submitted, and the information that I had submitted in my ESA form. I did not have to go to a DLA tribunal and had a review over the phone, and received my DLA. I think it's outrageous that disabled people are being targeted like this and having to see ATOS doctors that haven't got a clue about RA, and who seem to be unaware of the fact that it is a variable systemic autoimmune condition associated with other illnesses. I am highly qualified and was in a well paid job, no body in their right minds would give-up work to become dependent on benefits if their health circumstances had not force them into this position.

Rich has provided some sound information and advice, and wish you good luck with your appeal. I am a member of a benefit advice site, which helped me a lot with mine. I can also send you information on how to appeal both a negative ESA and DLA decision; if you ring NRAS they will pass on my email address and I'll send you the information.

love,

Barbara
XXXX
Dorothy-W
#11 Posted : Tuesday, November 09, 2010 2:42:13 PM Quote
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RICH,thanks for that, its never ending, much obliged though,hope all goes ok eileen.
maei56
#12 Posted : Tuesday, November 09, 2010 4:07:49 PM Quote
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Hi Everyone thanks for all your support.
I phoned the gestapo today and they have said that I do have to start all over again, after 12 months they automatically send out the ESA50 form and redo the medicals, so I have to go through it all again Sad I am already feeling worse just stressing out thinking about what I went through last year, dont they realise the stress and upset of it all makes the genuine people worse.
I'm not sure what happens when you fail the medical whether they only pay the £65.30 per week but I know they will fail me, I am not that lucky to pass first time, I always have to fight for everything, just so the government can say they have cut back on sickness benefits,
when I had to go to the work related interviews at the DWP last year the person I saw told me they had even failed someone in a wheelchair who had cancer too and cleared them to work, so what chance does anyone have now with this government juggling figures.
Sorry to be on a downer but Im so tired of fighting everyone and the world, it just gets to me
will keep you informed, the medical is on 23rd November
Eileen xxx
RedDog
#13 Posted : Tuesday, November 09, 2010 5:48:39 PM Quote
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Keep your pecker up girl! It seems ATOS are failing people just to get their bonus'. You've been through it once and come out the other side smiling so I'm sure you can do it again. Just make sure you exaggerate your condition, after all if they want to play games with sick people then show them you can play better than them! ThumpUp The process is worrying but you know how it all works now so put your experience to good use!
Take care Eileen.
A friend is someone who knows all about you but loves you anyway!
RichC
#14 Posted : Tuesday, November 09, 2010 6:56:46 PM Quote
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Hi Eileen ,

don't give up .. that's why their figures look so good ..when they say 39 % give up their claim they basically include a large percentage of people who are forced to give up fighting and claim JSA because they are too ill to carry on fighting.

I also CANNOT agree with red dog about exaggerating as that opens up possible issues in the future, just do not underestimate and remember the bad days . Just because you can do something once in the medical does not mean that you can repeat it , or do it on a different day . This is often good cause to lodge an appeal.

Best option at the moment is to gather as much evidence as possible , from your GP, Consultant , and even friends who help you , as to what you are and are not capable of.
Print off the ESA descriptors HERE, and go through them with the above people , and send written replies from them to the Benefits Delivery Centre who handle your claim .(This should be at the top of letters from Job Centre Plus) On each sheet you send be sure to add your NI Number and date of Birth !.

Doing this can help the DWP Decision Maker make a correct decision based on ALL the facts rather than what you were like in a 20 minute "medical"
I would get this information ASAP so the Decision Maker has it when he receives the medical report.

It can also be handy to keep a diary if you can , highlighting bad days .

If you do not pass the medical .. appeal immediately on a form GL24 available at JCP's, to ensure that your ESA continues at the assessment rate. You can ask for a reconsideration , but this rarely changes the decision unless you have very good further evidence, and normally only delays the process further.You will then have to start getting "fit notes" from your GP. Contact with an advice centre is then the ideal route , even possibly to fill out the appeal GL 24, as you have to state what decision you are appealing against and why.( i have seen some filled out with the reason for appealing being that they would lose money... needless to say this appeal request would have been turned down, and a good appeal letter and evidence can change the Decision as it has to be reconsidered by the DWP before going to appeal)

If you do pass the medical .. i would ask for a copy of the medical report , to keep for future reference. You do this by writing to you Benefits Delivery Centre and stating when and where you had your medical , include your NI Number and Date of Birth and simply request your medical report.
Remember always keep copies of everything you send them , and preferably send everything recorded delivery, if possible.

I know it's a pain , but remember it is odds on that even though from March next year the Medicals are supposed to take into account fluctuating illness to a greater degree , the descriptors for Bending and kneeling will no longer exist .
Strangely though you are at a slight advantage as you obviously have the experience of the system AND you have the DWP Appeal bundle from May's Tribunal.

Let us know how it goes .
All the best
Rich :)




"The difference between 'involvement' and 'commitment' is like an eggs-and-ham breakfast: the chicken was 'involved' - the pig was 'committed'."
dorat
#15 Posted : Tuesday, November 09, 2010 7:36:40 PM Quote
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It's disgraceful that genuinely ill people are having to go through all this hassle.

In an ideal world you should be able to say, with back up letters from GP and consultant, that nothing has changed in the last 12 months and they should accept that without wasting money on medicals and appeal tribunals.

Hope you are successful Eileen.

Doreen xx

RedDog
#16 Posted : Tuesday, November 09, 2010 9:10:56 PM Quote
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RichC wrote:


I also CANNOT agree with red dog about exaggerating as that opens up possible issues in the future..



What issues are those then Rich? Most people consistently understate their medical condition either through ignorance of what is required or just sheer embarassment! It's a normal human reaction to make yourself sound better and healthier than you really are. Therefore a judicious use of exaggeration should bring you out about level! You've obviously got to use your common sense though.

I'm sure young Eileen will sail through it next time!
A friend is someone who knows all about you but loves you anyway!
RichC
#17 Posted : Wednesday, November 10, 2010 10:49:59 AM Quote
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I agree that people understate their illness , but exaggerating means making it sound worse than it is , there is no need to do this and could cause overpayment/fraud issues in the future, believe me . I have seen this.

So the best advice , as i have stated above , is to ask friends and family to be involved , so you can get them to remind you of times when you are at your worst( preferably at the ESA 50 stage), and to get the support of your GP etc.
I must admit myself to forgetting sometimes how "disabled" i am on some bad days.
Many claims fail because the ESA50 is not filled in fully, although more and more i am seeing that the ESA 50 is being ignored to a degree and more weight being put on the medical.

Unfortunately , part of the reason why the system has been tightened up is just because people have exaggerated in the past. I recall a friends trip to her ESA medical , when there was a guy walking up and down the waiting room , talking into a mobile phone , when he was called in he suddenly developed a bad limp. Unfortunately things like that are also picked up by the press and tar us all with the same brush.

I am currently on IB and yes i am worried about passing the ESA medical when transferred next year , even though i know the system inside out. Especially since no one really knows how ATOS are going to interpret the proposed new descriptors.


Hence i try to keep a diary , which proves valuable evidence at all stages, and am totally honest with my GP about troubles i am having.

Unfortunately the DWP's own RA medical conditions summary HERE state this:

Quote:
The effects of disability in severe RA are generally worse than those experienced in OA. There is no cure for RA, but with modern treatment the effects of the disease have been reduced with fewer joint deformities and disability. After 10 years from diagnosis, 10% will have severe disability, whilst 25% will have minimal if any symptoms at all. The remainder will fall between these two extremes.


So if a decision maker is using this as a basis , with a poorly filled out ESA 50, limited medical evidence , and an ATOS medical , then what other decision can he reach except the fact you are fit for some work ? Hence it is vital that the ESA is filled out fully , and that you get further evidence.Having said that the process is not about the illness you have (apart from a few exceptions) , but on what your illness prevents or allows you to do.

Rich
"The difference between 'involvement' and 'commitment' is like an eggs-and-ham breakfast: the chicken was 'involved' - the pig was 'committed'."
RedDog
#18 Posted : Wednesday, November 10, 2010 12:27:37 PM Quote
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RichC wrote:
but exaggerating means making it sound worse than it is..............


Can you really make it sound worse than it is?? I've had RA and Type 1 Diabetes for 22+ years after an injury at work. Accepted by the then DSS. I fail to see how I can make it sound any worse! Over that time I've ran the gauntlet of DSS medicals, job medicals and reviews and a seven year court battle! ( which our team eventually won. )

I appreciate your honest technical advice but I feel some people with less experience are getting well and truly stung by Atos.


A friend is someone who knows all about you but loves you anyway!
RichC
#19 Posted : Wednesday, November 10, 2010 2:30:14 PM Quote
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Unfortunately , i have seen the other side where people have exaggerated then face having to pay back years of benefits , and a criminal record , so i cannot advise people to exaggerate.
If the symptoms mean you cannot do something part of the time , then say so . If the effects of any illness or medication are that bad then it is not exaggerating.

You are right though , some people think it is a walk in the park ..one honest guy whose appeal i handled...when i received his Appeal Pack , i looked at his ESA 50 and he had ticked he could do everything and had not written anything at all in the "extra information" ,failed the medical , had no supporting evidence from a GP , but we still won the appeal. Although he could be in trouble when they remove the bending and kneeling descriptors we will cross that bridge when it comes to it.

The best way to avoid an appeal is to make sure the Decision Maker has ALL the relevant information.Most badly done Medicals are easy to rip to shreds as they often have serious omissions and errors, and Tribunals tend to be sympathetic to this if the errors and omissions are highlighted prior to attendance at the Tribunal.

I agree It is a bad system and it is only going to get worse , including DLA medicals , Changes to the WCA , Time limited Contribution based ESA, not to mention huge changes in Local Housing Allowance , to mention a few.And yes the current spending review is hitting the poor and the "sick" extremely hard . There are also major issues with the allocation of Legal aid contracts for both Welfare rights and Immigration with many areas having limited or no cover

It is also not taken into account the reality of getting and staying in work for someone with a fluctuating condition , who can only work ad-hoc on a good day which for me are very rare at the moment.

Anyway this is not a political forum( there are others like B&W for that), and this is the system we have to deal with at the moment ..There are many public consultations on all of this coming up .. so have your say and submit evidence or you experience to them .Keep an eye on the Dept of Health( current consultation .."liberating the NHS" and DWP sites ( unfortunately the WCA consultations have ended ).
That is all i will say on the subject here.

anyway i am more than happy to give benefit advice on here but ultimately the best option is to go to an advice centre , and if there are issues about the way you have been handled by the "System" then ask to speak to a Social Policy coordinator there , as they should jump at the chance of listening to your experiences and submitting it as evidence.
Rich :)



"The difference between 'involvement' and 'commitment' is like an eggs-and-ham breakfast: the chicken was 'involved' - the pig was 'committed'."
Louise09
#20 Posted : Thursday, November 11, 2010 10:34:36 AM Quote
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I totally agree with what you are both saying but the top and bottom of RA v Disability funding /Working etc is during a flare up you cannot do what you usually do whether its making the bed or staying at work for 7 3/4 hours. And we all tend to forget how bad we were once the pain is under control. Its like giving birth - at the time its the worse thing in the world! but how many of us have more than one?

My rheumy nurse has just asked me to complete a diary and even I am amazed at the lack of ability and pain I experienced at the time and feel like a trooper when I read back what I've been through!

My advice would be "Keep a Diary" as rich suggested.

As for over exaggerating. We shouldn't have to. There are plenty of people who have the ability to work but "cant be bothered" In my opinion people who have a disability and feel as if they cant work shouldn't! I know what a great world it would be!! People who don't have a reason not to work should! The "over exaggerators are those who should be working! If only we could find a way to figure out who was who! Simples!

I like living in my own little world!!

Take care and good luck with your medical.

Lxx
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